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As I explained in my previous articles, I was pre-eclamptic and was admitted to the hospital at 37 weeks. I had a migraine that lasted for ten hours after I entered the emergency room. I had experienced migraines before and knew that Tylenol wouldn't ease the pain, so I went untreated even in the hospital. About twelve hours after admission, I was brought to the women's floor, where I waited for my already injected Levemir supply to diminish in my bloodstream.
When they brought me down to the labor and delivery wing, I was already exhausted from the headache pain, and the medical staff's continuous efforts to check on me had kept me from sleep. When the nurses began hooking me up to an IV insulin drip, I didn't argue because I knew that I didn't have the stamina to monitor my insulin needs on my own. Before and during pregnancy, I used Apidra for bolus insulin. However, the only IV drip the hospital had for bolus insulin was Regular, which I hadn't used since 2003. Surprisingly, I went from severe insulin resistance, needing nearly 30 units per meal, to needing only one or two units per hour, even without basal insulin. Nurses checked my glucose every hour and ensured that I remained in the 70 to 140 mg/dL range throughout my labor.
The hospital staff started to induce me by first attempting to ripen my cervix using Cervidil, which was used specifically not to put me into labor. Three hours later, though, I was having intense contractions and my cervix was dilated to two centimeters. Cervidil had started the labor process.
The contractions were steady and strong, and I was still not on any pain medication. I wanted to get up and walk around the ward to help ease the pain, but at that point I was hooked up to four IVs (insulin drip, saline solution, Pitocin not yet administered, and another I don't recall). There was also a baby heart monitor wrapped around my swollen belly to keep track of my baby's movements and heartbeat. If I so much as shifted onto my side, the baby monitor would slip and a nurse would have to come in and re-adjust the belt. I was very frustrated, tired, anxious, and in pain.
My OB/GYN came in to check on me and estimated that I was three centimeters dilated after six hours of labor. She broke my bag of waters with an instrument to move the labor along. We both wanted to have a vaginal delivery if at all possible. Around the same time, my OB/GYN installed an internal baby monitor. The staff then removed the baby monitor belt from my waist, so I could shift as I pleased as long as I didn't kink the IV lines going into four different locations in my arms.
I felt like I was strapped to the bed, but I took comfort from hearing my baby's heart beating in the monitor receiver next to my ear, knowing that I would be able to meet her in just a few more hours.
The contractions were coming every two minutes and lasting for about 30 or 45 seconds each. Had I not been so exhausted from having spent over 24 hours in the hospital, I might have been better able to withstand the pain. As things were, however, I was vomiting to cope with labor.
At fifteen hours, my OB/GYN announced that I was four centimeters dilated. Having progressed only one centimeter since the last time she checked, I took the epidural.
I progressed very quickly during the next six hours, getting to seven centimeters dilated with ease. My blood sugars were still perfectly on target, and I was able to take a few 20-minute naps to prepare for the part where I'd have to push. My baby, however, was having difficulty.
After 21 hours of labor, her heart rate dropped with every contraction, revealing that she was in distress.
The staff watched us closely for 20 minutes more, and then my OB/GYN came in to prepare me for a cesarean section. After all of the labor and worry, and with nothing going awry with my diabetes care, I was about to face the thing I feared most. My lowered immune system was going to have to cope with my being cut open so that my baby could be born into this world.
Throughout the entire C-section I trembled, not from pain, but from adrenaline and pure fear. Maybe I don't have the nerves of steel that I thought I did. Twenty minutes later, my husband had our daughter cradled in his arms, holding her next to me so I could kiss her face. It turned out that she didn't have a soft spot, so couldn't come down the birth canal. She weighed 9.4 pounds and was 20 inches long, hardly a chunky baby, but strong.
I was still terrified about how I would recover from the surgery, but I was also overcome with relief that my baby was healthy. In my next article, I'll share my experiences as a new mother recovering from the operation.
Categories: Apidra, Bolus Insulin, C-section , Cesarean Section, Diabetes, Diabetes, Epidural, Internal Baby Monitor, IV Insulin Drip, Labor and Delivery, Levemir, Migraine, Pain Medication, Pre-Eclamptic, Severe Insulin Resistance, Tylenol
1 comment - Jan 2, 2012