Evie's Birthday and first week

I have been struggling with how to start this entry. It is a HUGE entry that is going to be a very emotional read no matter who you are. Because of the nature of it, this should go without saying that it could be triggering, especially for those who have dealt with infant loss. But before you get worked up, know that Evie is currently sleeping snug and warm.

My induction was scheduled for New Year's Eve. I spent the whole day calmly wandering aimlessly throughout my house and then finally called my sister to hang out and distract me. My nerves were all bundled up and my stomach was feeling increasingly large and in the way. We went shopping at the giant plaza near my house and my sister bought a baby bootie charm for her bracelet, in honor of Evie. I dropped my sister back off with my dad and spent a few minutes with him, getting us both pumped for our new roles as mother and grandfather. Then I drove back home where I met with Gavin, his parents and my mom. We packed up the cars with our bags and I got some last-minute cuddles with my kitties and pups. 

The whole ride to the hospital I felt jittery on the inside, yet calm on the outside. I tried to keep up with the conversation, but was entranced by all the Christmas lights still up around the houses we passed. My back started hurting and I told my mom I was pretty sure I was having contractions. 

Getting ready to check in!

When we arrived at the hospital they checked us in pretty quickly and got me settled into a labor and delivery room. I nervously undressed and put my gown on, climbed under my blue blanket in the hospital bed and put my brave face on as they began poking me with needles for the IVs they'd need. 

Things started out pretty positive. Nervous, but positive!

The doctors came in and explained the procedure of things while setting me up on a monitor. Its mostly a blur during that time. I remember they went over the process of induction and the risks and had me sign some forms. But when the monitor was set up, it was apparent that I was already in labor and that each contraction was causing a dip in Evie's little heartbeat. That's when the C word reared its ugly head. 

I had given a lot of thought to how I expected Evelyn's birth to go. At first I imagined that she would be born like any other baby. I would go into labor at some point, get an epidural and then bam, baby. But throughout my pregnancy I read up on some things and decided I wanted to do natural birth, medication-free. I also thought I would deliver early, because I was certain that the doctors were wrong about her due date. I had not had a period since February, so I should have been due 9 months from then, in November right? And of course then I realized that mothers are pregnant for 10 months, not 9. Strange how that myth has proliferated...

When November passed and December rolled around, I approached my due date with great expectation. Evie would come on time, possibly on her due date exactly. I would have her in my arms, we'd come home and I would begin my new life as a loving mommy. But a week before my due date, the doctors began talking induction. A just-in-case. They wanted me to schedule the induction. I tried putting it off, but I wanted Evelyn to be born before the new year, too, so the tax credit for her would help us float a little longer until I have to find a job again. When I finally made the appointment, the only available time was New Year's Eve at 8pm. That was cutting it pretty close, so I decided to give up my dream of having Evie before the new year. I would settle for first baby of the new year? :) 

Never in that whole time of pregnancy did I consider C-section a possibility or option on the table. I didn't want one, didn't think I'd need one and frankly, I thought only people with type-A personalities and control issues got them (except for emergency ones, which I also wrote off as not-applicable. How could Evie be anything but exceptionally healthy when she arrived?) and I am neither. 

Now that the docs were mentioning Cesarean as not only a possibility but a probability, I began to freak out. The vibe of the room changed in a split second from calm and collected to chaos. I began to cry when they told me that I needed to get a Cesarean. Evie's heart rate was dropping with each contraction and she wasn't recovering enough between the contractions. If we waited very much longer, she could go into serious distress and might not make it. I felt like I was thrown into the middle of a battle, no shield, no weapons, no idea which side to fight for. On the one hand, I had been determined to have as pleasant a birth experience as possible. On the other, if that meant Evie would suffer for my comfort....screw that. I signed the waiver for the C-section and before I knew it I was being wheeled away. I was still in tears and my body began to shake tremendously. I could not for the life of me get control of my arms and legs. The doctors and nurses continued to try to talk me down as we got to the operating room. It was so bright and there were so many people. I was moved to the operating table and told to sit on the edge for them to administer the spinal block. My body was still shaking but I put all my focus into being still. I tried to sing to calm myself down. 

A quick prick and then the drugs began flowing. Soon I couldn't feel my legs. They laid me down and strapped my arms out to the table like Jesus on the cross. I continued to shake. They brought in Gavin, who sat at my head and caressed my hair and attempted to be the rock that I needed. 

He is so good to me.

They took a safety pin and poked me a few times to be sure that the anesthesia was working correctly. Pressure or pain, pressure or pain until it was all pressure and no pain. Then they began to work. The nicest person I've ever met, my anesthesiologist named Dana held my hand and spoke kind words of encouragement to me. Between Dana and Gavin, I made it through the hardest part: acceptance. 

Before I knew it we were ready to pull Evie out. The doctor introduced her in parts, "the head, the shoulders, the baby! Congratulations!" and I was in tears all over again. I did it! I had a baby! They took her away to the other side of the room and thus began the longest ten minutes of my life. 

I looked at Dana and said, "what are they doing? Where is she going?" and Dana reassured me that they just had to clean her off a bit and she'd be back. 

"I want to see her." 

"You will, they'll bring her over."

"Why isn't she crying? Is she okay?" (Panic dripping from each syllable).

"Yes, she's okay. They'll bring her over when she's done."

"Do you promise she's okay?"
"I can't make promises, Sarah."
"Okay, but you would tell me if there was a problem?"

"She's a little stunned, that's all."

"That sounds like kid gloves to me. I want to know if something is wrong."

I can't remember if at this point she told me or if I found out later, but Evelyn was born and did not breathe for the first 4 minutes of her life. When they finally brought her to me, she looked a little stunned, but I was so relieved to have her on my chest at last. 

The next few minutes are a blur as they cleaned me up, stitched me up and I guess at some point wheeled me to the recovery room. My memory clears as we are entering. 8 seconds to midnight, I'm surrounded by Gavin, my doctors, maybe my mom? 8, 7, 6, 5, 4, 3, 2, 1...Happy New Year!

Evelyn had decided to come before New Year's after all. (To be exact, Evelyn Marie Maxfield arrived at 11:05pm weighing 8lb 3.6 oz and was 20 inches long). 

I got to hold Evelyn again in recovery and I attempted our first breastfeeding. She latched on and I felt like a champion. After awhile we put her in Gavin's arms where he fed her a bottle and many photos were taken. 

First latch!

My heart melts every time I see this photo.

When her initial bloodwork came back, they told us that her blood sugar was low and she would need to be admitted to the NICU until they could stabilize it, since the feeding and formula did not improve it. I was bummed to hear that she was going to be away from me so soon after birth, but my mommy heart said that it was for the best. Still, I worried that all the soda I drank in the end had something to do with it. I am still not convinced I am not at fault. In the NICU they would also check for infection since she had swallowed some meconium as well.

On the morning of January 1st they were talking about Evie being able to return to me by 9pm. And by just before noon they had decided early afternoon could be feasible. As soon as I was able to get up and about, I was. No wheelchair for me! I walked up to the NICU several times to visit. I talked to her and sang to her and they had me try to breastfeed her again. 

When I had her in my arms, Gavin and I noticed she was twitching her leg. And when we unswaddled her, we discovered her arm was twitching too. Same side. I called the nurse over and asked about it. Normal?

Apparently not. The nurses looked concerned and began talking about it being a possible seizure. They'd run some tests. I tried to stay calm and not worry. I didn't really feel alarmed and I figured if it was serious, I would, right?

They decided to do a spinal tap to check for meningitis and do a blood culture to check for HSV since those are two common causes of seizures in newborns. They sent blood to test for other infections as well. 

The first attempted spinal tap did not work because Evie didn't have enough spinal fluid to draw from. They upped her IV fluids to see if it would help, but it didn't. They brought down the EEG machine to hook her up and observe her. They wanted to see if she was truly seizing. 

Thursday night while I was in my hospital room, the door opened and a NICU nurse wheeled in a bassinet.

"Here's your baby!" she announced happily. I almost exploded with joy. How?!

"She's back? They released her!?" 

"He's all yours!" the nurse exclaimed. (He? It was a mistake they kept making in the NICU, but I figured it was because they are around a LOT of babies).

"Oh my gosh, I can't believe it, I have my little girl back!"

"Girl? Oh my GOSH I am SO sorry, I am in the wrong room!"

Cue the waterfall. My heart sank so low I thought they'd need an archaeologist to resurface it. The nurse continued to apologize and then quickly made her exit. Gavin held me while I bawled my eyes out. Thank god he was there or I would not have made it through that. I am not mad, but I was heavily disappointed. I have made peace with this nurse and I know it will upset people that it happened at all, but I try to give people the benefit of a doubt and forgive them for being human. Everyone makes mistakes. 

We went back to the NICU to stay with Evie and help me feel better. We sat with her so long and every time I looked at Gavin he was dozing off. I asked if he wanted to go back to our room and each time he would say no. I was exhausted but I couldn't bring myself to leave if he wasn't ready either. We both nodded off a few times before I finally took his hand and said, "lets go." He didn't fight it, so I believe we were both trying to stay strong for each other. That gives me hope for us. 

The next morning, we received an update. Evie had suffered 2 subclinical seizures per hour throughout the night. They had started a second anti-seizure medicine (the first began right after her first seizure) and it was keeping her pretty heavily sedated. Her oxygen levels were suffering because of it. I was asked to sign an intubation release in the event they'd need to do one. They warned of the risk of aspiration and cut her off from breastmilk, relying exclusively on the IV fluids. Her heartrate also suffered a drop.

I kept pumping as much as possible. 

At 3pm we had a conference with the doctors. It was mostly to get my mom and Gavin's parents updated so we wouldn't have to worry about relaying the information to them each visit to the NICU. The nurse organized it and I am forever grateful to her for it. She saw that Gavin and I were overwhelmed and suffering from exhaustion and she jumped on to help. 

The jist of the conference was that a second attempt at a Spinal Tap failed. They weren't sure whether Evie was fundamentally lacking spinal fluid or if it was being pushed up into her head, but they wanted to do a head ultrasound to see. In the meantime, she would be given antibiotics for infection. This would necessitate at least a two-week stay. The seizure meds appeared to be working and she was no longer seizing clinically nor subclinically. They wanted to do an MRI on the coming Monday to see if the cause of her seizures would be apparent on the photos. They were going to insert a PICC line to make drawing blood and administering meds more streamline and less traumatic for her. 

After the conference we went down to the cafeteria and ate as a family. I was beginning to feel positive because the doctors sounded like they weren't worried too much. I ate a full meal and then some. 

Since Gavin had to go to work, my mom opted to spend the night with me. While we were talking, she received a call that my grandfather had fallen and was not able to help himself up. They didn't know the reason why he had fallen either, so he was being brought to UNC hospital (we were at Duke). Neither of us got very much sleep that night, between worrying about him and worrying about Evie. 

I was given notice of my discharge orders for Saturday, but they told me with enough prodding, I could be allowed to stay through Sunday. I prodded.

The next morning we were told that Evelyn had had an episode of "non-seizure activity". They hesitated to call it an actual seizure. It was not a fun thing to wake up to, but they tried to get me not to worry about it. Her temperature was dropping as well, so they set up a cooling blanket on the heat setting and got her on it. The heat lamp they had been using would not have been compatible with the EEG leads since they could heat up and cause burns. The first attempt at the PICC failed, but since the neurologist was there to stimulate Evelyn, she was awake and alert. Seeing her eyes open and hearing some coos made my heart melt. Despite the issues she was facing, I felt positive she was on the road to recovery.

Singing to sweet Evie. The nose tube is actually a thermometer placed down the esophagus to get a more accurate reading of core temperature.

The doctors gave me more good news: by 8pm she would be cleared to be held again. They were working on a feeding schedule, but hadn't finished yet.

January 4th:

The doctors let us observe Evie's rounds and had taken her EEG leads off before we arrived. They let us feed her with the NG tube while we practiced kangaroo care (skin-to-skin). Then Gavin got to hold Evie for the second time in her life. She gave him a wonderful smile to show her appreciation. 

Look at that smile! :D

The MRI was on Monday. They had some preliminary results and explained that they weren't necessarily the tell-all. There was a spot. It was small and they weren't sure if it was just a spot that people who have seizures have or if it was caused by the seizure. They told me that there is a chance that Evie suffered from brain damage and that many infants with brain damage caused by seizures still go on to lead relatively normal lives. With occupational and speech therapies, they were just like everyone else. I guess I expected to feel like I was being handed a heavy stone to carry. Ever since I had turned down the genetic testing, I had had this feeling that if I had a child with a disability I would feel resentful of it. But now facing the possibility of it, I felt lucky. Things could be a lot worse, as evidenced by the other residents of the NICU. Evelyn would be a miracle no matter what. I feel shame for ever having worried about her being "different" during pregnancy. Being a parent changes a lot about a person. I have grown so much and changed so many of my opinions and views in such a short amount of time.

Where during the first few days of Evie's life, every bit of bad news sent me into a puddle of tears, Monday turned a page for me. I no longer felt like the world was crashing down and even when being delivered the not-so-great news by the doctors, I managed to keep myself grounded. No more tears or meltdowns. At least not in the NICU. In my room I had still felt the need to process my emotions and that usually resulted in quite a few tears. (Side note: my favorite nurse from the NICU, Rosalyn, saw me crying and handed me "one of our finest tissues": a gauze pad. I am so grateful for the nurses that can manage to bring laughter to an otherwise depressing ward).

Monday also brought the lactation consultant and another attempt at breastfeeding. I had been warned that it was possible for Evie to have lost her instinct to suckle, but it was very clear that was not the case. She did have a hard time latching, but with her first actual latch she'd gotten enough to give herself hiccups. It was the cutest thing watching her get a little latch, get interrupted by a hiccup and let out a long, frustrated (but completely adorable) coo before trying again. The lactation consultant showed me how to bring her to my nipple and squeeze it to fit it into her mouth. I felt like I was going to suffocate her because my breasts were so engorged but it didn't happen. 

Feeding tube held by Gavin.

Gavin and I spent a lot of time with Evie on Monday evening after he got back from work. He had worked an overnight shift and didn't get much sleep when he first got back to the hotel. He dozed off while holding Evie, who was pretty sleepy herself after a dose of the phenobarbital kicked in.

Just a couple of sleepies.

We finally got what felt like a good night's sleep on Monday night. I still had to wake up every 3 hours to pump (and missed my 6am feeding, apparently I turned my alarm off but didn't pump. I only discovered this at the 9am pumping!) but I woke up feeling pretty well-rested. I have considered becoming nocturnal because I know during the day someone will be awake to wake me up for pumpings/feedings but at night I have a hard time getting all of them in.

Gavin had to go to work in the morning and I had an appointment with the lactation consultant at noon. My mom came by the hotel and we took the shuttle to the hospital, arriving early enough to spend a little time with Evie before the LC arrived. We snuggled Evie and read her a book and my mom did Head, Shoulders Knees and Toes to her while I took a video.

We spent a good 3 hours with Evie, just hanging out. It was very nice to sit with her and just bond. She made a bunch of cute faces and was pretty alert.

A little before 3pm we were visited by the hospital's Family Support Services rep, who gave us a handbook for discharge and a gift bag with a fleece tie-blanket, a journal and a book about going home. A lot of super-useful information. She also gave us wristbands for the Ronald McDonald room in the hospital. My mom and I went to check it out and found it to be very welcoming. We got a quick snack and sat for a minute. I decided that whenever I can drive again, I'm going to bring a big case of water bottles since they said they don't get enough donated. And when we check out of the hotel, any remaining snacks we have around will be donated as well. 

Mom went to visit my grandfather and I returned to the NICU to feed Evie again and then came back to the hotel to pump. 

This first week has been such a whirlwind, but we made it through. Evelyn is showing many signs of improvement and I am so grateful to be able to stay so close to her. When she is discharged sometime in the next couple weeks I will spend every waking moment (and many sleepy ones as well, I'm sure) making sure that she is covered in love. 

As I look back on the last seven days, I recall all of the hospital staff that were so incredibly kind to us, from nurses, doctors, even the discharge escort was hilarious. I ended up being impressed by every person we came in contact with, whether or not we started off on the right foot. And everyone seemed to fall in love with Evie, too. And Gavin, of course, was my rock the whole way. He did not waver, even once, in my presence. He held me and encouraged me when things were bad, and hugged me when things began to look up. He has truly proven his capabilities in the role of Dad, whether it be through jokes or the gentle touch. I would be lost without him.

My mother and in-laws were invaluable as well. My mom, of course, is my mom. She is the one I can confide in and be open with and she only sometimes oversteps the boundaries that I have set. And we have the kind of relationship that allows me to address that in a constructive way. For that I am thankful. My in-laws have given us every moment of their time, every spare dime they have to make sure that Gavin and I are able to spend the most time we can with Evie. Though it was hard to accept help from them at first, I have decided that I should stop fighting it. She is their first grandbaby and they have the right to put their money and time into whatever they wish. I hope they know how grateful I am.

I try to make sure that everyone knows how much they mean to me and Gavin. To the friends of friends of friends on facebook who have heard of Evie and send their well-wishes and the family members out-of-state that have sent prayers and good vibes and everyone in between, I appreciate you!!

We just can't wait for little Evie to come home. :)

Her second outfit (first one had a poopsplosion!) ever.