local anesthesia

London’s Birth: Part IX, What’s her name?

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

Throughout the operation there were tears slowly dripping from my eyes and my nose was a leaky faucet. I was aware that my snot had flowed through my mask and even in that moment I was mildly annoyed with the thought of having to ask for another mask. I would ask later, when the time seemed right. Until then, I tried to minimize the flow of tears and snot.

It may sound like my eyes were wandering once my daughter was out of Kate, but they weren’t. I glanced for split seconds here and there, but my eyes were essentially locked on the little human being in front of me. Vented now, the doctors seemed a little more relaxed with her and ready to move. They told me where we were going. It went in one ear and out the other. I would follow them anywhere. They started to roll my daughter a bit, making for the double doors I had come through to enter the OR. They halted for a second, one NP turning to me and asking, “What’s her name?”

I had not yet imagined when I would announce to those present in any room the name of my daughter, but if I had, it would never have crossed my mind that this would be how I would introduce her to the world. “Her name is London,” I announced. It sounded weird giving a name to her at this stage because when your child is born this small and fragile, they almost seem like a science experiment. I had started to become aware of a disturbing, but natural protection mechanism that sets in when you see your preemie like this. I wanted to protect myself from her in a way. I didn’t want to become so attached to her just in case I lost her in the next hour, but giving a name to her instantly made it harder to keep my distance.

London and the team working on her started moving out, rolling right by Kate’s face and slowing down a bit so she might possibly get a glimpse of London’s face. I saw Kate strain her head to try to see her baby before we went through the doors. I stopped and gave Kate a huge kiss, an exchange of tears cheek to cheek, and a word about how London is vented. I also checked that I should keep on walking with London and the team. Kate nodded yes and I was off through the double doors with an “I love you” and one last glance at the amazing team sewing up my wife.

London’s Birth: Part VIII, 18 People

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

I confirmed with Kate that I was to go be with the baby now. We kissed. I told her she was doing great and walked to the foot of Kate’s bed where the doctors had placed my daughter’s very small bed.

In front of me was an impossibly small baby girl. To call her a baby is not quite accurate. She looked more like a very, very small, skinny human being. There was no fat on her and she had none of the cuddly attributes that full-term babies have. There were seven doctors and residents attending to her, looking for signs of breathing, mostly. They seemed to poke and prod here and there with their hands and a few tools.

Immediately to my left, Kate was on the operating table, with her incision still wide open. I didn’t stare long, but I felt comfortable looking at the incision and the tissue and organs that were being rearranged so they could settle back into place. I turned my head ninety degrees right and continued to watch the doctors revive my daughter. I saw them prepping a blade to start the intubation when another doctor informed me that was exactly what they were being forced to do. She said this was very common. She was tall, had blond hair, and I remember a minute after my baby girl arrived on her miniature bed, she referred to her as a him. I clarified, “It’s a girl, right?” She looked again, “Oh, I’m so sorry.”

My daughter was successfully intubated a moment later. Her head and neck seemed impossibly flexible for the doctors to place the blade and insert the endotracheal tube. I looked left to Kate again. A nurse walked right in front of me carrying a metal dish with a big red blob in it that had what looked like puncture wounds. It was the deflated, tragic looking placenta that had prematurely detached from the uterine wall, aka placental abruption.

The OR was highly organized chaos to my uninitiated eyes. I took a moment, counting all the people in the room saving my wife and daughter. Eighteen. It was the beginning of a deep, new appreciation for the professionals around me. I was learning in the quickest and most explicit way possible that the quickest way to my heart was to save the two people dearest to me. It was early to have this revelation because I didn’t know if everything was going to turn out fine, but I still felt like I would love and cherish these people for the rest of my life because of their effort here.

London’s Birth: Part VII, 27 Minutes Later

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These posts are in reverse chronological order. Read earlier posts first. They can be found by scrolling all the way down or clicking the links provided here: Part I, Part II, Part III, Part IV, Part V, and Part VI.

The only time I have ever seen a C-section setup in an OR was on ER. Well, in that respect, the set of ER got it right. Kate’s neck and head were peeking out from a curtain draped across the top of her shoulders. There was a nurse standing to the right of Kate’s head. There was a chair positioned to the left of Kate for me to sit in. I walked over and sat in it. I gave her a kiss. We exchanged “I love yous” and I sat down.

At this point, we didn’t have to discuss whether or not I would watch the baby come out or whether I would go be with the baby once she was out. Just a few days ago at home over dinner we had talked about what we would do in the case of a C-section. I said I would sit by Kate and would want to be present for everything. We agreed that I would go be with the baby once she was out of Kate, if Kate was clearly doing okay. I also expressed interest in seeing the baby being pulled out. In hindsight, it is incredible that we had this discussion already.

When seated next to Kate, I couldn’t even see the doctors working on her lower body. Kate said all she felt was pressure. I could see Kate’s head and shoulders shifting up and down and left to right on the bed as the doctors peeled away the layers, pushed things to the side, and cleared a path to the uterus.

The urgency of the C-section and the speed at which it all happened was astounding. I was not next to Kate long before the nurse next to her spoke up, “They are about to pull her out. Do you want to look?”

“Yes,” I said. The nurse would tell me when to stand up and look. “Okay.”

“Alright, stand now if you want to see,” she said.

I hesitated just for a second or two, perhaps not quite ready to see what I was about to see, scared to see what I was about to see, or just trying to register the moment. I’m sitting by my wife behind a curtain and on the other side is the rest of my wife’s body with a significant opening in it from which they are pulling out this human being we made, our daughter, who will be in my thoughts for the rest of my life no matter what happens in the next few minutes, hours, or days.

I rose from my chair and saw two doctors lifting my daughter up out of Kate. My daughter’s foot, the last part of her touching Kate, was just slipping the protective casing that had collapsed around her. Nothing could have prepared me for that view. It was beyond beautiful and it literally took my breath away. My legs gave out a bit and I had to sit down quickly. I was crying and Kate was looking at me expectantly. “She is the most beautiful thing I’ve ever seen,” I reported. We smiled through our tears. It was 4:02am, twenty-seven minutes since I had texted my dad, saying we were going to the OR.

London’s Birth: Part VI, At the Doors of the OR

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Parts ONE, TWO, THREE, FOUR, and FIVE of this series should be read first.

The walk to the operating room was extraordinarily difficult. Dwelling on a worst-case scenario was unavoidable at times. Kate occasionally cried while she was being pushed toward the OR. The doctor told us that they would do their best to use local anesthesia so Kate could stay awake and so that they wouldn’t have to intubate her. I was told that I couldn’t come into the OR until the team had determined what type of anesthesia Kate would need.

At the huge double doors to the OR I had to say goodbye to Kate. No other goodbye I’ve had in my life had been that hard. How long was I saying goodbye for? I didn’t know for sure. Five minutes? I hope so. Five hours? I hope not. Five days because they had to intubate her and then there were complications? I don’t know how I would have gotten through it. But there was also the question in the back of my mind, for forever? The team pushed her through the doors and I was alone in this barren anteroom with two chairs and a couple of carts with masks, gloves, and other sterile clothing.

I did not expect to be alone at this point. I thought someone might stay with me. I sat down on one of the two chairs. At this point I continued praying, which I had not stopped doing for a while. It felt more like begging at this point or, more accurately, making demands of God. I sat with my head in my hands.

In a few minutes the doctors were attempting to place the epidural. Kate was screaming like she was being cut open. The trauma of having an emergency C-Section at 26 weeks coupled with the pain of the needle is enough to make any woman scream. I didn’t know what sounds to expect from the OR at this point, but that was as much as I could handle. Still seated, I think I may have been rocking back and forth at this point, still with my head in my hands.

The doors to the OR were to my right. A few doctors went through them once they got gowned up. Some of them wore clear shields that covered their whole face. One knows exactly what these are for. They’ll protect the doctors’ faces from splatters from cutting my wife open, moving aside some organs, and pulling a little human being out.

A doctor came through a different set of doors to my left. As she gowned up and scrubbed in she spoke with a healthy dose of authority, giving me a one-minute crash course on 26-weekers. “They have an 85% survival rate,” she said. That is higher than I thought it would be, I thought. “A common complication is with the eyes. It’s called ROP. It can be fixed with laser surgery,” she continued. And with that she walked through the doors. She was just very matter of fact and did not give me a parting “goodbye” or “see you in there.” But I completely understood. She was going into the OR to save the two most precious people in my life. If I could have sped her up somehow I would have. Godspeed, Lady.

A few more minutes passed and a different doctor came out of the OR with good news. “Kate is on a local anesthetic and doing great. You can come in now.”