Sleeping Isabel

Isabel is a bundle of surprises, being a lot heavier than her big brother; Isabel started her life right away, wasting no time at all.  The moment she was transferred to Dra. Enriquez and her team she promptly pooped on Dra’s hands, and she immediately informed Dra about her displeasure of leaving mommy’s tummy.  So far she has no hesitation letting anyone know how she feels, and loudly at that. One of her nurses dubbed her as a singer, in fact you can hear her singing from down the hallway.

She can also hold up her head, something that her big brother could not do till a few weeks after he was born.  She moves her head up and down and though you lay her on her tummy with her head facing left, she can lift up her head and face the other way.

Within a few hours with mommy she latched on and coaxed mommy’s mammaries to give milk.  She has pooped three and peed six times since she started breastfeeding.

Isabel holding her head up!!!

Solid 7.9lbs!!

Isabel's first bath

Isabel's first morning

– The Delivery –

Catrina’s delivery started at 6am, when she was brought to the delivery area and anesthetized.  She was scheduled for a 7:00am cesarean, but I was only invited into the operating room around 7:45am.  Dra. Capistrano, our OBGYN, has already begun by the time I went in.  I was surprised to see Catrina’s eyes wide open and looking at me, as if asking me why I took so long to get there.  Unlike our first cesarean Catrina remained more or less awake the entire procedure, slipping in and out of sleep every now and then.

Food for thought, the distance of the uterus from your outer skin is about 4 inches (depending on your adipose).  In a cesarean section the doctor will cut a horizontal cut just above where your underwear ends, about 5-6 inches long (called a bikini cut, for obvious reasons).  The doctor will not cut once, but multiple times, through several layers till the uterine wall.  Each cut is done carefully, pealing away layer upon layer of tissue, each layer the doctor will cut and tie up any veins or vesicles that bleed too much.  The uterus it self is three layers to cut through until the water bag.  Once you reach the final layer everything goes really fast.  You can tell when they have reached that far; there is a pause for 3-5 seconds.  The nurses behind the doctors start positioning themselves; the baby catching team edges closer, when they were keeping a respectful distance just a few seconds ago. No one says “here it goes” or “get ready everyone”, it just happens and then it’s done.  The baby is pulled out, the nurses press down of the upper part of the mommy’s belly, pushing the baby out through the relatively small opening, the baby gets free, the umbilical cord is cut and the hand over to the baby catching team is done.  A few seconds later, the baby cries.

Thank you Dra's for bringing Isabel safely into the world

No wonder surgeons have team preferences.  The only thing that seems to have no real function is the father and this clerical lady at the corner of the, room literally flipping through some papers.  Later on, she gets up, stands on a foot stool at the foot of the operating table, and the nurse handing the surgical tools to the doctor begins (rather loudly), to dictate every piece of item on her table, dictating the type of tool and the count for each (they repeat the process every ten minutes or so).  Then I realize, yes, the father is the only useless one there.

The baby catching team methodically cleans the baby, (in Isabel’s case Dra. Enriquez cleans more than the usual: D).  Apgar scoring begins, Activity, Pulse, Grimace, Appearance, and Respiration.  The scale goes 1-10, ten being the perfect score, but generally 7 and up means everything is okay.  Isabel was rated 9.9, I was going to ask by she did not get a perfect score, but decided not to.  There was time enough in Isabel’s life to give her pressure to score high in exams, 1 minute after birth seemed a little extreme.

Unlike the last time, when Miguel was whisked away to the nursery right away, this time we hanged around the operating room as Dra. Capistrano finishes closing up Catrina.  As I wait for Dra. Capistrano to finish, it is only then do I get the full appreciation of how hard this procedure is.

Everyday people talk about cesarean sections almost nonchalantly; it never occurred to me how extensive a surgery procedure this was.  As a doctor has to go through layers and layers to get to the baby, so does the doctor have to try to repair the damage that they do, by methodically stitching up every single layer.  And I am not talking of some running stitching either.  Think of the old ladies doing embroidery work on fine silk cloth, and then instead of hands, have them hold the needle with a long thin plier.  Make the needle incredibly thin, and shaped like a fishhook, and the thread incredibly fragile.  After that dress them in thick cotton surgery suits, and layer their hands with two sets of rubber gloves.

Mommy reviews the play-by-play

Now for the final brain twist: women go through this as a choice and in a lot of cases more than once in their lifetime.

– Catrina –

My hero!!

Mommies are heroes by default.  Mommies that go through labor and even cesarean should get medals.  Mommies who go through 14 hours of labor, cesarean section and the pain of recuperation, and then decide to do it all over again, should have awards named after them.  Catrina is my hero, and though I hated the fact that my mother until this very day reminds me of her 22 hour ordeal, I will personally make sure my children hear how much their mother went through just to bring them into this world.  How minor and inconsequential fathers are in the magnitude that mommies have to go through just to give us our children.  How humbling it is to see my wife, who once cried over a paper-cut, stoically bear the pain and stand from her bed 20 hours after her operation.  As I type this, Catrina is trying to walk down the hallway.

Mommies are heroes all, my Catrina is my own personal hero.

Mommy stands up, only 20 hours after her surgery

“breast milk is still best for babies”. Who ever wrote this slogan probably worked for some multinational baby formula company. Breast milk is the best for baby. We knew this and Catrina and I were resolved to breast feed little Miguel as much as we could and as long as it was feasibly and practically possible. No one ever told us about the “trying” part.

The trip to the nursery that afternoon was a revelation. Catrina, in pain since the 27th, smiled for the first time. Cradling little Miguel washed away any sign of pain from her face. Her eyes lighted up like stars and her hands would not stop moving when she talked about the experience. Catrina’s recovery leaped forward with the very presence of our little piece of joy.

I requested little Miguel to be roomed in with us. Little Miguel was wheeled in our private room at 3pm, at the same time his own personal nurse moved in as well. Her name was Lisa. Later on that night she was replaced by a night shift nurse, her name was Cynthia. The minute the private nurse moved in the breast feeding began.

I envy those mothers whose milk flows freely and abundantly the instant that their babies touched their breasts, as if Moses himself took his staff, and conked them one right at their nipples. I sympathize with those mothers, who with all the best intentions in the world, endured every stab to their hearts as their babies cried themselves hoarse with hunger, while trying futilely, to produce their own milk. With the challenges of giving birth, the pain of labor or the fear factor of cesarian, people just did not tell us about the trauma of trying to induce breast milk.

That night, the first time little Miguel latched on to Catrina, her facial expression told the entire story. Catrina compared it to someone using a pair of pliers on her. Watching her writhe in pain, I believed her. And I wondered, is there anything about having and raising a baby that does not bring physical and emotional pain to the mothers? Like always, as was these past few days, I felt useful as an appendix.

Our nurses and Catrina tried all night, every two hours, until Catrina fell asleep in pain and the nurses continued even while she was semi-comatose. Catrina felt like a cow being used for milking rather than a mother feeding her son. But the facial expression of little Miguel and his little gurgles and burps encouraged us on.

October 29, 2009

Witnessing Catrina’s stone faced resolution to visit little Miguel in the nursery despite the pain of her surgery, the lightheadedness due to medication, and the nausea of not having eaten anything for the past 48 hours, brought me to quiet tears. Our room was on the third floor annex; the nursery was a good five-minute brisk walk to the second floor. Just getting up the bed took ten minutes. The nurse slowly wheeled Catrina out of our room, to the elevator, and down to the second floor. Every bump on the floor, every separate tile on the hallway, sent little winces of pain through Catrina’s face. She kept her eyes closed the entire trip. Before that point Catrina, so exhausted from the previous day’s ordeal, had to make due with my failed attempts to describe our son. Now, this time, description just would not do, mommy just had to see her baby.

Arriving in the nursery, Catrina scanned the many carriages with blue tags; already trying to get a glimpse which one was hers. It took a while as I negotiated with the head nurse, they would not allow a wheelchair through as I explained that Catrina could not possibly walk the extra four meters to the feeding area. Finally a compromise was made, switching to a nursery owned and sterilized wheelchair, Catrina was escorted in. But just as success was within reach, the wheelchair would not fit into the feeding area door.

We agreed to be wheeled to a quiet corner, facing the wall, away from the other babies and visiting parents, little Miguel was finally scooped up and presented to Catrina. In the small corner, the quiet hum of various machines and the calm bustling of nurses around us, our little family was finally together. We held each other’s hands and silently cried happy tears.

2am: Catrina complains of severe contractions. Dazed and blurry eyed we drive to St. Lukes and get Catrina evaluated at the Delivery Department

4cm: Catrina’s cervix on initial exam.

25: The measured intensity of Catrina’s first contraction, Catrina describes as worst than the worst dysmenorrhoea

95: The measured intensity 0f Catrina’s contraction before she was eventually sedated and wheeled into the labor room, cannot imagine how painful each contractions were.

11am: Catrina is now 5cm dilated, it took –

9 hours: for Catrina to advance 1cm from the time of admittance

2pm: Catrina jumps to 6-7cm, encouraging doctors to proceed with induced labor

4pm: Catrina stops dilating, doctors declare labor officially arrested, calls in Migs to recommend c-section procedure

5 seconds: time it took to convince Migs to sign papers.

89bps: Catrina’s heartbeat as doctors began cutting into her

100kph: Mig’s heartbeat as he watches and slowly cries a silent prayer to God to not take his best friend away from him

25-30: total number of minutes it took to get little bun out of Catrina

16: hours of painful labor to give birth to –

3,170: grams, or 6.889 lbs of baby bun. That screamed out into the world to leave him alone inside Mommy.

19: inches of little bun is stretched out on the crib and promptly ignores everything around him and goes back to sleep

4:30pm, 10-27-09: Little Baby Boy Bun is born into the world and Mommy and Daddy Paulino are so proud and thankful