The day of January 29th, 1996, began normally enough. I awoke at 9:00 or so and was working by 10:00. It seemed that the highlight of the day was going to be the Monday afternoon staff meeting at 14:00 but 15 minutes before that happened, Tina called to tell me that she thought her water had broken at 13:15 when she was grocery shopping with her parents, Tom and Jan. She had already called the Ob/Gyn's office who advised her that we should go to the hospital to see if she was in the early stages of labor.
I arrived home at approximately 14:05 (cutting my normal 30 minute commute to 20) and began gathering the supplies and paraphernalia that we had deemed necessary for our hospital stay. Here is a partial list of the things that I brought:
I had compiled this list during the previous two weeks and felt confident nothing had been left out. Also on that list was a note to call my friend, Rob Marquardt, to let him know that he should begin thinking of a good design for the birth announcements. The list was contained on the Newton so I had to take it along.
So we packed up all that stuff, all Tina's stuff, a bunch of stuff for the baby (including the car seat) and headed off to the hospital with Tom and Jan trailing us. I did my best to keep them in sight, but yellow lights and anxiety served to seperate us. When we reached the roundabout at 39th and Glisan, I looked behind and saw that they were less than five cars away. Thinking that the situation was under control, I took a right onto Glisan and began the final five block trek to Providence Hospital. Within three blocks I realized that soon-to-be Grandpa Tom had "lost" us so I pulled over to see if they would catch up. Sure enough, they had driven around the roundabout at least once (I suspect more) but had seen us waiting and caught up with us several minutes later. Finally, we drove the last few blocks, parked and headed into the hospital with a small portion of our baggage in the event that it was a false alarm.
We checked in at around 15:30 and settled in for what would be a long wait. Or, more precisely, a series of long waits. I made calls to Rob and my friend Roger Bradley to let him know that we were underway. Tina called several of her friends to tell them the "news."
The first order of business, from a medical perspective, was to test the fluid that was oozing from Tina to see if it was amniotic fluid. The nurse who performed this test was not very confident of the apparent positive outcome, but she said she would call the doctor to see how to proceed. When he got back to us (after 16:30), it was to tell us that we should walk around (classic labor-inducing activity) until he arrived at 21:00. At that time, he would examine Tina to determine whether she was actually in labor.
So we walked and waited. Watched TV, waited and walked. We also discovered that nervous energy speeds up the digestive process considerably and we were all, consequently, very hungry. Tom and Jan went on a food quest and returned with turkey, mashed potatoes, stuffing and gravy from the cafeteria. Tina had a turkey sandwich from room service. It tasted good and I wolfed mine down, which proved to be poor judgment when we resumed walking after our meal.
When we weren't walking, they would hook Tina up to a fetal heart monitor as well as a second monitor to measure any muscle contractions made by the uterus. We were pretty familiar with these devices because Tina had already been hooked up to them several times throughout the last few months of the pregnancy as hers was considered a relatively high risk pregnancy because of gestational diabetes. During one of the monitoring periods that day, the baby's heart rate dropped below 90 but was brought back up to normal (120) by rolling Tina onto her side. Also during this time, Tina had felt several contractions--one very strong and others not--but they did not occur regularly.
The doctor finally arrived around 22:00 and proceeded to examine Tina to see how labor was progressing. The bad news was that she was not progressing. The baby's vertical position (station) had not changed, dilation had not even begun and the thinning of the cervix (effacement) had not increased by much (although it was now at 90%). Additionally, the amniotic sac had not broken as the nurse had earlier hinted. The doctor said that it was likely that the corionic (outer) sac had broken causing Tina to think that her water had broken when it had not.
Because of the incident where the baby's heart rate dropped (apparently called a "D-Cell"), the doctor wanted us to stay overnight so we could continue to monitor the baby's heart rate. He promised that he would return early in the morning to examine Tina to see if she had progressed by then. It did not seem hopeful.
Tom and Jan headed home to take care of the cats and watch the house while I transformed the couch into the evil bar-in-the-middle bed and Tina reclined in her hospital bed. In the meantime, the temperature outside dipped to an unusually low 17 degrees and the temperature inside the hospital fell. Evidently, the combination of rain and cold was enough to cause a major transformer on the east side to blow out. Soon after, our lights dimmed briefly while the hospitals generator(s) kicked in. Unfortunately, the heating system was not as effective with the generator and our room temperature dove to 55 degrees within a few hours.
(At this point I would like to note that nearly all times from this point on are only estimates. It is difficult to track time under duress and with little sleep.)
At least it felt that cold when I woke up around 2:30 or 3:00. The night nurse was in the room and reassuring Tina. Evidently, while I slumbered, Tina had begun to have semi-regular contractions. The nurse had been trying to help her, but I think Tina was relieved when I awoke and started coaching her through each contraction. These contractions were much different than the few she had previously. These were much stronger, much more painful and came much more often. The first two traits combined to give me mixed feelings about the final trait. On one hand, I didn't want them to come as often to spare Tina the pain, but, on the other, I hoped that they would begin to come more often so the labor would progress quicker.
During the next half hour, contractions were about ten minutes apart and lasted about a minute each. Tina asked the nurse if she could use the jacuzzi. She said that she would go fill it up for us. A few minutes later, we were in the jacuzzi room talking and relaxing. The warm water made it easier for Tina to bear the contractions, which continued to be about 10 minutes apart. Five minutes after the fourth jacuzzi contraction, Tina jokingly turned on the bubble maker and nearly instantly had another contraction. A very strong contraction. So strong, in fact, that the mirth of the jacuzzi no longer held an attraction to her and we headed back to the room. It was approximately 5:00.
Whether or not the bubbles triggered that contraction is unknown, but it was not a fluke because contractions continued to be five minutes apart for the next several hours. This was the hardest time period for me. It seemed that no sooner would one contraction die down then we were preparing for the next. Most lasted about a minute, but some of the stronger, more painful ones lasted as much as a minute and a half. By 7:00 Tina was very worn down and getting to be very listless. I was quite amazed at how silently she would bear the pain of each contraction. After asking the nurse if it was supposed to be so painful and commenting that she wasn't sure she could make it, the nurse set about arranging for some intravenous pain relief.
The doctor was supposed to show his face early in the morning before some surgeries he had scheduled, but he called in to say that he couldn't make it because he feared the weather conditions (icy) and their impact on the traffic situation. He was kind enough to approve the IV and an examination by the nurse. The examination (at 7:00) showed the station and effacement to be the same but dilation had reached 2 cm.
At about 7:30, another nurse came to place the IV and administer a narcotic called Stadol. At first she was able to raise a vein on the side of Tina's forearm, but after inserting the needle into the skin, was unable to puncture it. After about five minutes of chasing the delinquent vein around with absolutely no reaction from Tina, I asked if it would be easier to use a vein on the back of Tina's hand. She said that it would be easier, but it may be uncomfortable. At this point, after watching this woman move a needle around inside my wife's arm for an seemingly cruel length of time, I said that she should just get it done so we could take care of the pain. A minute later, the IV was inserted, she drew some blood for tests and then administered the Stadol.
Anyone who has gone through a pregnancy knows that there are two sorts of pain relief available to the laboring woman. The first, a narcotic of some sort, does not provide complete relief but is generally known to "take the edge off" the pain. You see, contractions are graphed as a wave form, or a series of hills. When the contraction starts, the hill begins. As it progresses, the hill gets higher and higher until it peaks at the halfway point and then declines at the same rate that it rose until it is over. The Stadol made it possible for Tina to ignore the bottom thirds (the beginning and end) of the contractions making the peak much more bearable. It also allowed her to sleep in between contractions and, consequently, for me to catch a much-needed and welcome ten minute nap. It proved to be enough for the time-being and I figured that I could get a little more later. This would prove to be a major miscalculation...
The second kind of pain relief is called an epidural. An epidural is a special kind of anesthesia that effectively numbs all the areas of the spinal cord that it touches. That's right, in order for it to work properly, it must directly bathe the spinal cord. The procedure to administer it involves having the patient sitting bent over on the side of the bed in order to stretch the spine out. The anesthesiologist inserts a very large needle into the spinal column. He then runs a thin plastic catheter through the needle into the spine. He can then remove the needle and inject the anesthesia in through the catheter. For convenience, the catheter is run up the back and over the shoulder. To avoid accidental removal, the catheter is taped at the point of insertion as well as at several points on the back and shoulder.
Tina had her epidural administered at around 11:00 after dilation had exceeded 3 cm. Prior to that she had been given another shot of Stadol at 9:30. Shortly after the epidural was administered, Tina's blood pressure dropped drastically and, consequently, so did the baby's heartbeat. They quickly put an oxygen mask on her, turned her on her left side to maximize blood flow and cranked up the fluid IV to fill up her veins. Soon after, her blood pressure and the baby's heart rate returned to normal. Scary but evidently not unusual. Nonetheless, they decided to forego the use of the external heart monitor and applied a scalp monitor to the baby's head for a more accurate reading (although I'm not sure when this was done). Evidently putting this in place also caused the amniotic sac to finally burst.
At this point things begin to get a little hazy for me. Tom and Jan returned shortly after the second Stadol shot, but the extra sleep that I had associated with their return never materialized. By the time that Tina started to become lucid after the epidural, I began to have waking dreams and strange feelings of deja vu. I also feared dizziness greatly (due to an unfortunate incident earlier in the pregnancy), but that luckily was never an issue. Nevertheless, I was definitely in rough shape for the following two hours. With that in mind, I cannot really recall what happened during that time except for a few disparate events with no real time frame attached to them.
There was a bit of a problem with the epidural not getting full coverage of the spinal cord, but it was solved by either repositioning Tina and/or by injecting more anesthesia into the catheter. If these hadn't worked, they would have had to completely redo the entire procedure.
Sometime after the administration of the epidural, a nurse examined Tina and found that she had fully dilated on one side of the cervix and that the station had improved. This had to have occured in less than two hours. Upon discovering this, they rolled her onto her other side (to finish dilation) and began preperations. Preperations included (but were not limited to): calling the doctor, bringing a tray full of scary looking surgical instruments and carrying in the "stirrups." When I saw the stirrups come in, I knew that things would be happening soon.
Tina's friend, B.J. Hayhurst, arrived sometime after 13:00 to see how things were going. She would soon find that things were going very fast!
The doctor arrived at about 13:30, performed an examination and declared "This baby is crowning! Let's have a baby!" At that point I realized that I would be completely unable to concentrate on running the camcorder and turned that responsibility over to Tom, who had no experience whatsoever using our camcorder. Consequently, he did not realize that the tape was not "rolling" until a few minutes after the doctor arrived. He still did a great job.
And so the pushing stage of labor began. After they got her legs in the stirrups, I was at her side when they told her that she needed to start pushing. I was lucid enough at that point to remember to count to ten and tell her when to push and when to breathe. However, that was all I was lucid enough to do and was completely oblivious to everything else that was happening. After about three pushes, somebody said that his head was out. I stood long enough to get a look and watch the doctor cut the umbilical cord that was wrapped around the baby's throat. Evidently, the scalp monitor had either fallen off or had been removed to facillitate the use of the suction machine (today's equivalent of the forceps). Because of this, they did not know what the baby's heart rate was and were justly alarmed when he came out with a cord around his neck. When the doctor cut it, it shot a little squirt of blood about three feet into the air causing all those present to jump back a little.
After the cord situation was resolved and one or two pushes later, the baby sort of squirmed the rest of the way out like a little fish. Thomas John Laurren Ring had arrived! They quickly carried him across the room to the heated changing table where he would spend the next 30 minutes.
The first order of business was to clear his lungs of goo so he could take his first breath unobstructed. At the time, I didn't realize that it took over a minute to accomplish this. After it had gone on for awhile, a nurse asked if anybody had noted the time when the cord was cut. Shortly after that, we heard young Thomas John's first cries to the world.
Sometime after that, they handed me a pair scissors and pointed to what remained of the umbilical cord. At this point, the act had become a merely symbolic gesture, but I carried it through with shakey hands. Nobody lost a finger and less blood squirted than the previous cut.
The remaining time on the table was spent performing a number of procedures (that I won't go into here) and raising his temperature to normal. I guess that the loss of cord blood (from cutting the cord early) and the slowness in getting breathing started resulted in a temperature drop. This was the major reason that he spent so much time on the table before his mother got to hold him. Unfortunately, when she did get him, it didn't last for very long because she had to check her blood sugar.
Fortunately for me, though, I got to hold him for a few minutes before the nurse took his temperature and determined that he needed more time on the warming table. During those few minutes though, I found it fascinating that he was already reacting to external stimulus. His reactions to having his cheek and chin rubbed, in particular, were most interesting as he opened his mouth and stuck his tongue out.
And so, back to the table to be further poked, prodded and generally marked for life. A short trip to the scale showed a weight of 6 lbs., 13 oz. and the tape measure found him to be 20 inches long. Examining the video tape now, it is easy for me to see that he had a slightly yellow tinge to his skin, his eyes were more than a little swollen and he a number of marks and bruises from his journey, but to me he looked like the most perfect, tiny being I had ever seen. I found it amazing to see such perfectly shaped fingers and fingernails at such a miniscule size! I marvelled at his dark, dark eyes which appeared to me to have the slightest hint of green in them (like mine). I was delighted to discover that he had been born with the same misshapen ears that I had when I was born. The lobes were turned up so they stuck out at a ninety degree angle from his head. My mother elected to tape mine down for a time to get them to "normal." As of this writing, we have taken no corrective action.
Eventually, his temperature came up and he got his first taste of breastfeeding. Since he and Tina were both neophytes, it did not come easily during the first few days but eventually they both became experts. I had looked forward to my long, lost sleep that night but it was not to be once again as the cry of the newborn pierced the halls of the hospital and the depths of my consciousness. I did manage to get a few hours and enjoyed being up with Tina and our new son, anyway. The next day was long as T.J. continued to undergo tests. Because of the early cutting of the umbilical cord, much cord blood had been lost and he was, consequently, anemic (low on red blood cells). He also suffered from a condition know as ABO blood group incompatibility which is a incompatibility in the blood types of the mother and child (although not an RH incompatibility) and is evidenced by a slight jaundice in the skin. This condition can cause red blood cells to be destroyed which, of course, would worsen the anemia. Whether he had enough red blood cells was of great concern because babies don't produce new red blood cells until their sixth week. Our pediatrician told us that as long as his jaundice did not worsen, we had little to worry about.
Aside from that, we had little to do that day except to wait for the Tina's obstetrician to release us. As before, this proved to be a lengthy wait. Even though there were no complications, he ignored the nurse's suggestion that he release us over the phone (which is allowed if the nurse recommends that all is well). He insisted on seeing Tina before releasing us. He further infuriated us by telling us that he would not be able to be there until 17:00. As it turned out, he did not arrive until 18:30 and spent all of five minutes in determining that we could be released. We have not and will not seen that doctor since (we had a number of other problems with him that I won't go into here).
And that was it as we headed home for sleepless nights and dirty diapers. A few days later we visited the pediatrician to have the circumcision done and to check on the jaundice. Within a week or so, the yellow tinge had gone away. I think the moment I shall remember most is when Tina had left me with him in the hospital room for a few minutes. As I held him in my arms, I began to realize what a huge responsibility this would mean for me. I also realized how tremendously lucky we had been to get such a healthy baby when so many things could have gone wrong. As I sat there holding my son, crying with relief, joy, worry and a torrent of other emotions, I promised him that I would always do my best to make his life the best. And I will. I have to. I promised.