Saturday, July 24, 2010

Update and Birth story....

Greetings! Sorry for the delay in posting...we have been spending the last few days catching our breaths. :) What a whirlwind it has been! However, things are going very well and God has shown Himself to be merciful, faithful and good.
Just a quick update before telling the "birth story" (midwives love that stuff)....
Toby had 7 days of antibiotics - 3 days intravenously and 4 days intramuscularly receiving 3 injections in his thigh per day (not an adventure I want to ever repeat).

By day 5 of the antibiotics, Toby's jaundice was beginning to subside with morning sunlight treatment and his activity level and awake, alert times were increasing. :) He gained a bit of weight taking him back up to his birth weight and managed to breastfeed 2 times per day without trouble (I had to pump the rest of the day and feed him by bottle).

Today, now two weeks old, Toby has passed his birth weight (PRAISE THE LORD!), is looking more and more like a little man, is having normal bowel movements (AND FREQUENT, TOO! No "fairy farts" and "angel burps" for THIS kid! He is ALL BOY!), is becoming a bit playful, smiling, cooing and seems like a completely different baby! The doc said that he believes Toby is out of the danger zone, though we were advised to be monitor him carefully over the next few months to make sure there are no side effects to his infection.

He sleeps well and only cries when he is overtired, falling quickly asleep at the breast....and not necessarily eating. Grr. He quietly wakes every 3 hours to feed...but doesn't cry...just grunts and nice of him.

Promise is still adjusting, but has stopped trying to steal his clothing and toys. She is still very clingy and high maintenance, fearing Toby has taken our affection, but she now pokes him and will kiss him on the cheek when prompted. She even pokes his nose saying, "Cute Baby Tobes".

Gramma Con (my mom) is coming to Davao this Tuesday (!!!) and Promise and I are sooo very thankful for the company, Tim is thankful for the help (he needs to work!) and Toby is thankful that his mommy will enjoy peaceful conversation over coffee with her mom. :) for the "birth story" for those of you who like that kind of stuff. For those of you who can't handle reading about blood and private parts, stop reading now. :) many of you knew, we had tried to naturally induce labor as a result of my excruciating hip pain. After trying evening primrose oil, stripping the membranes, exercise, "contact" (sex), blue and black cohosh, and red raspberry, my midwife and friend, Bea and I decided that enough was enough....nothing was working and we were both very tired. At 39 weeks, I was exhausted, Tim was fried, and Promise was getting more and more annoyed with my decreasing ability to play with her. Then we got the flu.

The flu sent all three of us into a tailspin, giving me very painful contractions and hip pain without any cervical dilation...I THOUGHT I was in labor, but then the contractions just stopped. Grr.

A few days passed and my other midwife, Erin, came over to take me on a fast walk....I had mentioned to her that when I was active, the contractions would come every 2 minutes, but as soon as I would enter air con or sit, they would just stop. Erin and I walked briskly with Promise, Tim, and Erin's sister, Colleen, in tow with my contractions coming every 2 minutes...strong...when we got back to the house..yeah, you guessed it...they stopped. Erin and I discussed my need to just get this little man out or get a good night sleep. After talking to Bea, we decided that I needed to drink a beer and get some sleep. We would try inducing with stripping the membranes and walking again tomorrow.

Beer was had and I fell right to sleep....until 2 am when I woke up with strong contractions every 4 minutes putting intense pressure on my hips and cervix. YEAH!!! I definitely felt like I had reached true, early labor. Thankfully, I was able to stay lying down and rest through the contractions. Upon waking and showering, the contractions slowed a bit, but I felt as though perhaps they had done some good. Bea came over at 10 am to check things out while Tim took Promise to church...I had told her about my night, but I that I didn't think anything had progressed....she did an internal exam....4 cm dilated!!! WAHOO! We both cried....we had started labor.

She stripped the membranes for a long time and when I got up, my contractions nearly knocked me over! YEAH!!! We were both excited....we knew today was the day...Toby was coming and we were ready. We decided to make pancakes with chocolate chips and walnuts and visit....except my water broke as soon as I sat down to was a high break causing just a little fluid to come out....Bea and I prayed, checked Toby's heart tones and the color of the fluid and headed to the air con bed room to eat, labor and wait for Tim to come home. We also texted Erin and An-An so that they would be ready when Bea and I decided baby was coming. Erin was to assist Bea while An-An was to assist Promise. :)

Labor pains increased significantly after my water broke, which is totally normal, except my hips started to seize making the pain very different than the labor pain I remembered with Promise. The pain was so intense that I thought I was dilating much faster than I truly was. Bea was busy squeezing my hips together and reminding me to eat my pancakes here and there between contractions. We totally enjoyed our time together....we talked with our dear friend Sherry Gregory (remember her from previous posts?), Heidi and Kate, and my parents breathing through contractions and trying to shoot the breeze in between. Fluid came out periodically, but no bloody show or anything else. Early labor.

Then things got more intense....Tim came home and Erin came shortly thereafter to find me not coping as well as I once was. Tim put Promise down for a much-needed nap and Erin and Bea began checking heart tones again. An-An came just in case Promise woke up from her nap wondering what all the grunting and heavy breathing was coming from. :)

Promise slept from 1 pm to 4 pm (a record for her for sure!) and during her sleeping hours, I progressed from 4 cm to 6 cm...we knew this because I was in excruciating pain desperately desiring to push or bear down....Bea did an internal exam and broke the bad news, "Bethany, you can't push, you need to only breathe." I think at this point, I said a naughty word and eagerly rose to my feet to try and cope with the next contraction...this was where Tim, Erin and Bea were needed to help me cope. The pain came like a HUGE, angry 10-wheeler barreling down on my hips....I screamed bearing down a bit and needing to bite something. Yup, it's true. I wanted to displace the pain, so I bit myself in the arm! Ha ha ha...Erin, Tim and Bea bursted into laughter....

Then there were the contractions that made me cry out "TCHOO-TCHOO!" and "I REALLY can't do this anymore!" and "BEA, JUST GET THE BABY OUT!" and "TOBY! COME OUT IN JESUS' NAME!!!" Followed by a series of giggles. I nearly bit Tim twice, nearly broke Bea's hand off and chewed out Erin for telling me to breathe one million much-needed times. Contractions came faster leaving no time for adequate breathing and Tim's strength became the only thing I could physically feel holding me up. It was at this point that I literally felt abandoned by God.

Now, I know He was there the entire time, but I distinctly recall Him being tangibly, emotionally and graciously present when I labored with Promise. So much so, that I sang hymns and thanked God for the contractions....this labor was totally different. I felt no peace, no grace, no mercy, and though I know in my heart He was there, I honestly felt abandoned....on my own...though we prayed, I felt no emotional relief, no spiritual encouragement, no strength or power outside of myself to continue. It was the most difficult place I have ever been in...I felt so strange ....I felt like Tim was it...His strength was all I felt.

An-An hung out with Promise outside the bedroom and managed to keep her totally content. :) I love An-An.

Around 4 ish, after copious position changes and coping attempts, Erin suggested I head into the bathroom for a warm shower. Erin, Bea and Tim followed me in the tub, an enclosed space about 4 feet by 6 feet...and me thrashing about in the hot shower spray. I was still wearing my "duster" (dress) squatting with each contraction held up by Tim and Erin on the edge of the tub while Bea coached me to breathe.....

Then it came...the BURN....then, the BLOOD...then I said, "TOBY IS COMING!!!!!" Bea maneuvered the tight space to get a good look at my pwerta..."HEAD VISIBLE!"
We managed to turn me around so that I was in supported squat held by Tim, Bea was at Toby's head, and Erin donned gloves checking heart tones and getting towels prepared. We laughed and cried as we knew this labor nightmare was almost over.

I pushed through only 2 or 3 contractions moving Toby to 4-5 cm head visible...more BURN! I could feel my body gently pushing without me...stretching further and further...

Bea coached me to breathe Toby out little by little....we met eyes and I touched Toby's head...Erin was encouraging me that it was almost there while Tim leaned over my shoulder to see Toby's squished skull between my legs. Poor kid!

Erin was unable to find heart tones during the 20 minutes it took to get Toby's head out....he was just so deep in my pelvis. As his head came out, I felt some relief, but another contractions barreled down on my lower abdomen making pushing so hard seizing my hips, too. I could hear Bea call out, "Body wrap"...the umbilical cord was around Toby's body, though not around is neck...his purple body came out with a gush of fluid and blood....he was purple. No cry. Limp. Instinctively, Bea and Erin placed him on my naked abdomen and chest stimulating him to breathe....nothing. He had passed terminal meconium, so we were covered in the thick, sticky, black goo. Good thing we were in the tub!

It was then that Erin jumped out of the tub grabbing the stethoscope and locking eyes with Bea and myself. We all knew the severity of the situation. Toby was in trouble. His first Apgar score was 2 and his second, at 5 minutes after birth was 3. I started to call out to Toby - "'s your gotta breathe, your eyes and breathe, Toby!!...Jesus, make Him breathe, please!" I heard Tim begin to pray in tongues...

Bea grabbed the Ambu-bag to start PPV (resuscitation) while Erin checked Toby's heartbeat (it was steady at 130 bpm). His heart was strong, but he just could not take a breath. His eyes closed, I yelled for An-An and Promise to come in...An-An began to pray aloud and I heard Promise say, "Toby came out!" :) It was then that above Bea's "Breathe, two, three, Breathe, two, three" I heard Tim, Erin, An-An and myself storm the gates of Heaven for mercy. Praying in whatever language we could speak under the circumstances, we claimed life for our precious boy. Erin and Bea cut his umbilical cord and moved him to a flat surface to continue resuscitating. We continued to storm Heaven claiming Toby's name..."God is ALWAYS good...Tobias Robert James Stewart....GOD is ALWAYS GOOD! You are a TESTIMONY of God's goodness so you cannot will LIVE in Jesus' Name to PROCLAIM the GOODNESS OF GOD! You are POWERFUL in the KINGDOM and the breath of LIFE and the HOLY SPIRIT are on you!"
The peace in the bathroom as we prayed and prayed was thick...the Presence of God had returned. We all knew it, too. Though Toby was still not breathing, we were feeling God's grace in the room.

An-An called 911 for an ambulance to be transported to the hospital and while we waited, Erin had the idea to literally turn Toby upside down, hanging him by his feet to get blood to his head...his eyes flew open and he grimaced! The first sign of improvement. Bea brought him to my chest again and gave him oxygen...he was a bit more pink, but still could not breathe...his chest was pink, but his hands, feet, and head were purple like death....we continued to pray...LOUDLY. Erin and Bea scurried around the bathroom preparing a transport bag and wrapping Toby up tight.
The ambulance came and the EMTs came in looking like deer in headlights as they saw a half-naked white lady in an empty tub with three large white people running around, a new baby purple and not breathing and An-An and Promise directing them. It was quite the sight for them...I am sure it was their first homebirth experience!

Toby, Tim and Erin raced to Brokenshire hospital while An-An stayed with Promise here at the house and Bea assisted in delivering my placenta, checking for tears, and stabilizing me. She was amazing. I immediately showered off with Bea's help and went pee. She checked me for a tear...a slight 1st degree that, though she suggested we suture, I argued that I would try the natural healing way if it closed straight...Bea looked a little skeptical, but she knew I was just wanting to get to the hospital ASAP. She relented and helped me dress, got me food, checked me for excessive bleeding (total estimated blood loss was 200 ccs), assisted me with the horrible afterpains, and helped pack an overnight bag for the hospital. Meanwhile, Promise and I skyped my parents, my brother, called Tim and sent out a facebook plea for prayer.

We were getting periodical updates from Tim and Erin...the last one just before leaving for the hospital was a noise I will never forget...Toby's cry...a shrill, but strong cry. Made me cry.

An-An offered to stay at the house while Bea, Promise and I raced to the hospital by taxi to meet up with Toby. Tim would then take Promise back home, tuck her into bed, An-An would be relieved by one of the girls from Mercy (thank you to Beth and Sarah for that!) and Tim would head back to the hospital overnight with me and Toby. Bea would be back in the morning to assess the situation and stay with me at the hospital while Tim headed home to check on Promise. It was quite the scheduling party!

At the hospital, Erin and Tim shared how the emergency room nurses and docs seemed so taken by the "white, peaceful baby" that they really stunk at helping him to breathe. Tim and Erin had to fight to get care for Toby and argue for his needs to be met as the nurses were thinking the baby was just quiet. Erin and Tim both shared how they emphatically, nearly yelled, "HE CAN'T BREATHE!!!"to the nurses. However, the pediatrician was being reached by phone and was ordering a bunch of tests. When I arrived, he was already hooked up to a oxygen-checking machine checking his O2 saturation and had been poked several times. I tried breastfeeding and he immediately latched on though he was still struggling to breathe and came off often in order to catch his breath.

Nurses came and went...we were all quite shaken up. And then Toby developed jaundice....the bad kind that develops within the first 24 hours of life. He rapidly turned from yellow to orange, making him irritable and difficult to feed. The next 24 hours were extremely difficult, though we were happy Toby was crying, he did not stop. He cried for 36 hours straight, arching his back and flexing all his muscles as if he was in great pain. He could not relax. His breathing was rough and his grunts sore. His voice was so hoarse. Tim and I were fried. Bea and Erin stayed super late to make sure we were okay for the evening. We were brought food and supplies while waiting for the next nurse to check Toby's vitals. None of them would give him anything for his distress. In the morning, after a sleepless night, Bea came and pleaded with the nurses to help Toby with his discomfort. We waited for the doctor to come while feeding Toby breastmilk by syringe.

The doctor, Dr. Estuart (the husband of the amazing OB doc I had at Brokenshire the previous month) was super friendly and helpful. He shared that the blood tests showed that Toby had a serious infection, though we had no idea what the bacteria causing it was. Bea and I thought it might be Group B strep as they do not test for that here, but it is quite common. Dr. Estuart ordered more tests and by Monday evening, Toby was on his first dose of intravenous antibiotics. Between the heel stick glucose testing, the multiple attempts at intravenous lines, and the blood tests, Toby had been poked 20 times....I cried a lot. So did Bea. Erin came Monday, too, and together we tried to figure out what we had just been through and what possible bacteria could be causing Toby such horrible chest pain and retractions.

Tim stayed at home with Promise Monday night while Bea stayed with was another rough night. Bea helped me take a sponge bath and held screaming Toby while I slept. My hips were in excruciating pain as a result of afterpains and labor trauma. It was awful. Bea brought me beer to help with the milk production and pain, milk tea, and malunggay pills. Her house brought us a TON of groceries and snacks...we were in tears we were so grateful.

Bea and I had it out with the resident doctor as she was not doing her job and met with Dr. Estuart the next day to discuss the possibility of continuing Toby's treatment at home given the fact that the bacteria had still not been identified. There was the possibility of Listeria...though the onset of symptoms did not match....everyone seemed baffled. With Bea's help, we argued a good case to continue Toby's care at home. The Doc agreed as long as Bea gave the antibiotics intravenously until his catheter could no longer be used and then switch to intramuscular injections. We told him that we would keep in contact and he wrote our discharge papers.

The next few days were extremely rough. I was happy for a hot shower, but between the aftermath of labor, my tear, no sleep, and the stress of poking Toby 3x a day made healing very difficult. Promise was sensing the overall stress of the house, too. Tim was eager to get back to work, but with Promise struggling with the new addition, he spent a long time manning her while I focused on Toby. Toby began taking a bottle again of pumped breastmilk. We woke up by alarm every 2 hours to feed him as the jaundice had caused him severe lethargy that he wouldn't wake up even when hungry. My milk came in and between the early morning sunbathing and the new milk, Toby's jaundice started to subside. It was awful giving him injections in his thighs 3x per day, but he started to improve. Meanwhile, we were in close contact with Dr. Estuart regarding his care. Bea came over everyday either to bring food or arrange for food to come and to help give Toby his meds or check on me.

After a week, we met with the doc again....Toby was given an "out of danger" sign and we were told to monitor him closely for any residual side effects. 12 days after birth, I went to Bea because of severe pain in the pwerta...I was not healing...the stress and pressure had caused my tear to stay open and we opted to suture. A little late and painful, but needed.

So, though I am leaving a whole bunch of details can see how God truly walked with us the whole way.
Today, I said goodbye to the dearest friend. Bea left Davao this morning for good. She is returning home after two years of midwifery training and I have to tell you...she is the best midwife I have ever seen...the most caring and qualified of nurses I have ever met and the dearest friend I have ever made here in Davao. Her service and grace, compassion and mercy over me and my family has truly impacted me...for life. She has been incredible....a source of encouragement....a source of help....His hands and feet when I could not "feel" Him....the Spirit of God in flesh. My life will never be the same because of her. She enriched and challenged me more than anyone I have met in our travels. I will miss her.

Not only Bea, but the whole 2010 Newlife International School of Midwifery class left this morning...the dearest friends I have ever had. We went to the airport together today to say our tearful goodbyes. They left a HUGE hole here. Tim and I have been so impacted by them. Amazing group of women. I am so thankful for the two years I had with them. They were there when Promise was born and they stayed to see the birth of Toby. Wow. Two years and so much has happened. I am grateful.

Tuesday, my mom arrives and not a moment too soon...or too late. The emptiness I feel as a result of losing such friendships here, no doubt will be alleviated by the sweet friendship, conversation, and companionship of my mom. I can't wait to hug her....and cry. A lot.

Tim is getting back into a routine and Promise is adjusting. Toby is growing and is now breastfeeding well. He is awesome....and burps and farts like a boy. :)

I better quit now. I am tired....crying now, too, as I reminisce on the past two weeks. Whew.
God is ALWAYS good.
Be blessed and thanks for reading.

Thursday, July 15, 2010

Tobias Robert James Stewart....we are so thankful for YOU!

Greetings! I have to make this short and eventually I will share Toby's more detailed birth story. It's a long one and very very different than Promise's birth story.
For those of you who have been commenting on facebook and via e-mail, your encouragements have been priceless and we are so grateful for your prayers. :)
Now here's the quick version:

I finally went into labor Saturday night late and 15 hours later, at 4:42 pm, Sunday, July 11th, our son, Tobias Robert James Stewart was born in our empty bathtub weighing in a 9 lbs .4 oz., 51 cm long. :) (Told you it was a short version....but it REALLY is a LONG story)

He came out not breathing and could not be stimulated to breathe adequately despite resuscitation efforts at home. We were literally storming the gates of Heaven in tongues of prayer while trying to resuscitate him, but he just refused to cry or breathe. After 35 minutes of stimulation through PPV and oxygen, though his heart was beating strong, we transported to Brokenshire hospital here in Davao. Tim and my assistant midwife, Erin, took him while my primary midwife, Bea, and friend, An-An stayed to make sure I was stable. Three hours after birth, I headed to the hospital to feed Toby and find out his status. Promise was great the whole time and stayed with An-An while I went to the hospital. Toby was given oxygen and finally began to take breaths on his own. He was taken for blood work and a series of quite invasive testing.

After him not sleeping for 36 hours and screaming in pain, we found that he had a fairly serious infection and required immediate treatment. He then turned jaundice and within 2 days of birth, could no longer breastfeed. I immediately started pumping and fed him through a syringe and bottle. With the help of our midwife and nurse, Bea, the doctor allowed us to take him home to further his antibiotic treatment. (I have to tell you how amazing she is when I post the birth story). We came home Tuesday, hopeful that he would improve keeping a very watchful eye on him. Since tuesday, he has made remarkable progress...and he is beautiful.

Despite the extremely rough few days we've had, Toby is recovering well. He is not out of the woods, yet, but he has made drastic improvements in the last 12 hours. We are now giving him antibiotic IM injections 3x/day until the 19th as opposed to the IV catheter injections we were giving the last 4 days. I am not too thrilled with having to cause him such pain daily, but I know it will be a short season making the rest of his life a healthy one. :) Bea has been so encouraging and is teaching me how to care for him during this process of healing.

Tim, Promise and I are coping. I don't know how else to say it. She is struggling. She misses being an only child and having our complete attention...she is currently wearing Toby's bib, tried to put on his clothes, and stole his pacifier walking around the house with it in her mouth refusing to let it out of her sights. She bit me today, too. We have such grace for this, though, because Tim and I are both feeling the same way. :)

We sure love our Tobias Robert James and his sweet disposition constantly melts our hearts.
We are making daily visits to the morning sunlight to help with the jaundice.
My nerve pain in my hips has not subsided since birth, but I am sure God will cover that, too, in His time. We have been well cared for and looked after by the Mercy midwives and friends here. They have sent us prayers, meals and have looked after Promise while Tim and I were in the hospital with Toby. We are very blessed.

We will post more pics soon, most of them are already on facebook, so if you are curious, you can check them out there. But here is one taken just a few hours after birth. :)
Be blessed and thank you for your continued prayers.