April 19th

April 19, 2013

———— It Begins —————-

On a Thursday afternoon my 38 week pregnant wife told me that she’d be spending the night in the hospital with me. My mother reluctantly agreed to leave the hospital for the night so I could spend time with my wife.[1] After walking into the room and eating yet another Sparrow provided meal, she turned to me and said, “Babe, I think I’m starting to have contractions.” She began to time them- 8 minutes apart. With us both working quite a bit in Obstetrics, we knew we had time. The advice I typically give to patients is to wait until the contractions are somewhere between 3-5 minutes apart and regular. She called her Obstetrician though to warn him of her impending delivery. She then turned to me, “Should I call your mom yet?” She knew once she called my mother she would leave immediately and come to the hospital. She was right. When we told my mother of Fleur’s contractions, despite their being so far apart, and despite my mother’s experience as a past Ob-Gyn physician, her first response was, “I’ll be right there!” From our house on a good day (no traffic, all green lights) it takes somewhere between 15-20 minutes to get to the hospital. After getting off the phone with Fleur, my mother somehow got to the hospital and into the room in 10 minutes. To this day I don’t know how she did it. I’m still waiting for a police officer to show up at my door with a speeding ticket in hand for travelling at 300 miles per hour. The first words out of her mouth as she burst in to the room was, “You should go to the Labor and Delivery Unit.”

Thinking of my mom's drive to the hospital makes me think of this.
Thinking of my mom’s drive to the hospital makes me think of this.

“The contractions are still too far apart, I’ll go in a couple of hours.”(It was about 8pm then) my wife replied.

Even though my mother is strong willed and opinionated, when it came to my wife she’d often bite her tongue. I think she knows it upsets me if they argue. I knew that this was one of those times that she had to hold back. I could see it in her face, she was thinking “No! You should go now!” Instead what came out was, “Okay, sounds good.”

————- We Go ————

Finally at around 930pm the contractions were close enough to warrant a trip to the Labor and Delivery Unit (L and D)[2]. I’m not sure what it is about that unit but once she was roomed, her contractions suddenly increased in intensity. This was to be our second child. Our first one, now 7, was born in Omaha, Nebraska naturally. She was able to give birth without the aid of pain or labor augmenting medication. That was the plan for this one, but as I had learned, plans change. The pain was too great and her cervix was not progressing so she decided to receive epidural analgesia.[3]

At that point in my hospitalization I was still dependent on a wheelchair for my mobility. When Fleur first went to L and D, my mother accompanied her there, leaving me in the bed. “I’m going with her,” she told our nurse, “please watch him until I get back.” When the nurse came into the room to check my vital signs, she found me sitting up in bed looking as if I was getting ready to leave. “Chris, where do you think you’re going?” She asked me. She was right, I wanted to regain the ability to walk so I could go to see how my wife was doing. I knew, however, that a fall could set back my recovery for months, or even kill me. The nurse checked my vital signs, and it was not a surprise: my heart rate and blood pressure were high.[4] Finally my mother walked in. “She’s doing okay. Have they given you your therapy schedule for tomorrow? They put her into room 5.” We then went down to see her.

When I wheeled into the room, Fleur was in the middle of a strong contraction. When a patient calls me to tell me they’re in labor, I always ask the same questions as the ultimate decision point for me is whether or not she should come to the hospital yet. “Have you lost any fluid? (a ‘yes‘ warrants an automatic trip to L and D) Is baby still moving okay? (a ‘no’ response means they should be immediately evaluated in L and D). How far apart are the contractions?” Finally if the patient answers all those questions with a non-alarming response and if she tells me that she is experiencing a contraction as we speak, I know we have time. Labor can be a multi-day event, and being able to speak during a contraction is a tell-tale sign that the patient is in early labor. When I entered my wife’s room in the middle of a contraction she could not speak. In fact, she couldn’t even acknowledge that I was in the room.

When she finally saw me she managed a forced smile, said hello, then said, “They’re too strong. I think I need an epidural.” I could see the pain permeating her whole body. Some people equate child birth to passing a kidney stone for a male. I’ve never suffered from a kidney stone but I bet it pales in comparison to childbirth. I’m guessing there’s no male equivalent to the birth of a child (sorry to anyone who’s had to pass a stone). The kidney stone analogy was probably thought up by a male who got tired of being told how painful child birth can be. Anyhow, I immediately said, “Sure thing, you do whatever you want hon.” I was still in disbelief that she didn’t have any medication with our first. I didn’t care about having a natural delivery. I just wanted my wife to be as pain-free as possible, and our child safe. Since her labor was not progressing and the pain was unbearable, she finally decided to get the epidural, which was placed with little difficulty. “Ok, we should go rest,” my mother chimed in, “it’s 1230. You need to be rested for your therapy tomorrow.” Leave it to my mother to always think of me, no matter what the situation. I resisted and she persisted. My resistance only bought me 30 minutes of time with my laboring wife. At that time my wife turned to me and said, “Chris, this medication’s kicking in, I’m going to fall asleep. You should go to your room with your mom so you can rest.” I reluctantly agreed. By the time I was laying down in the bed it was probably 130. The next thing I remember was being awoken at 3 by my mother “She’s ready to push. Let’s go!” I had never gotten up from my bed so quickly. When I arrived in her room, she was indeed pushing.[5] Her OB was in the room, along with the nurse yelling words of encouragement, “You’re doing great! Just like that! You’re almost there!” I had met our OB through my work in the hospital and loved the way he thought of and dealt with patients (it’s for this reason that we decided to go with him). When he saw my condition in his clinic he told us of his son: sadly at age 30 his son was at work when he suffered a seizure. It was discovered that a brain tumor was the cause of his seizure. He was not as fortunate as I in that the tumor was malignant and even though he underwent surgery to remove it, he passed away 1 month later. This saddened me, just hearing this story and the hardship this man endured made me think of how it would have affected me as a father. I then thought of the similarity of his son’s situation to mine, with us being the same age and both diagnosed with brain masses. Luckily for me the tumor was found to be benign, and my life span was not shortened. I was also fortunate in that I did not suffer seizures prior to or after the surgery. Regardless, hearing the story of his son brought me through a wide range of emotions.

————— Birth and After —————

Finally at 349 AM on April 19 2013 my second son was born at a whopping 9lb 2.6 oz. Unfortunately because of my double vision and stiff neck I was unable to witness the miracle. My head had to stay locked on the floor, as this was the position of least discomfort for me. I could occasionally try to lift either my head or my eyes but this caused me too much pain, and also seemed to make my double vision worse, which in turn made me nauseous. Thus, my mother who was also present for the birth, was able to witness the delivery and also cut the umbilical cord. My wife was understandably exhausted and our newborn son was crying which, at the time, was music to my ears. My wife suffered from a vaginal tear (not too uncommon during child-birth) which required suture repair; she seemed to not even notice the physician at work after they put our son in her arms.

Cormac Robert Chiou
Cormac Robert Chiou

I was wheeled back to my room after the birth, separate from my wife and newborn son. My daily routine went from awaken -> breakfast -> therapy ->nurse and/or doctor -> nap -> lunch -> therapy ->smoothie -> therapy with my mother ->sleep, to now awaken -> breakfast -> therapy ->nurse and/or doctor -> see my wife and son -> lunch -> therapy ->see my wife and son -> smoothie -> therapy with my mother ->see my wife and son -> sleep. I normally give 100% effort to my therapy. Giving 100% also requires 100% attention. In the days following my son’s birth I know that I was unable to give my full attention to my therapy. I often wonder if the therapists noticed a change in my performance.

Our family
Our family

The topic of a name had come up but was not discussed at length between us. Unlike for our first, for whom we didn’t find out the sex until birth, we figured knowing the sex of the baby beforehand would aid us in our preparation. Thus we knew we were having a boy but had not thought of a name. My wife, who had been transferred to the Mother-Baby Unit (a Unit designated for recovering mothers), turned to me one day and asked, “How do you like the name Cormac?” I liked it. Cormac is the name of the neurosurgeon who operated on me; I liked the sound of it: Cormac Robert Chiou.[6] As you can imagine there are not too many names that go well with ‘Chiou’.[7] Our oldest son, Christian, now had a new brother, and insisted that his first name start with a ‘c’ to be like him, thus he loved the name. When we tell people his name, we often have to explain its significance to us. It is not exactly a traditional Taiwanese name, in fact it is a traditional Irish name meaning ‘charioteer’.[8] I often tell people that the name is subject to change depending on how my recovery goes. His name remains Cormac today.

 
[1] My wife was there much of the time for my therapy, however my room was not big enough to room me and two other people for the night.
[2] For Labor and Delivery.
[3] This is a form of delivery of pain medication during labor. A catheter is placed in the spinal canal (via a needle) which delivers strong pain killing medication, typically something like Fentanyl.
[4] Stress and anxiety can elevate your heart rate and blood pressure. In fact, I was taught in medical school that a way to determine if someone was ‘faking’ pain was to look at their heart rate. A normal heart rate in someone complaining of excruciating pain should raise eye brows.
[5] Labor is classically divided in to stages: 1. Dilation -> 2. fetal expulsion -> 3. Delivery of the placenta
[6] We had already come up with a middle name, after her father Robert Broughton.
[7] Pronounced like ‘Chew’ it was suggested to us (obviously by someone who had not thought it through) that we name our first-born Hugh, making him Hugh Chiou.
[8] It also means ‘son of defilement’ apparently, but I’ll stick with ‘charioteer’.

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