Sunday, April 27, 2014

One Year Later

Well, we made it. One full year as parents and Ellie is no worse for the wear. Exactly 365 days ago at this time I had only glimpsed Ellie briefly and held her for a minute before the nurses whisked her away. I had NO IDEA what was in store for me. That first week was intense...and it only got worse before it got better. I had all these emotions running through me, not the least of which were thoughts that someone, somewhere made a huge mistake and I wasn't supposed to have this tiny flailing creature. I remember vividly one night, after a long and stressful day, I just broke down crying on my mom's shoulder. I kept repeating that something was wrong, that this wasn't the way it was supposed to be. I was convinced I was doing everything wrong. And then, one day, she smiled in her sleep. That was all it took, I fell in love. I can admit that I was not head over heels in love with my tiny intruder from the first moment I laid eyes on her. I felt it later, when I saw that first milk drunk lazy smile on her face. I knew I would give my life a thousand times over just to see that smile. That is how strong the love of a parent is. And the thing is, you think you are the first person to feel this way. Sure, other parents love their children, but no parent in the world can possibly love their child as much as you love yours. It's impossible. Plus there's the simple fact that a cuter, smarter, sweeter child DOES NOT EXIST. Period. You find yourself staring into her tiny face in wonder, marveling at the fact that your world now begins and ends with her. You tell anyone who will listen how your heart will simply burst if you loved her any more than you do right at this moment. You briefly wonder if your parents ever felt this way about you. You daydream about what she will be like, laugh when you see how stubborn she can be, cry when you imagine any heartache she will one day feel. There are days I wonder how different my life would be had our married life continued according to plan. Ellie would not be here, Giuliano and I would be using our free time to travel and we would not be so adept at changing a diaper in less than 15 seconds in the middle of the night, in the dark, without waking up the baby. I try and try to imagine what my life would be like, but I can't. And while I know my life would be ten times easier, I don't want to imagine that life. If ever I needed a reason to wake up in the morning or be a better me, I look no further than my daughter. The cliche is real. Children renew your faith, they show you what it truly is to love another human unconditionally. I am lucky to have her.

Sunday, July 21, 2013

You always remember your first. He was in his sixties and I was 22. As a nurse, dealing with death and dying is inevitable. It is an ever present possibility. Sometimes, it is a peaceful, uplifting experience that reminds you why you do what you do. A doting husband holding his deceased wife's hand, crying softly while telling you what a wonderful life they shared, and how happy he is that she is at peace. Children and grandchildren sharing stories, laughing, singing, and even praying by the sides of their loved ones. These are the good ones.

My first time losing a patient was slightly different. For some reason it has been on my mind today and I find that writing about it is cathartic in a way, so bear with me.

It was my first month off of orientation working in the ICU. In those early days I was terrified of making a mistake. You know on some level as a nursing student that you are responsible for keeping people alive. Mistakes on your part can lead to patient injury, and in some extreme circumstances, death. But when you actually have your own patient assignment, knowing you are solely responsible...well, it is a tad overwhelming as a new grad. That night I was working in the step down part of our unit. My patient was transferred from the critical care side to step down right as I came on shift. I even helped move his bed over; the distance from one unit to the other is only a couple of feet, with an open doorway in between. I received report, he was recovering from a brain tumor resection and had a pretty good prognosis. I met his son, who was very worried and anxious and had not been home the entire time his father was in the hospital. He was using a hotel room to shower and change, taking all of his meals at the hospital and sleeping in a recliner at his bedside. I reassured him over and over again in that first hour. His father was doing great! He was being downgraded to a less critical area, his speech was improving and his vitals were stable. I joked around with both the patient and the son. At some point in the night, I told the son to go home. Get some rest. Sleep in a real bed. He was very hesitant, and felt that if he left something would happen. I told him not to worry; I would personally guarantee his father's well being and if anything were to happen, I would call him right away. Reluctantly, he left. But not before giving his dad a kiss on the forehead and triple checking I had the right contact information.

You already know where this is going. His father did not survive that night. Without going into too many details, he went into respiratory failure and eventually cardiac arrest. In my heart I know the events that led to his death were out of my control. His death was unpreventable. But I sent his son away on the one night he wanted to be there. I wasn't even able to call him when he started to become unstable, it was that fast. We coded him for 40 minutes. If you work in healthcare, you know that's a long time to be doing CPR. When we finally called it and I was able to think straight, my heart broke as I realized the phone call that I needed to make. It was the single most difficult conversation I have ever had with a patient's family member. I felt responsible. I felt guilty. And his son was in no mood to assuage my guilt. He screamed. He cried. In the end, he didn't even come to see his father's body. His brother called me soon after we hung up (or rather, he hung up on me) and told me he would make the arrangements but to please not call his brother anymore.

I have had many patients die since that night 5 years ago. Some were expected, some were not. I can't even say that my first experience of patient death was the most unexpected; there have been worse cases. But it was the one that had the most impact on me as a nurse. It made me more humble and compassionate, I think. You never know what can happen, life is not a given. I have never again promised with certainty the health of a patient. I have never again pushed for family to leave the bedside to get rest. I love my job, I love the feeling of accomplishment and sense of purpose that comes with being a nurse. But it can also be very difficult.

There really is no point to this entry, except to put my thoughts into writing. I hope my career continues as it has, with the good experiences outweighing the bad. And I certainly hope that somewhere, a son can forgive the well meaning nurse who sent him home on the night his father died.

Wednesday, May 1, 2013

Birth Story: Ellie Rose

So I guess I should really do better keeping my blog updated, and what better way to get back into it than to share my experience of the birth of my first baby, Ellie.

It all started nine months ago...jk!! Seriously though, from the moment you find out you are expecting until that moment you are holding the baby in your arms, there is such a roller coaster of emotions. After the 20 week mark, I started really delving into any information I could get my hands on regarding birth, caring for newborns, breastfeeding, diapering, post partum care, etc. If it had something to do with pregnancy and/or babies, I was reading it. I thought I was prepared.

First off, I was going to have a regular, vaginal delivery with as little medical intervention possible. If I could focus and breathe through the pain, I wouldn't even need an epidural, but I was not against getting one. Then, after minimal pain (because I would labor at home for hours, coming in to the hospital only when the pain was unbearable or when contractions were less than 5 min apart) I would give birth to a beautiful baby girl, breastfeed with no issues (because I would be vigilant about getting the perfect latch) and go home after 48 hrs with my new little family. That was my imagined scenario.

What really happened:
Friday morning I had a 39 week appointment at my OB office, and was also following up on my blood pressure/protein levels from the previous appointment. My blood pressure was 145/96, not significant by itself, but pretty high for me and it had been steadily increasing since about week 34/35. My protein levels went from trace, to +3 in 4 days. As soon as the doctor walked in, I knew I was being sent to the hospital for induction. At first, I was excited to think that in a couple of hours, if everything went well, I would be finally DONE with pregnancy and holding my baby!! Then I realized that having an induction meant I had no control over my labor. I would be in the hospital from the beginning of the process to the end. On monitors, not being able to eat or walk around, pretty much just waiting for things to kick into gear. That's when I started to think that maybe this whole process was going to take a completely different turn.

We left the office in a little bit of a shock, went home to eat (only Giuliano, I was told no eating for me) and pack our hospital bag. Arrived at the hospital around 1 PM, went into triage and pretty much got rushed in to sit around and wait. The OB on call came to talk to me about my blood work and plan of action around 3 PM. He said, among other things, that I was having a baby and needed to choose induction or C-section. I said I would really like to try induction since it was still important for me to have some elements of my original birth plan. The OB didn't really like that, and kept telling me I was very unfavorable for a successful induction since my cervix was only 1 cm dilated, not very soft, about 60% effaced. Also, he said based on my last ultrasound, baby girl was weighing approximately 8lbs 13 oz. Another reason  should just choose a section from the get go and be done with it. Giuliano and I spoke about it, prayed together, and decided we should just go ahead with the induction. Why not try? I was admitted into labor and delivery, got started with an IV, and connected to all the monitors. Around 5 pm I was given cervidil to soften the cervix, which needed to be in place for 12 hours (2 hours of which I had to stay in bed for) and then in the morning they would do another cervical check before starting pitocin. I was also given one "last" meal before delivery. Lucky me!

I won't go into details, but it was a long night. Every time I moved wrong, the monitor would lose Ellie's heart beat and the nurse had to come back in to fix the positioning. Blood pressure checks at least every hour, and since I was getting a lot of IV fluids I had to pee a lot. Which meant calling the nurse to come in and remove all the monitors. In the morning, they removed the cervidil and checked me: no softer, still 1 cm dilated. Then the pitocin was started, and the nurse told me not to wait for the pain to become unbearable before requesting an epidural. (never happened, I didn't feel the contractions) We settled in again, eagerly awaiting the progress that would signal the much anticipated arrival of my tummy dweller. I would like to point out that during this time, I was not allowed out of the bed at all. So my dear husband had to be my personal nurse and bring me the bedpan every time I had to pee (which, being 9 months pregnant and getting lots of IV fluids, was very often) and empty it since I couldn't wait for the nurses. Such a trooper, he was amazing throughout the entire experience.

At 4 pm I was checked, and despite having contractions every 2-3 minutes, I had made no progress in 8 hrs. I was spent. Exhausted from being in the hospital with very little sleep for more than 24 hrs, mentally and emotionally tired from just the whole ordeal. I would've agreed to anything at that point and my doctor knew it. She recommended a C-section and I practically begged her to schedule it ASAP so I could just be done with the whole process. Looking back now I feel cheated out of a "regular" birthing experience, almost like my body didn't do what it was supposed to.

Off we went to the OR, Giuliano dressed in scrubs and me waddling down the hall knowing the next time I was up and about we would have a new baby in our lives. Pretty surreal. The actual OR experience was not the best, mostly because I am very sensitive to any kind of sedation and the spinal block made me VERY nauseous, resulting in me trying to dry heave for 10 min but unable to bring anything up since I was pretty much numb/paralyzed from the stomach down. Also an odd experience to be unable to take a deep breath or even cough adequately while having the spinal block.

Nothing prepares you for the moment you hear that first cry from your baby. Immediately Giuliano was being told to come and stand to the side, taking pictures and watching them as they cleaned her off and let him cut the cord.







After stitching me back up and sending me to recovery, Giuliano and I were able to go back to our room around 10 pm for some family bonding time. Ellie has been such a joy to take care of. Even her cries are cute to us (which I'm sure won't last, but for right now we are enamored with every little thing she does). I would never have been able to imagine the love you feel for your newborn or the way your love changes towards your husband watching him with your child. It is indescribable.

Recovery from the C-section hasn't been too bad, especially with so many people around willing to help. The biggest difficulties so far have been sleep deprivation (thank goodness for grandmas!!!) and breastfeeding. I have had a really rough time of it, and although I'm told everyone goes through some difficulties, it doesn't change the frustrations I feel. But, then again, if those are my only issues during her first few months of life, I will consider myself extremely lucky. I know for a fact that others have it harder, so I can't complain about my lot. 

Monday, January 14, 2013

For all those who have been bugging me!!

Here are the belly pics for my lovely friends...we are a little more than halfway there!! 

(Slightly terrifying)















Sunday, December 2, 2012

Elliot (still fighting on the middle name) Grahl

This post is dedicated to my tummy dweller, Ellie. So far this is a name we can both agree on, even though my dear husband is fighting me on the middle name. (Doesn't he know childhood promises to your BFF are meant to be kept??) It may change in the next 5 months ( I can already picture my mother trying to pronounce Elliot) but it feels awesome to refer to her by name and not just "it". It has been quite a roller coaster of emotions since finding out I was expecting, and I'm only halfway there! Seeing her move around on the ultrasound and finding out she's a "she" makes it that much more real...and terrifying. What kind of mother will I be? Will she be proud or embarrassed of her parents? Will she have Giuliano's eyes? My nose? Endless worries and concerns regarding her healthy development. Knowing that I will probably never stop worrying. And in spite of (or maybe because of) all this, I am beyond excited. Excited to see Giuliano hold his daughter for the first time. To see him squirm as he changes her first diaper. To watch her grow and find out what kind of little person she will be.

I have so many examples of good mothers surrounding me, starting with my own mother and grandmother, to my mother in-law, aunts & stepmother, to my amazing friends Karem, Ashley, Vivian, and of course Daleth who I am in awe of almost daily. And now Johanna, not even just a friend anymore, more like a sister. My heart aches knowing we are so far apart, but our friendship has survived 21 years and I know it will be around for the next 20 (I kind of owe it to her anyway for putting up with me during my middle school chongalicious phase). I feel blessed to have the support of all these women, not to mention the support and love I am already receiving from my non-parent friends! Ellie will be one loved child :) To her, I would like to promise a few things. She can even bring this up in the future and hold me accountable.

I promise to:
-Love you as if you were my own
-Hold you for ridiculous amounts of time, even after my mother tells me I'm spoiling you
-Never ever dress you in an ugly outfit (Remember, times change!!)
-Let you eat yourself sick on Halloween just once, as long as Daddy takes you trick or treating (I can't promise he won't eat all of your candy)
-Force you to read and learn to love it (You'll thank me later)
-Always take your side when you argue with grandma (This one is for selfish reasons...)
-Leave you with your grandpa so he can tell you all the jokes and stories that would entertain me for hours when I was little :)
-Let you drive your uncle Oscar crazy. This one is more of a request from me than a promise to you...
-Support you in everything, as long as it doesn't involve small animal sacrifices
-Never say "I told you so" (I will, however, smirk to myself and reinforce my belief that I know better)
-Kiss you where it hurts, but to also make you get right back up and face the challenge again
-Keep your dad busy when you get picked up for dates so he can't intimidate them
-Always have time for you


I'm sure there are more things I can promise you, but I don't want to paint myself into a corner! We will just stick to the basics for now. In all seriousness, though: Please feel free to bother your uncle Oscar as much as your little heart desires. Ask to spend entire days with him. Play the game of shadow (I'll teach it to you as long as you promise only to play it with him). He loves it.


As a bonus to my few readers who actually make it through my posts, here's Ellie being a drama queen with her hand on her face:       

             ( For those who can't see it, her tummy is on the left and head on the right where it says profile)





Thursday, September 6, 2012

All the best laid plans...

    Man plans and God laughs. Is that the saying? I'm pretty sure a huge laugh is currently had at my expense! So to catch up since my paternal grandmother's death in July: we found out my maternal grandmother has Stage 4 lung cancer that had already spread to her liver; it was a pretty tough moment for her and her remaining children. She decided to come visit Miami and ended up staying with a close family friend, Carlos (my stepfather growing up) in Cape Coral. The decision to live with him caused some strife as my aunts naturally wanted her to spend her last days closer to them in Puerto Rico.
     Two and a half weeks ago we get the phone call: she fell. She's been rushed to the hospital and is in the ICU. The nurses are telling Carlos they might need to intubate her since she was in respiratory distress. Imagine the difficulty of the situation. Last minute plan are made by my mother in order to take time off from work, to drive the two hours and be at her side, but she also has to alert my aunts/arrange flights from PR/wait for them to arrive so everyone can make the journey west together. It was a long day and a half. We get to the hospital Tuesday night, she looks terrible. Barely recognizable from the facial swelling and very confused/agitated. Not an easy moment for my mom and her sisters. Unfortunately, on top of everything else her kidneys were failing; things were not looking good. The staff was amazing, and the intensive care physician did an amazing job of calmly explaining to my family that there really was not much else to be done; even if she pulled through this, the lung cancer would take her before year's end. My mom and aunts made the extremely difficult decision to focus care on comfort and place her under hospice; she passed away that Friday surrounded by her three remaining children, and I'm sure my deceased aunt and uncle were present as well. Again, plans had to be made for cremation, one way flights home for my aunts, and round-trip flights for myself, my mom and brother. We held the memorial this past Saturday, September 1st and it was a beautiful day on the island :) I'm glad was family was able to gain some closure.
    My brother and I, although saddened, did not really feel deep grief given that we unfortunately were not close to our maternal grandmother. All the same, I am happy she is at peace and no longer in pain; I am especially happy she is reunited with two of her children and her 1st husband


    Cut to the unexpected surprise: I found out I am 5 weeks pregnant the Wednesday before going to PR. Shocked is a major understatement; I think I cried for two days straight. Telling Giuliano was the single most exciting/nerve wracking/hardest thing I've ever done in our marriage. I was irrationally scared of his reaction knowing we had both decided to wait until he finished school before starting a family. He guessed before I could even tell him! *shakes fist* He cried with me and then reassured my troubled heart that all was well. He has been my rock; being more positive than me (which, if you know us, is not the norm!!) and constantly telling me everything would be all right. He even went as far as asking for twins...one at a time, please!!

    My emotions have been all over the place, truth be told. First (and I'm going to be completely honest here, no judgement allowed!) I was disappointed. Disappointed because I didn't plan for it, and didn't want to be that girl. Well, guess what, I am that girl and I've learned that there is a lot of stigma behind surprise pregnancies. Sometimes they DO happen even if you are being careful! I'm by no means irresponsible, and now understand the tough situations women can be in, even though I always thought as a woman I inherently understood. It goes beyond pro-life and pro choice; it is an understanding of what it really means to know you created life and will be bringing it into the world. Or your decision not to. Talk about mind-boggling. I am, more than ever, happy women still have a choice in this country. I personally do not think I could ever seriously consider it, but you can never dictate the path your life will take nor would I force this life changing experience on anyone who did not want it!

   As the days have passed, my emotions cheered up. Telling my parents, my in-laws, my brother, close friends and seeing the happiness on their faces gave me the first glimpse of excitement. Then I began to find myself pondering on what the gender is, what they would be like, how amazing it would be to experience motherhood, and my excitement quadrupled. I affectionately started calling it my little poppy seed :) I have a small worry in the back of my head about making it to 12 weeks unscathed, especially since getting a phone call from the OBGYN wanting to move up my first ultrasound from October to next week due to low progesterone levels. Now the thought of losing my poppy seed is heart wrenching, and I will sending positive vibes to the womb!! I am hoping to keep a diligent record of my thoughts and feelings over the next 9 months so my child can one day read this and know how much they are loved, even right now as a tiny embryo.

                                

Thursday, July 5, 2012

Late 20's

Well I can see how well I've done keeping up with my goal of at least one blog post per month....

I'm learning about the stages of life. In my late teens everyone was discovering first love, applying to college, and for some of my friends, experiencing out of state college experiences. The most important things seemed to revolve around school or close friends/significant others. You're invincible at 18.

In my early/mid twenties, everyone was experiencing the "real world." College graduation meant either continuing with grad school or finding a job with this degree you've worked so hard (hopefully) to earn. Some of us were lucky enough to start our careers right away, others went back to find another, more meaningful degree/career. Still others continued on their long journeys toward law and medical degrees. At this stage, many of my friends and old schoolmates were getting married. Some married earlier, and some are still not there, but the majority happened from ages 21-24. I was a little late with my own 25 year old wedding, haha.

Now, I'm learning about the "late" twenties. My friends are having babies. Buying houses. Finishing doctoral degrees. Learning more about what it takes to make it as an adult. My least favorite part about the late twenties is the start of the inevitable; grandparent/parent death. (I do apologize for the morbid turn, but my writing is cathartic) My paternal grandmother died yesterday. It was not unexpected, but that does not take away from the sorrow in the least. Cucu, as we called her, was diagnosed with breast cancer in 2005, and battled for 7 long years before deciding early this year she did not want any more chemo or radiation. The cancer had spread to her bones, and there really was nothing more to be done. I supported her decision fully, and just wanted her to be comfortable. The eye-opening moment was her not being able to come to my wedding; we both shed some tears over that but with the help of technology, we were able to broadcast the ceremony and reception to her sick bed. I will always be grateful she got to see me walk down in the aisle, albeit virtually.

There is something to be said about the way a family comes together at a time like this. I love my family all the more in the dignified way her decisions were handled. She died knowing she was loved immensely, and was even able to welcome the newest member in the family, James. She told me once in confidence that her only regret would be not meeting any of her great-grandchildren, but at least she was able to meet her last grandchild who was born just 3 weeks ago.

I cannot adequately express the feeling of losing a grandmother. There is a special bond between grandmas and grandchildren, and I was lucky to have her. I think back to the days when I used to take her to chemo appointments, and cannot quite fathom a world where her stubborn opinion isn't making its way out of her mouth. She was honest to a fault and gave the best advice (as grandmothers are wont to do). Case in point: after a particularly rough break up from my boyfriend of 2 years, I was crying on the phone to her, expecting some sympathy. She promptly told me to stop crying, and that she was glad he finally grew balls and walked away. I was 20 and pretty selfish, so she kind of had a point. I will always remember her being unapologetic about her opinions, no matter how unpopular, and she was usually right (frustratingly so).

So here's my homage to my abuela cucu. I love you dearly and will miss your comforting shoulder always. I will also regret my children not being able to meet you, but there will be so many stories to tell they will feel as though they  know you. I know wherever you are, there is no pain, and that is what comforts me the most.
love, your favorite granddaughter :)