Wednesday, October 30, 2013

Deep Breaths

Last night, for the first time in our nearly five years of parenting (four years of parenting live children), Ed and I almost called 911 to summon an ambulance for Jackson in the middle of the night. He is much better this morning, and the pediatrician gave us instructions for what to do in case he has a similar episode again, but for a few minutes at about 4:30 this morning, I was absolutely terrified.

Jackson had RSV at 8 months of age, due to my much-regretted decision to put him in day care at St. Ann’s even when I didn’t really need full-day care of any kind. As a result, when he gets respiratory illnesses, they tend to be more severe than they might be for other kids. We’ve had a nebulizer with albuterol refills in our home for about eighteen months now just in case he has an episode of reactive airway disease symptoms. We’ve probably used it five times during those eighteen months, but when we’ve needed it, we’ve been really glad to have it.

Last night, Ada woke up at about 2:15 and couldn’t settle herself back to sleep. I was so frustrated, because she’s been sleeping through the night (from about 8PM until about 7AM) almost every night for the last several weeks. I have been worried that we’ve been relying on the pacifier too much during the daytime, making it harder for her to settle herself down when she wakes up in the night, which, until recently, she’d been doing very well. So I brought her bed to nurse and then put her back into her bed about 15 minutes later after she’d fallen asleep nursing. About thirty minutes later, before I’d even really been able to fall asleep again, she started fussing again. I waited a few minutes, hoping she’d settle back down on her own, but finally she started to cry, and I went in to her room to try to calm her back to sleep. I didn’t want to give her the pacifier (even though I was sure it would work instantly) because I wanted her to be able to go back to sleep on her own, so I just sat by her bed and soothed her with shushing and patting. It seemed to be working for a bit, and she started to settle into “the zone,” but then she cranked back up again. I was trying really hard not nurse her again—I knew she wasn’t hungry and didn’t want her to rely on nursing to get back to sleep either—so I picked her up, walked around the room with her a bit, bounced her some, changed her diaper. Nothing helped. Her crying kept escalating.

Meantime, we started to hear Jackson crying over the monitor. I assumed that somehow Ada had woken him up (although he usually sleeps like a log) and that he was having trouble going back to sleep, too. Then we started hearing him cough and cry and cough and cry. At first, Ed thought he was just mimicking Ada, but when it didn’t change, Ed finally went down to him.

I finally gave up and brought Ada back into our bed to nurse her back to sleep. Once she got quiet, all I could hear downstairs was what sounded like very hoarse wheezing interspersed with panicked cries. My heart seized and started beating very fast. I yelled to Ed from the bed, “Is he OK?” I didn’t get a reply, so I yelled again, louder, “Ed, is he OK? Can he breathe?” Ed said he wasn’t sure what was going on but that he was going to try giving him a breathing treatment. All the while, I kept hearing that terrible sound. Poor Ada was still latched on and trying to nurse through all of this, but I popped her off, stuck the pacifier in her mouth, and ran downstairs.

When I got down there, it was clear that Jackson was having trouble breathing, but it wasn’t clear why. We couldn’t tell if he was just really stuffy (he’d had just some very minor cold symptoms the last few days, and just a little runny nose, sneezing, and mild coughing yesterday) or if his airway was actually constricted, either from mucus in his throat or inflammation in his lungs. He was able to gasp a few words, but again, we couldn’t tell if he was panicking from being unable to breathe or if he was just crying really hard and couldn’t catch his breath. Intermittently, he would try to cough, making a very high-pitched, hoarse, barking sound, which I knew was characteristic of croup. Ed was already getting the nebulizer set up, and I took Jackson, but as soon as we sat down to try to give him the treatment, he freaked out and started crying even harder, refusing to let the mask anywhere near his face. I knew that if he kept at the hard crying, the breathing problem was just going to get worse, so I pulled him close to me and started rubbing his back and talking in a soothing voice, telling him to try to slow down and take deeper breaths. By this point, Ada had started crying again upstairs, but there was just nothing I could do about it. I knew she would survive a hard crying jag. I had no idea what was going to happen with Jackson, so I knew where I had to stay. I heard Jackson say that he wanted some medicine, so I poured him some Ibuprofen and he was able to swallow it, but he still seemed to have trouble breathing, and each breath sounded like a gasp. We had no idea if he was getting enough air or what was going on. Ed said he thought we needed to take him to the hospital, and I said, “Well, do we need to just call 911?” He said, “One or the other.” Again, we just didn’t know what was happening, and I was terrified that if we took the time to get dressed, get everyone in the car, and go to the emergency room, he might deteriorate quickly.

Adrenaline was racing through every nerve ending in my body. Ada was still screaming upstairs. I could barely think about what to do. As I was imagining calling 911, for some reason I was picturing in my head picking up a corded landline phone like we used to have in our house when I was a kid and pressing actual buttons on it. I wasn’t even thinking that my phone, with a touch screen, was back upstairs plugged in by the bedside.

And then I stopped myself. I took my own deep breath. I took Jackson, who was still visibly panicked and frightened, back into the bright light of his bathroom. I looked at his face and his lips and could see that he was not turning grey or blue anywhere, even around the edges of his lips. They looked pink and vibrant. I decided that if we could just get him to settle down and take the albuterol, his breathing would improve. We sat down on the bed again and tried to get him to take the nebulizer. He again freaked out, this time launching into a coughing fit that brought up so much mucus that he choked on it, and we had another near-emergency on our hands. Fortunately, his cough brought it up into his mouth where I was able to fish some of it out with my fingers. But the breathing still seemed labored. We decided we’d just have to hold him down for the neb. Ed held him tight on his shoulder, and I just held the mask in front of his face for a bit, hoping he’d breathe in some of the medicine. I remembered Hudson’s pediatrician telling us once that it can actually work even better if the kid is screaming because it helps to inhale the steroid deep into the lungs. So I just held it there and hoped.

Within a minute, Jackson realized that the mask wasn’t going to hurt him. He let me put it over his nose and mouth and started breathing more slowly. Within another minute or two, he turned around and faced forward on Ed’s lap and held the mask to his own face. This is when I finally knew he’d turned the corner and was going to be OK. He eventually started talking about the nebulizer (he had a classmate at his old school who took breathing treatments regularly, to the point that Jackson would beg us to give him one at home—he actually loved taking them, oddly enough) and other things in the room, and then I really knew he would be OK. Somewhere in here, I’d heard Ada finally stop crying, which freaked me out, too, so I ran upstairs to check on her. The poor thing had just crashed out from all the crying—I, who have never once let a child cry it out for any reason, had just let my poor, tiny, precious 11-week old baby cry herself to sleep. I could tell she was still snuffling in her sleep. It was awful, but as soon as I knew she was OK, I went back downstairs.

Once Jackson finished the treatment, we all went back into the kitchen to get him a drink, and then we went back to his bedroom. Ed asked if he wanted to snuggle in the big-boy bed with Daddy, and he said yes, and then he said, “Mommy snuggle in the big-boy bed with Jackson and Daddy,” and I said of course I would. So the three of us got into the bed and turned out the light. Ed planned to sleep with Jackson the rest of the night, just so that he would be right there if Jackson had another episode. Once the light was out, Jackson started chatting away, petting Ed’s face saying, “Daddy’s scratchy cheek,” and then mine, saying, “Mommy’s soft cheek,” and so on.

As we laid there, all I could think about was laying in bed with Hudson just like this, one night back in May 2010, when she’d woken up again with fever—we’d given her some medication and kept her in the bed with us to make sure that her temp went back down. After 20 or 30 minutes, she sat back up in the bed between us, chatting and playing with the bed rails. I said, “I think it’s time to put you back in bed, missy.” How could I have any idea it would be the last time I would ever put her in bed again? An hour later, she would wake up crying again, her fever having spiked despite the medicine we had recently given her.  Four hours later, we had her at the pediatrician’s office as soon as it opened. Fourteen hours later, she was having a lumbar puncture in the emergency room that would reveal a very aggressive bacterial meningitis infection. Twelve hours after that, she was in a medically induced coma from which she would never wake. I sat there wishing so much that she was there in bed with us, all arms and legs, cuddling and laughing with her little brother.

As I laid there with Jackson, I remembered that night, Hudson chatting in the bed between us just like Jackson was now doing.  I imagined whatever bug causing this coughing fit marching its way across the blood-brain barrier into his cerebrospinal fluid and causing meningitis in him, too, even as I knew how ridiculous that was.  All I wanted to do was bury my face into his little neck and breathe him in.  I held his hand and slowly let the adrenaline seep back out of my bloodstream. He asked for some water, and I got out of bed to get him his water bottle. On my way to the kitchen, Ada started crying again, so reluctantly I gave Jackson his water, gave him a trifecta (a kiss, a snuzzle—which is a nose rub, and a hug), and left him in the bed with Ed.

I went back upstairs to Ada in the bed. She nursed to sleep again, and I contemplated taking her back to her own bed, but I decided to just lay there with her for a while, too. As frustrated as I was with her night-waking (not that night-waking is not totally normal for a 11-week-old—I had just gotten used to her NOT night-waking), I remembered how much I wished I could have just these kinds of moments with Hudson back. I would be able to sleep later. I settled in next to her and listened to her breathe. I could hear Jackson over the monitor still chatting away to Ed. At about 5:30, Ed finally put Jackson back in his crib and came upstairs. I was still awake, Ada snoozing away in the crook of my arm. I was so tired by this point and knew I needed to get at least a few hours of solid sleep, so I took her back to her room and laid her down in her own bed.

Finally, both kids were quietly sleeping again, just as they’d been before they’d roused us two-and-a-half hours before. I crawled back into bed and spooned with Ed, pulling his arm over me and holding his hand tight against my chest, marveling at how fucking resilient we are. Not long after that, sleep overtook me.

We all slept late. Jackson woke up feeling much better, but we kept him home from school to rest and to monitor him in case he had another episode.

I have no idea how I managed to re-gather my wits in the midst of that terrifying scene in the wee hours of the morning. But just as I was holding Jackson, rubbing his back and shushing him and encouraging him to take deep breaths, I imagine now that Hudson was doing the same thing for me.

Friday, October 25, 2013

Cancer-Free!

I will write more later, but I just wanted to let anyone reading know that my PET scan today was clean. My gut was right.  Thanks for the words of support.

Thursday, October 24, 2013

Follow-Up

Tomorrow I have my first PET scan in over a year, the first one since the scan I had about a month after completing my treatment. Normally, I’d have had another one six months ago, but when I unexpectedly (and wonderfully) turned up pregnant with Ada, we had to skip the intervening one.

Am I nervous? I’d be lying if I said I were. That’s right. I’d be lying if I said I were.

“Really? Not even a little bit?” you may ask.

No, not even a little bit.

Quite frankly, it hadn’t even occurred to me that I should be nervous until Ed surprised me by telling me that he wanted to go to my appointment with me. I hadn’t told him about it, and then when I mentioned it, he asked me to send him the date. I thought he meant so that he could take care of the kids while I was gone, but I told him that my dad had that covered already. Then he said that he wanted to come.

“You want to come? It hadn’t even occurred to me that you’d want to come.”

Hadn’t even occurred to me.

In my head, I’m thinking, “Why does he want to come? He didn’t come to the last one. He didn’t come to any of the clinic appointments over the course of the year when they checked my bloodwork and felt my lymph nodes. Why would he want to—”

Oh.

Oh. I get it.

He’s worried. Maybe not a lot. But at least a little. Worried enough that he wants to be there just in case the news is not good.

Never even occurred to me. I figured I’d go, get the scan, the doc would say I’m still clean, and then I’d go home and pump and dump the radioactive mess they injected into me.

And in all likelihood that is what will happen, Ed said to me tonight.

And I said, “Yeah. But that’s what I thought when my mom had her CT scan.”

And it’s true. I remember the day, the moment, like it was yesterday. My mom had been having digestive problems for many months before someone finally suggested she get a CT scan. They’d been planning to remove her gall bladder because they couldn’t figure out what else could be wrong. But the surgeon said they should take a look before just taking her gall bladder out. So she went for a CT scan. Sometime in the late afternoon of that day—it was April 16, 2002—I remembered that she was supposed to have the scan earlier that morning. So I just called her up from my office (which I shared with three other people), chipper as can be, to confirm what I already knew—that her gall bladder was bad and needed to come out. What else could it be? They’d ruled out everything else.

I asked her how the scan went. She asked me if I was still at the office. My heart began to race. I said yes, and she suggested that we talk when I got home. My mom never postponed a conversation with me. Ever. I was already on the verge of tears when I blurted, “Just tell me!”

“I have cancer, honey.”

Just like that. I can still hear those four words over the phone, over the many miles. “I have cancer, honey.” I lost my shit completely. The only girl in the office with me quietly got up and left.

I don’t remember the details of the rest of the conversation except that she told me she had pancreatic cancer. I didn’t know much about cancer (who the fuck pays any attention to this before it hits your family?), but I knew that was bad. What I learned over the course of the next 24 hours was even worse—the median survival time from diagnosis was 8 months. My mother died on December 19, almost eight months to the day from her diagnosis date.

I have never written much about the days in between April 16 and December 19 of 2002. Much of it was so horrible that I can still barely believe any of us endured it. These words I am writing now comprise the first effort I’ve made to write about the beginning of that journey. I will probably write more some day. But I’ve mostly wanted to forget about it. The end result was my mom dying, so why remember?

So should I be worried about tomorrow’s PET scan? Experience tells me I should (go in with low expectations and be pleasantly surprised… don’t get blindsided… don’t be a fucking idiot AGAIN). Statistics tell me I shouldn’t (fuck statistics—where were they when Hudson died?). My gut tells me I shouldn’t. I’m going with my gut. (And God, I hope my gut is right).

I never wrote much here about my cancer journey, either. When it began, I had this idea that I’d document it all, the wretched moments and the enlightening ones. And while I did write bits and pieces, I never got into the nitty-gritty of what it was like to be a cancer patient. I will probably write more some day. But I’ve mostly wanted to forget about it. The end result was that I got cured, so why remember?

Really. This is where I have been with cancer for the last year. The first ten days after the needle biopsy on March 29, 2012, were terrifying, because all I knew was that I had cancer, but I had no idea how bad it was. I had a terrible tightness in my chest that I was convinced meant that the cancer had already moved there, but as it turned out, it was just the stress of the diagnosis. We’d caught the cancer early, and I was headed for four months of very straightforward chemotherapy, after which I’d be, in all likelihood, cured.

And so it was. Four months of chemo (yes, they sucked, but in the grand scheme of chemo and cancer treatment, were really not that bad) and I was, as far as we know, cured. I started a new job. My hair began to grow back (and is now this crazy mess of ringlet curls that never existed before). I got pregnant with our third child. We moved into our lovely new house after seven long months of renovations. I gave birth to our third child. My illness seems like something that almost didn’t even really happen, like it was something I dreamed about one time. Sometimes I do a double-take when I remember it really did happen (like when strands of my hair fall into my hand and I am amazed at how long they are).

And here we are. On the eve of my first scan in a year. And am I worried? Who has time to be worried? I am chasing a very active two-year-old boy around, nursing a two-month-old every few hours, remembering my oldest child every time I look into the faces of her younger siblings, and trying to keep my sanity through it all.

I am not my mother. Despite my experience to the contrary, statistics really are on my side. I hit the cancer jackpot.

I am not worried. Really.

Famous last words, right?

Sunday, October 20, 2013

I Love...

Jackson:

I love to watch your imagination at work. Like the other day, when you discovered some new magnets that came with our dry erase board, you put them together and pretended first that they were a shark's mouth, and you fed the other magnets to it. Then you pretended they were different kinds of soda-brown, blue, and white. Then you pretended they were nail clippers and you clicked them together as you "cut" my nails.

I love you how like to play with vowels. Just like the song "I Like To Eat Apples And Bananas," you like to try out how words and songs sound with all the different vowels in them.

I love how you phrase all your statements as questions. Instead of saying, "I want some milk" or "I wanna go outside" or any other assertion, you ask, "Want some milk?" or "Wanna go outside?"

I love, love, love to listen to you laugh. It's my favorite sound in the world right now. And I love happening upon the silly things that make you produce that beautiful sound.

Ada:

I love the precious squawk you make before you start to crank up for real. It's kind of like, "Hello? I'm still here!"

I love watching you beginning to notice things and stare at them, fascinated.

Wednesday, October 16, 2013

Everybody All Together

Tonight, after a long tough afternoon with both kids (maybe it’s my imagination or a product of having two at once for the first time, but this Ada kid is giving me a run for my money) and a total meltdown by Jackson, who missed his nap this afternoon but was trying to avoid going to bed like it was his job, I finally got Jackson up on the changing table to put on his diaper and jammies and get ready for bed. He had gone from screaming, crying, and tears running down his face to laughing and chatting in about ten seconds.

He started gleefully shouting the names of everyone in the family. “Daddy!” “Mommy!” “Jackson!” “Baby Ada!” “Bess!”

How could I not notice? How could I not?

No “Hudson!”

We talk about her. Often. Her pictures are everywhere, and Jackson can point to them and say, “Hudson!” If I ask him who Hudson is, sometimes he’ll say, “Sister!” or “Big sister!” Whenever the Iz version of “Somewhere Over the Rainbow” comes up on Pandora, he’ll say, “Hudson’s song!”

But no “Hudson!” when rattling off the names of everyone in the family. Not that I blame him. “Sister” is still a pretty abstract concept, even with a baby sister now in the house, nursing half the time and crying the other half. “Family” is an abstract concept, too, even for my extremely verbal son, who surprises me every day with the words and concepts he understands.

The book he chose tonight was “A Baby Sister for Frances.” If you don’t remember the Frances books, they are about a little badger named Frances and her family. This one in particular is about Frances trying to get used to her own baby sister. I ordered it for Jackson back before Ada was born. Life gets pretty crappy after Gloria is born (no blue dress ironed for school, bananas instead of raisins in her oatmeal), so Frances runs away to the dining room one night. Her mom and dad talk about her while she’s run away to the other room, about how even though it’s really nice to have the baby, they are just not a family without the big sister. “A family is everybody all together.”

“A family is everybody all together.”

The first time I read those lines to him a few months ago, it was like I’d been hit by a bag of bricks. Everybody all together. Everybody. All together.

We are not. All together. The big sister is gone. Not run away to the dining room table to snack on sandwich cookies. Gone. Altogether.

And yet she is here, isn’t she?

Today I caught myself staring at her Easter egg photo, which serves as the wallpaper on my phone (Jackson looks at it and says, “Hudson!”). She’s always there, behind all the icons. Sometimes I stop and pay attention to her. Many times I don’t. She is just there.

I use some combination of letters in her name and numbers as my password for a variety of things now. Sometimes I stop and think about her when I type them in. Sometimes I don’t. But she is there.

Ada is working her way through Hudson’s hand-me-downs. Sometimes (often) I stop and conjure an image of Hudson in the same pair of jammies or the same outfit. Sometimes I don’t. But she is there, too.

As I wrote in Ada’s birth story, I felt remorse later when I realized that I hadn’t thought much about Hudson in the moments right after Ada’s birth, nothing like the bittersweet moments I spent just after Jackson was born. But as I wrote there, what I have realized is that, much like these other two kids who are here with us living, breathing, screaming, yelling, running, eating, pooping, smiling, giggling, and snuggling, she is so much a part of us that we don’t need to “think about her” for her to be here with us. Maybe that is just a rationalization on my part for what I know and understand to be, finally, acceptance of her death and integration of it into our lives. But it makes sense. We live and breathe her just as much as we do our other kids, maybe even more so.

“A family is everybody all together.” Jackson doesn’t understand this now. He doesn’t understand “family” or “sister” or “Hudson died.” But he will. And when he does, he will know, probably better than we do, that even though we are not together in the way we wish—the way we wish in every single living, breathing second—that we could be, we are still all together. We are still a family.

Wednesday, October 9, 2013

Ada’s Birth Story


We welcomed Ada Rose Hitchcock Chaney into our lives on Wednesday, August 14, at 8:30PM. She weighed 7 pounds, 7 ounces, and was 19.75 inches long. She gets her first name from Ed’s great-grandmother, and her first middle name partly from some other relatives of Ed’s, but largely in memory of her big sister, who also had a flower for a middle name. This is the story of her birth.

The weeks and days leading up to Ada’s birth were long. They are long ones for any pregnant mom nearing her due date, feeling big and swollen and sleepless, but they felt especially long for me. Although I’d been able to stave off most of the anxiety that had plagued me all during my pregnancy with Jackson, the last weeks of my pregnancy with Ada brought many of those fears roaring back. I dreaded the possibility that she might not arrive by her due date, because I feared that my anxiety would just skyrocket at that point. I talked with the doctor about when they’d want to induce, and she said they would probably not let me go past 41 weeks, given my age. But I wasn’t sure I’d be able to make it to 41 weeks. We went ahead and scheduled an induction for the day after my due date, but I knew that I could change my mind if I decided I didn’t want to go through with it, and I was just hoping that this baby would follow in her big sister’s steps and come several days early rather than following her big brother, who arrived right on his due date.

I was nesting like a madwoman during those last three weeks. I baked, I cooked meals for the freezer, I organized the basement, I organized the baby’s room (some more), I knitted—you name it, and I was probably doing it. I think I was hoping that all the activity would bring on labor. I know I was hoping that all the activity was a sign of impending labor. At my 38-week appointment, I was about 1 cm dilated, and the doctor went ahead and stripped my membranes in hopes of helping get things going. This, of course, did nothing. At 39 weeks, I was about 2-3 cm. I saw a different provider that week, a nurse practitioner, and because I didn’t know her and she didn’t offer, I didn’t ask her to strip my membranes again. As that week went on, I felt the induction looming large in my mind—I really didn’t want to go through with it, because I was committed to another drug-free delivery and I was concerned that Pitocin would make that difficult. I had acupuncture for the first time the day before the due date. The due date, August 13, arrived, with no sign of the onset of labor, except that I was dilated even more, to 3-4 cm at this point. I told the doctor to go ahead and cancel the induction, that I was feeling OK anxiety-wise and really didn’t want to induce unless the anxiety got unbearable. We scheduled a non-stress test for the baby for a few days later. And although the doctor stripped my membranes again that morning, the due date came and went with no excitement.

Early the next morning, around 2AM, I woke up for no reason, as I had a tendency to do during that last month or so. I lay awake in the bed for a while, trying to decide if the contractions I was feeling were real contractions or just Braxton-Hicks, which I’d been having off and on for a few weeks. I was also counting the baby’s movements, and by 4AM, I felt like I hadn’t felt her moving enough and decided to go into the hospital to get her checked out. This kind of anxiety and overreaction was just exactly what I’d been hoping to avoid, but there it was just the same, just as soon as the due date passed. I went to labor and delivery and they hooked me up to the monitors. The first 20-30 minutes really didn’t look that great—Ada was moving occasionally but not showing any real accelerations of her heart rate during the movements. The nurse said to me, “How do you feel about staying here and having a baby, because in about five minutes, that’s what they’re going to come in here and suggest that you do.” I called Ed (he had stayed home with Jackson because I didn’t want to wake up my sister-in-law and have her come over for no reason—I imagined I would get the baby checked out and be back home in a couple of hours) and asked him to come to the hospital so that we could talk to the doctors and make a decision. Of course, after I called him, the nurse gave me some juice, and I went to the bathroom, and within a few minutes, Ada was bouncing all over the place. During all of this time, I had been having what I was pretty sure were real contractions at this point, although they were still only mildly painful and were very irregular, and I’d also had a fair amount of bloody show. The resident checked me and said I was still about 3-4 cm. She talked to the chief resident and they decided to send me home since it still did not appear that I was in active labor. I asked if it were possible for me to just stay and see if the labor started to progress more, and she said the only way they would let me stay is if I agreed to go ahead and let them do some kind of artificial augmentation of labor. We started planning to go home, and then there was a shift change. A new attending came in to see me and he said that not only was it fine for me to stay if I wanted to, he’d actually prefer it—he said that OBs are anal and conservative and that they’d have preferred for me to have delivered before the due date. Ed and I thought I’d probably be more comfortable laboring at home until things seemed to actually be progressing. The new doctor, who was really very nice, said that if we went home, he would be on shift until 5:30 that day, so if we changed our minds and wanted to come back in, we could do so, and at point, we could talk about some other options besides Pitocin to get labor started, including breaking my water. This seemed like a good compromise to me, so home we went.

I remembered the advice my very first doula gave me, which was to rest as much as possible, so that’s what I tried to do. I laid down in bed and tried to sleep, but the contractions I was having were getting more painful, even though they weren’t getting any more regular. They were anywhere from seven to fifteen minutes apart, and I was still not convinced that I was really in labor.

Finally, close to 4:00 in the afternoon, I was getting frustrated and anxious. Several Facebook friends suggested that perhaps the labor wouldn’t really start to progress unless and until I felt safe and confident that that baby would be OK. I was also worried that once things really did get going, they might go very fast, and I did not want to be faced with the prospect of having a baby in the car. While most women feel more comfortable at home, it seemed like perhaps I would feel more comfortable at the hospital, where I knew we could monitor Ada and get help immediately if we needed it. I also wanted to get back there before the attending I’d seen that morning left his shift, so that we could talk about some things and anyone who took over for him would know about any plan we came up with. So we decided to go back in, even though the contractions were still not regular.

I called our doula to let her know that we’d decided to head in to the hospital. UNC has a volunteer doula program that provides labor doulas for free to anyone who wants one. I decided to go with the volunteer program because I wasn’t totally sure that we needed a doula on the third time around, but I still thought it would be nice to have one there just in case. I’d met her twice already, and Ed had met her once. She was . . . odd, to say the least, and I wasn’t sure I was totally down with her approach to being a doula, but I tried not to let this get in the way. I knew that I had not really connected with her, but she was a volunteer, and I didn’t really feel like I could call up the volunteer coordinator and say, “I’m sorry. I don’t like this volunteer that you are providing to me for free. Could you please provide me with someone else for free?” You know, it just felt like a looking-the-gift-horse-in-the-mouth kind of thing. She seemed like she knew her stuff, and I just tried to ignore her quirks and the fact that I didn’t really like her approach. That was a mistake. When I called her to let her know that we were heading in to the hospital even though the contractions weren’t 4 minutes apart yet, she immediately started trying to talk me out of it. I explained to her that my instinct was just telling me that I should go on in, that I would feel safer and more comfortable at the hospital, but she proposed several doom-and-gloom scenarios and basically suggested that if I went to the hospital now, my chances of being able to stick to my birth plan would go out the window. I mouthed silently to Ed, “SHE’S DRIVING ME CRAZY!” as I simultaneously made arrangements with her to meet us at the hospital later. What I was thinking, I have no idea.

The human body is an amazing thing, though. It seemed that almost as soon as I made the decision to head to the hospital, the contractions started getting more intense and started coming much closer together, well under four minutes. We got to labor and delivery, and thankfully, because I’d already been in that morning and they’d wanted to keep me there in the first place, they skipped triaging me and put me right into a labor room. The resident checked me, and I was already to 6 cm. I was really hoping that the rest of the way would go really quickly, but alas, it was not quite as fast as I’d hoped. Fortunately, UNC had wireless heartrate monitors, which made it much easier for us to keep an eye on Ada while I was laboring.

It was about 5:00 PM at this point. I talked to our nurse while Ed put Hudson’s pictures around the room. Our nurse was fantastic—she was totally on board with drug-free delivery, and she actually sat and read our birth plan through, asking us questions as she went. I was amazed. One of our requests on the birth plan was to have a nurse who was enthusiastic about unmedicated birth, and she assured us that she was a and that when the shift changed again, she’d make sure the next nurse would be as well. She brought me a birthing ball, which I sat on for much of the rest of the evening. The same doctor I’d seen earlier in the morning checked in with us, and since he could see that I was in active labor, he left us in the nurse’s hands.

This is when we fired the doula. The volunteer doula. Yes, we fired our volunteer doula. After we’d gotten settled in, I texted her to let her know they’d admitted me and how far along I was. She texted back that she’d already left and was going to stop and get something to eat along the way. I started explaining the situation to the nurse about how I didn’t really like the doula much, and she immediately said, “You need to tell her not to come.” Ed agreed right away. I hemmed and hawed, saying that I couldn’t fire a volunteer, and I certainly couldn’t fire her on the way to the hospital, but the nurse persisted, reminding me that labor is very psychological and that I didn’t need any stressors or distractions in the room. If the doula was going to be more of a burden than an aid, then she needed to stay home. I relented, and Ed so kindly agreed to call her for me. I was both too embarrassed and also having to concentrate pretty hard through contractions at that point, making a phone call difficult.  I was so relieved once it was done, and I was glad to have two people thinking smarter than I could at the time.

The contractions were getting worse and closer together. A few different times, I went into the bathroom and straddled the toilet backwards for a while, hoping to get my water to break (this position had done the trick with Jackson), but to no avail. We talked about the possibility of having the doctor break my water, and the nurse was really great about explaining the pros and cons of this procedure. I was still frightened enough of scary things like prolapsed cords that I decided to wait it out. Ed was a champ this entire time, massaging my shoulders and back and cheerleading me through the contractions.

At the shift change, two wonderful things happened. First, the attending who came on to the service was one of the two doctors I saw through most of the pregnancy, and I loved her. We were both really excited that she happened to be on call that night and would be delivering my baby. And second, the new nurse was an unexpected gift from the universe. She had recently received her midwifery certification, of all things. We fire our volunteer doula, and suddenly, we get a midwife. And she was fantastic. She sat down on the couch in the room while I labored on the ball and just talked with us for a good half-hour. She was visibly moved when we told her about Hudson, and by the time it was all over, she felt like our friend. Where she really proved her worth was about an hour later, at the very end, when I hit transition. During the last hour or so, I had been in the bathroom again, hoping desperately that my water would break. I was starting to fall apart emotionally, feeling like I couldn’t hang on much longer (a sure sign of transition, but I wasn’t convinced of that), and my legs were beginning to get tired from supporting my body as I straddled the toilet. They were starting to shake, and the nurse suggested that I try lying down on the bed. This idea terrified me a little bit (the pain you know is better than the pain you don’t know), but she made a good case that I needed to give my muscles a break. I lay down on my left side and by this time, my whole body was trembling. I could not stop shaking. I didn’t realize that this is a sign of transition—I’d never had the shakes before—but the nurse did and she paged the doctor to come check me. Meanwhile, she placed one hand firmly on my hip and slid the other hand firmly down the outside of my thigh, a gentle massage that slowly helped my body calm down and stop shaking. It was absolutely amazing, and I told her so.

The doctor that I loved so much came in to check me, and lo and behold, I was fully dilated. I couldn’t believe it. For the last half-hour or so, I hadn’t wanted the doctor to check me because I was sure that I was only 7 or 8 cm along, and I just couldn’t take knowing how much longer I might have to go. So when she said I was complete, I was so relieved. She asked me if I wanted her to break my water, and at that point, I didn’t care anymore, so I said, “YES!” (Hudson’s delivery was similar to this—the doctor didn’t break my water until I was already pushing, and hardly anything came out because Hudson was already in the birth canal). The doctor broke the bag, and I felt the warm whoosh of water and said, “You broke it!” She laughed and said, “I did!”

And then, out of nowhere, I had this incredible urge to push. It was like the doctor broke my water and all of a sudden, the baby was ready to just ride the wave out. I screamed that I needed to push, and both the nurse and the doctor said to go ahead. I pushed once, but I was scared and thought I heard one of them saying something about holding up for a second. I remember thinking that I was going to tear like crazy. I looked up at the doctor and screamed her first name (I was embarrassed about this later), feeling like I needed someone to give me some instructions. But like with Jackson, there was no waiting on this baby. My body was in total control, and I pushed once more and she was out. It took about 20 seconds altogether.

And then, there she was, little Ada, tiny and screaming on my chest. The relief I felt was immense—even having done this twice before, the dread of the unknown can weigh so heavily, and I was just so glad that the delivery was over and that Ada was safe and sound. (Funny—I just went back and read Jackson’s birth story and saw that I wrote almost this exact same sentence at the end of his.) I held her close and spoke softly to soothe her, and I started crying almost immediately, thanking everyone in the room and letting the euphoria wash over me. UNC is wonderful about not taking babies from moms for at least an hour after birth, so Ada stayed right on me for a long time and was nursing within twenty minutes. She looked pretty small to me—her limbs didn’t have much chub on them at all—but her official birth weight was one ounce heavier than her big sister’s. But to no one’s surprise, she looked just exactly like her big sister and brother, as if they were all popped out of the same mold.

So much was different about this labor and delivery. It was so much less loaded and emotionally fraught. This time, I already knew that I could love another child as much as I loved Hudson. I already knew that I could love another child and still love Hudson. Hudson was still present in the room with us, but in a way that felt much more integrated than when Jackson was born, when there was still the very strong sense of a giant hole just waiting to swallow me up. Later, I felt badly that I hadn’t spent much time thinking just about Hudson in those moments after the delivery, but as the time has gone on, I realize that that is what it really means for her to still be a part of our family. She is right there with us, whether we are thinking directly about her or not. And that is a blessing.

In a lovely twist of fate, Ada was born on the one-year anniversary of my last chemo treatment. It’s almost hard to believe that is a coincidence.

And so we keep moving forward, now a family of five, a baby sister, a big/little brother, a big sister, a cancer-surviving mommy, and a daddy who somehow helps us keep it all together every day.