Kaiser vs. Bautista

I've been asked - a few times - what it was like to have a baby in Paraguay. Here's the basic breakdown of what was different between the two hospitals in terms of location, rooms, food, technology, staff, paperwork, and departure procedure. 

LOCATION

In terms of the building itself, Kaiser was a sprawling set of buildings, parking structures, and construction zones.  

In contrast, the Bautista is a much more basic structure, smaller in stature but with all the necessary departments, albeit compact. 

ROOMS

The recovery room at Kaiser was basic.  My bed was against one wall, with Brandon's fold-out chair in the opposite corner.  The walkway between the door and the shared bathroom doubled as Bailey's bassinet's parking spot.  It worked, but with all the family and friends that stopped by, it was rather crowded at times.

Our room at the Bautista was outright spacious.  My bed stuck out into the room with room on both sides to walk.  I had my own bathroom with a large walk-in shower and Brandon had a full couch to sprawl out on.  And since Papa, Graw, Bailey, and Sarah (our pastor's wife) were the only ones to visit us in the hospital, it never felt cramped, even though they were all there at once. 

FOOD

The pictures of Kaiser's food is a bit deceiving since this was our celebratory dinner and not a "normal" meal, but it helps paint the stark contrast between U.S. hospital food and . . . 

. . . Paraguay's morning after breakfast: three triangles of bread with slices of cheese between, a serving of instant coffee with a thermos of hot milk, and sugar packets to make it palatable.  I was hungry enough to eat the bread and cheese.  The milk and coffee went to waste.  

TECHNOLOGY

Kaiser was fully digital . . . 

. . . and the Bautista was not.  

STAFF

At Kaiser, we had one nurse in particular that was AMAZING.  She was older - a grandmother type - and was nothing but encouraging when it came to helping me nurse Bailey.  Because of the IV drugs I received pre-epidural, Bailey was pretty out of it for the first 12 hours of her life.  This nurse was on the night shift and coaxed Bailey's first meal out of her.  

The nurses at the Bautista were your average nurses; nothing to write home about.  Although I'm confident that I frustrated two of them.  The first told me that she could give Boston some supplemental formula since my milk hadn't come in; all I had to do was ask.  She came back to "remind me" when I didn't call.  The second brought me a towel and change of hospital gown so I could shower.  I'm guessing that she also told me to let her know when I got in the shower so she could change the sheets on my bed, because after I had showered she returned and looked a bit perturbed as I stood by, watching her change the sheets.  In my defense, I warned them all that my Spanish wasn't too good.    

PAPERWORK

At Kaiser (and I'm sure any American hospital), there were pages and pages of paperwork to fill out in order to start the birth certificate process.  I think there was something to do with social security cards, too.  At any rate, my hand was starting to cramp by the time I finished the last page in the packet the nurse had handed me.

I didn't fill out a darn thing for Boston at the Bautista.  When we were getting ready to leave the hospital, one of the nurses handed us a one page form (of which only the top half was filled out), that listed Boston's birth date, time, parents names and a doctor's signature.  We didn't even have to name her.  Note: we've since taken that form to a "Registro Civil" to register her birth and get her Paraguayan birth certificate; we'll then take that to the U.S. Embassy to get the equivalent of a U.S. birth certificate and start the social security card and passport process.  

DEPARTURE PROCEDURES

This element of the journey was by far the most different; the different-est part, if you will.

Kaiser's procedures for leaving the hospital were strict and a matter of legal liability if not followed to a T.  Bailey's ankle bracelet was de-activated as to not signal a lock-down as we left our wing of the hospital. I was wheeled out in a wheel chair. The nurse that escorted us to the car checked to make sure we had an appropriate infant seat correctly installed in the car.  

At the Bautista, one of the insurance reps gave us two slips of paper that Brandon dubbed "hall passes." These passes verified that our insurance was paid up and we didn't owe any money.  Once we packed up our bags, we took the passes to the nurse's station, handed them in, waved good-bye, and walked ourselves out of the hospital.  When we got to the street, we hailed a taxi and Boston rode home in my arms.  

And the babies themselves?  They share the same plump nose, but that's where the similarities stop . . . 

Bailey Janette Trevino

Boston Diana Trevino Fulbright
(yes, she has two last names; when in Rome...)

The Details

10:54 . . . 11:32 . . . 12:06

1:22 . . . 1:33 . . . 1:38 . . . 1:50 . . . 2:00 . . . 2:04 . . . 2:15 . . . 2:37 . . . 2:50

Contraction times.  Nothing regular, but coming often enough to know that "today" could be the day (and if not today, definitely "tomorrow").

I had already called my doctors office earlier Thursday morning to schedule an appointment with him to check on Boston's heart rate and do the other routine "stuff".  At 3:00, though, I gathered the courage to call my doctor's personal cell phone (yeah, I was intimidated by that) and told him that I'd been having irregular contractions and asked if he wanted me to keep my appointment, meet him at the hospital, or ____?  He said that as long as they didn't pick up in frequency and intensity over the next hour, we could just meet at his office at 4:20 and assess the situation from there.

My dad and I called a taxi at 4:00 (at Brandon's insistence; I wanted to walk the six blocks, but noooooo...) and Grandma stayed home with Bailey. We figured that if doc wanted me to report straight to the hospital, I could go there and meet up with Brandon while Dad reported back to Mom.  But the contractions still weren't any more consistent (4 minutes between one set, then 10, then 20, back to 6) so Dr. Schmit sent me home to wait it out.  We walked.

I started tracking contraction times again at 4:40, but it wasn't until 6-ish that they became regular.  And even then, they weren't like clockwork (as they had been with Bailey).  If I was sitting down, it was 8 minutes between; walking around the house, 4 minutes.  By 7 the dull, almost-ignorable ache contractions had progressed into something more and I told Brandon that we needed to start getting things together to head to the hospital.

We finished dinner (rather, the family finished dinner while I watched), double checked the hospital bag, said goodbye to Bailey, and called a taxi.  It was 7:30 when we loaded into the cab and asked him to take us to the hospital; "Estoy en trabajo de parto," I said. (I'm in labor)

At this point I also tried to call Dr. Schmit to tell him we were on our way to the hospital. Tried being the operative word.  The call went straight to voice mail. No ringing, just "leave a message after the tone" well, "despues del tono . . . " yada yada yada. Perfect.

One contraction later, we were in front of the emergency room doors, headed for check-in. Thankfully Dr. Schmit had written out an order for me to be admitted right away, so we were able to just hand that to one of the clerks and he jumped right up to help us (well, called someone else who jumped right up to help us).  Brandon continued to try to get in touch with Dr. Schmit, trying his cell and home number, while I filled out some paper work.  I'm still not sure what the form was all about since it only asked for Brandon's information, but I didn't ask.  I just did what I was told.

Two contractions came and went, and we were headed upstairs to the OB department.  They offered to get me a wheelchair, but I insisted I could walk.  It was about 20 steps to the elevator and another 20 to the room they put me in.  Definitely NOT wheelchair worthy.

The doctor on call  and a nurse helped get us situated and were extremely patient with my constant "I don't understand" or "a little slower, please" responses to their questions. Together we got through the rest of MY paperwork (general health, allergies, family history of disease, etc.) and they checked my progress.

8 cm dilated.

Yikes! We don't have much time . . . and still no word from Dr. Schmit. The nurses tell us that he's been called, but I haven't seen him.

8:12 is the last "entry" on my contraction log; at that point, it seemed a bit silly to continue.  Dr. Schmit came waltzing into the room in his golf polo and khakis and quickly took over. He confirmed the 8cm dilated status, but also informed me that my water hadn't broken (as I thought it had earlier in the day). You could have just had a small leak, he said.

At this point Brandon had the foresight to exit the room as they slid a bedpan under my hips so the doctor could break my water.  The contractions picked up in frequency and strength and I started thinking about drugs.

My sense of time for the rest of this is non-existent.  

All I know is that I started having to stop everything and clutch the sheets to get through each contraction.  Then Brandon started lending me his hand because the sheets just wouldn't do.  I sent Brandon off to ask good ol' Dr. Schmit about getting some drugs.

"Well, you said you wanted to do this without drugs, right?" Brandon stated as he walked back in.  "Schmit says he wants you to see if you can handle it without."

I started kicking myself right then and there.  I should have never even had that thought.

Before I knew it I was being wheeled down the hallway to the delivery room and Brandon headed off with the doctor to suit up.

And I know that the actual delivery of the baby was the "worst" part pain-wise, but the next request the nurses had of me was a close second.  Almost a tie for first.

I had to switch beds.

The request came mid-contraction, which didn't help the situation. I just remember propping myself up on my elbows, looking UP at the bed I had to hoist myself into, and telling them "no puedo hacerlo, no puedo . . . " (I can't do it).  One nurse started rubbing my shoulders and saying something about "si, estas guapa mama, que guapa."  And while her hands on my neck felt nice, I couldn't help but think "I'll 'que guapa' you!"

I made it (as I'm sure everyone does) and as they strapped my legs in and my hands felt the grab bars on the side of the bed, I realized that I needed to push. But Brandon and Doc still weren't there.  Oh what was that phrase in Spanish? They just asked me a few minutes ago to tell them if I felt like I needed to push. I understood what they meant, but now that I needed to repeat the words back to them . . . "NECESITO EMPUJE!"

I hear the scampering of feet (my eyes have been and continued to be clenched shut) and a flurry of unintelligible (to me) Spanish.  Finally I heard Doc's voice and felt Brandon's hands on my arm.

And the rest is history.

Rumor has it, my arms looked like something out of the Hulk, with my muscles and veins bulging out as I gripped the sides of the bed, and I may have politely asked the doctor to "JUST PULL HER OUT!!!" but I'm not one to gossip . . .

If I Were His Daughter

Thursday, I had a routine check-up with my doctor.  Side note about Dr. Schmit: he's a great family doctor and has delivered a lot of babies; he's even got a weekly spot on a radio station.  But he is THE most laid back physician I've ever met.  Until today, he never requested a single ultra sound and didn't even do a blood test to confirm I was pregnant in the beginning. He just told me that if I started my period soon we'd know that I had a false positive on the at-home test.  That's the kind of doctor he is.  And I'm okay with that (too late if I'm not, right?).

Back to Thursday.  We started the check-up as usual.  Bailey situated herself in his two kid chairs and the doc and I chatted about expected hospital stay time.  He checked my weight. It was fine (still holding out at +11 kilos; I assured him I was eating - I've weighed 71 kilos ever since arriving back in Paraguay, all that sweat I guess).  He checked my blood pressure.  Perfect.  Then he went to check the baby's heart rate, thus beginning this weekend’s “adventure.” 

The good doctor has always checked Boston's heart rate (I LOVE being able to type in a name, now!).  And not that I have perfect rhythm (or there is any such gift), but I've gotten used to the beat that usually emanates from his little device.  I thought it sounded slow.

And he was listening for longer than usual.

Then he grabbed my wrist (to check my pulse?). Never done that before.

Doc? What's going on?

"Well, it's a little slow" he says.  Again, for a doctor who doesn't bat an eye at anything, his slight concern sent my mind racing.

He kept listening, checking his watch, counting beats.

"I'm going to write up an order for you to go to the Bautista (the hospital where I'll deliver) to have another test done. A biophysical profile. You can go over there first thing in tomorrow morning and then bring the results back to me."

This from the man who doesn't "believe" in ultra sounds or blood tests.

Trying to keep from full fledge panic mode.

Choking back tears and restraining the concern from my voice, I asked if it was something that I needed to go take care of NOW.  It was only 4 P.M.  I was his first patient of the evening.  In my mind, I could get to the hospital, do the test, and return with the results before he left for the night.

No, no, no, he says.  Tomorrow morning is just fine.  She's been moving normally, right?

"Yes, yes . . . of . . . course . . . " I spit out. But doubts crept it. Had she been? She was awfully still right now.  Boston's usually using my ribs and right hip bone to push her shoulder into my left hip.  But now . . . I nudge my side to coax some movement out of her . . . nothing.

Don't cry, don't cry.

As he wrote up the order for me to take to the hospital, I thought back through the day.  I couldn't remember her moving.  Could I have just been so distracted playing with Bailey and cleaning up around the house?  How do I not know if my baby is moving?

Just then a kick.

And a punch.

"Mom, I'm okay" she seemed to say.

Needless to say, I was tuned into her every movement for the rest of the evening and throughout the night.  When I got up in the night to pee (twice), I didn't let myself fall asleep until I felt her move again.  Those were two very long, anxiety filled moments, let me tell you.

I know what you must be thinking: if it were THAT worrisome, he would have directed me straight to the ER right then and there.  I know that, but just the fact that he showed slight emotion and concern about something piqued my interest (and anxiety). And he mentioned the "induce" word.

Thankfully, Brandon was able to go with Bailey and I Friday morning to the hospital since his first classes don't officially start until 11:15.  We were out of the house a little after 8 and at the hospital by 8:30. 

The first test was a 30 minute monitoring of Boston's heart rate. After having me eat something sugary and drink a juice (also choked full of sugar, thank you very much, Paraguay), they strapped two heart rate monitors across my belly.  They left a button in my hand and instructed me to press it every time I felt the baby move. Brandon took Bailey to a play room they have in the OB department and I spent the next half hour pushing a button, listening to the whirr of the ceiling fan and the beat of little Boston's heart.

It's now 10.  Brandon had to leave to get to school in time for his classes.

Bailey and I spent the next hour and forty-five minutes waiting outside the ultra sound room for our name to be called.  She was quite the trooper, eating her snack, playing with the few toys in the bottom of her stroller, and making friends with anyone who would make eye-contact with her.

At 11:45 we were finally called into the ultrasound room.  The ultra sound doctor was the same doctor that did my previous ultra sounds.  I know I said Dr. Schmit never ordered any, and that's true, but when you go to the ER with spotting/bleeding, you don't need a doctor's order; they take care of you themselves.  Each time, she was super friendly and gushed over how perfect everything looked. I went in hoping for the same.

But she didn't.

Looks like Boston is going to have the same squishy
nose and serious scowl that Bailey had when she was born.

She prodded around, measured Boston's femur and head circumference (both measuring in the 39 week range), then locked in on the heartbeat flickering away on the flat-screen.

She, too, said that the heart rate was slow.

And I believe she suggested getting the baby sooner rather than waiting. I think. But my Spanish isn't all that great, especially with technical doctor talk, so I couldn't be certain. I KNOW she said that she was going right away to call Dr. Schmit and talk to him about it. Now if that's not a red flag, I don't know what is.

It's now after noon and Dr. Schmit's office will be closed for lunch until 4 (his secretary comes back on duty at 3:30).  Bailey is getting crabby, hungry for lunch, and ready for a nap. "Night, night?" she keeps asking me. 

God had it all worked out for me as my mind started to panic over how to balance feeding and getting Bailey to bed with taking the results to Schmit (do I call his cell phone and interrupt his lunch?).  The official ultra sound report wouldn't be ready for me to pick up until 3.  Thank you, Lord.  We picked up empanadas for lunch on the walk home, Bailey ate in her stroller, and went down for a nap once we got home. 

I spent nap time trying not to freak out.  There was no chance of a nap for me; I didn't even try.

Friday was also supposed to be the first day of a Bible study I'm doing with our pastor's wife and a few other English speakers she is discipling.  When I texted her about the drama at the hospital, she called right back and said she would come take me to the hospital and doctor in the afternoon.  I owe her BIG for her help (thank you, Sarah!).

The "plan" was to go to the Bautista, pick up the results, and get them to Dr. Schmit before his first appointment at 4.  I'm not one to interrupt and cause a big fuss. Diaper bag in hand, Bailey and I got in Sarah's car and we headed off to the hospital.  

Trouble is, my results weren't at the counter where they should have been.  Turns out the heart rate test didn't come out well and they wanted me to do it again.  Another sugary snack and thirty minutes on the exam table...you've GOT to be kidding me. 

Fast forward an hour or so and Brandon met us at Doctor Schmit's office to go over the results. And yes, we had to interrupt his schedule and inconvenience a few patients.  Though, at this point, I’m over feeling bad about it.

According to Schmit, the ultra sound doctor was recommending immediate admittance to the hospital and a c-section to get little Boston out.  At the very least, try induction with pitocin.  He threw out a third option: wait and see. 

Oh, Lord, what do we do?

As Schmit walked to the other room to retrieve my chart and his heart beat listening device, Brandon leaned down over me and started to pray.  Praying for wisdom. For peace.  For the safety of our darling little Boston.

So, what do you want to do? Schmit asks.

Good question, doc, good question.

There's obviously something "wrong" that's causing the low heart rate.  More than likely, it has to do with her umbilical cord.  The ultra sound showed that it wasn't wrapped around Boston's neck (or leg or arm), but the doctor couldn't be sure quite where the cord was beyond that.  It could be getting pinched somewhere (which would explain why sometimes her heart rate is fine and others it's not) or tied in a knot.

Clinging to Brandon's hand, I timidly asked (afraid of the answer): What do you recommend?

And from his mouth came the words: If you were my daughter, I'd wait and see what happens.

And that was enough for me. For us.  We're going to wait.  I'm carefully monitoring her movements and we'll go to the hospital if she goes too long without moving.  I have the doctor's cell and home number if I have any questions or concerns.  We have an appointment first thing Monday morning to reassess the situation.

And we have all weekend to pray over little Boston.  

What's in a Name?

Oh baby names!

When Brandon and I were still dating - I don't think we were even engaged yet - he let me know that his future children's names would all start with a B.  It's something his mom and dad (and then dad and step-mom) had done with his siblings, and he wanted to continue the tradition.  I had plenty of time to mull it over, he reminds me, and if I didn't like it, I should have gotten out then.  I didn't really think naming our children was a deal breaker, but apparently it should have been?!

So here we are.  A "B" name, hu?

A few months back, we were scouring - well, let me clarify, I was scouring - baby name websites searching for a good B name that would go with the middle name Diana (after Brandon's aunt).  Nothing seemed to click.  B isn't the most popular letter to begin with, and there are several B names already taken by family members and close friends. Throw in those "off limits" names after spending several years in the classroom (you teachers know what I'm talking about), and we were left with a very limited pool of names to choose from.

We narrowed it down to three options: Bristol, Boston, and Bentley.  We liked them all, but had "issues" with them all, too.  Bristol has the Palin connection that we aren't overly fond of.  Boston is a city name.  And Bentley is a car.

At this point, we continued - rather, I continued - to get suggestions about other names to consider.  What part of "we have it narrowed down to three" don't you get? And one family member went so far as to tell others that we had decided to name our baby girl Bianca Diana . . . what?! But I digress . . .

The most helpful advice I got about our final selection from the above mentioned names was to check their meanings.  Don't get me wrong, I didn't, not until today, and we've known for a few weeks now what this little one will be named (the suspense is killing you, I know), but it's turned out to be helpful in confirming our choice.

Now, I should care somewhat about the meaning and significance of names.  After all, I'm an English major and there's almost always insight about characters that you can glean from the name of each.  That should matter to me.  And when it comes to literature, it does, but for some reason, that hasn't transferred to real life.

Today, though, I put Bailey down for her nap and began some research into all of our names.  The last name Trevino doesn't have a "meaning" per say, but I did stumble across a website with some interesting information about it's history/origin.  If you care to check it out, you'll have to scroll all the way to the bottom of the page for the Trevino section.

Here's what I found out about the rest of our names:

Brandon - from a surname, meaning a hill covered with a broom
Doyle - descendent of a dark stranger

Stacy - from a surname, meaning fruitful
Faye - form of fairy

Bailey - from a surname, meaning bailiff
Janette - derived from Janet, form or Jane, feminine of John, meaning Yahweh is gracious

After looking up our names came the moment of truth.  If you haven't noticed the pattern, all of our first names have been derived from surnames so it would be nice if #2's did too.  And Bailey's doesn't have a phenomenal meaning, so it would also be convenient if our choice for #2 didn't either (I know, wishing insignificance).

Well, we're pretty sure we're going with the name Boston Diana, and here's what I found:

Boston - town by the woods
Diana - heavenly, divine

While it's missing the "from a surname" piece, it's meaning is right up there with bailiff. And both of the girls' middle names can give them significance.

Besides, Brandon says if he had to re-choose his sports teams, he's be a fan of the teams in Boston (Celtics, Red Sox, and Patriots).  Who can argue with that? :)

Library Time

While visiting California for Christmas (and then all of January, into February), we had the chance to go to story time every week at the library down the street from my parents house.  Bailey absolutely LOVED all the songs and chants they did and Mommy loved the fact that Bailey-girl had a chance to interact with other kids her age.  Before we even left LAX, I knew our weekly library time would be something I would miss.

Now that we're settled back in here in Paraguay, we are back to a weekly library routine of our own.  There's not a public library (that I know of, anyway, and I've asked around), but the library at Brandon's school has been gracious enough to open its doors to us.  Every Friday now for the past three weeks, we've been making a morning out of going to Daddy's school, returning our books, and getting new books for the week ahead.

Children's section of the library

Every week we've had a different theme; first cows, then the jungle, and now cats (random, I know).  While I'm busy scouring the shelves for books that fit the theme, Bailey bounces from bin to bin, pulling books, looking at a few pages, and replacing the books.  She's not perfectly consistent about returning one before getting out another, but she has caught on that the books belong in certain spots.

Pulling out a handful of books before Mom could
stop her

When she forgets where she got one of them, we look at the spine of the book together and talk about the first letter of the author's last name.  Then she scurries off to find the matching letter.  It's a fun "game" that warms my little teacher heart - especially when she guesses right on the first try! :)

Checking out books with Daddy

Who knows what form our library time will take once #2 arrives in a few weeks; after all, I'm not planning on boarding the bus solo with TWO young'ns in tow and it is a decently far walk. But we'll cross that bridge when we get there. For now, we'll just enjoy our time discovering BOOKS!!

Doing some independent reading :)