Elizabeth's Dramatic Arrival!

As many of you already know, we were recently joined by a new addition to our family. The arrival was somewhat unexpected and dramatic. As promised on Facebook, here is the story, as well as some more pictures. Enjoy!

On Tuesday, May 29, I went in to work at the usual 5 am. I rounded on my patients and was assisting with General Surgery Clinic when I received a series of texts from Julie which essentially asked me to come and be with her at her scheduled OB/Gyn appointment. I arranged with the Nurse Practitioner and my fellow Intern to cover for me for a half hour or so, and I went to the OB/Gyn Clinic. Upon finding Julie, I discovered that she had been crying. Further investigation revealed that her blood pressure was still elevated despite her blood pressure medication and her urine protein levels were elevated, giving her a diagnosis of pre-eclampsia. As if this news wasn't enough, the OB/Gyn resident was mentioning admission and induction of labor, since she was term at 38 weeks. For those of you who know Julie, this was, quite literally, her worst nightmare. She hates doctors (the irony of her marriage to one is not lost on me), hospitals, needles, monitors, and everything associated with a modern delivery in a monitored setting. The resident asked us to go to the labor and delivery deck for evaluation, and, thankfully from my point of view, Julie agreed.

Upon arrival at L&D, Julie had some blood drawn, and was evaluated by the on-call OB/Gyn Intern. He determined that she did need to be admitted and induced given her high blood pressures. He did a fantastic job of explaining everything to Julie, much better than I could have done. Julie reluctantly agreed to the admission and induction at about 11:30 am, and everything happened very quickly after that. Julie's sister Laura, who decided at the last minute to stay until my Mom arrives on June 9, took control of Andy, I called my fellow Intern and Resident and received the rest of the week off, we were moved to a delivery room, Anesthesia placed an IV after multiple attempts (which has left several nice bruises on Julie's arm), magnesium was started to prevent seizures (a danger when pre-eclampsia develops into full eclampsia), and pitocin was started to get things going. Julie refused an epidural, and delivered Elizabeth without any pain medication. I'm convinced she has superhero powers when it comes to the endurance of pain, with her fatal weakness being her unnatural fear of needles. Anyway, the pitocin was slowly increased over several hours and Julie slowly progressed until about 10 pm, when her water broke. The nurse examined her at that time and determined that she was 4 cm dilated. At that time I expected another 2-3 hours of labor. I was wrong.

Approximately 10-15 minutes later, Julie felt the need to push. At the same time, the labor nurses and the on-call resident came into the room to evaluate Elizabeth, whose heart rate had suddenly slowed dramatically. Julie was examined by the resident and found to be 10 cm dilated, fully effaced, at -3 station. The delivery cart was wheeled in and everyone began to get ready. Julie asked if she could push, was told to give it a try, then frantically told to stop when Elizabeth immediately crowned. Her next words were something along the lines of, "I can't stop. She's coming out"! Plastic was thrown down at the foot of the bed (they didn't have time to break it down), and 2-3 pushes later, Elizabeth Carol was here. The cord was clamped, I cut it, and she was handed off to the waiting Pediatric team. She was examined, found to be perfectly healthy, wrapped, and handed to me. The drama was continuing at Julie's bedside, however.

During delivery, Julie sustained a 4th degree laceration which involved an artery. She was bleeding somewhat profusely, and had not yet delivered the placenta. The resident, Dr. Hill, immediately began suturing the artery closed, and did a fantastic job, a calm eye in the center of the storm of health care responders arriving at bedside to address Julie's active hemorrhage. He was able to slow the bleeding enough to enable transport to the operating room for definitive repair. Julie was wheeled by Elizabeth and me, looking very pale. We gave her a kiss, and waited for her to come back. For those of you who know me, this was my worst nightmare. I could only envision the worst case scenario. Fortunately, the repair was complete within an hour, she did not require a blood transfusion (she lost a total of about one liter of blood, which is approximately 1/6 of the bodies total blood volume), and she was safe and sound in the recovery room. The rest of the hospital stay went well. Julie was a model patient and was ready for discharge by Thursday, two days later. We came home and are enjoying Elizabeth immensely! Julie's Mom, Dad, and sister Laura are here helping us more than we ever thought possible, and we can't wait for everyone else to see her. Drop what you're doing and come see us! Andy and Elizabeth eagerly await visitors!

Andy wanted to help paint Elizabeth's room. We thought we were preparing pretty far in advance, since she wasn't due for two more weeks. Instead, we finished the day she was born.

Revising my initial cut of the cord. Note the proper surgical use of the scissors.

Elizabeth Carol Scarborough, 7 lbs 1 oz and 21 inches of absolute presciousness!

A very proud big brother. Much better than when he initially was told that he would have a little sister.

I love these two to pieces!

Auntie Laura with Lizzy. We're eternally grateful that you decided to stay past the baby shower!

A very proud Grandma. Thanks for coming to San Diego so quickly!

An even more proud Granddad. We're glad you made it too...particularly me. I have some projects I need help with!

My three favorite people in the entire world, all on one hospital bed. It's the simple things that make my day.

As you can see, Andy was pretty excited to hold the baby...

...which worried the adults just a bit.

Andy kept bringing Elizabeth toys every time he came to visit. He had a hard time understanding why she wasn't playing with them.

Dressed and ready to go home!

Andy picked out Elizabeth's outfit. He's got good taste.

My tired girls. I love them so much!

Stretching out in the bassinet.

Hanging with Auntie Laura.

We want to thank everyone that has helped, come by to visit, and offered congratulations. We are very excited to have Elizabeth with us, and can't wait to update the blog with even more pictures.