I've been meaning to write this for weeks. Hopefully I can still remember
everything.
So Sarah had a c-section the day before we were scheduled to have our
c-section class. We'd both read a bit though, so it wasn't like we were
going in totally uninformed and unprepared..
Firstly, Stanford Hospital's operating room area is rather mind-blowing.
Sarah was transferred from Lucille Packard Children's Hospital to Stanford
because they could get an operating room there sooner. The transfer was
trivial, just roll the whole bed down the corridor, through the magic double
doors into the operating rooms. The doors in question have a whole heap of
video cameras pointing straight down, so they see everyone that gets wheeled
in and out, which I found interesting. Good for records of patient movements
I guess.
Anyway, through those doors is a maze of corridors. There was a light-up
board hanging from the ceiling in the middle of the main corridor with
lights for all of the ORs. I think there were about 20. The illuminated ones
were available. We went down a corridor, and past a few ORs. Outside of each
one is a big stainless-steel scrub area.
We got to "our" OR, and they transferred Sarah onto the operating table.
Because of her heart condition, they wanted to have an arterial line in her
for the duration of the procedure. This is some sort of gadget that goes
into an artery and monitors your blood pressure beat by beat.
The "interesting" thing with the anaesthesiologist was the New Zealand woman
that we'd seen when we had an anaesthesiologist months prior, but the
appointment was with a different anaesthesiologist, and this New Zealand
woman was "observing". At the time, the anaesthesiologist we had the
appointment with told us that she was going to be on vacation at the time of
the delivery, so she wouldn't be attending. So I don't know if the Kiwi
woman got promoted out of "observing" to "doing" in that period, or what,
but she reintroduced herself to us in LPCH prior to moving to Stanford as
being our anaesthesiologist for the delivery.
Anyway, in the OR, they handed her the arterial line, in it's plastic
packaging, and the first thing she asked was whether it came with anything
else to put it in. At this point I figured she hadn't put one of these in
before. (The answer to her question, by the way, was "no")
She then proceeded to have a terrible time getting the line into Sarah's
arm. Normally intravenous lines go into a vein, but this has to go into an
artery. Apparently when you go poking an artery, it spasms. It then becomes
very hard to get it into a moving target. She had a few goes on one arm,
then gave up, and had to move over to the other arm.
Sarah doesn't like needles at the best of times, and getting this honking
great big thing in was no picnic. The bruising on both her wrists afterwards
was phenomenal. She tends to bruise fairly spectacularly whenever they stick
a needle in her. I almost stepped in and asked if it was really necessary
that she have it, because they were having so much trouble getting it in,
and it was clearly hurting Sarah. I think someone else ended up getting it
in, not the anaesthesiologist. Not "that" one anyway. There were heaps of
people in the OR.
Next, came the epidural. Again, we had the inexperienced anaesthesiologist.
This time she said to someone else how she was so nervous because there were
"too many eyes". Not really reassuring. They gave Sarah a numbing injection
first, and then proceeded to poke her in back with the epidural catheter
needle thing.
Sarah was flinching when they did it, and they kept yelling at her not to
move. Apparently it didn't
hurt, but it caused discomfort every
time they tried to get it in. Eventually the associate professor of
anaesthesiology stepped in and got it in. Later, they said that Sarah had a
slightly curved spine or something, and that had made it a bit more
complicated.
I'm not begrudging the obviously inexperienced anaesthesiologist for
anything. Stanford is a teaching hospital, and doctors have to get their
experience somehow, but I think that when the patient is conscious, it's
important to come across a little more confident.
So once they got all of that sorted out, they could get her lying down on
the table and get down to business.
Apparently one of the side-effects of the epidural is that it can cause your
body to think it's got hypothermia. Part way through the procedure, Sarah
started shaking uncontrollably. I can't remember whether she complained
about feeling cold or not. She also got a really itchy face. Apparently
that's a side-effect of morphine.
Sarah also doesn't tolerate anaesthetics very well, and started feeling
nauseous part way through the procedure. Sure enough, as has happened
countless times previously post-operatively, she threw up. At least we had
warning and I got a kidney dish in place in time.
That was about all the eventful surgical stuff. They had the usual screen up
from about her neck area, so I couldn't see what they were doing. After
Joshua was delivered, one of the nurses asked me if I wanted to see him, and
took me around from her left shoulder where I'd been sitting to around below
her right foot, to where they had him in one of those perspex portable crib
things. I could see a lot of red out of the corner of my eye, and I could
have seen a lot more if I'd bothered to look, but I was more interested in
seeing my son at that stage.
They let me bring him back around to where I'd been sitting previously, to
show Sarah, but it was hard getting him up to a point where she could see
him properly, and she was partially out of it by this stage. I think she
dozed off for a little bit not long after that.
I forget what time we got into the OR, but they started the operation in
earnest at about 10:00am, and we were out of there by 10:45am if memory
serves. The nurse in charge of the recovery room really didn't want me
there, so I went back to LPCH with one of the nurses to spend some time with
him while he was weighed and measured, and I took some photos, and held him.
This was good, because I got to have a good cry on my own with him.
So overall, in my "I'll never be squeezing a watermelon out of my nether
regions" blokey perspective, having seen what Sarah went through, and how
much discomfort that it looked like she was going through, both in the OR
and afterwards, I'm not convinced c-sections are any less painful than a
vaginal birth (taking the average case of both). I think you're trading some
"short term" (depends on how long your labour is I guess) pain for some
"long term" pain while you recover from your incision. Granted, Sarah wasn't
really laid up all that badly for all that long, but it still didn't look
all that pleasant.
I guess really only the women who have done both delivery methods can really
comment. All I know is I found it very difficult watching Sarah go through
so much pain. So much so that I'm not really looking forward to that again.
Maybe, hopefully, after her
aorta is
repaired, they'll let her delivery vaginally next time. I'm not holding
much hope though. The high-risk obstetricians are fairly paranoid. There's
also the possibility the baby will make the decision very easy for everyone
by being breech.
Sarah raised an interesting point today. Why didn't they just knock her out
with a general anaesthetic? There was no need for her to be conscious for
the delivery. That would have spared her the pain and suffering of getting
the arterial line in, and they wouldn't have needed to bother with an
epidural. One for her to ask the obstetrician at her follow-up appointment.
On the train to my parents' house for Christmas I finished up a wild run
through the book Coders at Work. The book
isn't even mine, but I'd been borrowing it very often, sometimes to the chagrin
of its owner, because I could barely put it down.
The book is a collection of interviews with 15 great programmers of our time,
starting with Jamie Zawinsky and ending with Donald Knuth. It's written in an
interview style each interview starts with a brief introduction to the
person being interviewed, summarizing what the person is known for and what he
or she has accomplished and a few of the highlights of the interview, and then
a transcript of the interview follows, with the author/editor, Peter Siebel,
will saying something or asking a question, and the interviewee responding. I
was skeptical about this format at first because I feel like it can be an easy
way out of good editing and make the reader have to do the work of the editor,
but on finishing I think that Siebel uses the format to his advantage in this
case.
For one, the speech format allows the reader to really form a picture of how
the person being interviewed speaks and would act in a conversation. Jamie is
somewhat bitter and pretty informal. Brad Fitzpatrick is flippant and
energetic, his speech littered with profanity and colloquialisms. Others seem
more stately and verbose Joe Armstrong's responses can go on for a page or
more. In this way, not only do readers learn something about what these greats
have learned about programming, but we also feel a bit more like we've met or
know them, and can connect to them more as people.
I always have this problem where I want to read computer books, but often
computer books seem inextricably tied to the computer, so there's this dynamic
of reading a bit and then wanting to get on a machine and try something out,
write some code, play around especially with books focused on a specific
language. Coders at Work retains some of this computer-book dynamic in that I
constantly encountered things that I want to investigate or play around with
more: Erlang, OCaml, various papers and essays, Knuth's literate programs, and
books such as Higher Order Perl and others. Siebel makes a point to ask each
person what her short-list of books and papers programmers should read are, so
this book is a great source of pointers to other reading material. Unlike a
more specific book, however, keeping a list in a notebook was enough to settle
the mind to read away-from-a-computer for chapters at a time.
It's obvious that despite the interview format, Siebel has done some serious
editing. None of the prose is boring to read, and I can't imagine that the text
is a straight transcript of how the interviews went. He also has arranged the
interviews in an order such that different interviews play off each other. In
Branden Eich's interview, for example, he disparages the book
Design Patterns:
I'm in Portland, Oregon for the week where I'll be at 
In the past I was not blogging small things if they were not worth a full blog entry on their own (or if I did not have the time to make up a full entry of it :). Inspired by the example of 
