During labor, when my wife’s contractions got strong, the nurses gave her fentanyl to ease the pain, but after about an hour and a half the drug started wearing off and the pain returned. It came back as before and then started to get worse. At this point, Carolyn told the nurses, “I want my epidural!” The epidural could not be administered by the nurses; we needed an anesthesiologist to set it up. On that day and at that hour there was only one anesthesiologist on the Kaiser campus and he was very busy. An hour passed as we waited for him to arrive. We knew that after labor got to a certain point, it would be too late to have an epidural. Carolyn and I both were beginning to wonder if she would get the epidural in time.

After another hour, the anesthesiologist arrived. He cleaned Carolyn’s back and rubbed some orange liquid on it. He numbed her back and then stuck a needle into her spine to set up an IV for the epidural. The anesthesiologist did a great job. He was slow, methodical and precise. He explained everything he was doing as he went through this step by step procedure. The epidural machine was on a continuous feed. Carolyn had a button she could push if she felt pain and wanted to increase the flow. After a little while, she started feeling a lot better.

I was concerned about having an epidural for a couple of reasons. In the past, some women had a become permanently paralyzed by epidurals. Apparently, they are a lot safer now, but I still worried. I heard a recent story about a woman who got an epidural that was placed poorly. She ended up getting temporarily paralyzed. It took her about six months to get back to normal. I knew that medical science had advanced quite a bit in this area, but I was still concerned. Also, I had heard that women who use an epidural are more likely to end up with a cesarean birth. I knew there were several health benefits for both mother and child if she was able to have a regular vaginal birth. Also, cesareans are trouble if you want to have more than three or four kids. You can only have so many cesareans. Epidurals can slow down contractions and make delivery take longer. Despite my reservations, when I saw the pain my wife was going through, I supported her in the decision to get an epidural.

Posted: February 25th, 2009 under California.
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After trying all Monday to induce my wife (Carolyn) using pitosin, the nurses gave up. Kaiser labor and delivery wasn’t very crowded, so they let us stay the night. On Tuesday morning about 11:00 AM, the doctor came in and said, “Let’s break her water and see if we can get this labor going.” Normally, they only break the water after the woman is dilated at least 4 cm, but the doctor wanted to speed things up so she broke the water even though Carolyn was only 3 cm dilated.

To break the water, the doctor used a plastic stick that was pointed at the end. She stuck the pointed end into the birth canal and broke the sack. A bit of light brown fluid came out. It looked like watered down coffee. I was actually expecting more liquid, something like a mini waterfall. Since the baby’s head was so low, I believe the head had sealed off the rest of the fluid, so only the fluid that was below the head came out. Carolyn said that more liquid came out later little by little as she started to experience stronger contractions.

Pitosin hadn’t done much for Carolyn, but breaking her water did! She really started to feel the contractions. After about an hour and a half, she was asking the nurses for pain killers. So the nurse brought in another needle and gave her a shot of fentanyl. Almost instantly, Carolyn was feeling better. She relaxed and her contractions started to spread out a little more. In her drugged state she got sweet and romantic. She even gave me kisses.

Posted: February 23rd, 2009 under California.
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We entered Labor and Delivery on Monday, February 9, 2009 to induce. After checking into room 5 and getting set up, the nurses came in and set up machines to monitor my wife (Carolyn) and our baby (Chloe). They monitored two things, the baby’s heart rate and my wife’s contractions. The nurse had Carolyn put a stretchy material around her belly. The nurse placed some jelly on the monitors and placed them underneath this stretchy material. The monitor for the heart rate was smooth and flat, but the monitor for the contractions had a bump in the middle. Carolyn found this second monitor uncomfortable. She often had to move it around when it got irritable.

Next, the nurses hooked Carolyn up to an IV so they could give here pitosin. Pitosin is a synthetic version of oxytosin. Oxytosin is the hormone in a woman’s body that causes her to start having contractions and go into labor. They stuck a needle in her arm, near her left hand to set up the IV. Through the IV they gave her pitosin and water. They started at such a low level of pitosin that if they didn’t add water, her vein would have closed up and they would have had to re-set up the IV.

Then it was time to wait. Chloe’s heart rate was good. It fluctuated between 120 and 140. The nurse said it was good that it didn’t always stay the same. The machines on Carolyn’s right showed that her contractions were starting to increase. They lasted about a minute and were about two to three minutes apart. You measure how far apart they are by counting the time from the beginning of one contraction to the beginning of the next. The nurse said, “You’re having a contraction. Do you feel that?” “No,” Carolyn responded with a smile. She was sitting up happily in her bed playing cards. If we just went by the machine, I would have said that this baby was coming very quickly, but the nurses were far more interested in how Carolyn was feeling, and by the looks of her casual demeanor they weren’t so hopeful that this baby would be coming soon.

Later that evening, Carolyn was still feeling fine. The nurses took her off the pitosin and decided they would try again the next day. I was afraid they might send us home. We had everything at the hospital, and I really didn’t want to go home. But, they let us stay the night. Carolyn slept in her bed, and I slept in a chair that expanded out into a somewhat stiff bed.

Posted: February 17th, 2009 under California.
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Our baby was due on January 30, 2009, but she came a little late. The due date came and went without even a sign of a contraction. We were going to induce on Friday, February 6, but after a positive NST (Non-Stress Test) the day before we decided to hold off until Monday, February 9^th. Our baby was healthy, the placenta was still in good shape and there was still plenty of fluid in the uterus.

The morning of the 9^th we got up at 6:00 AM and called 707-393-4632 to reach Labor and Delivery at the Santa Rosa, California Kaiser Permanente facility. We had to make sure there was a birthing room available to induce. If there are two many women in L & D, then they would have told us to hold off for a day, but Monday worked out fine. That morning we were running late, so we didn’t actually arrive at 7:00 AM as planned. At around 8:00 AM, we took off in my wife’s red Volkswagen Jetta with words written on the back window that said, “Our First Baby! 2-9-09.” Little did we know that February 9^th would not be our baby’s birthday.

When we arrived at the Kaiser hospital facility on Bicentennial in Santa Rosa, we were blessed with a front row parking space. We entered the “Admittance/Discharge” room on the first floor where my wife signed in. They asked us to pay our bill, but I didn’t have enough money in our Health Savings Account at the time, so I asked if I could pay later. I could have just paid with a debit card or credit card, but I wanted the tax benefit of paying with our HSA. The lady was friendly and said we could pay later. She directed us to go to the third floor, room 5. After exiting the elevator, we showed our ID’s to the security guard there and he issued us a card which served as a key for us to get into Labor and Delivery. We waved the magic card over a black box and the doors opened automatically. Quite regularly you would hear the alarms go off up there as people tried to enter/exit these doors without waving their card.

3^rd Floor was the baby floor. When you got into the elevator and pressed 3, people often would ask questions. “Are you having a baby?” “Is it a boy or a girl?” About a quarter of the floor was dedicated to birthing rooms and the rest was for moms and babies to go after the birth.

We headed toward the birthing rooms. Room 5 was huge! I was amazed at how much space we had. We had the room all to ourselves. I was glad we didn’t have to share a room with another woman going through labor. There’s a lot to giving birth, lots of fuss, noise and don’t forget family. So having our own room was nice. The first healthcare specialist we met, Sheila, was either a nurse or some kind of technician. She was great! Sheila set my wife up, took her blood pressure and made sure she was comfy. She and my wife talked about babies (She had had four.), playing tennis, and riding horses. She made us feel very welcome.

Posted: February 16th, 2009 under California.
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We recently suggested group health insurance coverage for an applicant who was waiting on her status on a private insurance application from underwriting. Her status was not yet available and she needed to get coverage in place quickly. In January of 2009, Kaiser received a high volume of applications and the process has been taking longer than anticipated.  We anticipate processing times on individual and family applications to improve in the near future, but in the meantime group coverage may be the best option for some. There are a couple advantages to small business medical insurance.   

1. You can get coverage in place more quickly

Recently, underwriting has been taking six to eight weeks to process private health insurance applications. Group medical applications are processed more quickly. Small businesses and self-employed individuals can often get coverage in place in a week or less. 

2. Pre-existing Conditions are OK

The small group medical insurance forms do not include any medical questions. Preexisting health conditions that would be cause for automatic denial on a private health insurance application are not a problem when applying for a small business plan. To qualify for group medical benefits, you simply need two people on the plan. Husband-wife businesses are OK if spouses file taxes jointly. We have even qualified one person groups in some cases. In one instance, one spouse was on medicare and the other was too young. Since medicare is counted as group coverage, we were able to qualify them. The younger spouse we put on the Kaiser group plan and the older spouse signed the declination of coverage saying that he had group insurance through medicare.

Posted: February 3rd, 2009 under California Group.
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