Thursday, March 18, 2004

Welcome to the world


After a long effort, a Landen couple are first-time parents who know the anxiety and joy that accompany the birth of a child

By John Johnston
The Cincinnati Enquirer

PHOTO GALLERY

Moments of Life: First baby
The room is ready. Brady's room. Pale yellow paint. Midnight blue wallpaper adorned with whimsical suns, stars and crescent moons. An animal-theme mobile above the crib. Five white pillows with embroidered letters that spell the word "DREAM."

Lori and Doug Neltner are ready, too. Their dream is about to come true. A child, their first. "An extension of our love for each other," Doug says.

It's dark and cold when they leave their Landen home for Bethesda North Hospital. They arrive shortly after midnight and make their way to Labor and Delivery Room No. 7.

Lori's blood pressure is a bit high and she's showing signs of mild toxemia. So her obstetrician, Dr. Larry Johnson, has decided to induce her early this morning.

MOMENTS OF LIFE

This part of an occasional series that documents moments that connect us. This year, the series focuses on firsts that are life's milestones. We welcome your suggestions. Contact John Johnston at 768-8516; e-mail: jjohnston@enquirer.com.

THE STORIES

First trip to the dentist
First flight
First baby
First comedy gig
First T-ball game
First college graduate

About 1:30 a.m. and again at 5:30 a.m., Lori takes medication to thin her cervix. Between that and frequent trips to the bathroom, she sleeps little. The same goes for Doug, perched on a cot next to her bed.

At 7 a.m., registered nurse Amanda Schulz begins her 12-hour shift. And just after 7:30, Dr. Johnson tries to break Lori's water, but her cervix hasn't dilated enough. The Neltners settle in and wait.

• • • 

They married in August 1999. A good-looking couple. At first, they expected to wait a couple of years before starting a family. But both were eager, so they began trying after only a year.

Doug, now 30, is a sturdy 6-foot-3. He's a LaSalle High grad, and works in the AK Steel coke plant. Lori, a 29-year-old brunette, graduated from McAuley High. She was an information systems administrator until leaving her job a few weeks ago.

After nine months of trying, they hadn't conceived. A doctor ran tests on both, but found no problems. Lori began taking a fertility drugs, to no avail.

Growing more concerned, the Neltners visited Dr. Glen Hofmann at the Bethesda Center for Reproductive Health and Fertility. More tests followed. But no answers. Frustrated but hopeful, the Neltners began artificial inseminations.

For a week, Lori received daily shots of a fertility drug, which either she or Doug administered at home. She also visited the doctor's office for blood tests and ultrasounds about every other day for 10 days. On the fifth visit, Doug's sperm was placed into Lori's uterus.

The Neltners repeated the procedure for several months. Still no pregnancy.

"Unexplained infertility" is not uncommon, Dr. Hofmann told them. He outlined the next step: in-vitro fertilization. Eggs are fertilized in a laboratory and the embryo transferred into the uterus.

The decision weighed on the Neltners. They had been trying to have a baby for almost three years. They worried that if in-vitro didn't work, they might not have enough money to pursue their other alternative, adoption.

They chose in-vitro, a more aggressive procedure with more needles, more shots, more tests and more doctor visits. The shots, sometimes twice a day, began late last May. Eggs were retrieved in early June, and were transferred into Lori's uterus on June 11.

One week later, Lori was sure it hadn't worked. She had one home pregnancy test left. Dozens of times she'd been disappointed when only one line appeared in the little window.

That day: two lines.

Lori woke Doug by unceremoniously pounding on him. "Look at this!"

• • • 

8:25 a.m. Schulz checks the fetal monitor flashing numbers beside Lori's bed. "She's having pretty strong contractions," the nurse says.

Lori has already decided that when the time is right she'll have an epidural, a local anesthetic. Dr. James Weller stops in and explains that pain will be reduced, but, "It's not going to make you numb. We want you, when it's time to push, to feel the contractions, and be able to push with the contractions."

Lori's mother, Mary Kay Harmeyer, arrives. It's a beautiful day, she says. But Lori's room, with lights dimmed and curtains drawn, is downright gloomy. Mary Kay opens the curtains, brightening the space.

9:40 a.m. As Schulz examines Lori, her water breaks.

10:50 a.m. Lori grimaces as the contractions grow more intense. Doug folds up the cot to make room for John Henzmann, the nurse anesthetist who will do the epidural. It's over in 15 minutes.

"It wasn't bad at all," Lori says.

11:40 a.m. Lori's father, Denny, and brother, Mike, arrive. Lori happily greets them. The epidural is working.

1:58 p.m. Lori awakens from a nap, feeling uncomfortable. "I can feel the contractions again," she says. Doug calls for the nurse. She finds Lori fully dilated. A call is placed to Dr. Johnson, in Fairfield.

Doug leans close to his wife. He kisses her. He fetches a cold washrag for her forehead.

Lori asks that the curtains be drawn. A gloominess again settles over the room.

A knock on the door. It's Doug's parents, bearing gift-wrapped presents.

"We're going to start pushing," Schulz says. Family members wish Lori well and depart.

Schulz directs Doug to stand to Lori's left. The nurse positions herself at the foot of the bed.

"He has a hairy head, I can tell you that," Schulz says.

She tells Lori that she'll feel pressure build with each contraction. She instructs her to take a deep breath, blow it away. Then take another deep breath, hold it, and push. Three pushes with each contraction.

Here comes one. Breathe in. Exhale.

"Now big, deep breath in," Schulz says. "Hold it like you're under water. Push ... Push ... Push. Push, push, push, push, push. Blow it out. Take a breath in and push hard again."

Lori tightly squeezes her eyes shut.

"Blow it out. Big deep breath in. And push hard again. Harder, harder, harder, harder, harder. Good job," Schulz says.

2:44 p.m. Schulz says Dr. Johnson has been delayed by traffic.

More contractions. As Lori pushes, Schulz counts aloud. "... four, five, six, seven, eight, nine, 10. Blow it out. Big deep breath in and push."

Contractions come at 2:49 and 2:51 and 2:53 and 2:55. Lori's face contorts each time. But there are no grunts or groans. "If it feels like your eyes are going to pop out of your head and fly across the room, that's normal," Schulz says.

3:12 p.m. Dr. Johnson arrives. He has graying hair and a mustache, and the experience of having delivered more than 2,000 babies. He pulls on rubber gloves and examines Lori.

"Can you see him now?" she asks.

"You've got a little bit of work yet."

Contractions come steadily, every two minutes. When not pushing, Lori wears an oxygen mask.

3:50 p.m. "Is it getting closer or is he being stubborn?" Doug asks.

"Yes," the doctor says. "A little of both."

4:05 p.m. Lori's breathing is heavy. She's battling exhaustion. Dr. Johnson asks she if she wants help. She does.

Schulz gets on the intercom: "I need the vacuum, please."

Dr. Johnson explains that suction will be applied to the baby's head to assist with delivery. "He'll have a bump."

"Temporarily?" Lori asks.

Yes, the doctor assures. He removes his watch, pulls on fresh scrubs.

Lori is almost completely covered now: wash rag on her forehead, towel across her chest, blue sterile drapes over her legs.

More contractions. "Deep breath in," Schulz repeats.

"C'mon baby, c'mon baby," Doug says. "Good job, sweetie."

4:16 p.m. "Time for him to come - what you've been waiting for," Dr. Johnson says.

Lori summons a deep breath. Everyone urges her on.

"Let's see this baby!"

"Push, push, push, push, push ..."

Doug: "Good job, good job. One more time, push, push, push, push ... Here he comes, baby, here he comes."

And then: "He's gorgeous, Lori."

Dr. Johnson quickly removes the umbilical cord from around the baby's neck. The infant's face is purple.

Lori sees her son for only an instant before Schulz whisks him away to an infant warmer.

"He's going to be fine," the doctor says. "He just needs a little help."

Doug leans close to a tearful Lori, and they fix their eyes on the tiny body in the warmer, a few feet away. They say nothing. The room becomes quiet.

"His heart rate's fine," Schulz says, working quickly and methodically. "He just needs to get going a little bit."

Schulz rubs his back. Flicks his foot. Usually, that does it. Usually, the baby cries.

Seconds pass. A half minute.

"All right, Brady," Schulz says with a hint of impatience, "time to cooperate, bud."

She places a small mask over his face. Oxygen.

A minute has passed. Schulz rubs his back and bottom.

Let the record show that at 4:20 p.m. on Feb. 27, 2004, Brady Alexander Nelt-

ner, 6 pounds, 10 ounces, announced his arrival in the world.

Waaauhhh.

"There you go," Schulz says. "Welcome."

The curtains remain drawn in Labor and Delivery Room No. 7. But the gloominess is gone, replaced by an unremitting joy that, moments later, looks like this: a man stroking his wife's hair as she sways gently, holding their healthy, first-born child to her chest.

E-mail jjohnston@enquirer.com




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