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Tuesday, November 29, 2005
Welcome to the International House of Boobs
I smell like pancakes.
My OB's office for some reason wanted me back on birth control right away. I made sure they knew I was breastfeeding and went along with it. I was to take the first pill Nov. 20, but having been off the pill for several YEARS...I forgot. I took the first pill Monday, Nov. 21. By Saturday morning I had almost NO milk left.
Turns out the nurse practitioner in the peri's office accidentally prescribed the wrong type of pill (estrogen only when she should have written it for progesterone only) and she had me start at three weeks after delivery when she should have had it start no sooner than six weeks after delivery.
As a result, I am now taking a prescription drug (the same drug used to treat my son's acid reflux, which by the way seems to have gone away and as of yesterday he no longer takes medication for it) to increase my milk supply. In addition to that, I am taking fenugreek. The fenugreek, an herbal supplement that is thought to increase milk production, smells like maple syrup. In fact, it is used in artificial maple flavorings. And it makes my skin smell like syrup.
Production is slowly coming back. I'm thrilled as my little man had to take formula for a little over a day and I desperately wanted it to never come to that.
In other news...I have received many beautiful hats from many wonderful women. I'll have to take pictures at some point. I have just been so damned busy with all the goings-on at the NICU and lots of family visiting (five family members for Thanksgiving, more expected over the next few weeks/months). One day I'll be able to get things in order again. If you did send me something, thank you so much! If you wanted to and I didn't respond to your email, please forgive me. I hardly have time to post here and am now just over a month behind in responding to emails. I'm trying, but I just can't seem to keep up! Don't feel neglected -- I haven't emailed many members of my family nor have I returned phone calls to friends and family. When I'm home, I mostly just sleep and occasionally post a badly written update here.
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Friday, November 25, 2005
Family invasion
We are infested with family members right now (alright, my in-laws, my parents and my step dad's mom....but in a 2 bedroom, 2 bath apartment? INFESTED!)
Things are going well. The lowercase was moved from the "D pod" section of the NICU (right next to the doctor's station and where the newest patients and the most critical patients stay) to the "A pod" section which is normally the developmental pod where parents take over much of the care and babies are prepped to go home. Of course, they are renovating the pods (A is done, B is currently being done) so they are down 12 bed spaces and the A pods are not entirely developmental. They've annexed a portion of the pediatric ICU and that has become the developmental "pod." (In reality it is three separate ICU rooms each staffed with a single nurse and three stable babies.) Quintuplets were born at 24 weeks shortly after the lowercase moved to the A pods. Bed space was needed in the D pods, so the most stable there were moved to either C or A and the most stable in those were moved either to A or the annex. The lowercase made the move to the annex in the PICU.
The PICU where I do NOT shift my head to the sides because it kills me to see children suffering the way those children are (cancer patients, cardiac patients, those awaiting or recovering from organ transplant....just don't look!) (And for someone who spent a large portion of her life in and out of a large children's hospital -- not many overnight stays, but lots of tests, exams, blah blah blah -- it surprises me that I am now bothered by it. It used to be common for me and "normal." I think having a son changed that. I am now so afraid of those things because I know how it would kill me if it were my little boy and I CAN NOT THINK OF THAT!)
So...anyway, PICU annex of the NICU. Quiet. Private-ish. The lowercase is the smallest baby in our room. One is on the countdown to home (a 33 weeker who stayed in the NICU because he had some feeding issues; now 2 1/2 weeks later he's an eating pro and looks huge to me at 5 lbs; however he isn't gaining weight as fast as they would like). Likely he will be home by Sunday unless he has another event (our requirements to go home: Open air crib with self-regulated temperature; All feeds by bottle or breast; no events of apnea or bradychardia for a week). The other baby in the room is still being monitored, is working on getting the amount of his oral feeds up (but he is off gavage feedings), still has some events and is having trouble getting his reflux under control as he gets bigger and his previous doses are outgrown.
In good news: as of 9:00 last night, my little man had had only one event in almost 48 hours! Also! He is now just over 3 lb 1 oz! (For those of you non-pounders: 1390 grams!) AND! He is allowed and ENCOURAGED to wear clothes now! And some of his preemie clothes are actually not that much too big for him! (But they are still too big for him. He'll be able to wear them for quite some time.) And they took away his snuggle up (a fabric ring that goes around his sides and feet and has ties that wrap over the top to pull it tight against him creating a "womb" effect by giving him boundaries to kick and hit at). This has to be done in order to start getting them used to sleeping on their own. He also is gradually moving towards sleeping only on his back since that is how he will have to sleep at home. So...we're moving forward.
(Breastfeeding is another story. He doesn't like it yet. He plays tricks (opens his mouth as if he's going to latch and then yawns; stick out his tongue and lick me, then closes his mouth and refuses to open it; latch for 3 sucks then goes to sleep....the list goes on). The nurses keep reminding me he has only been trying this since Saturday and is not quite to 33 weeks developmentally, so no cause for alarm. More later. Everyone is now awake and Mr. W is cooking breakfast. (Bacon smells so horrific! WHY does he eat it? How did a primarily vegetarian [me] ever fall in love with a beef and pork lover??? [And why does his JEWISH family love pork so much???])
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Sunday, November 20, 2005
No time for titles
Things here are good. Mr. W is well again. I am fast approaching 100%. Currently, I'm at that final stage of the cold where everything that was causing the stuffy nose drains. Thankfully, I am allowed back in the NICU!
Yesterday I actually got to hold my son for the first time in almost a week. He was wrapped in a gorgeous blanket made by the fabulous Julie as he made his first attempts at breast feeding. Honestly, he's not too bad at it. He doesn't do more than a few little sucks before taking a long break, however he doesn't let go of the nipple. The nurses were all quite impressed -- at 32 weeks ("gestational age") he is doing extremely well.
Two of his neonatologists (our original attending and the woman who covered for him during his two week vacation) were walking through the NICU and stopped to talk to Mr. W. They told him that our lowercase is doing fabulously. And they assured him that our baby is "not as far from discharge as you might think."
They think he could go home as early as the end of 33 weeks. Obviously, he isn't as likely to come home then, but it is possible. More likely he'll be in the range of 35-37 weeks. Regardless, that is all before Christmas! I'm trying to not let my hopes hinge on those date ranges though and am instead still planning on his original due date of January 12.
Things that have to happen in order for him to be released:
- "Graduation" from the isolette to a crib (which is made of steel bars and seriously looks like some sort of prison-esque cage)
- All feedings by mouth
- No episodes of bradys, apnea, or O2 desat for one full week
Both attendings assure us that for most babies all of these issues clear up at exactly the same time. They simply "get it" and everything moves forward. Further, they assure us that weight is not an issue for our hospital. They don't say that a baby has to reach a certain point as they could hit that mark and not be ready yet or they could be healthy and ready before they reach an arbitrarily set weight.
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Wednesday, November 16, 2005
Photo of Baby W at 5g over birth weight!
His face and arms have gotten a little rounder while we're both home sick.
-Mr. W
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Tuesday, November 15, 2005
It is official. I am sick.
My peri's office did a strep test for me. I called them for a referral to somewhere that I could get it done quickly and one of the NPs said "Just come here and I'll do it."
Of course, they don't have the rapid strep tests since they don't do those normally and they have to send it to the lab. They said it takes 2-3 days for the lab to get it. HOWEVER...she did not see any strep colonies and felt it looked like swelling of the throat due to sinus drainage.
And...if it is a cold and nothing more....
I can still breast feed because my milk will give the lowercase antibodies against this particular virus and he will not catch it. They said that if I'm still worried, it is fine to scrub thoroughly for 3 minutes and then wear a mask while I'm with him so that I don't breathe my germs out on him. The same goes for Mr. W, however his nose is draining forward, so he can't easily wear a mask. It is rather inefficient when you have to continually remove it to blow your nose.
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Monday, November 14, 2005
Mr. W is sick!
He is, however, feeling better than I am. I have had a sore throat for several days. Generally it has eased when I go home from the hospital, so I had thought it was just the dry hospital air.
Tonight it hasn't eased. I am fearing the return of the strep. Since I began student teaching, I have a tendency to get fairly severe strep throat every year in the fall. I thought it was because I picked it up from the kids. However, I haven't been teaching for over a year. And I didn't have it last year. But I fear that that is what I'm getting.
I am now panicking because if that is the case....
Well, it can't be the case. That's all I can say. We are supposed to start breastfeeding on Friday! FRIDAY! I. Can. Not. Be. Sick.
I think Mr. W's hypochondria may be contagious ;)
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Sunday, November 13, 2005
A rough day (For me; not he)
Today was very hard on me. I'm not sure why. I just couldn't handle it anymore and had to come home at 3:00. I'm going to go back in after the shift change (ends at 7:45 pm). My little one is continuing with his current protocol. All is good.
But I couldn't take it any longer. His acid reflux always leads to bradys and de-sats. And I just didn't want to watch it again. It hurts my heart to know that he's having acid reflux and I can do nothing to help him. I hate it. They assure me it's all very normal and that he will outgrow it. Logically, I know this is true. But, as I've said, it just hurts me so badly. I couldn't bring myself to have to watch it again even one more time. So, I called Mr. W to come and get me.
Of course, Mr. W is having issues of his own. He either has a cold beginning or is suffering from allergies for the first time in several years (in the concrete nastiness of our former home, he had no allergy issues; here? There are TREES and FLOWERS and GRASS everywhere). Sadly, we don't know which it is and just do not want to risk passing something to our lowercase. It's just so stressful and Mr. W has cried several times since last night because, "If I'm sick, I can't see him and I've never gone a day without seeing him since he was born!"
So...kind of rough day for me.
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Yesterday afternoon my little lowercase was weighed again. And I am a bad mother because I can't remember the weight in grams. It was either 1145 or 1150; I'm not sure which it was called on. But his nurse did something wonderful. She pushed the button that told me his weight in pounds and ounces: 2 lb 8.6 oz. We are inching ever closer to his birth weight and I am absolutely delighted!
Timmy's feeds are now up to 14 cc/3 hours...at least through his 9am feeding today. At noon, his protocol goes up again.
He is beginning to wake up shortly before his feeds and several times the nurses have seen him rooting. He knows. He knows! When I hold him as he feeds, if my hand is anywhere near his mouth, he pulls one of my fingers in and sucks vigorously for a couple seconds -- until he realizes that it is producing nothing and what the hell? If I can't get anything, I'm not doing this! He is the same with his pacifier.
We have begun to have a few more instances of decreased O2 saturation at the beginning of feeds (most likely associated with the beginning of sucking while he is being fed through the NG tube). He has also had a few more bradys near the ends of feeds, associated with acid reflux. He is getting reglan 30 minutes before every feeding and the doctors assure me that both of his issues will begin to go away with the medication and his increasing age.
His overnight nurse told my family yesterday that he is the cutest baby she's seen in a very long time. She assured us that he is currently the cutest baby in the NICU -- and then she said, "Believe me, we get some UGLY babies in here. Yours is one of the absolute cutest I think I have ever seen." And she repeated that several times throughout the evening. Nothing like external validation to prove you aren't as biased as you thought you were ;)
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Saturday, November 12, 2005
Yes, I am a lying liar!
Quick post before I sleep.
My little lowercase GAINED MORE WEIGHT!
We are now up to 1105 grams -- that much closer to his birthweight of 1210 grams! Don't ask me to convert things. It took me (literally) an hour to do it. Too much work for me!
I was speaking to my nurse and I told her about the woman mentioned in yesterday's post. I said that because I am a teacher and am therefore required by law to report anything like that, I was feeling really guilty that I had no way to do so. Since I don't know the name of the mother, there is no way that I can. And I said that, obviously, based on what she said to me, there was something going on. My nurse immediately told the NICU social worker, who came to sit down with me and discussed it all. She wrote down all the pertinent details and is adding that to the file. She also assured me over and over again that they do not try to take people's babies away and certainly don't kill any of them as their main goal is to save these little lives and send them to a safe and loving home. I told her that I understood that fully, that I am used to the type of ignorance that I heard from that mother and child because of the types of schools in which I teach. My main concern out of all of it is the poor children of that woman (I've now met 3 of them in waiting rooms -- dinner for the appx. 6 year old boy tonight? Some kind of creepy smelling red fruit punch and barbecue flavored cheetos). They deserve so much more damn it! It really sickens me.
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Thursday, November 10, 2005
Photo update on the lowercase
Peeping out from the isolette (11/03/2005)
Checking things out (11/06/2005)
Sleeping soundly after dinner (11/10/2005)
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Reflux Sux
My little man has begun displaying behaviors associated with acid reflux. By "behaviors" I mean that he has a couple bradys near the end or just after a feeding. He is at 8 cc/3 hrs now so it's a lot for his little tummy to take. I have been a wreck all day as a result. All of the nurses assured me it was nothing and in fact, many of the bradys didn't even make it to his book because he self corrected so quickly that it "doesn't count" as the real thing. Still scares the bejeezus out of me (is that a midwestern thing? Getting the bejeezus scared out of you? Or is it more national/global?). Mr. W even asked the doctors during evening rounds and they assured us that it is all quite normal and that he is alright. He is alert, his behavior isn't altered by any of it, he shows no signs of distress, and today he gained 45 grams putting his weight at 1080! We're creeping ever closer to his birth weight of 1210 grams! I think the day that happens I'll bring in a cake and have a little party of relief in the NICU.
I did have a rather bad start to my day. Having nothing whatsoever to do with the lowercase. I got in as rounds were happening in my pod, but it was my team so it was just a matter of time until I got called back for my son. It ended up being even sooner than I had expected, so I didn't get to scrub on my way in. (The results: he's doing great, keep going with the current protocol)
I then had to go back into the scrub room, wash my hands/arms for three minutes (fyi, you will get soap burns from the caustic surgical scrub if you do this multiple times a day. I now have been instructed by the nurses to skip that and use the purell on the wall in my pod for several days to give the welted, bleeding burns on my arms time to heal). Once that was done, I sat on the couch in the scrub room and waited to be called back in.
A woman and her daughter walked in (I will not go into any more description than to say she was extremely ghetto). The little girl appeared to be 5 or 6 years old. The woman told her to sit on the couch beside the lady and then said "You gon' be here a while?"
"Yes, until they're done with rounds and I can get back in to sit with my son."
"You'll watch her for m?"
"Um...ok, but I'll be going in as soon as they tell me I can."
"You just had a baby?"
"Yes."
"There's some serious mess goin' on in this place. They gon' try to take ever'body's babies away. They try to take my boy. They gon' try to take yours. They just ain't no good here. These doctors and nurses....(Miss W tuned out for several minutes)...you know?"
"Um...they've been really great with my son. I haven't had any cause to think ill of anyone here."
"You just wait."
And then the little girl, "They're gonna kill your baby."
"No. No, they're not. They're helping him get healthy enough to come home with me."
Followed by mom's, "If you're lucky. They gon' try to take ever'body's babies away."
The mother goes in to her son's room -- he is not in a pod, but in an isolation room. He looks to be about 3 months old as I have seen him being held by several nurses. His hair is...odd....it has strange bald patches in the middle of his mass of unruly tight curls. It does not appear that these patches are as a result of something medically required. There are no tubes or wires anywhere near his head. I begin talking to the little girl, who at 9:00 am is opening a blow pop and sifting through a large bag of candy.
The little girl tells me that the hospital "done sent people to look at our house. But our house is clean! They ain't got no right. Besides, we're movin' soon anyway, so it don't matter what this house looks like. We won't be there too long."
I couldn't take any more of that, so I changed the subject.
"What grade at you in?"
"..." (accopanied by a blank stare)
"Are you in kindergarten or first grade?"
"I go to kindergarten."
"Do you go in the afternoon?"
"Yes....(confused look)"
"Or do you go all day?"
"I go all day."
"But not today?"
"No, I'm not going today. I might go back Tuesday."
"..." (now I'm the one with the blank stare)
I then changed the subject to ask about the candy and her favorite kind of blow pop. At that point, her mother came back out and my son's nurse came to tell me that it was clear for me to come back again. I said good bye to the little girl and walked inside.
As we walked in to my pod, I looked at my nurse and said, "You know, the daughter's cute, but that mom....well, I'll be nice...she's a piece of work." My nurse looked at me and said, "You don't know the half of it."
I am haunted by that little girl's words. There are so many things I wish I could have said, but I value my life more than that. The mother was easily 3 times my size and I don't think she's above extreme violence (I've seen security guards standing around the doors of th NICU when she's around; when she isn't, which is most of the time, they are never there). The things I wanted to say though?
"Um...I don't think they try to take away everyone's babies...just the babies of women who leave their kindergarteners in the care of complete strangers. Sure, I look nice, but you have no proof that I am."
"Maybe they have a problem with parents who think it's appropriate for their child to be out of school on a Thursday and who 'might' send them back on Tuesday."
"Well, if your daughter's breakfast is any indication of the way you care for your young children, maybe they're right to try to take away your baby."
"You know, bitch, you don't deserve that little boy in the other room and you don't deserve this little girl either. If you have any idea how much so many women who want what you have have had to go through, you'd shut the fuck up, get yourself in order and actually care for these children the way they deserve to be cared for you worthless piece of shit."
That experience alone tainted what could have been an otherwise peaceful day. It just ruined my mood right from the beginning. Still, being with my son, holding him in my arms while he took his feeds...it was the best feeling in the world. One that I just can't get enough of. He is so absolutely perfect. I love everything about him -- including what appears to be a tiny birthmark shaped like a rubber ducky on one of his hips. It's possible that it will fade, but damn it's cute!
I won't be posting much or checking mail for about the next week. My parents will be arriving around noon tomorrow and staying with me until Sunday. On Sunday evening or early Sunday morning, my grandparents will arriveand will be staying with us until Wednesday. I promise to try to post at least once in that time, but I can't guarantee anything.
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Tuesday, November 08, 2005
The one with no punctuation (and measurements)
If for some reason you find yourself missing two pumping sessions because you are in a rush to get to the NICU to see your baby and immediately walk in, change his diaper, give him a feeding, and realize you are now over an hour late to pump, and, oh, yeah, you need to run to the other wing of the hospital and up five flights to have your staples removed, and then you have to wait nearly two hours to have them taken out, and then you have to run back to the NICU because it's time to diaper and feed your baby, and then your husband arrives to have lunch with you and as you are walking out you find out that they are taking out your baby's nasal cannula because he is a breathing superstar, and you and your husband decide to stay for that, and then you realize you're an hour late for this time to pump and are four hours late for the previous pump, and you are hungry and they are about to close the lunch lines in the cafeteria so you run downstairs and then finally you get upstairs and pump, then spend some quality time with your baby and when it's time for you to pump for the 4rh time of the day, it's also time to diaper and feed your baby, and then you need to get home because your husband has a work crisis, so you can't pump until then and when you finally do, you pump for 20 minutes, don't get a ton of milk, and it hurts like hell so you finally stop....FIVE minutes later, milk will begin pouring down your torso.
You will also lose all ability to punctuate and form anything other than one long incoherent sentence. Also? You will feel like a terrible mother for pumping only 3 times since 6 am. How crap is that?
In other news, his feeds were increased to 3 cc every 3 hours. His protocol is to go up 1 cc after every fourth feeding. He did have to have reglan introduced today as he has had mucus residuals (no breast milk -- he's digesting that) and they want to give him a little help with his digesting. But the most exciting part of the day was the removal of the nasal cannula! My little one is doing really well right now. Just hoping we can keep the momentum. I want him healthy and at home with me so badly.
*The lowercase's head circumference is currently 26.5 cm.
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Monday, November 07, 2005
A really good day
Today was a great day in the NICU. When I got in, the doctors from the "blue team" (Timmy's team) were doing rounds. You are only aloud to be in your pod during rounds if the doctors are in another pod or are rounding on your baby. Of course, I wasn't allowed in.
So, I hung out in the breast pumping room "preparing breakfast." I took my time and relaxed until just after 10 (yes, I made a 10-15 minute pumping session take an hour (I was anal retentively scrubbing the pieces of my pump, cleaning the counters where I would lay them down, etc.) I may have also taken a nap.
At ten, I finally got in to see my beautiful son. And then the "gold team" began rounding in my pod and I had to leave. Stupid "confidentiality." Screw that! Seriously, I don't notice a fucking thing when I'm in that room if it doesn't have a direct connection to my son.
So, out I went to sit on the couch in the scrub room just outside the NICU. I spent about an hour there, flipping through various baby catalogs. Finally just before 11, I was in.
When Timmy's doctors rounded, they discussed his protocol for the next 24 hours. Nasal cannula back down to 1.5 L of room air (still no oxygen). No more bilirubin tests -- he's leveled off and is past the point where most premies have to go under the lights. That isn't to say that he couldn't still become jaundiced, he's just past the most likely point when he would. Feeds back up to 2 cc every 3 hours. So far, he has digested them all. He gained weight for the first time today! He's up 5 grams to 1025 g (birth weight was 1210 g). AND...he's pooping again! Today he had a bit more meconium mixed in with his poop making for a tarry black and green mess and one pissed off little boy as I tried to get it off his little thighs and butt cheeks. He got so pissed off that he pissed all over my hand. But I totally deserved it. It had to have hurt getting the same tiny spot wiped over and over again. Then after Mr. W got off work this evening, he changed Timmy's diaper. Another poopy mess. And as Mr. W wiped him off? The boy shit on his father's hand. I felt such pride! Since I had held him and fed him several times during the day, I let Mr. W do it all tonight. There is nothing so heartbreakingly beautiful as watching the man you love caring for your child. I literally melted into a puddle of goo right there on the NICU floor.
So...all of those are good things, but the best part of the day? Feeding Timmy while he laid across my bare chest. Feeling the rhythm of his body against mine. Knowing that that is the way it is supposed to be. Me and him, together, closer than anything else in our lives. After he finished eating (it takes about 15-20 minutes) we reclined in the chair and just laid that way for nearly two hours. He only went back in the isolette because Mr. W arrived for lunch and I was more than an hour and a half late taking my pain pills. Otherwise, we might still be there in that chair. I know I would have never gotten up.
All that good stuff...and now I have to start loading up on the pain pills. Tuesday morning my staples get removed. Am ever so scared!
For those who asked, I do have the current circumference of Timmy's head. I accidentally left it in the car when we got home and I am very tired. It's either 26.5 or 29.5 cm. I will look in the morning. I have no idea how fast his head will grow...maybe we shoot for a number a bit bigger than that so that it fits after shipping?
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One week
As of 4:12 am, my son is now one week old.
I can't believe it. It seems like he's been with me forever, yet no time at all. I can't remember how my life functioned or what purpose I served in the grand scheme of things before him. I told Mr. W that last night and he said, "Sure you remember. That's when our lives were lonely and empty only we were too stupid to realize it." When we did begin to realize it and started trying to start our family two years ago we were optimistic about everything. And then it all fell apart and I didn't know when, how, or if I would ever be able to do this. I only knew that I couldn't stop trying. I wanted to, but I couldn't.
From my vantage point now, I am thrilled that I didn't stop. I can't imagine my life without Timmy.
It's amazing the way things change so quickly.
Now for the updates. Timmy did really well with his 2 cc/3 hours feeds. For a while. He handled 3 feedings no problem. But we had to skip the 4th as his tummy just wasn't done digesting all of the third. He was fine for the next several, but then had another that didn't get finished digesting. At that point, the doctors decided they would switch him down to only 1 cc ever 3 hours to let him get used to it. They also had to adjust his nasal cannula back to 2 L of room air from the 1.5 L they had backed down to. To me, it makes sense. I couldn't believe it when they turned down his cannula and started him on way more feeds and larger quantities than they had told me they would the day before. It's strange because he's ready, but not completely. He's just right on the borderline.
During evening rounds last night, the decision was made to stop feeds overnight. He had digested all of his food, but had 2 cc of mucus/gastric juices in his stomach. He has the same problem his mommy does right now -- he's just not pooping regularly. So they put him back on glycerin shaves (tiny pieces of pediatric suppositories) every 12 hours to help him feel those sensations. He has gone on his own without them, but that was before the introduction of the milk. The thought is that if he has the shaves every 12 hours, it will teach him that sensation, help him to clear out the mucus/gastric juices, and allow him to digest better so that he can take more milk.
It's amazing how strong he is for such a little guy. I am so damned proud of him. He's been a fighter from the start. He took on my fucked up uterus and he WON! I just can't wait until I'm able to hold him whenever I want. The only times I'm truly happy during the day are the times when I'm holding him, taking his temperature, changing his diaper, feeling him close to me. I melt every time he looks at me. I have never seen a child so perfect and so beautiful. And as I look around Timmy's pod, I see how really good we have it. He's in such a better place than many of the other babies there. Today Timmy's gestational age would be 30 weeks 4 days; 7 days of NICU life down; 7 days closer to bringing him home.
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Saturday, November 05, 2005
Lowercase's first teddy bear!
The nice folks at Teddy Grahams donate teddy bears to the NICU and our lowercase has been with his all day. He's gone from hugging it close to it spooning up behind him.
More photos will be posted in the coming days.
-Mr. W
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Calling all knitters/crocheters;/hat makers!
I need a bit of help here ladies. My son is tiny (allow myself to introduce...myself: Miss W, Mistress of the Obvious!). The little old ladies who volunteer at the hospital knit hats for all the NICU babies. Except they are all bigger than my son right now.
I went to Babies'r'Us and looked at their PITIFUL supply of preemie clothing. I bought two hats hoping *maybe* they would work. They will not. They define preemie as "0-7 lbs" What the fuck?
I bought two cotton/jersey ones and plan to wash them in the hopes that they will shrink up a little bit for him.
Whenever we take him out of the isolette to be held, he has to wear a hat. The one that fit well while he was on CPAP got damaged from the pins that were holding the tubes against his head. He's got a couple that look like they will fit in about 3-4 weeks. In the meantime, there is one knit hat that is rather cute, but he hates it. It might just be that he, like his parents, doesn't want to wear a hat. But it could also be because that hat was not made with the softest of yarn.
I know nothing about how to size a hat, but for those of you who make them, it shouldn't be a long project, I mean, he's not even 3 lbs yet (soon, I pray...so long as those feeds work) so I can't imagine a hat for him would be that many stitches.
If you are willing to take on a project like that, let me know and I can get whatever information you need -- I'll measure around his head if you need that. I'll send you all the shipping information. I'll pay you for your time and services. I just know that it's not something I know how to do and I seriously hate the manufacturers of clothing for preemies.
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An update without much actual updating
Timmy did not start breast milk today as planned. The attending physicians were rotated and the new attending on our pod decided she wanted one more day of suppositories to be sure that all the meconium plugs had been passed and he would have a clear intestinal tract.
We went ahead with the kangaroo care (skin-to-skin contact where the mother holds her diaper clad child to her bare chest) and he loved it. We sat that way for nearly two hours and his breathing, temperature and heart rates were excellent throughout. It was an amazing bonding experience and one that I cannot wait to repeat over and over again.
The plan as of now is to introduce a specific quantity of breast milk via a feeding tube (either through the mouth or nose) while holding him skin-to-skin. This way they can have an exact quantity of milk reach him and evaluate his digestive system's effectiveness while allowing him to connect the feeling of a full belly with maternal contact. Over the next several days, quantities will be increased and then a bottle will be used to help him connect the concept of a nipple (again, while still controlling the amount of intake). As he gets stronger and those connections begin to click, we will move on to feeding directly from the breast whenever I am there with him.
I am trying to not speculate on the time when he will come home since it's uncertain when that will be. For now, I prefer to look at it this way:
NICU, day 5 complete. Five days closer to coming home.
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Friday, November 04, 2005
Birth Story, Part 2
As soon as anesthesia was ready, I was taken into the OR. I'm not sure what she said, but the L&D nurse who took me in made some comment that put me completely at ease. She reminded me of my aunt (one who was my favorite as a child, but who in recent years has shown herself to be completely inflexible and actually not a likable person; but that isn't the point. My nurse reminded me of my aunt back when she was someone I could idolize and love).
It took two anesthesiologists well over 30 minutes to place the spinal and at least another 15 with my body strapped to the table being turned and angled in various directions before my right side (full of baby) was numb enough to begin. Several times I heard "we can always do general anesthesia if we need to" "lets switch to general." But my L&D nurse knew how badly I wanted to be awake and each time she'd look to me, I shook my head no and she would encourage anesthesia for one more try. To be honest, each time one of the anesthesiologists wanted to give up, the other would say "but I think there's a way..." and eventually they got there.
Mr. W was allowed in and within 15 minutes of his arrival, he was standing to look over the drape at our son lying on my blood covered belly.
Our little lowercase (Timmy for those in the know) was whisked away to another room to be cleaned up and examined. We heard nothing and had no idea what was going on. Mr. W could see the neonatology team through a window in the door and he said to me, "He must be alright. They're smiling. And laughing. They wouldn't do that if he wasn't alright."
Mr. W was finally called back into the room with the lowercase. He nearly passed out (and succeeded in falling against a wall breaking the rack from which charts are hung) when he saw our little boy. There were no tubes. No wires. And there was no need. Timmy was breathing on his own beautifully. He was just quietly laying on the scale as they wrapped him up to be brought to me.
Mr. W doesn't remember what they said the APGAR was at 1 minute. What we do know is that the 5 minute APGAR was a 9! I can honestly tell you that I will never ask for the 1 minute score. I know what I need to know. My son was brought out to me and as soon as his cheek touched mine, he made the sweetest, softest cooing sound. I have never been so happy in my entire life. He is beautiful. He has the ten tiniest fingers I have ever seen and 10 teeny tiny toes (on feet that are huge for his tiny little body).
He is doing so well now, just over 72 hours since his birth. He was initially on CPAP, but they found he didn't need it. If anything, it caused him to have apnea moments rather than preventing them. For him, the constant flow was like trying to catch your breath after a run while standing in front of a large fan -- it's just too much air at once and you can't breathe it in. He was switched to a nasal cannula set on 2L of room air -- there is NO extra oxygen needed. Since the switch there has been absolutely no apnea.
His heart rate and blood pressure have remained constant. He is on absolutely no medication except for a precautionary 10 day round of antibiotics. His first blood count showed that his white cell levels were the slightest bit off, but he has no markers for infection and the cultures have grown nothing. The current thought is the white count was off because of the infection I was being treated for last week having nothing to do with him -- he's just working through mommy's issues.
We were afraid yesterday when he began having bile suctioned from his tummy. They took him to radiology and ran some tests -- upper GI perfect. Lower GI showed several small meconium plugs preventing him from eliminating his own wastes. The enema that was part of the testing began to clean him out and he passed several small plugs. To help get the rest out, he is getting suppositories and they appear to be working. He has passed enough now that they feel certain his digestive system is mature enough and knows how to function.
I have been pumping every 3 hours religiously since Monday afternoon when I was finally functional enough to move (the morphine in my spinal caused me to have serious itching, for which I was given a shot of benadryl that subsequently had me in and out of consciousness for several hours. Thank God for digital cameras and a husband and parents willing to point to each image and say, "No, that's a knee. See, his knee is fine!" when I couldn't even focus well enough to see what was on a picture.
As of yesterday afternoon, I have produced enough milk (in tiny drips and drabs...almost half an ounce from one pumping!) that they have what they need in the freezer for his first few tries at nutrition. I will know after morning rounds if the milk will be put into his IV today or tomorrow.
I continue to be amazed at how well he is doing. He even started displaying the rooting instinct last evening. As I was holding him, I gently laid a finger on his cheek. He opened his mouth and turned toward my finger. His nurse said that usually she doesn't see babies do that until they are around 31-33 weeks at the earliest.
The doctors and nurses all have said that they never see a pre-term baby doing this well his quickly. He really doesn't "need" so much of what they can offer him. He is just "a peach" according to his nurses. He sleeps well, he likes to be held and touched...
He is my little pumpkin butt. I am terrified for him when he is unwrapped and I see just how tiny he is. I know we could still have set backs. But for now, he is well and he is exceeding expectations on all levels. The director of the NICU and his nurse from yesterday and last night have all three said to me that if he continues as he is, he will meet his milestones earlier than expected. They told me to anticipate taking him home on his due date, January 12, but to have everything prepared earlier as they really feel that at the current pace, he could be coming home with me in as little as 4-5 weeks.
We are taking mass quantities of pictures every day (is it wrong that we have filled a full albm already???) and will keep posting his progress.
I know there are days where I will break down completely coming, but for right now, I am able to focus on how well he is doing. Don't ask his nurses though -- I have called them twice since leaving at 9:30 last night and will likely be sitting by his isolette in as little as an hour. However long it takes me to pump, shower, dress, take some drugs and get Mr. W in the car.
Please, continue to pray for us all, from the biggest to the tiniest of W's. We definitely need your love and support. And to all of you still reading...I have read through each of your comments sicne my trip to the hospital a week ago. I would respond to each of you personally if I had any free time. Just know that I appreciate it all. I now have so little free time and what little I have has to be spent preparing things for my son -- we had bought so little and refused to let anyone actually purchase things from our registry based on my fear of the evil eye, so we're going to have a very busy time getting things here and rearranging furniure to set up his room.
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Wednesday, November 02, 2005
Miss W is back!
I am here, and I am alive. And I am far from 'clever.' I am a heaping mushy mess of a woman. To say that I am hormonal would be an understatement. To say that I am in love would not do justice to the true depth of my feelings. I think it's time for a birth story, from my perspective, from what I know of the events leading up to the birth of the lowercase.
I seem to recall writing a post about contractions that I had off and on all day last Thursday, October 27. I finally realized at 9:00 p.m. that I might actually be having contractions and made a call to the peri. He told me that he didn't think they sounded like they were productive and that I should call the office at 8:30 to schedule a quick check to be certain. He advised me to keep track of them overnight and if I had more than 6 in an hour I should come in to labor and delivery to check what was going on.
I counted and recorded every slight contraction until 1 am when I fell asleep. Mr. W had been called back in to work due to some catastrophic system failure or another (please note my sarcasm; I somehow doubted it was important, but the VPs of several other departments at his corporation thought it was). He arrived home at 2:30 am and I rolled onto my left side as he crawled in bed beside me.
At 4:51 am, I woke up. I don't remember feeling any kind of pain that might have caused me to wake. I only knew that I felt extremely uneasy. I reached up above my head and began quietly petting the cat who was curled up against my forehead. And then it hit. A contraction. I wrote the time down and continued petting the cat. At a bit before 6:00 am, I realized that I had already counted 13 contractions. I rolled over and gently woke Mr. W.
I asked him if he thought I should wait until 8:30 and call the office since, you know, this really wasn't anything real, or if I should call now. He answered with the obvious, "Call the doctor NOW while I jump in the shower to try to wake up."
I had many more contractions on the way in to the hospital. Upon reaching labor and delivery, they were hitting at 3 minutes apart, yet they didn't hurt so I was still convinced I wasn't in labor. A resident did a speculum exam and said that I was definitely dilated and that he thought he saw something, but could he get the chief resident to look because he wasn't sure what he was seeing. The chief resident confirmed that my membranes had not been ruptured, but I was 3 cm dilated and 90% effaced.
My peri's office was called and I was rushed into a high risk delivery room where a magnesium sulfate wash was connected to my IV in an attempt to stop the contractions. Alone it didn't work, so endocine pills were added every 6 hours. At 9 am Friday, October 28, I was given a steroid shot to try to mature my son's lungs with another steroid injection given on Saturday at 9 am. I stayed on the mag and endocine through mid-day Sunday (October 30). This was the exact duration needed for the steroids to reach maximum effectiveness. After the labor-stopping drugs, we wanted to clear my system and re-evaluate the situation. This would give us a way to determine if we had merely stalled labor while on the drugs or if we had truly stopped the labor.
By midnight the contractions began coming closer again. And they were increasing in intensity. Additionally, I could NOT lay on my left side. Every time I did, my lungs felt as though they were being crushed and I just couldn't get any air. If I rolled onto my right side, my bladder was irritated -- I kept having to get up to pee...and I peed a lot each time...but I hadn't had any fluids in over 3 hours. I laid on my back, but then I just felt so heavy and uncomfortable. Something was not right.
Around 1:30 am on October 31, one of the residents came over from labor and delivery to the high-risk antepartum unit where I was staying to examine my cervix. He watched the frequency and intensity of my contractions and determined that I was 3 1/2 cm dilated, though he felt I was only 80% effaced. Regardless, he knew it was time to move me to labor and delivery. I was immediately placed on a stretcher and the nurses ran with me around the corner to the labor and delivery unit. It took under 5 minutes from the exam done by the resident before I was in L&D and a resident working at my peri's office was examining me. 4 1/2 cm dilated, 100% effaced, contractions increasing, water still unbroken.
The peri on call from my office was called into the room and the announcement was made: Let's have a baby. They quickly did an ultrasound to see if there was a chance the lowercase had changed position, but we had no such luck. He was still complete breech. We were having a c-section in 30 minutes when the anesthesiologist was finished getting things going with an emergency procedure in the ER.
Obviously, I'm just now getting to the really interesting part of this story, but it's after midnight and I need to take some pain meds, eat some pie, pump some milk and go visit my son. Check back soon for the next installment of the birth of a lowercase.
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