Old News: Past Blog Posts

Saturday, December 20, 2014

Dear NICU Mom

Dear NICU mom,

I saw you this morning in your hospital gown, an IV dangling from your forearm. You were half raised from your chair and peering into a lonely isolette at a tiny miracle, sleeping soundly amid leads and wires and monitors. That expression on your face spoke a billion words to me and made me want to give you a hug that could maybe speak a few words back.  

But I didn't want to be creepy, so I just walked on by and instead, I am writing you this letter that you will never read.  

See, there are some things you should know that might just help you get to the other side of this; some things I am still learning on this, my third trip through the NICU.
You should know that you will be okay. Despite what may come and how you may get there, today will eventually be nothing bigger than a memory and you will only be stronger than you were even just a moment ago.  

You should know it's okay to feel whatever you are feeling. I saw your eyes go watery and I heard that stuttered sniff and I know you were swallowing back tears. Please know, you are allowed to be sad and scared and confused and yes, even angry. Watching your baby -- literally a piece of you -- born too soon or too sick, struggling with even the most basic needs, is just barely one step shy of maddening. Plus, the new-mom hormones make it difficult to get through a Pampers commercial with dry eyes, so guess what, you get a free pass on this one. 

Cry. Do it. Whether it's at your baby's bedside or in the middle of the supermarket checkout line. The urge will hit you both places, trust me. And you know something? People may get uncomfortable for a minute, but they will most definitely get over it and you'll feel always better after you give in to the tears.

You should know that sometimes these things just happen. There has been no adequate explanation for my early babies. It makes me frustrated and discouraged and yes, pissed that no matter what I do, I can't seem to carry a baby past 34 weeks. I followed all the rules, went to all my appointments, took all the vitamins and quit eating and drinking all the appropriate things. By this, my third pregnancy, I did some pretty drastic things involving a carefully selected specialist, activity modification, a very uncomfortable surgery, and more drugs than I can count, yet here we are again. 

It's easy for John Q Nobody to think that NICU moms brought this situation on themselves, and it's easy for us to worry that maybe he's right. Sure, there are unfortunate circumstances when mom's decisions during pregnancy may increase the risk of landing in the NICU. But you know who you are in your heart and what sort of mom you are capable of becoming, so quit worrying about what Mr Nobody thinks and focus your efforts on things you can control.

Speaking of control, you should know that you will have very little of that, but welcome to motherhood (preemie or otherwise). Try to engage as best you can in your baby's care and put some trust out there in the doctors and nurses and therapists and whatever higher power you might be familiar with. It may not be easy or comfortable but it will be necessary. 

You should know that you may feel a little bit alone. People don't always know how to react to a sick or early baby and sometimes it's easier for them to just not react, or they might not say all the 'right' things. You may find yourself doing your postpartum shuffle past the healthy newborn nursery and feel a pang of jealousy for all the plump, sleeping newborns, free from monitors and g-tubes who will go home with their families in a day or so. You may develop a yearning to connect with someone -- anyone -- who can understand and commiserate with your complicated feelings and help break you free from this strong sense of isolation. 

Finally, you should know that you are stronger than you think. Just because you are presently being held hostage by your postpartum hormones and just about everything makes you cry, it doesn't mean you are weak. You are strong enough to wake several times in the night to a hospital grade breast pump instead of to a crying baby. You are strong enough to march (ok, waddle) in and out of the NICU several times a day to participate in cluster care and allow your infant feel the heat of your skin on his. You are strong enough to immerse yourself in medical terms like 'O2 saturations' and 'tachycardia' and 'gavage.'  You might even be strong enough to walk that narrow and delicate balance beam between parenting a newborn in the NICU and parenting a toddler or two at home. I won't lie. At times it will seem damn near impossible and like you are completely flailing, but I promise you that you can do this. 

I'll say it again, because it bears repeating: You should know you will be okay.

Best of luck, 
Another NICU Mom

Wednesday, December 17, 2014

The Epic Week of Delivery: PART THREE



Friday I am antsy. I wake up feeling compelled to do things. I am determined to finish addressing Christmas cards. I move and fold laundry and carry small stacks of it up the steps to put away.  

And it's not just me, apparently. Our new mattress is delivered unexpectedly and we get a visit from the furniture store to repair some minor dings from the delivery of our head board and night stand. 

I change positions slowly and frequently, nervous to stay in one place and anger the uterine gods but also nervous to move too quickly or in the wrong direction. It occurs to me that my uterus is calling the shots now. I take lots of breaks and drink lots of water. I find myself sitting on my feet next to the coffee table hunched over piles of white envelopes and my laptop. I take a short trip into the world to the nearest branch of our bank with a drive-through to collect cash needed for delivery of our mattress. During the ride, I realize I am shifted sideways and reclined in a white-lady gangster lean, squirming with every crack or irregularity the pavement, making for a ridiculous sight in the seat ahead of two car seats and a shifting and sliding pile of picture books and snack traps. 

When I get home, I start to wonder how long I can live like this. I am so pleased to still be pregnant, but the debility leftover from just two days in the hospital and the discomfort from no longer medically managing my unruly uterus is leaving me a mere shadow of myself. I feel like this bloated, winded, contracting animal just sort of wading through life at speeds and an efficacy generally reserved for the shifting of continental plates.  

I am not nice to the dogs because I am crabby and they are there...and because they always forgive me, God love them. 

By the time my husband returns home in the late afternoon, I have given up on my to-do list and am testing out the new mattress. 

I am also contracting at regular intervals.

I had been feeling them creep on as I folded the last load of laundry and by the time my hubs returns from dropping our old mattress at his parents house, they are starting to jump up and down and beg for attention. I spend just about an hour on our new mattress before I decide I can no longer avoid their persistence. The contractions are coming every 2-4 minutes and lingering for around a minute each (according to my app...how DID we function pre-smart phone??) 

We arrive at the hospital with a better idea of where to park this time. We also quickly discover that L&D has had a busy day. The receptionist tells us they've had twelve babies in as many hours and the place is hopping.  

Maybe that's not what you want to hear between contractions, but I am learning to accept my life as one long series of calamities. I stand with my elbows propped on the receptionist's desk and endure the waves of pain for what can't be more than 7 minutes but feels more like a century or so. In between, I try to act cool and no one buys my act. The receptionist apologizes a lot and finally just walks us back to the triage unit where we find an amped up tech changing linens and looking ready for shift change. 

It takes another 15 minutes or so for the nurse to arrive. I pee twice in that time and pace around the room trying stupidly to walk off my labor. 

The monitor finally connects with my baby and even the unseasoned ear can tell you there's something wrong. The high cadence gallop of his usual heart rate has slowed to lazy, whimpering walk. 

In less than a minute, the room fills with busy bright blue scrubs and crisp white coats with reassuring words (directed at me) and less reassuring words (directed at each other). Someone slips an oxygen mask over my nose and mouth ('for baby'). Two women start fishing around my left arm for a vein to stick asking me to flex and supinate and extend and grip while tugging my limb in all directions and being openly unimpressed with the quality of my veins. 

One of the lab coats identifies herself. She is a short, pleasant-faced, gray-haired women who looks like someone's grandmother. It's the same doctor who checked my cervix at 3 am two days earlier. She recognizes me, which makes sense because basically nothing about me has changed since early Wednesday morning: I am still in labor and my cervix has gone from being dilated to one to being dilated to two. She tells me this and then explains gently that there will be a c-section because, 'baby is ready to come now.' I am not dumb enough to believe means that things are all Bon-bons and Cumbaya inside my uterus. This statement doesn't mean that she just had a cup of tea and a lovely conversation with my baby and he would just be thrilled to have his birthday today. Still, it takes until the third or forth 'it'll be okay' for the tears to come. 

The contractions are coinciding with the dips in baby's heart rate. I am hearing numbers like 60 and 80 and I know this is trouble. Things are moving even faster now. More people arrive and more chaos ensues. The IV ladies are still struggling to find a cooperative vein and I am busy trying to listen to 18 different instructions and also remember to breathe (that being about every other instruction). 

My eyes scan the crowd to find my husband. Somehow in the middle of this tiny three-ringed circus, he has magically donned a pair of scrubs, scrub top, and an expression that makes me instantly feel better and also certain that he is the absolute best choice I could have ever made for a husband. I want his hand, but it is too far away. 

The IV ladies finally find success on my opposite arm and now we are moving. The instructions continue to come from all directions and it seems someone has located my doctor (whom I have decided is either secretly cloned into a small army of men or actually resides in the above ground lot between his office and the hospital). I am aware that they may need to administer a general anesthetic, but not sure where that decision has landed. Fewer people are taking the time to talk to me now. 

When we arrive in the OR the light is brighter and I am instructed to 'scoot' over to the operating table from my gurney. I am grateful to have been given a task. I am given a mask and a pretty dark-haired lady introduces herself as the anesthesiologist from behind the mask. My husband isn't there. Someone allows me to squeeze their hand. I am reminded, absurdly, of gripping my dad's hand as a child with long, unruly hair while my mother brushed the tangles out. I am just about to ask about the general anesthetic when the room and everyone in it vanishes. I swear it's just like the movies when the protagonist loses consciousness and screen goes black. Those movie guys really nailed that.

Just over 30 minutes since first applying the monitor to my belly, I became a mom for the third time in so many years. 

Seconds later, I am awake again and things are still bright, but they aren't quite as busy. I am only momentarily disoriented. People are telling me my son is here and he's doing well. I am nodding a lot.

I am wheeled into a patient room for my recovery period. My husband is beaming and showing me photos on his phone of a baby I have never met with a little mess of chestnut hair and a breathing tube. Other than the tube and the leads attached to his torso, I marvel at how substantial he looks. He lacks the wrinkled skin and wiry limbs his older brothers had in their first photos. I hear real pride in my voice as I say, he looks like a real baby!

Before long, I am wheeled (bed and all) into the NICU to meet my newest baby. They are already removing the breathing tube for less substantial respiratory support when we arrive. Only a few hours old, my youngest son is already amazing me. After a few more minutes, I am peering at him and reaching through the portholes on his isolette to touch the velvety skin along his tiny right arm. 

I know that every moment of every day, in all corners of the planet, mothers are bringing babies into this world under all sorts of circumstances. And this is not a new phenomenon in any sense. It's not even really new for me, even though, (cliche alert) every baby is different!

Still, I am humbled by the enormous gravity of the event. There is this whole new person here in the world. He will grow and develop and make an impact on people and places. He has already taken up residence in my heart, where I didn't realize there had been a spot waiting for him all along. Anyone can see by the pride on his father's face that this baby is completely adored. 

Welcome to our family, little man.  It's chaotic and noisy and there are lots of messes and diapers and barking dogs and sometimes there is time out. You will get more screen time and processed foods than your mother wished for her family and you will hear her curse more than once. She won't be with you as much as she wants to be because she has lots of student loans to repay, but she will never stop thinking about you on some level or loving you completely. 

34 weeks, 2 days
5lbs, 2oz

The last hospital bed I hope to see for a good, long while.  

Sunday, December 14, 2014

The Epic Week of Delivery: PART TWO



I am sleeping. And it's nothing short of glorious. There was a little cheating involved, I suppose since I took an OxyContin, but the end result is a beautiful, restful, smack-your-lips-together sort of sleep; the type that leaves you aching for just a little more, just one more hit from the sandman. 

It's not too long after 3am when I wake to shuffle into the bathroom, so I find myself reaching for the narcotics. Just before I pop another chalky white magic pill, I remember my doctor's practical advice to count kicks before rewarding myself with prescription pain-killers. So I grab a couple swigs of water and crawl cautiously into my pillow-top with one hand on my belly.  The irritability in my uterus is persistent, so I am not just looking to reap the rewards of the oxy's fatigue-inducing side-effects. I am however, silently congratulating myself on my growing ability to identify the regular and persistent contractions from the usual activity and position-related unrest in my uterus. 

I feel one solid kick, shortly before 4am...then nothing.

I poke my belly.
I roll over.
I drink again.
I look at the clock.
I get up.
I go down to the fridge and eat a leftover bratwurst.
I hobble back upstairs and crawl into bed.
I poke again.
I look at the clock.
I drink some more. 
I remember to breathe.
I roll again.
I poke some more.
I look at the clock again.
I swallow some tears.
I roll and poke.
I rationalize.
I breathe.
I look at the clock.
I text my mother.
I wake my husband.

Very soon, the house is stirring an hour earlier than normal. My husband is showering and I am remembering to breathe as I pull on a hooded jacket and sweatpants. My parents are in town partially due to circumstances and partially due to a previously planned trip to 'borrow' our children for the weekend. Now they are walking through the front door shaking the sleep off and looking concerned. I need help with my boots, partially because I have trouble flexing my hips without pain and partially because I am having trouble remembering to breathe while I do benign tasks. 

Soon, we are at the nearest hospital where I delivered my past two early babies. A man in an official security looking jacket greets me at the front door and eyes my belly with a smile. I blink back tears and return his smile, making my way past the Christmas decor of the lobby. The sterile smell of the halls and the elevator brings back vivid memories from my previous deliveries. The air seems somehow electric and I veer my thoughts to a positive, rational place. This is okay. We are okay.

Now I am sitting in a small, familiar room in the Women's Examination Unit across from a nurse in scrubs who breezes me through the intake form and seems used to gathering information from women who are just barely holding themselves together.

In no time, I am strapped to monitors and listening to the steady and very reassuring gallop of my baby's heart. My breath returns to normal, I feel the tension in my shoulders loosen. 

Baby doesn't like to preform for an audience and squeezes by his biophysical profile without meeting the 'practice breathing' criteria (though manages to get in a few good hiccups now and then). No problem, says the resident just need a good twenty minutes on the monitor to assure a steady heart rhythm. One episode of a dip in his heart rate earns us another hour and forty minutes held hostage to the monitors. 

Now I am feeling bad because the whole ordeal has left my husband late for work, my over-tired parents scrambling to get my son to school, and me feeling less in control than ever of this insane pregnancy.  

We discharge sometime after 8am with strict instructions to drink plenty of fluids and watch this kid carefully. I spend the morning acting like I can handle a trip to Target, a couple quick errands, and 20 minutes alone with my 1-year-old, then reside to my bed for most of the afternoon. 

My boys strap into their car seats for a long weekend at Gammy and Nonno's house and I watch them leave, experiencing a strong mix of sadness and relief and a nagging sense of foreboding.

At least it's not a hospital bed...

Saturday, December 13, 2014

The Epic Week of Delivery: PART ONE



Magnesium sulfate, my darling old nemesis, it seems we meet again...you dirty rat bastard.

I would gladly nudge you casually down a flight of stairs if it weren't for the inaccessibility of such a thing in my present state. Plus, it seems we're tethered together via that peripheral IV which is anchored securely to my forearm so, I suppose the joke would then also be on me.

And so I am resigned to endure your heat, the weight of you sitting heavy on my eyelids and your persistent pressure on my temples.  

This dance with intravenous magnesium sulfate is intended to suppress my third episode of early labor (in so many years) and lasted just about 20 hours in total. It left me boggy, headachy, and staggering a bit, like any self-respecting hangover might do, but it has granted me access to the 34th week of pregnancy; uncharted but highly anticipated territory. So I will try not to be too ungrateful...maybe.

Now, 12 hours later I am perplexing the night nursing staff with my frequent and undetected contractions. It feels all too familiar. The bag of tricks I have acquired in calming my uterus is running dangerously low, having exhausted shuffling and stooped trips to the toilet to empty my bladder, swallows of ice water (thus sending me back to the toilet), visualization and amateur bouts of meditation combined with pursed lipped breathing and occasional muttering profanities from behind closed eyelids, and scare tactics which include recounting the grizzly details of my past two deliveries to a bewildered looking nurse as she prods my belly and squints at the monitor. 

Still, the contractions leave me groping the plastic bed rail and hissing through clenched teeth for a minute or so at a time, coming in regular 2-3 minute sessions, but they don't always register on the monitor and I am somehow feeling like a fraud or imposter or--at the very least--a giant weeny.

Thus, it seems I have moved into the mystery phase of this epic labor I have been experiencing at some level since my cerclage was placed at the dawn of my second trimester. In the early hours of the morning, my symptoms aren't aligning with what the medical books proclaim as gospel truth of labor and delivery.  It's too early. It's too vague. It's real pain but they seem to want numbers and frequencies and bioelectric read outs and things aren't that substantial. Worst of all, I am not dilated beyond 1 cm as of 3 am, meaning all this pain is in vein. It's now 530am and although sleep is not an option for those of us in the trenches, we are calculating our next moves based on the desire to least inconvenience the next players (my doc, my husband). 

The persistent though perhaps foolish optimism of my doctor and myself had the audacity to propose this morning would include a quick hospital discharge. I then envisioned the day would evolve into an cheerful afternoon of addressing Christmas cards and wrapping gifts.  Perhaps this fantasy had been aided by the magnificent epidural I had received prior to the doctor digging the knotted piece of glorified packing strip known as my cerclage out of my hoo-ha. I appreciated it as it had been the only thing standing in the way of my delivering a baby until this point and also I wanted to murder it, as it was causing me increasing misery and varying levels of debility and general aggravation. the epidural provided a pain-free state I had forgotten was even possible. Those things are the shit

The night before my (foolish?) optimism had sent my sleep-deprived husband home so he might dare to consider a full night of sleep on something other than a glorified vinyl chair. I was then administered the most worthless Ambian in the history of sleeping pills, and had begun contracting with some very convincing frequency and growing intensity starting around 2am.

When my doctor finally arrived at 10am, he finds me clinging to my bed rail, earbuds feeding me a soothing 'Genius' inspired playlist including artists like Sia and Alexi Murdoch and intending to help me remember breathe and also not throw myself out the window. He also discovered there hadn't been any real progression in the proceeding 7 hours.  I was still dilated to only 1 cm. And because: Childbirth! There's an app for that!...I can tell you that my contractions were coming fast and furious at this point, lasting over a minute each at a frequency of 10-15 in an hour.  

And yet, no official labor.  We had spent weeks -- no, months -- taking every possible measure to ensure a strong cervix and now suddenly my cervix was proving itself iron-clad all on it's own. 

Having made it safely to 34 weeks, a place where baby's immediate health is generally not seriously threatened by delivery, the doctor has decided to bail on all our previous efforts to keep me pregnant. No more nifidipine, no more magnesium. What comes will come. He instead orders a hot shower, a light meal, two percocet and the possibility of a nap. I haven't graced the unconscious world for greater than a 45 minute stretch in over 80 hours so once I've been escorted through the delicate process of showering one-handed with a seran-wrapped IV and persistent contractions, I swallow some cereal and 2 narcotics, crawl into clean sheets and a pile of pillows and slip into a 2 and a half hour coma. 

I awake early in the afternoon to a relatively calm state of the uterus.  Shortly after dinner, I am headed home. Feeling bewildered, but still very much pregnant.

For now...

Peace out.