Thursday, May 29, 2008

Follow the Yellow Brick Road: A Guide to Getting Your Baby Out of the Hospital. AKA, Part II

I don't feel like writing about the NICU, thus the long delay in a follow-up post. But I'm going to do it anyway. I know that our NICU experience was a trip across the slip and slide compared to some other NICU experiences, and for that we feel deeply fortunate. But our time there shaped my initial experience of parenthood, big time, so it's worth writing about.

Let me start by saying that, of all the things we wanted for our baby's birth, what we wanted the most was for her to be with us right after she was born. We had gotten so much reassurance from our numerous OBs that baby would be fine that I was pretty flippant about this particular aspect of the birth. Every other goddamned thing had gone wrong, this would be the one thing that would go right. How ever she came out, at least she'd be here. With us.

The OBs assured us repeatedly that she may be a little grunty when she was born, a little lethargic, but that would just be "The Mag," and not a sign of any critical illness, as it can be for more premature babies. We extracted multiple promises that our baby would not be taken away due to magnesium induced sluggishness, and we reminded our poor L&D nurses over and over to bring her to E after she came out. These poor people must have thought we were insane.

Turns out all our fussing meant diddly. It was the pediatric nurse that made all the decisions about our baby, while the L&D people were busy with E. We were so wrapped up in the process of getting her out, that I forgot that in the alternate reality of Hospital-land, you must Talk to the Right People, otherwise fresh hell will descend upon you at every turn.

So, without further ado, I present you with PART II.

They carried Evan out of surgery and across the hall to the transitional nursery. The hour or so that followed is sort of lost, but I do remember sitting on the window ledge in our L&D room and wondering what the fuck just happened.

Once E was out of recovery we rolled our way over to the transitional nursery. Evan was the only baby there, stretched out in an open bassinet like a tiny bird. Her eyes were squeezed shut and smeared with ointment, an IV was taped to her hand, 3 monitors were strapped to her chest, and the CPAP (continuous positive airway pressure) device was pushed up her little nose. The sheet in her bassinet, as well as her tiny foot, were streaked with fresh blood from a blown IV. Two nurses sat at a desk at the opposite end of the room, surfing the internet. As we approached our baby, one of the nurses barked: "don't touch it!"

The L&D nurse who wheeled us in had to explain that we were the moms, and E hadn't gotten to hold her baby yet. The pediatric nurse looked up from her solitaire game and said: "you can't hold that baby. That is a very sick baby. She's going to the NICU."

I shit. You not.

So E cried, and we put our fingers in Evan's palms to feel her tiny squeeze reflex. She looked so small, and so much paler and more fragile than she did right after she was born. They paged the doctor, because these particular minions of satan were unable to explain what was wrong with her and why she had to go to the NICU, aside from repeating the words "she's very sick."

Sick. Such a helpful word. The doctor came and told us she had underdeveloped lungs, and why hadn't we gotten a steroid shot? Oh, only because the OB, in response to my query about the appropriateness of a steroid shot before induction, described it as, and I quote, "completely unnecessary."

She was moved to the NICU later that night, and her first nurse was the most wonderful person, so calm and gentle. I sat in a rocker for a while, and in my delusional state, I quite clearly imagined the gods reaching a giant finger down from the heavens and anointing her with every golden attribute that a NICU nurse should have. "She's fine," lovely nurse said, her halo shimmering in the dim lights. "She'll be home in no time. These doctors are just covering their asses." In that moment I felt love for this woman.

The NICU couldn't accommodate beds, only wheelchairs, so E couldn't visit the baby until she was off the magnesium sulfate, which wouldn't be for another 24 hours (E, btw, finagled this down to 18 with strong language and threats. She was, I imagine, what they call a "difficult" patient). I spent these 18 hours visiting our baby in the NICU and reporting back to the increasingly frantic E, who, by the time her mag drip was out, was in a sort of primal hysteria. Girl needed to see her baby. She was actually escorted to the antepartum unit by the attending physician, who surely did this kindly deed just to get E off her unit.

E's first visit with Evan in the NICU was one of the most heartbreaking moments of my life. I wheeled her close to Evan's isolette, so she could reach a hand through the porthole. She was silent for a few moments, touching Evan's tiny chest. But then she pulled her hand out and closed the porthole, dropped her head and stared at her lap. A minute later she started to sob. Great, big, slow sobs, a kind I'd never heard from her before. I felt a piece of my heart crack open then, seeing our baby like that, and seeing E so broken over it.

The first time I got to hold Evan, my heart was beating out of my chest. In fact, every time I held her for the first week or so, my heart would just hammer away, so hard that you could see it beating through my shirt. It was such a strange feeling, but it seemed to work for Evan, because when her little body was pressed up against my chest, her breathing rate would slow, and her heartrate would drop to the "sleeping range." It was strange and sweet, holding her like that with all her monitor lines draping out the bottom of her swaddle.

The ups and downs of the 10 days that followed will not be so dramatic, since you all know the ending, so I won't bore you with the details. But know this: the NICU is no place for the faint of heart. The lows are quite low in the NICU. The highs do not reach the same levels, because, hey, your kid's still in the NICU. But I swear to god if I were a writer I would have some amazing material from the days spent there, what with the beeping monitors, crazy family visits, drill sergeant nurses and condescending doctors, and just the blinding bewilderment of it all.

I learned many useful things during our time in the hospital, however.

I learned how to speak calmly to a security guard reluctant to grant me a my own official, laminated "Parent Pass," because, quote, there can only be one mom. Unquote.

I learned how to change a diaper. Through a porthole.

I learned that new babies don't really have a smell.*

I learned to dump out many a cc of bottled breastmilk behind nurses' backs to prevent the introduction of a nasal-gastric tube.

I learned how to reattach a monitor to prevent a desaturation alarm from causing my baby to choke on her bottle.

I learned how to silence a desaturation alarm (although I still have panicked moments of hearing a de-sat alarm as I stand on the corner with my morning coffee, looking wildly around to discover it is merely a car alarm).

Anyway, the day she was finally released from the hospital was totally momentous. We harassed the doctors to release her until they finally buckled, releasing her "WITH RESERVATIONS." Also, we were thoroughly underprepared, had no idea how to work the car seat, and were nearly demented from lack of sleep (I worked days and went to the NICU all night, E stayed all day only to wake at 3 AM and take a cab back to the NICU), so walking out of the hospital with her felt a lot like kidnapping a sweet child from some other, more normal parents.

I remember very clearly that as we finally walked out, this time with Evan, we were making fun of a capella music, laughing maniacally as we drove through the rain.



*this proved untrue, because once evan arrived home she almost immediately smelled of sugar cookies.

Wednesday, May 21, 2008

Hell in a Handbasket: The Birth Story, Part I

E and I had the coolest birthplan ever. It wasn't a birthplan in any physical sense. We never wrote shit down or talked about it at any great length, but we both had a vision of how Le Fetus would get here, and I can assure you that it involved minimal medical intervention.

Ah, best laid plans. Slippery fellows.

As we get further from the days of Evan's birth, those days are losing their heiniousity in my mind. Heiniousity. Like that word? Yeah, you like it.

So I decided to post the story before it becomes happily distorted in my memory to something flowery and cliche, "but it was all worth it" style. As if being worth it makes it any less shiteous.

As I posted earlier, E became suddenly and severely preeclamptic at 35 weeks - she was as swollen as Violet Beauregarde at the end, poor thing. Evan (who should still be Le Fetus, dammit) was measuring big for her gestational age, and none of the battery of OBs who looked at her on the ultrasound were concerned about her readiness for New York City air. We followed the OB's advice and started the induction process.

The cervix softening drugs did their job, and when she was 100% effaced and 1 cm dilated, they put in the Foley catheter. What is a Foley catheter, you ask? Well, it is mostly a balloon! A fun little water balloon! Who doesn't love a water balloon??

Well this water balloon is a little different. Instead of preparing for a fun antic by filling up your balloon at the sink faucet, you stick this balloon up your vagina and into your cervix and then fill it up with a syringe. Instead of tossing it out your window at an unassuming passerby for a silly trick, you lie there and wait for it to force open your nethers until it slips out and lays limply between your legs.

Essentially, instead of getting your shirt wet, it pries open your cervix to 3 centimeters.

Good times. Anyway, Foley did it's jobby job and then pitocin was introduced and E's uterus was off and running.

36 hours later, E was getting rolled in for a section. E, as I may have mentioned before, swore up and down and backwards that she'd never get sectioned, that she'd push that baby out come hell or high water. I swear that had she been floating on an inner tube in Satan's flooded basement, she would still be pushing. But after 24 hours at 3 centimeters, her cervix began to swell, and poor E had no choice.

At that point, though, we were both ready to throw in the towel. E didn't want to be sectioned because she thought of labor as something she could do while standing, sitting up, or generally changing position. But because she was preeclamptic, her body was attached to approximately 29 machines (really), most of which involved catheters. She was also on magnesium sulphate throughout to prevent seizures from the preeclampsia. Magnesium sulphate produces a similar effect on the mind and body as the stupefy spell, as I understand it.

Poor girl was going no where.

She was a total champion laboring with all that shit attached to her, though. Had things gone differently, she could totally have pushed the baby out, I know it.

Anyhizzy, the section is where things got ugly.

We had a little pep talk right before they took her in.

We're gonna meet the baby, we said, smiling dumbly at each other. Tonight we'll have a baby in our pimped out L&D room. Yay.

So they prepped her for surgery, then brought me in. I sat right next to her head, behind the sheet that kept her from seeing her abdomen sliced open.

She was way drugged. The shit they pumped into her epidural on top of the mag made her Loopy Mcloopified, and not in the funny or good way. When they started cutting, she started moaning. They kept cutting, and she started screaming.

Bottom line: her epidural had slipped, and she had a window of feeling across the right side of her abdomen.

They gave her nitrous oxide to calm her, as she was distressed and tearing at her IVs. The nitrous, drugging her further, had the opposite effect. She started crying about the baby, asking me over and over what's wrong with the baby, what's wrong with the baby. It took them 3 hours to section her because her abdominal muscles were so tight. I felt like I was in a horror movie.

When they finally pulled out the sweetest little fetus, E was beyond reason. I didn't feel like I was soothing her at all, so I left her momentarily to go see our baby, and things got worse from there. I thought once the baby was out that E's pain would be over, but I had forgotten about the placenta, and the pulling of the abdominals to sew her back together. She was screaming while I met our baby for the first time.

I was wedged in between the pediatric team who were roughly rubbing her and clapping on her tiny body with a plastic cup. She looked wonderful to my untrained eye, pinking up quickly, crying her tiny bird cry, so mad. But the peds team frowned disapprovingly at her.

She's grunting, they said.

Of course she's grunting, you're smacking the shit out of her, I said.

No, no, frown frown, you don't understand, it's a medical term, they said.

I know that babies full of magnesium sulfate often grunt when they're born, please don't take her away, I said.

She needs to go to the transitional nursery. Don't worry, she'll be back with you within 8 hours, they said.

And our baby was taken away. At the time, I was preoccupied with E. I was on the other side of the sheet now, and I could see the nurses holding her legs down, and the surgeon sweating, white as a sheet. E's moans filled the room. I sat down on a chair in the corner until a nurse escorted me out.

Part II, in which our baby lives in the NICU, to come.

Friday, May 16, 2008

Home

We couldn't take it anymore. We busted her out of the NICU, and I think she's as happy as we are that she's finally home.

Thanks everyone for all the sweet comments.

Wednesday, May 7, 2008

Getting so much better



The birth story is long and horrific and I'm not up for writing it yet. Maybe ever.

But look at that baby. One look at her and I couldn't even remember what I was so worried about.

Saturday, May 3, 2008

Evan Brooke


The last three days have been the most relentlessly heartbreaking of my life. But our baby is here, and she's perfect.

Thursday, May 1, 2008

More

hi loves. I'm in the hospital and was frightened by the angry mob demanding updates so here I am.

E had a rapid onset of severe preeclampsia symptoms on Monday. After, I might add, we went camping all weekend and E rocked it out. But Monday found her swollen beyond recognition with headaches and abdominal pain, so we decided to get this party started.

Le Fetus, at 35 weeks, is measuring around 6.5 lbs, so we felt okay about inducing so early. Let's get this girl some fresh air before she busts E at the seams.

Last night was wicked, what with induction at 35 weeks being akin to prying open a tin can with your fingernails. But lo, Epidural made the sun shine on E again. The anesthesiologist totally hooked me up with some nitrous oxide, too, so 4 AM was party time in Labor & Delivery Room 10.

So, I am rolling with this baby coming early as all get out. I can still go to Kanye West on May 13, which is a huge relief. Priorities, you know?

So she's on her way dudes. What a wild fucking ride this has been.