Thursday, July 31, 2014

Adventures in the NICU #1

After the nurses cleared me to visit my son, I hopped (actually I sat down very very gingerly) in a wheelchair and a volunteer pushed me over to the NICU while my husband followed.

Long Beach Memorial is quite a maze. There's the birthing center, the main hospital, and the children's hospital. My husband and I were already familiar with the birthing center, and the hospital lobby, but the children's hospital was a mystery to me. The volunteer explained that to reach the NICU we could go through the nursery (only if we had a nurse with us though), or we could go down to the elevators, make a right down this one hallway, then a left, then another right, and there it was.

Once at the NICU we had to sign in. Then we had to wash up at these old school sinks. You pressed a red button to turn on the water, and scrubbed up while the light was green, when the light turned yellow, you rinsed off, then dried off, and then you could enter the NICU nursery.

I gingerly stepped out of the wheelchair, dragged my IV over to the sinks, scrubbed up, and then followed my husband into the nursery.

Thankfully my little one was in the first incubator on the right, so I didn't have to walk far.

Unfortunately, by the time we got there, they were getting ready to give our baby an umbilical IV. It's a sterile procedure, so only those in hats and gowns were allowed to be near the incubator. My husband and I explained that I had only been able to see our son for a second after he was born, so the nurses made an exception and allowed us to take a peak at him before they got started.

At 3 pounds, 15 ounces, our baby boy was tiny. However he was long, clocking in at 16.5 inches. Despite the loud cries he had made at birth, they had him on oxygen, and it was heartbreaking to see his little face covered up by the mask. I had thought the steroids had helped, but apparently not.

After a couple of minutes the nurses ushered us out of the room and we headed back to the Post Partum ward. They had told me that I could come back in an hour or so, but my husband insisted I relax and get some sleep since I had been through so much. Plus, in the morning my nurse would be removing my IV, so it would be easier to get around since I wouldn't be dragging an IV pole around.

As much as I wanted to spend as much time in the NICU as possible, I listened to my husband's advice and crawled back in to bed. I was able to nap a little before the night nurse came in and showed me how to pump and advised me that from here on out I would be pumping every three hours to establish a milk supply for my boy. He was too young to nurse right now (babies don't develop the coordination to suck, swallow and breathe at the same time until around 34 weeks) but once he was stable they would be feeding him through a tube that went through his nose into his stomach, and they would need the milk then.

The night nurse was fairly impressed by what I was able to get whenever I pumped that night, but by morning my supply had dwindled. She told me not to worry, and explained that it could take up to a week for my milk to come in - I just had to keep at it.

After breakfast, and after the nurse had removed my IV, I headed back down to the NICU. At some point during the night, they had removed my son's oxygen mask, and he was breathing room air without any issues. He was having some issues with his blood pressure, but he was responding well to his medication. Also, while they were giving him nutrients through his umblical IV, the doctors wanted to do something called a PICC line (which is a more permanent form of an IV) instead - but they wouldn't do it until that afternoon when the PICC nurse was there.

The nurse watching over him said it was safe for me to open up the incubator and reach in and touch him - however I couldn't do so for very long because they didn't want him to get cold. I quickly opened the door and reached in and touched his head - which was covered in a full head of hair - and marveled over how soft his skin was.

I stayed for two hours, before finally returning to my room in the Post Partum ward. I didn't want to go, I would've stayed there all day if I could have, but I needed to go to the restroom and it was almost lunch. Plus my Dad and Stepmom had brought breakfast for me since the hospital breakfast had been so disappointing.

Others stopped by throughout the day, bringing flowers, gifts of soda and reeses peanut butter cups, and company. Finally, after my husband got off work, he brought the biggest present of all - himself and In and Out.

Once we were done we went back over to see our baby boy. The doctor stopped by and explained that they were worried about how red and bruised he was. They decided to start phototherapy to help prevent jaundice.

My husband was able to touch his son for the first time, and he agreed that his skin and hair were soft. Then baby boy grabbed his finger in his tiny hand and my husband and I absolutely melted.

By the next day more photo therapy lights had been added to baby boy's bed. Apparently his jaundice levels had gone up over night. It was sad to see, but we weren't very worried since most babies nowadays seem to develop jaundice and, as a preemie, baby boy was just more susceptible to it.

Since they had added the PICC line, he no longer needed the umbilical IV, so they removed that - which was good to see. In addition to that his blood pressure had finally stabilized, so they had stopped those medications.

Because he was doing so well, there was talk of moving him to one of the other NICU nurseries - but that wouldn't happen until later that evening or very early in the morning.

Finally, since I was being discharged that day, the nurses allowed my husband and I an opportunity to hold our son.

He was a bit fussy at first, which we suspect was because they had the oxygen sensor wrapped around his arm. The connector is heavy for a newborn (heck its annoying for an adult to deal with!) so the nurse moved it to his leg instead and he calmed down quickly. We cuddled with him as long as they would allow, and then, with heavy hearts, we headed home.

The next day we were up early and headed back down to the hospital. Just like the doctor had warned us, over night our baby boy had been moved to a new NICU nursery. Thankfully, this one was closer to the entrance of the Children's hospital, so it was easier to get to. It was also much much newer and larger than the old NICU.

The phototherapy seemed to be working. Our son was still very red, but it had faded a lot from the day before. Also the bruising on his forehead (a battle wound from being born) had faded, as had the red mark on his nose. He had also lost a little weight (which happens with newborns). Thankfully it seemed to be mostly water weight as his swelling had gone down significantly.

They set him up with his feeding tube, and to ours and the nurse's surprise, he didn't fuss or complain while they were putting it in. He did sneeze a few times, but that was understandable since there was something going through his nose - poor guy.

We were allowed to change his diaper, and afterwards we read him a story one of my Aunts had mailed me. I had wanted to read him Harry Potter, but I was too emotional for that just yet.

Sunday we went to church for the first time in a month. It felt soooo good to be out and doing something normal. Sadly, we couldn't stay to chat with people afterwards because I had to run home and pump. But I'm sure they understood.

When we finally got to the hospital the nurse explained that as soon as his feedings reached the maximum the doctor had inputted into the system they would be removing our son's PICC line. Which was good, because it was in an awkward spot on his arm. Whenever he bent it, the alarm would go off, and he hated having to keep his arm straight. He would cooperate for awhile, but it wasn't long before he had wiggled around so much that the splint had fallen off. The nurse finally started placing a bean bag on his arm, but he was such a determined baby that he eventually figured out how to free himself from that.

Since his jaundice levels were a little better, we were allowed to hold him while he was fed. I jumped at the chance for skin to skin time, and our son enjoyed being out of the incubator. He looked around, staring at his dad, then me, then back again. I hated having to put him back, but hopefully the phototherapy would be over soon.

Monday was a bad day. I had posted something online talking about how my stay in the hospital had made it easier to get up every couple of hours to pump and not be tired. A friend commented that I should get used to it as I would never sleep again. A lot of people had actually said something similar to this ever since baby boy had been born - but this was the one comment that broke the camels back. Didn't our friends understand that our son was in the hospital? That we hadn't been able to take him home like a normal baby because he had been so early? That we would give anything to have him at home with us? Every time someone made a comment like that it was like rubbing salt in the wound.

I spent most of the morning bawling. I did better once we were at the hospital and I was able to hold our son, but then I had to leave early to go to a WIC appointment, and I was bawling once again - this time because I felt like I had been rushed and hadn't been able to spend enough time with him. I went back after the appointment though, and finally calmed down when the nurse reminded us that we could visit whenever we wanted.

The next day was a much better day. I was able to spend all day at the hospital, and my Mom and my Aunt finally got to meet our son. We went out to lunch afterwards, which was really nice.

On Wednesday, more visitors stopped by - this time my cousin and two of her daughters.

Also, baby boy was finally up to his maximum feedings, so they finally removed his PICC line. My son was free to wriggle around as much as he wanted to, and boy did he ever! He kicked off his cover and stretched out his legs, enjoying his freedom.

In addition to that, when it was time for his feedings, the nurse had me hold him, gave him his pacifer. She then took a tiny syringe full of a little extra of my breast milk, and would stick it into his mouth next to his pacifer and give him a few drops at a time. Baby boy loved it and happily sucked away.

This was a pretty big deal since one of the big steps he had to conquer before going home was learning how to breast or bottle feed. Normally baby's don't pick up the coordination to suck, swallow and breath until they're around 34 weeks. Baby boy was only 32 weeks adjusted (one week old officially) and they weren't supposed to start working with him on breast or bottle feeding for another couple of weeks - but he was so smart he had figured it out on his own.

Afterwards he wanted nothing to do with his pacifier unless a nurse pulled the same trick again!

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