Thursday, August 14, 2014

Adventures in the NICU #2

On Thursday, my husband and I had our first conference with our son's doctor and his social worker*. We had met both before, but this was our first meeting together, away from baby boy's bedside.

We discussed what milestones he needed to meet before he could be discharged. I already knew most of them thanks to a friend who's daughter was also in the NICU, but it was good to hear them again. The doctor was hesitant to give us an exact ETA on when he would be discharged, saying that she had seen babies leave earlier than their due date, and babies who had left later than their due date - it was all up to baby boy. 

Considering how well he was doing so far, I totally expected that he would be out of their sooner rather than later. 

His nurse that day was not someone who normally worked in the NICU, and, as they had given her three babies to watch over, I suspect she was a bit overwhelmed. She let me hold our son during feedings longer than normal, which was nice, but I worried that his jaundice levels would go up as a result.

Thursday was also the day my husband brought up baby boy's hearing. He had noticed that when alarms went off, or other baby's started crying in the unit, our son didn't react. As the day went on I noticed the same thing, but the nurse quickly pointed out that since he had been in the NICU since he had been born, he was used to the noises which was why they didn't faze him - but if something unexpected happened, like the fire alarm going off, he did react. 

Sure enough, when my husband came to visit that night, he opened one of the windows on the incubator to reach in and touch our son. The window swung open really fast, and my husband didn't catch it in time, so it banged against the side of the incubator, and baby boy flinched. 

Yup, his ears were working all right.

Despite my concerns about hims being out from under the lights for longer than normal the day before, Baby Boy's jaundice levels had gone down enough on Friday that the doctors stopped the phototherapy. It was lovely to be able to see his beautiful face again outside of feeding time, and he certainly enjoyed looking around. He was especially active when my Aunt brought my Uncle to meet him!

In addition to stopping the phototherapy, they also removed his oxygen pulse sensor, and his temperature sensors - so that was two less wires to worry about when we held him.

Little did I know that we would soon have a whole new problem to worry about - breast milk.

As soon as our son had been born I had started pumping every three hours. I woke up in the middle of the night to pump. I pumped while at friends and family members houses. I pumped at the hospital. I had even rented a hospital grade pump from Baby's R Us to use at home, since the one that WIC had loaned me was total crap. However, the most I could get was 20 to 30 mls at a time - which was just barely enough for the nurses to use.

Since I was having issues producing the milk needed, we had signed a release allowing the hospital to give our son donor milk. However, the hospital was running out of donor milk and would soon be switching our son to formula. While there is nothing wrong with formula - heck, I and my cousins were raised on it - my husband and I had both read that breastmilk really was best for preemies like our baby.

I began to feel like I was failing my son - and we hadn't even brought him home yet!

His nurse that day questioned me about my breastmilk production. I explained what I was doing, and braced myself for a lecture. Instead, she offered a couple of suggestions that she believed would help improve things: first she pointed out that I needed to stop wearing an underwire bra, because apparently that could cut off blood flow which would affect my supply. She explained that I should be wearing nursing bras, or going, as she put it, 'free bird'.

Since our son had been born so early, neither I nor my husband had been able to take any classes, and I had no idea that wearing the proper support (or not wearing any support at all) could affect things.

Then she suggested indulging in a beer every night. 

Surprised, I gave her a look, and she quickly explained that she wasn't promoting alcoholism, but that some of the ingredients in beer helped with milk production. A couple of friends agreed with her when I mentioned it to them. 

It still sounded strange to me, but I figured it was worth a shot. 

Friends had also suggested trying Mothers Milk tea and Fenugreek. I couldn't find any Fenugreek at Target, but they were having a sale on Mothers Milk tea, so I stocked up on that. It seemed to help a little.

The next day we took our son's godmother to go and meet him. Afterwards we went to dinner and I shared a beer with my husband.

The next day things improved dramatically. Just like the nurse and my friends said, the beer had really helped! Unfortunately, they had also upped the amount that they were giving baby boy at every feeding, so now I was playing catch up.

On Monday a nutritionist for the NICU stopped by to remind me that they were running out of donor milk, so they would be switching our son to formula soon. Unlike the nurse I had encountered on Friday, she was more condescending and critical, and I began to feel, yet again, that I was failing my son.

However, despite her miserable attitude, she did do something good - she sent in the lactation consultant to speak with me. The lactation consultant and I went over everything that I was doing and she reassured me that I was doing everything right. Unfortunately, it's just harder for some preemie moms to produce milk because we're pumping and we can't actually breast feed our babies from day one like normal moms. Since breast feeding releases hormones that help with milk production that pumping can't, she suggested we start doing non nutritional breastfeeding.

Since our son was being fed through an NG tube that went from his nose down into his stomach, that would be his primary source of nutrition, but doing non nutritional breastfeeding would help teach both him and I how to breastfeed so when it came time for him to start nursing, we would be ready to go. Plus, having him latch on would help release those much needed hormones, and would help bump up my milk supply.

At the next feeding we pulled the curtains closed, and the lactation consultant showed me how to hold my son and how to get him to latch on. It was a lot more involved than I thought it would be, and he was very resistant to latching on at first, but eventually we figured things out and it wasn't long before he was sucking away.

The next day was a bit crazy. I had my first postpartum follow up in the morning, which meant I wasn't there for baby boy's 11 o'clock feeding like I normally was. When I finally showed up, he was fussier than normal and was actually crying a bit. I quickly soothed him and apologized for not being there.

And then I met the first NICU nurse from hell.

Any time my son began to fuss or cry, she would show up and glare at me and give me this attitude as if I done something to cause him distress. In addition to that when I asked if I could hold my son during his feedings, which is what I and my husband always did, she acted as if it was too big of a hassle to do that. And even though the lactation nurse had put in our son's file that we were allowed to do non nutritional breastfeeding, she refused to let me do that. Last, but not least, she kept removing things from our son's incubator. We had brought him a little stuffed zero from home and kept it inside the incubator, but well out of our son's reach so he wouldn't smother himself on it. Any time I left to do go to the restroom or get something to eat, I would come back to find it, and my son's lovey missing.

I had won an opportunity to see the fist episode of Outlander that evening, so my mother and law and I went off to see it while my husband stayed behind. Apparently the nurse did not give him any problems - but then he's a big intimidating guy. However even he admitted that it was a relief when the shift change happened and the night nurse came on.

*Regardless of how they came into this world or what their familial situation is, every baby in the NICU has a social worker. Ours was a lovely woman who got me a letter from lactation so I could get my breast pump from WIC, offered to set me up in a parent room or over at Ronald McDonald house if I needed it, and told me a tip that helped with parking 

Wednesday, August 13, 2014

Small but Mighty...

The last time I posted was a little over a month ago, and, as you can see, a LOT has happened since then. At that time I had been in the hospital for 18 days, and, to my surprise, I was actually discharged to continue my bed rest at home the very next day since both I and the baby were stable enough! Unfortunately, I was only at home for a grand total of 3 days before going back to the hospital for preterm labor again. They kept me for two more days, then released me yet again because the contractions had stopped and I and baby boy were stable. And then twelve hours later I was back at the hospital again for preterm labor (So much for being 'stable' right?)

However, this time things were progressing far too quickly. So quickly, that the doctors told us they wouldn't be able to stop it. 

At 4:53 pm on July 16th, my son was born

You know, how a few months ago I said being pregnant was the greatest WIP ever? I was wrong. Taking care of this this little guy is the greatest WIP ever!

Despite the fact that he was only 31 weeks and 4 days along when he was born, he is a strong and determined baby. We had been told by the NICU doctors that we wouldn't be taking him home until his due date - well, he actually came home after 3 weeks and 2 days!

Even though he's doing well, I'm still having some issues. During labor I hemorrhaged and then last week I began to hemorrhage again! Another hospital stay and a blood transfusion later and I'm doing much much better - however it looks like I'll be going in for surgery next month (pending insurance approval). The doctors (both the ones I met during my various stays in the hospital, and the one I was seeing prior to everything going down) believe that the cause of the preterm labor and my issues since then is a large fibroid hanging out in my uterus, and it needs to be removed pronto.

Anywho, as a result of all these things going on I haven't had much time to write (now that things have calmed down, hopefully that'll change). But I have been thinking a lot about an old nano project of mine. Since today's date is the 13th, here are 13 sentences from the first chapter of that project.
The vagrant had chosen to fall asleep across the wrong doorstep this time; instead of being rudely awoken by a kick to the side and being told to move by a grumpy shop keep, he was pulled to his feet and shoved in the back of a wagon. It was crowded with other poor souls who stunk just as badly as he did, and one or two moaned in pain as he collided with them. Blinking away the last of his drunken haze, he was able to make out a man dressed in the uniform of the city guard shutting the door and locking it. He had heard rumors that the King had wanted to clean up the streets of Anglon’s capital, but this was a bit extreme.
“Another happy colonist!” The man cried out. “And another groat for us!”
“Only if they’re still breathing when we get them to the docks. They won’t pay for dead ‘uns.” Another guard poked the vagrant  with the butt of his staff to make sure the man was still alive - as if his groan of pain hadn’t been a good enough sign.
A colonist? Docks? The vagrant hadn’t signed up for any sort of expedition... at least he didn’t think he had.
To read more WIPpet Wednesday posts, please go here.
To read more about my time in the hospital, go here, and to read more about my son's stay in the NICU, start here.