Sunday, September 7, 2014

Adventures in the NICU #4

Our baby was moved into an open crib that night - but this time the nurses were smart and moved his crib away from the air vent. Once they did that, he did much much better and maintained his temperature easily.

Unfortunately I wasn't doing so well.

Over the weekend, my post partum bleeding had gotten heavier and heavier. So much so that I often felt I was spending more time in the bathroom tending to it than spending time with my son. I had called one of the doctors at the hospital regarding it, but she had insisted that having such a heavy flow, and passing large clots was fairly normal considering the fact I had such a large fibroid.

I trusted she knew what she was talking about, but another part of me was worried. The blood clots were now the size of the palm of my hand, and I was going through a pad an hour. Everything online said that that was not normal even though she swore it was. Finally a family friend pointed out that I needed to go to the hospital because it sounded like I had a retained placenta - which, considering I had had placenta abrupta when I had delivered my son, was entirely possible.

My husband and I drove down to the ER, where I was brought into one of the triage rooms. My pulse was higher than normal so I was escorted into the back. There they took my blood, hooked me up to an IV, and escorted me to an ER bed.

Over the next five hours, the ER doctors ran several tests. Finally they explained that while I did not have a retained placenta, the fibroid wasn't allowing my uterus to shrink normally (In fact it still felt like I was four months pregnant when they did their examination) and the uterine lining was unstable as a result. This was why I was bleeding so heavily.

In fact, I had lost so much blood over the past few days that they needed to admit me and do a transfusion. Normal hemoglobin levels for an adult woman is 12 to 16 - mine was 8.

The doctors wanted to put me in the post partum ward, where I would be close to them in case anything went wrong, and where the nurses knew how to handle situations like mine. Unfortunately the only bed they had open was all the way over in Oncology though - which was on the other side of the hospital.

The next 24 hours were absolute hell. The blood was supposed to be ready as soon as we reached the room but it wasn't. Apparently the nurses thought the blood bank was supposed to call them, not that they needed to call the blood bank. It took my doctor showing up on rounds and yelling at them to get them to do their job. In addition to that, the ER had put my IV in a horrible spot - the crook of my elbow - so any time I moved, or, heck, even looked at the IV the wrong way, it would stop and an alarm would sound. Even though I was right next to the nurses desk, and they could hear the alarm, whenever I clicked the call button and told them what was going on, it would take them sometimes an hour to check on it. Finally I had asked to be brought a breast pump so I could pump milk for my son, but they never brought one.

To add insult to injury, once the blood transfusion was complete around 6pm the nurses wouldn't let me go see my son in the NICU until they did a blood test to make sure my levels had gone up. They said they called the tech right then and there, but when she showed up at 8pm, she told us that she hadn't been called to come over until 750. Unfortunately that blood test came back showing my levels were lower than they had been when I entered the hospital. Rather than realizing that that had to be wrong and doing another blood test themselves, the nurses called up my doctor - who then proceeded to yell at them again and tell them to do another test. That took another hour and a half, because, again, the nurses didn't call the tech to come and do the blood test like they were supposed to until my husband yelled at them. Then once that blood test was done the nurses still didn't want to let me go to the NICU until they'd had another chance to talk to my doctor.

I had a melt down. It was ten o'clock. I hadn't slept in 36 hours, I hadn't seen my son in over 24 hours, and a simple transfusion that was supposed to take 6 hours had taken 12 because these nurses were incompetent and would rather spend their time at work gossiping rather than doing their jobs. My husband started yelling again, and my mother in law also got involved and gave them the what for.

Finally I was allowed to go and see my son.

Of course by the time I made it to the NICU it was past his feeding time and the night nurses there didn't want me to bother him. Thankfully, once they heard my story, they broke down and let me hold him even though it wasn't his 'touch time'.

I was pleased to see that he had been moved back into a crib. In addition to that they had also moved the crib out from under the air vent, so he was maintaining his temperature better than he had the first go around. In addition to that he had also been finishing his bottles since 5pm that night. If he kept up the good work, the nurse told me, they would be able to remove his NG tube.

By the time my mother in law and I made it back to my room from the NICU, I had finally been discharged from the hospital. Also, the manager of the nurses for the area had come over and apologized for what had happened and had offered us a free parking pass - as if that could make up for the hell we had been through.

We finally made it home and I promptly collapsed in bed.

The next day, after I'd had a chance to shower and eat, my mother in law drove me back down to the hospital so I could see my son. Thankfully he was still doing well; he was maintaining his temp, and he had finished all his bottles through out the night, so they had removed his NG tube just like the night nurse had told me they would. The day nurse told me that if he continued to finish his feeds for the 24 hours, then he would be discharged on Friday.

I stared at her in shock.

FRIDAY? My son would be coming home FRIDAY? We had originally been told not to expect him home until his original due date! We were not prepared!

The next 24 hours were spent rushing around to get everything ready. My aunt and my cousin had bought a travel set for us that included a stroller and a car seat. They dropped that, and plenty of diapers, off the next day and my husband and I spent a good hour trying to figure out how to install the car seat base in my car. Then we had to clean our room, move some of the furniture around, and set up his bassinet.

Just as the nurse had told us, after being circumcised and receiving his first vaccination, Garrett was discharged the next day.

We carried him out of the NICU very carefully, and drove home oh so cautiously. Then we sat him in the living room in his carrier and looked at each other as it slowly began to sink in.

Our baby boy was home!

Tuesday, September 2, 2014

Adventures in the NICU #3

The next day we had the same nurse again. She was still grumpy and condescending. In addition to that she still moved things out of our son's incubator - but at least this time she explained why. Apparently the doctors wanted to try to move him into a crib by the end of the week since he was large enough now that he should be able to maintain his own temperature on his own. Once he made the move to the crib, he wouldn't be allowed to have any stuffed toys or blankets in there with him, just like he wouldn't be allowed to sleep with toys or blankets if he were at home.

They turned off the temperature for his incubator, raised the lid, and bundled him up in a preemie hospital shirt (which was way too big), a hat I had made him (which was also too big), and then they swaddled him in a blanket.

Throughout the day they checked his temp every couple of hours. He was maintaining it well, but once night time came, his temp dropped, so they closed the lid on the incubator and turned the heater back on. I was sad to see that when I came in the next morning, but, at the same time, I reminded myself that he was still young. He would get there eventually.

Eventually turned out to be two days later.

I walked in to the NICU to find that one of our son's neighbors had been moved into an open crib. I commented on it to his nurse for the day and she smiled back at me telling me that he wasn't the only one who had graduated. I blinked at her a couple of times in surprise, and then walked over to my son's cubicle to find that, yep, he had been moved to a crib as well!

I promptly told my in laws, who rushed down so they could hold him and see him without all the wires.

The next day we had to deal with yet another nurse who harassed me about my milk production. I was finally beginning to produce 40 to 50 mls, but in her opinion that wasn't enough. In addition to that none of the clothes we had brought for our son to wear were good enough. Apparently she required that all onesies, pajamas, and sleep and play suits should have buttons. The sleep and play suit we brought had a zipper which was just not acceptable. Also she had started bottle feeding our son without calling us to notify us so we could be there. Last but not least, I was having some problems that evening - my post partum bleeding had suddenly increased drastically and now included large blood clots, so I had to keep running to the restroom to attend to them. Every time I passed her she quizzed me about how I had done on my latest pumping, and when we would be getting our son something better to wear, and if everything was okay.

I spent most of my time visiting my son crying because of her behavior and finally her harassment got so bad that my husband and I had to leave - which made me feel even worse.

To top the horrible day off, we got a call later that night from our son's night nurse telling us that he could not maintain his temp and was moved back into an incubator after being in a crib for a day and a half. My husband and I were disappointed, but not surprised - when we had changed him out of the NICU preemie shirt and into the sleep suit, we had noticed that he was bundled up pretty heavily. Even though the doctors had thought he was ready, it was obvious that he was not.

I went in early the next morning, wanting to reassure myself that my son was okay, and protect him from that nurse just in case he had been assigned her again. Thankfully he had someone new, a girl who was on rotation from the PICU, and who was just as shocked as we were by the other nurse's behavior. On the downside we discovered that several of his things were missing; his hat, his stuffed zero, and the lovey that had been in his incubator from day one. Everything else had been moved over, but apparently these items had been overlooked.

The hospital had always said that they were not responsible for personal items, but it was upsetting that when they had switched him back to his incubator they hadn't taken five seconds to open a drawer and make sure everything had been cleared out.

We told his nurse, and she promised that she would call the nurse he had the night before. However she never did. It was the night nurse who finally found them and she was only able to do so because the crib he had been in had not been cleaned out yet.

The following day the doctors were determined to get our son into an open crib. The nurses began preparing him for the transfer once more by turning off the heat on the incubator, raising the lid, and bundling him up. For awhile, he maintained his temperature fairly well, and then it slowly began to drop. The nurses were exasperated.

Suddenly an idea occurred to me. Our boy was staying in the isolation room for the NICU because it was the only space they had had open when they had transferred him over from his old NICU nursery. It was a nice little room, but it was enclosed with heavy glass doors and windows, where as all the other rooms were cubicles and were open on one side to the rest of the NICU. Also, there was an air vent directly over his incubator. The other cubicles had air vents as well, but they were located closer to the corridor running down the middle of the NICU, and not directly overhead.

I pointed this out to his nurse who agreed that the room was colder than the rest of the NICU, and that this was probably why he was having problems with his temp. She called up the maintenance department to see if they could raise the temperature in the little isolation room, but they claimed that they could not and that it was warmer than the rest of the NICU.

Both the nurse and I called shenanigans on that.

As there was two babies going home that day, she suggested that we try moving him out of the room and into one of their cubicles. She told us that she would keep us updated, and we headed home for the night.

Little did we now that we wouldn't be away from the hospital for very long...