Daily Archive: March 5, 2013

Birth Story [part II – NICU]

[cont from Part I]

Kyle went with P and suddenly I was alone in my room (with my mom at least) and no baby.  WTF?!?  Did that really just happen?  I felt like I was in a nightmare.  What was going on!?  Worst of all was that Kyle had my cell phone and his so I zero way to get a hold of anyone.  I was stuck in my room without my husband or son.  Can someone please update me!!!!!  I was so out of touch.

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The only photo I had of my baby (taken by Kyle in the NICU)

Eventually Kyle came back to my room to tell me what was going on.  P had been in respiratory distress and they were doing everything they could to keep him adequately oxygenated.  Kyle didn’t know much about the rest of the details because he’s not very medically inclined, but I managed to piece things together.

[I will say that at no point did actually fear for P’s life.  He didn’t actually code despite the “code team” being there after his delivery.  Also, I trust the doctors and nurses at my hospital without reservation.  The staff at UCLA Ronald Reagan is 100% who I want providing care to me or my loved ones.  So I never doubted that he was getting the absolute best treatment available.  However.  Even though knowing he was in such capable hands did offer some comfort, the rational part of my brain was at odds with the emotional (and hormonal) part of my heart.]

I was in a sort of daze that first hour after delivering.  Or shock.  Everyone else seemed to want to move ahead as if things were normal (and I did too), but things weren’t normal.  I went through the motions.  I ordered breakfast.
Later an attending from the NICU came to talk to me.  Kyle brought her to my room in L&D because he wasn’t able to take in everything she was saying to him in the NICU.  She was optimistic that they wouldn’t need to intubate him, but wanted my permission.  I said do whatever you have to.

It seemed like both an eternity and no time at all that I was on the L&D unit, but as soon as my epidural wore off I was on my way to the maternity unit.  But not before testing out my sea legs with a short shuffle to the bathroom.  Oh man what a mess.  But I couldn’t even start to focus on that.  My mom and Marie brought all the crap from the room to my new room while Kyle pushed me in the wheelchair to meet my son in the NICU (up to this point I only had that one crappy iPhone photo of him that is shown above).  As soon as I scrubbed in and went to his crib I burst into tears.  I have no words.  It’s not something I can write about.  Not now, maybe never.

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First NICU visit

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Meeting P

It was weird (sad) to be on the maternity unit without a baby.  I’m really glad my family was there, with presents and a positive attitude, to distract me.  I was holding it together pretty well on the outside, but on the inside I was in turmoil.  The medical part of my brain was on overdrive.  Texting and talking to my dad and bestie Lauren was a huge help too since they are also in the medical field (especially Lauren since she’s an OB expert with MD friends in peds).

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Fake it ‘til you make it smile (nervous/freaking out on the inside but staying composed on the outside)

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New parents

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These are the only pics I had of him for a while.  I looked at them during breast feeding to remind me of what my little guy looked like.  It’s actually really hard to look at the NICU pics now.

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Because I was limited in my activity (and was required to take a wheelchair if I wanted to go anywhere in the hospital), Kyle would walk over to the NICU to deliver my pumped milk.  He got to see P way more than I did those first few days and it broke my heart.  He took lots of videos, which I also watched while breast feeding (and around the clock), that are hard to watch now.  They just remind me of that scary time.  It’s difficult to put into words.  I had so many emotions running through me, as a nurse and as a patient and as a mom.

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Kyle and PAC man

I pumped every 2 hours while I was on the maternity unit (during the day at least – during the night it was more like every 3-4 hours).  I wanted P to get my colostrum desperately and I realllllly didn’t want him getting the nasty* formula that the hospital used.  Whenever I could I visited the NICU to see him.  Kyle would push me over in the wheelchair, where we had to scrub in.  Even though he was the stud of the NICU (full term, no warmer, no incubator thing, etc) he still had oxygen, an OG tube, a central line, and the tele monitors attached to him.  So for the first day and a half I couldn’t even hold him.  It was one of the most tragic parts of my whole birth experience.  I always pictured myself getting to bond with my boy, him on my chest, breast feeding, and just being with him constantly after he was born. But what ended up happening was basically the opposite.  I’m actually more depressed thinking about it now than I was in the moment, but that’s probably because at the time I was just so focused on him being okay.  I couldn’t even think about the stuff I was missing out on (we were missing out on).  Fortunately, he was getting the absolute best care so I was really confident that whatever happened, he was in the best hands.

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Another NICU visit

My little guy proved his resilience right away (maybe he just wanted to create some buzz around his arrival).  There was some question over whether or not he aspirated meconium during delivery or if the respiratory distress was retained fetal fluid or pneumonia, but in the end his x-rays cleared up and he was was weaned off oxygen by his second day of life.  So I was able to pick him up!!

Next step was removing the OG tube (it was in place because infants swallow a lot of air when on high flow oxygen, so it was there to remove the air from his stomach).  That meant he would (finally) be able to get my breast milk (and we could start trying to breast feed).  All the colostrum that I’d previously pumped was being stored in the NICU freezer.  I’m lucky that my supply was pretty solid from the start.  I had enough that they didn’t even need to supplement with formula the entire first day.

*I know formula isn’t the enemy.  I don’t want to get into a debate about it.  I don’t mean to make it sound awful, it’s just not what I wanted for my son.  I ate organic veggie hippie food my entire pregnancy, so the idea of non-organic dairy based processed stuff going into him before my breast milk was…frustrating.  That said, I quickly realized the ticket out of the NICU involved formula.  You have to pick your battles.

The thing about breast milk is it doesn’t have as much sugar as the TPN he had been getting through his central line.  Obviously he couldn’t eat while he had the OG tube, so he was getting vitamins & minerals via IV.  Weaning him off that was the next step after the oxygen (aka ensuring his blood sugar didn’t plummet from the change in source of nutrition).  My goal was to get him home asap.  Hospitals are for sick people and my baby was healthy.  The longer you’re a patient, the more you’re at risk for getting sick(er).  I think it’s the result of being a nurse, but the hospital grosses me out.  Maybe everyone feels that way.  Maybe not.  I’ve seen too much though.  The behind the scenes.  But back to the story.  As badly as I wanted him to get exclusively breast milk, my priority was getting him home, which meant I had to compromise on how I felt about formula.

Initially, I was very clear in communicating to the staff that I didn’t want P getting formula without my permission (my breast milk supply in the freezer was more than adequate to feed him via syringe since I couldn’t be there around the clock to know when he wanted food).  So the nurses were feeding him my breast milk.  I’m so so happy the NICU staff was behind me.  They were (are) wonderful.  They also wanted me to give him breast milk and encouraged me to bring the pumped milk every 2 hours; and in the end they used every last drop.  They never made me feel like I was a nuisance.  Or that I was an anal new mom.  They also wanted the best for P.

However, at a certain point it became clear that my breast milk wasn’t going to be quite enough.  So that’s when I had to decide which was more important – supplementing my milk with some formula to get him off the TPN to get him home vs. feeding him my breast milk only.  Well, obviously I chose the first one.  I wanted my baby home, in my arms, free of lines and tubes and monitors.

Once again, my little boy showed his ability to overcome.  He was off TPN by the end of the second day and the NICU team decided to send him to the step down.  Hooray!  No more central line!

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Look ma, no tubes!

I didn’t really know what I had in store for me at the step down, but I did know he got his own room and we could continue to work on breastfeeding.  The step down unit was called the “growers & feeders”.  The bummer about the whole thing was that I was about to be discharged (but he had to stay another night).  Kyle and I figured that him having his own room would be okay though, so we quickly went home, showered (in my own bathroom!! hallelujah!!), re-packed, and returned to the hospital.

FYI, it’s super hard to part with your infant.  Leaving the hospital to go home without him was the most bizarre thing ever.  It’s definitely not what I ever anticipated.  But again, I was just focusing on the most important thing of all, my healthy boy.

To be continued…