A different nurse again this day. Alex has been at the second hospital for nearly a week and is on his seventh nurse. This one scared me as she's younger than the ones we'd had and really quite loud; and a little in-your-face. But it turned out that this wasn't a bad thing as she encouraged me to take on a more hands-on role with Alex. She had me cleaning what was left of the umbilical cord, changing his diaper, warming his milk, and putting him into diaper shirts and sleepers before I took him out of the incubator, rather than just wrapping him in a blanket. She was also the first nurse to show me how to bathe him. He was so tiny in the giant tub that I had immediate anxiety about having to bathe him myself at some point, but I tried to just focus and watch the nurse as she carefully washed his face and hair, and then down his front, and then flipping him to his back before drying him off.
First thing this morning was difficult as I sat next to Alex in the incubator and watched as another mom and baby neared discharge. They were breastfeeding 5/8 feedings now, and the baby was taking the other 3 feedings by bottle, so his feeding tube was now out. I find these moments hard as it always seems that Alex is still so far away from reaching that point; but at the same time it's nice to see that one day he should get there as well.
I enjoy weekends at the hospital much more because of the quiet. The NICU has their regular visitors but less staff and less noise. There's always lots of room in the parking lot and when I take a break and wander down to the lobby, there are very few people in the halls. My husband also comes to the hospital with me on occasion since he's off work which is great company. It's not the same having my mom or a friend with me; they just don't seem to understand what it's like to be going through this experience, at least not like my husband.
I also noticed when I arrived home later in the day that I was excited to see my dog for the first time since this whole adventure began. I curled up with her on the couch; lay my head on her back, and stroked her fur gently. It was very comforting, and something that I realized I had been missing. I guess that's the thing about pets, their unconditional love and loyalty cannot be matched and it's something I should be taking advantage of.
Friday, December 3, 2010
Wednesday, December 1, 2010
Regurging (Spitting Up)
Apparently it's quite normal for preemies to spit up. I was told this has to do with an undeveloped flap that keeps food from rising out of the stomach. Like everything else with babies, some spit up more than others.
Alex seemed to have great difficulty with regurging from the start. His nurses tried many different things, from my holding him up for over an hour after a feed (probably worked the best- but he would still spit up after I put him down- and it wasn't manageable for me to be there for every feed); to keeping his head propped up on blankets; to keeping him on his tummy. It became routine quite quickly for me to hold him up when I was there, or to keep him on his tummy if I wasn't. A new nurse would come on and often try the normal way, him lying close to flat on his back, but that would usually only last once. I would tell them that it wouldn't work, but they would try anyway. And then he would spit up all over the place and they would quickly panic and try to clean it up, and say 'wow, he really does spit up'.
It was scary the few times I was sitting alone with Alex and he spit up so much that he would start choking. After the first time when I panicked and yelled for a nurse, I learned to quickly grab him and sit him upright, patting him lightly on the back. It was terrible to watch my little guy go through this every couple of hours; and it seemed that just when he would finally start to settle down, it was time for another feed.
Giving the tube feeds became quite the challenge as Alex did everything he could to push the milk and medications back up the tubes. It made some of the nurses quite unhappy as it meant they had to stay with him until he finished the feed so they could cap the tube before he brought it back up. I imagine it was easier when they could just hook the syringe to the top of the incubator, or later cot, quickly dump the milk down and come back a while later to unhook it and cap the tube. But between the regurging and pushing the milk back up, Alex could not be left alone during a feed.
Alex seemed to have great difficulty with regurging from the start. His nurses tried many different things, from my holding him up for over an hour after a feed (probably worked the best- but he would still spit up after I put him down- and it wasn't manageable for me to be there for every feed); to keeping his head propped up on blankets; to keeping him on his tummy. It became routine quite quickly for me to hold him up when I was there, or to keep him on his tummy if I wasn't. A new nurse would come on and often try the normal way, him lying close to flat on his back, but that would usually only last once. I would tell them that it wouldn't work, but they would try anyway. And then he would spit up all over the place and they would quickly panic and try to clean it up, and say 'wow, he really does spit up'.
It was scary the few times I was sitting alone with Alex and he spit up so much that he would start choking. After the first time when I panicked and yelled for a nurse, I learned to quickly grab him and sit him upright, patting him lightly on the back. It was terrible to watch my little guy go through this every couple of hours; and it seemed that just when he would finally start to settle down, it was time for another feed.
Giving the tube feeds became quite the challenge as Alex did everything he could to push the milk and medications back up the tubes. It made some of the nurses quite unhappy as it meant they had to stay with him until he finished the feed so they could cap the tube before he brought it back up. I imagine it was easier when they could just hook the syringe to the top of the incubator, or later cot, quickly dump the milk down and come back a while later to unhook it and cap the tube. But between the regurging and pushing the milk back up, Alex could not be left alone during a feed.
Monday, November 29, 2010
Day 11- Numb
Pumped throughout the night so woke feeling anything but rested this morning. Feel like some sort of machine when I'm pumping; can't believe how different the whole breastfeeding experience has been so far. But I woke up, pumped again, had breakfast, jumped in the shower, and was off to the hospital again.
I was anxious to see my son (Alex) as always, but wasn't really feeling up or down. Probably closer to the down side, but more I just felt tired and numb to everything on this day.
I checked Alex's chart and was excited to see he had gained almost an ounce since he was last weighed the day before. Soon after I arrived Alex's new nurse introduced herself and asked if I wanted to hold him while she gave him his tube feeds. He had been regurging (spitting up) following his feeds for some time so they hoped my holding him upright would help. I held him upright for the 10 a.m. and 4 p.m. feeds, and against my breast for the 12 p.m. I continued to change his diaper and was told that I could soon start bathing him. This was all good news, but I just felt out of it.
During the hour I spent at home in the afternoon I checked my email which I had avoided doing for some time. My heart sank at the number of people requesting to come to the hospital to meet Alex. I don't know if I was supposed to feel the opposite- excited that people wanted to meet him- but all I felt was sad. No one was supposed to have met him yet, and it didn't seem right having people come in to see the little guy for the first time while he was in an incubator. So I decided to ignore the requests. I was finding it hard enough to 'entertain' my parents when they arrived for a few minutes here and there to see their grandson; it was taking all of my energy just to get through each day. I think too it was hard seeing other people happy and excited to meet him as I was still feeling overwhelmed with guilt, worry, and uncertainty.
I was anxious to see my son (Alex) as always, but wasn't really feeling up or down. Probably closer to the down side, but more I just felt tired and numb to everything on this day.
I checked Alex's chart and was excited to see he had gained almost an ounce since he was last weighed the day before. Soon after I arrived Alex's new nurse introduced herself and asked if I wanted to hold him while she gave him his tube feeds. He had been regurging (spitting up) following his feeds for some time so they hoped my holding him upright would help. I held him upright for the 10 a.m. and 4 p.m. feeds, and against my breast for the 12 p.m. I continued to change his diaper and was told that I could soon start bathing him. This was all good news, but I just felt out of it.
During the hour I spent at home in the afternoon I checked my email which I had avoided doing for some time. My heart sank at the number of people requesting to come to the hospital to meet Alex. I don't know if I was supposed to feel the opposite- excited that people wanted to meet him- but all I felt was sad. No one was supposed to have met him yet, and it didn't seem right having people come in to see the little guy for the first time while he was in an incubator. So I decided to ignore the requests. I was finding it hard enough to 'entertain' my parents when they arrived for a few minutes here and there to see their grandson; it was taking all of my energy just to get through each day. I think too it was hard seeing other people happy and excited to meet him as I was still feeling overwhelmed with guilt, worry, and uncertainty.
Sunday, November 28, 2010
Routine
I realized that I had fallen into a daily routine. I would usually pump once overnight in order to give myself some extra sleep, and then starting in the morning, every 3 hours until I went to bed. In the beginning I used a single pump so one session took upwards of 45 minutes to an hour; between getting things set up, pumping for 20 minutes on each side, and then storing and labelling freezer bags and cleaning the pump and bottles.
In the morning I would first pump, have breakfast, and then shower. After I was changed I would put some things in a bag; usually a book, crossword, agenda, camera, water bottle, and snack. I would head to the hospital and park in pretty much the same spot each day. I'd walk through the halls and often pass the same staff going in the opposite direction. It was usually quite busy when I arrived during the week as it was around shift change (8 a.m.) and the start of visiting hours. Although the NICU did not have visiting hours for parents; we were allowed there anytime except during shift change morning and night.
I would then stay with my son, helping with feeds, diaper changes, and anything else I could, until about 1 p.m. In between I would have to pump, usually sometime between 10 and 11. Just after 1, I would either head out to do errands or go home and lie down for an hour, prior to being back at the hospital for 2:30/3. During this time I would try to remember to eat something, and would usually have to try to fit a pump session in. And there were definitely days that I had to leave the hospital earlier because I found it so upsetting, but on average I stayed there most of the day.
I would then leave the hospital again at about 5/5:30 so I could be home when my husband arrived from work. We would eat dinner, I would usually pump, and then we would head to the hospital following shift change in order to meet our son's night nurse, hold him for a little while, and say goodnight to him. My husband did not always come with me to this one as he found the hospital extremely difficult; which I could understand.
Once we arrived back home, I would pump before bed, and then try to get some sleep. The next day it started all over again.
In the morning I would first pump, have breakfast, and then shower. After I was changed I would put some things in a bag; usually a book, crossword, agenda, camera, water bottle, and snack. I would head to the hospital and park in pretty much the same spot each day. I'd walk through the halls and often pass the same staff going in the opposite direction. It was usually quite busy when I arrived during the week as it was around shift change (8 a.m.) and the start of visiting hours. Although the NICU did not have visiting hours for parents; we were allowed there anytime except during shift change morning and night.
I would then stay with my son, helping with feeds, diaper changes, and anything else I could, until about 1 p.m. In between I would have to pump, usually sometime between 10 and 11. Just after 1, I would either head out to do errands or go home and lie down for an hour, prior to being back at the hospital for 2:30/3. During this time I would try to remember to eat something, and would usually have to try to fit a pump session in. And there were definitely days that I had to leave the hospital earlier because I found it so upsetting, but on average I stayed there most of the day.
I would then leave the hospital again at about 5/5:30 so I could be home when my husband arrived from work. We would eat dinner, I would usually pump, and then we would head to the hospital following shift change in order to meet our son's night nurse, hold him for a little while, and say goodnight to him. My husband did not always come with me to this one as he found the hospital extremely difficult; which I could understand.
Once we arrived back home, I would pump before bed, and then try to get some sleep. The next day it started all over again.
Thursday, November 25, 2010
Day 10- A Better Day
I slept well after the 2 emotional days prior. I did not wake to pump and allowed myself to have a full night's sleep. It meant feeling much more rested in the morning. I also realized that I started to believe my son was going to be okay; we were all going to get through this. I did my usual morning routine- pump, breakfast, shower, and then was off to the hospital.
I checked my son's chart upon arrival as usual, and noticed that he had another weight loss. This concerned me but when I looked closer at my baby I realized that his IV had been removed. I found his nurse and inquired and sure enough he was now receiving enough fluids from his feeds that he no longer required an IV. I was also now pumping much more than my son was eating so began freezing my breast milk.
Since arriving at this second NICU, there had been two other babies on the more intensive side where our son was placed. One was in an incubator, the other in a cot. I had yet to see any family visit the little girl beside us, who had some personal blankets around her incubator and a name printed on the outside. I later learned that the blankets had come from the hospital, and the crafted name had been made by one of the night nurses. I overheard a couple of the nurses talking about how the parents never came in, but they had one or two other children at home so maybe they were too busy. This made me feel very sad. The little girl often cried out and wiggled around her incubator, but received no attention in return unless she carried on for some time. According to her whiteboard she had been born at a younger gestational age than my son, but was currently a week or two older than him.
The other baby was in a cot against the far wall, a little ways away from the two in the incubators. There had been a lot of activity around this baby as the young mom had told me in the pump room that social services were involved. Apparently there were concerns about her boyfriend, the father, who had been violent in the past. The young mom insisted that these were false accusations, but the investigation meant that he would be placed in foster care upon discharge. So at pretty much all times the baby had one of his parents or the foster mom there holding, changing, and feeding him. The mom had told me that she was kind of sad that her son was doing so well as the longer he was in hospital, the better the chance that they would be able to take him home as it would give enough time for the investigation to run its course. She was also concerned that once he was placed they wouldn't have the same access to him as they did in the NICU.
Only a couple of days after this conversation with her, he was being prepared for discharge to the foster home. That morning there was the pediatrician, the hospital social worker, the community social worker, the foster mom, and the young parents all surrounding the baby's little area. I heard the mom ask if she could visit her baby at the foster home that afternoon but the community social worker told her it would be a bad idea as he needed to settle and adjust to his new home. I could see the young mom fighting back tears as the foster mom put her baby into a car seat, received follow-up instructions from the pediatrician, and left with their baby. I tried smiling when she walked past me but she held an empty stare.
It was always hard to see another baby go home; especially when it seemed like my baby had so far to go still. But then again, this case presented far from ideal circumstances, so there were a lot of mixed feelings. I think it was also hard in this situation because it meant feeling lonely again- at least I had the young mom to talk to on occasion. After they left it was back to beeping machines and nurses wandering around from time to time.
I checked my son's chart upon arrival as usual, and noticed that he had another weight loss. This concerned me but when I looked closer at my baby I realized that his IV had been removed. I found his nurse and inquired and sure enough he was now receiving enough fluids from his feeds that he no longer required an IV. I was also now pumping much more than my son was eating so began freezing my breast milk.
Since arriving at this second NICU, there had been two other babies on the more intensive side where our son was placed. One was in an incubator, the other in a cot. I had yet to see any family visit the little girl beside us, who had some personal blankets around her incubator and a name printed on the outside. I later learned that the blankets had come from the hospital, and the crafted name had been made by one of the night nurses. I overheard a couple of the nurses talking about how the parents never came in, but they had one or two other children at home so maybe they were too busy. This made me feel very sad. The little girl often cried out and wiggled around her incubator, but received no attention in return unless she carried on for some time. According to her whiteboard she had been born at a younger gestational age than my son, but was currently a week or two older than him.
The other baby was in a cot against the far wall, a little ways away from the two in the incubators. There had been a lot of activity around this baby as the young mom had told me in the pump room that social services were involved. Apparently there were concerns about her boyfriend, the father, who had been violent in the past. The young mom insisted that these were false accusations, but the investigation meant that he would be placed in foster care upon discharge. So at pretty much all times the baby had one of his parents or the foster mom there holding, changing, and feeding him. The mom had told me that she was kind of sad that her son was doing so well as the longer he was in hospital, the better the chance that they would be able to take him home as it would give enough time for the investigation to run its course. She was also concerned that once he was placed they wouldn't have the same access to him as they did in the NICU.
Only a couple of days after this conversation with her, he was being prepared for discharge to the foster home. That morning there was the pediatrician, the hospital social worker, the community social worker, the foster mom, and the young parents all surrounding the baby's little area. I heard the mom ask if she could visit her baby at the foster home that afternoon but the community social worker told her it would be a bad idea as he needed to settle and adjust to his new home. I could see the young mom fighting back tears as the foster mom put her baby into a car seat, received follow-up instructions from the pediatrician, and left with their baby. I tried smiling when she walked past me but she held an empty stare.
It was always hard to see another baby go home; especially when it seemed like my baby had so far to go still. But then again, this case presented far from ideal circumstances, so there were a lot of mixed feelings. I think it was also hard in this situation because it meant feeling lonely again- at least I had the young mom to talk to on occasion. After they left it was back to beeping machines and nurses wandering around from time to time.
Wednesday, November 24, 2010
Guilt
No one could prepare me for how much guilt I would feel for giving birth prematurely. The only time I seemed to not be overwhelmed by it was when I was able to completely block it out and not even let it enter my mind. As soon as I gave the situation any thought, my mood dropped considerably. Time and time again my support system would assure me there was likely nothing that I could have done to prevent his being born early, but that's a hard thing to accept. Even more so as I hoped to have more children and if there was no preventable cause than there was nothing I could do to improve the chances of a full-term birth in future pregnancies.
I went over everything I did before and during the pregnancy trying to figure out what could have gone wrong. Prior to conception I had gone off the pill for a few months to assure that my cycle was regular again. During that time I also took a prenatal pill religiously, never skipping a day. I started eating much better, and stopped all caffeine intake. I got necessary shots beforehand and did a lot of reading and research around healthy pregnancies.
Once pregnant, I continued to take the prenatal pill, I went to every doctor's check-up, ultrasound, and blood test. I ate quite well, never drank, smoked, or did drugs. I took a prenatal class and had been signed up for a breastfeeding course. I did moderate exercise everyday. These were all the things I knew I did right.
The things that I truly obsessed about were the times I was not perfect. I had lunch meat on occasion. I dyed my hair early in the second trimester. I continued to use face cream and hand ointment. I had caffeine on occasion. Once in a while I exercised slightly harder than at a moderate level. I had warm showers here and there. I continued my stressful job full-time. All of these things are apparently not likely to cause any harm, but none are fully recommended either.
The biggest guilt came from my having had some likely leakage of amniotic fluid for a week or two prior to my water breaking. I assumed it wasn't anything to be concerned about, as it had been brought up in the prenatal class as being a relatively common occurrence. But my gut had told me to say something, or at least ask my doctor about it, and I didn't. Maybe if I had they could have confirmed leakage and I could have been put on bed rest, or changed something, in order to keep him safe and protected longer than the 31 weeks. This is the one that I struggle with, the one factor that I definitely did have control over.
I went over everything I did before and during the pregnancy trying to figure out what could have gone wrong. Prior to conception I had gone off the pill for a few months to assure that my cycle was regular again. During that time I also took a prenatal pill religiously, never skipping a day. I started eating much better, and stopped all caffeine intake. I got necessary shots beforehand and did a lot of reading and research around healthy pregnancies.
Once pregnant, I continued to take the prenatal pill, I went to every doctor's check-up, ultrasound, and blood test. I ate quite well, never drank, smoked, or did drugs. I took a prenatal class and had been signed up for a breastfeeding course. I did moderate exercise everyday. These were all the things I knew I did right.
The things that I truly obsessed about were the times I was not perfect. I had lunch meat on occasion. I dyed my hair early in the second trimester. I continued to use face cream and hand ointment. I had caffeine on occasion. Once in a while I exercised slightly harder than at a moderate level. I had warm showers here and there. I continued my stressful job full-time. All of these things are apparently not likely to cause any harm, but none are fully recommended either.
The biggest guilt came from my having had some likely leakage of amniotic fluid for a week or two prior to my water breaking. I assumed it wasn't anything to be concerned about, as it had been brought up in the prenatal class as being a relatively common occurrence. But my gut had told me to say something, or at least ask my doctor about it, and I didn't. Maybe if I had they could have confirmed leakage and I could have been put on bed rest, or changed something, in order to keep him safe and protected longer than the 31 weeks. This is the one that I struggle with, the one factor that I definitely did have control over.
Tuesday, November 23, 2010
Day 9- Emotional Rollercoaster Continues
After the very difficult day before, I woke up the next morning unsure if I could keep going. I felt so terrible and as though I had no control over anything. Unlike the day prior, I could no longer hold back the tears. I forced myself to get out of bed, purely on the need to see my son as it was feeling more and more like I was missing an arm or a leg without him being at my side. I cried when I pumped, I cried through a brief shower, I cried while I got dressed, I cried when I drove to the hospital... I parked and tried not to cry as I walked through the familiar hospital hallways towards the NICU. I kept my head down but knew my face was red and puffy from the tears. I washed my hands and quickly passed by the nursing station, hoping that no one would see how upset I was. I checked my son's chart and was relieved to see that he had a small weight gain from the day before. I then leaned against his incubator, opening one of the slots so I could slide my hand in over his.
My son had a different nurse than the previous 2 days and my spirits were lifted when she was open to kangaroo care and allowed me to start changing his diapers. I also spoke to the lactation consultant who wanted me to start putting my son against the breast so he could start getting used to it, even if he was too young to be able to understand how breastfeeding works. Around noon I drew the drapes around my son's area and placed his little body against my chest. He was so tiny but absolutely adorable and I felt that I could hold him in that position forever. He stayed with me for nearly an hour at which time I reluctantly gave him up to the incubator once again.
I left the hospital feeling happy that I got to spend some intimate and bonding time with my son, but devastated once again that I had to leave him there. I arrived home around suppertime and noticed that a relative had left sushi on our doorstep. Considering we had no food in the house, this was a very nice surprise. My husband arrived briefly prior to having to return to work which resulted in a stupid argument over my not giving our dog enough attention. He was right, as I had barely even looked at our dog since returning home a few days prior, but I needed him to understand. It wasn't about our dog, it wasn't about anything except my longing for my son, and the increasing guilt I was feeling for him coming early and needing to be in the hospital. Nothing seemed fair, and no one seemed to understand.
My son had a different nurse than the previous 2 days and my spirits were lifted when she was open to kangaroo care and allowed me to start changing his diapers. I also spoke to the lactation consultant who wanted me to start putting my son against the breast so he could start getting used to it, even if he was too young to be able to understand how breastfeeding works. Around noon I drew the drapes around my son's area and placed his little body against my chest. He was so tiny but absolutely adorable and I felt that I could hold him in that position forever. He stayed with me for nearly an hour at which time I reluctantly gave him up to the incubator once again.
I left the hospital feeling happy that I got to spend some intimate and bonding time with my son, but devastated once again that I had to leave him there. I arrived home around suppertime and noticed that a relative had left sushi on our doorstep. Considering we had no food in the house, this was a very nice surprise. My husband arrived briefly prior to having to return to work which resulted in a stupid argument over my not giving our dog enough attention. He was right, as I had barely even looked at our dog since returning home a few days prior, but I needed him to understand. It wasn't about our dog, it wasn't about anything except my longing for my son, and the increasing guilt I was feeling for him coming early and needing to be in the hospital. Nothing seemed fair, and no one seemed to understand.
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