Wednesday, February 19, 2014

Two Weeks in the NICU

Now that Shrimpy is a little over one month old, gaining weight consistently (4000 grams last week!), screaming at her sneezes, grunting at her hiccups, vocalizing and catching our eyes with hers- our stay in the NICU seems so long ago!

It all started in the middle of the night on Sunday the 19th. I was holding her in bed, trying to get her to calm down from crying to feed, when she seemed to have a fit, getting quite upset (it seemed to me), and then falling asleep. Exhausted, I decided to try later and put her in her co-sleeper and slept myself. Surprisingly, she didn't wake up again, and we changed her diaper when we woke up at 8, where she had another fit, then fell into a deep sleep. Broom and I found it odd, but had no idea what was going on, and knew the midwife was going to visit us at 10. While we waited, Shrimpy was too tired to nurse.

When the midwife arrived and I told her about Shrimpy's refusal to nurse (and she had been such a vacuum suction-feeder prior!), she looked concerned and said that she couldn't go that long without eating- and we explained that we couldn't get her to feed. While the midwife was holding her, she had another fit- after which she told us she was going to call the hospital to tell them that we were coming and that she was also writing the admissions desk a letter about her observations- all the while staying quite calm but making clear that we needed to leave immediately.

The 5 minute drive was hell- Broom drove well, though- considering this was her 2nd nerve-wracking drive in a few days, just a week after getting her license. The admissions desk was nice though, getting us into a room really quickly, despite the fact that that nurse was incompetent- failing to realize that we had no clue what was going on, and talking a mile a minute about other things, like weighing Shrimpy daily, taking her temperature and such- and we had no idea whether or not we would be staying! The doctor on call that day was also weird, coming in and picking up Shrimpy without talking to us or introducing herself. Once I realized that she was getting ready to leave the room with her I stopped her with "Excuse me- the nurse said that the doctor would be coming in to examine her?!?". To which she replied "Oh, yes, that's me, I guess I should have introduced myself."

That shift failed to ask us what we saw and why we were there, but did hook her up to sensors measuring her breathing, heart, and oxygen saturation and putting in an IV to rehydrate her. After several requests, I was shown where I could pump, since I wanted to get my milk coming in as soon as possible. Only after we asked did they ask if we were ok giving her formula until my milk came in- of course, giving her anything I could pump first.

During the first shift, she had a few episodes, during which we rang the incompetent nurse- but no one seemed to believe us! Unfortunately, at night, Shrimpy had an episode every hour- and I rang the nurses every time, even though doubt was still there- but eventually, the nurses saw an episode and decided to wake the weird doctor, and explained that it was seizures. At that point, the doctor finally decided to check for head trauma, which came back clear.

In the morning, (Shrimpy had been seizing all night on a regular basis), she had another seizure right when the doctor's had started their rounds- including the head doctors. Luckily, all 7 of them were able to see her have a seizure, and they ordered that she be given meds via IV to stop them. The meds made her even more lethargic, but gave her peace.

In the coming days, a multitude of tests were run to see what could be causing all of this. As a precaution, she received antibiotics since some of the lab work took a while to get back. Each and every test came back negative, and we tried to get as much skin-to-skin time as possible, learning to navigate all of the wires and her incubator like experts. With time, the medical team (who was excellent, with the exception of the team working when we were admitted) came to the conclusion (which could only be made by the process of elimination) that she was having benign infant seizures. My mom did research for me while we were there, and discovered that there are several women in our family that have had the same thing.

They switched Shrimpy to a less harsh drug, even though I still had to wake her to feed- mostly from the bottle, as she didn't have enough energy to feed from the breast. Luckily, my milk came in on Tuesday the 21st, and I had her exclusively on breast milk by Thursday. In that week, they even put us in a normal ward for an evening- but Shrimpy had mild seizures all night that night, and a few where she couldn't breathe. Her longest seizure yet, which happened after a nice bath and feeding from the breast, was one where she turned blue around the mouth, causing me to start screaming like a banshee (something along the lines of "get my baby some fucking oxygen!!!"). Broom took her from me (we always tried to hold or at least touch her during her seizures as a comfort measure) and screamed back at me to get me to calm down.

At that point, we were promptly re-admitted to the NICU, where they spent the next few days trying to get her meds right. Luckily, after being re-admitted to the NICU, she only had 2 more seizures where her breathing was an issue. Two meds, administered twice a day turned out to be the right combination for her. Her last seizure was the 26th, and within a week of them keeping her meds steady, she developed a regular wake/sleep pattern, although we still keep an eye on her.

After being home a week, the midwife and I worked on getting me off of the medical grade breast pump (I had too much milk) and purely using Shrimpy's cues- and it worked! In about a month, she has another EEG to see if her brain is still seizing. If not, then we will wean her off of her medication. A week after that, she has an echo cardiogram to see if the normal, newborn "heart hole" that hadn't closed for her yet (the midwife said that she has seen this with babies who have been under stress) is now closed.

Her two weeks in the NICU were some of the hardest of my life- and I don't think I have ever cried that much- ever. Watching her small body be in so much pain (after some of the seizures, she would whimper- talk about breaking your heart!) and not be able to do anything about it was extremely difficult. I would have gladly switched places with her ten times over- but we couldn't. She is such a strong girl! And Broom and I were thrown into the deep end of the parenting pool- and realized, that if we could do this, we were gonna be fine. Our relationship seems to have grown even deeper through that family trauma, and we were able to alternate who was the strong one, while keeping our spirits up when we could. We kept an eye on one another, and after I had spent 4 nights in the hospital with Shrimpy, Broom convinced me that we needed to alternate so that I didn't lose my shit. It was a good call.

Despite everything, I am grateful for the following: that, if our little girl has to have a sickness, that it is one that doesn't leave any damage (and if it does turn out to be epilepsy, that is manageable, too!), for a health care system that is excellent (all of her care is at no cost to us), for a relationship as strong as ours, and for family and friends the world over! We asked for positive thoughts and prayers and wow- were they given. I really, truly believe that they helped, and am so glad that we all got showered with that positivity. Our Shrimpy has quite the fan club- as she should, since she is incredibly adorable!

Once this is even more behind us, I will be even more at ease- but it is pretty neat how my brain has been able to regularly forget and not worry all the time- even though we both keep a close eye on her.

All in all, we are a very lucky family.

Monday, February 10, 2014

A Shrimp is Born!

Wow, what a difference a month makes. I feel like I have aged 10 years since my last post. It will take two posts to cover everything that has happened since, but I will start with Shrimpy's birth story and then post about the two weeks we spent in the NICU (so glad to be home now!). Both posts are bound to be quite long...

The prodromal contractions that I had been having continued and I lost more of my mucous plug in the little over a week that passed between my last post and labor. They were still manageable, and my spirits were high, although I did start drinking raspberry leaf tea as well as verbena tea, as recommended by my midwife. All of my visits confirmed that everything was fine, and that we were in no rush to meet baby. Since I was ready, I kept on with the tea, and tried to stay well-rested.

On the night of the 16th, I decided to put the theory of eating eggplant parmesan (with plenty of oregano and basil) to the test. The food turned out great, and I was lying on the couch watching the news when my water broke after a mild contraction at 20:10. It felt like a small "pop" and I said to Broom "I think my water just broke!". I stood up, had a small gush, and went to the restroom, where I lost more clear water (as described by the midwife, it looked like mozzarella water. We got excited, and checked our bags for later and decided to try and get some sleep after letting my family know that we could use their positive energy.

The contractions were 20 minutes apart and only mildly more painful than the contractions that I had been having for the past 3 weeks, and they stayed like that for three hours or so. I was able to rest some, but then the contractions got more intense and were 15 minutes apart, so I went to the couch where I turned on Tim McGraw (his music always helped me sleep while flying) and dozed in between them while timing them the best I could.

At about one in the morning, my timing made me notice that the contractions were coming every 5 minutes- a pattern that I observed for 45 minutes before waking up Broom, after which I woke her to have her support. She applied counter pressure on my back and helped me breathe in the living room, where I had set myself up. They were intense and required all of my concentration, but the pain was instantly gone after the contraction was over. Broom and I decided to call the midwife at 2:30 to let her know that my contractions were still 5 minutes apart, and she thought we could still be a long ways out. I talked to her on the phone and realized I was dealing quite well and found talking to her to be quite distracting, and to wait to go to the birthing center.

After talking to her, I decided I wanted to try and take a bath. The first few contractions in the tub were fine. Suddenly, they got much more intense, and my whole body, each and every particle from my head to my toes, convulsed and drew together, automatically pushing the baby without me actively doing anything. This felt wrong. I had just had ok contractions, and now my body was pushing?!? Something had to be wrong, and I knew, that if this was early labor, that I couldn't do it.

Instinctively, I put my hand between my legs when these contractions came, but I seriously doubted that this could be what I thought it was. In between the pushing contractions, I kept thinking to myself- it would make sense if this was transition...and then I threw up, which really had me thinking- "could I already be there?!?".
After throwing up, I had to get out of the tub. I laid down on the bed and continued to have the pushing contractions, every 2-3 minutes.

At about 3:15, Broom called the midwife again, who heard my guttural, growly contraction and told us that she was leaving for the birthing center and would call us once she confirmed that the room was free. Broom got stuff ready while I tried tipping my chin back and panting to hold back the pushing contractions that were so intense and heavy. I told Broom, "This sounds crazy, but I think the baby is coming, I swear I can feel the head."

About 15 minutes later, the midwife called back and told us we could come any time we were ready. Broom somehow got me dressed, holding me up through the contractions. In the car, I braced myself in the back so that I wasn't sitting down, so convinced I was that the head was right there. I gave Broom directions (who had only gotten her driver's license a week beforehand), who was understandably nervous- so I didn't tell her how I felt like the head was there- that, and I was in disbelief.

Once she parked, I went to get the parking ticket, where I had such a strong pushing contraction, that I was starting to believe what I was feeling. On our 2 minute walk to the birthing center from our parking spot, I had two more contractions, one of which on the few steps down to the birthing apartment.

The midwife proceeded to ask me if she should fill the birthing pool or check me. I told her "You better check me- it sounds crazy, but I think the baby is right there". She asked me to sit down, but I refused, stating that I didn't want to sit on the baby. Broom and the midwife helped me get my pants off, and she took a look, stating: "Yes, the baby is right there, reach down and touch it's head." After doing so, I realized that I could, indeed, trust my body. She told me to kneel at the end of the bed, bending my body over the bed itself (since the kneeling pad wasn't there yet, I asked "But you are going to put something down, right?"), of course pulling out the birthing pad and something sterile for the baby to be collected on underneath me.

After kneeling, I had another pushing contraction, letting my body do all of the work, and immediately felt the "ring of fire". Another pushing contraction came, and the head was out! The body followed immediately afterwards...two minutes after entering the birthing center, and the midwife just barely had enough time to put on gloves!

I looked down, and couldn't believe that my baby was already here! I picked up baby and crawled into the bed. After expressing concern about keeping baby low enough to let the umbilical cord pulse out, the midwife let me know that it was already pulsed out and I had some skin to skin time with baby while the midwife gave the umbilical cord a gentle tug. Out came the placenta without any problems.

It was only at this point that we asked if it was a boy or a girl, at which the midwife told me to look.With my first glance down before crawling into bed with baby, I thought we had a boy- but I was wrong! We had a little girl! After seeing that surprise, baby and I were able to nurse for awhile, with the midwife checking on me and determining, despite the fact that our Shrimpy came out with her hand on top of her head, that I had no tears, only a few scrapes. Baby weighed in at 3250 grams and 49cm long and had perfect APGAR scores. Since she had spent such little time in the birth canal, her head wasn't deformed at all, and her cheeks were really filled out- making her look older than she was. Surprisingly, she also had quite a bit of hair!

After feeding, it was time to attempt my first trip to the bathroom in order to empty my bladder and encourage my uterus to contract further. My midwife and I made it to the bathroom, but while on the toilet, I passed a large blood clot and passed out- waking up on the floor. After Broom helped me to bed, the midwife gave me a catheter to empty my bladder, and continued to give me sugary drinks. However, she stated that if I didn't come around with my dizziness within 30 minutes that she would have to transfer me to the hospital for a transfusion. Luckily, this wasn't necessary, and we were allowed to stay in the birthing center room longer than usual after the birth so that I could rest and regain my strength.

It was a truly amazing experience, feeling the power that my body possesses, and finally meeting the little girl that made us parents! A part of me wonders how long her birth would have been had I not fought the pushing contractions- but either way- 8 hours from water breaking to holding a baby is pretty amazingly intense for a first child!

These wonderful moments would keep us going once our Shrimpy got sick a day and a half later....which will be another long blog post itself.