Jul 272013
 

I’ll start with some pictures:
This is a picture of Justin in the operating room, right when he was born. 2 lbs, 8 oz; 16 inches long.

Birth picture

Birth picture

A little bit of perspective on just how tiny Justin was…he often looks bigger in pictures.

Tiny boy

Justin with Jack’s hand

Perhaps the most excruciating part after having my c-section wasn’t the pain itself (after all, I was on lots of pain meds), but the fact that I couldn’t see the baby until I was out of labor and delivery and into the recovery room. After the c-section, my oxygen levels weren’t where they should have been. Because of this, I was stuck in labor and delivery until I saw a respiratory therapist. It wasn’t all bad…my pain levels weren’t that bad, and I had lots of visitors. I had initially been against visitors right away (when we were planning for a non-emergency birth), but now they were a welcome distraction. I must have sent Jack to the NICU six or seven times. While I was still under heavy medication, anyone who asked me how I felt got the response of “hungry.” Probably not the most appropriate response, given that my son was in the NICU, but I think it was the only response I could muster without completely losing it.

We waited for hours…literally. It got to the point where they seemed to think they would be moving me soon, so my parents, Jack’s parents, and Jack’s brother and sister-in-law waited for me in the recovery room. And then we waited…and waited some more. I thought the respiratory therapist forgot about me. The heavy medications were wearing off, and I was getting more anxious by the second. I wanted to see my baby. It was almost 10pm before I got to see him…almost 7 hours after he was born. Don’t get me wrong, he was briefly wheeled by me in the incubator before he was taken to the NICU, but I was still about 2 feet from him. I hadn’t REALLY had the chance to see him. At that, I only got to see him for a few moments as I was wheeled on the bed to my recovery room.

What I learned about his prognosis was promising. He was briefly intubated, but the breathing tube was removed even before Jack saw him in the NICU. He was on a C-PAP machine (the same sort of machine used for sleep apnea) and on room oxygen.

The first time I really saw Justin

The first time I really saw Justin

I entered the recovery room to a crowd of people. At that point I didn’t really want to see anyone. I hadn’t really realized until moments before when I saw the baby, just how tiny he was and how big of a fight he would have. I was choking back tears. I quickly whispered to Jack to take them to the NICU to see the baby, and to send them on their way so I could sleep. While Jack was gone with everyone else, the night nurse came in. She was very kind and motherly, and I felt very at ease with her. I think I sent Jack to the NICU one last time before we went to bed, after everyone else was gone. I wouldn’t be allowed to see Justin until the next night (Sunday, February 10th, if you’re keeping track) once the magnesium sulfate IV had been removed and I was able to stand up and go to the bathroom on my own.

I got as much sleep as I could that night, with vitals being taken every two hours to monitor my blood pressure. I woke Jack up very early on Sunday and sent him to the NICU to check on the baby. That happened several times throughout the day – I was very paranoid that something would happen and no one would be there for him. I had visitors: My mom and dad, Jack’s mom and dad, Jack’s brother, sister-in-law, and both of our nephews, and Jack’s aunt and uncle. All well-meaning, but I didn’t really want a room full of visitors. I was too exhausted and too worried. Lots of preemie clothes came with the visitors, and they were so very tiny. I think I zoned out through most of the conversations. It was really because of how worried I was but at least I could blame it on the pain medication. Finally everyone left, and it was just us. In the evening, the nurse removed the magnesium IV. She also told me I could be off the oxygen since my saturation levels were better. I had to get out of bed and use the bathroom before I would be allowed to go to the NICU to see Justin. Getting out of bed was horrible. I had two things going against me – the muscle weakness from the magnesium sulfate and being bedridden for three days, and the pain from the c-section. I had to lean on both Jack and the nurse to stand up. Slowly but surely, I made it to the bathroom. I had to sit on the toilet for some time to manage the pain, but I managed to use the bathroom and Jack helped me back to the chair in the room. He was able to track down a wheelchair and he took me down to the NICU. I must have looked like a total disaster – I hadn’t had a shower since Tuesday night, my feet were so swollen from the IV fluids that I couldn’t even get socks on (the NICU staff told me I should have something on my feet for safety purposes and not to walk around barefoot- it was at that point that I thought about what I was going to put on my feet to go home). It didn’t matter at that point. I just wanted to see Justin.

We got back to Justin’s room and washed our hands, as we had to every time we entered and left the room. I looked around at all the equipment, and the writing on his whiteboard. “Welcome to the NICU, Justin!” it said. I immediately saw that there was a blanket covering the incubator. It came from Project Linus, the first of many donated blankets Justin got during his stay. It was a strong reminder that we weren’t prepared to have a baby yet. We didn’t have anything, except for his furniture…but his room wasn’t even done. We had someone come in and talk to us about participating in a few medical studies regarding premature babies – nothing invasive, just collecting daily stool samples and analyzing for certain illnesses. I agreed to participate, after all, you never know how this might help future premature babies. I had also signed up for a study regarding preeclampsia – all it involved was an extra vial of blood from me, a small tissue sample of the placenta, and a phone interview about my and my family’s medical history. I could have stayed in the room all night, but I was on limited time, as I had to get back for vitals. At that point, I finally got to have food. I was given a menu and was told I could call the cafeteria for room service. I had a ton of choices = I got an entree with four (!!) sides, two drinks, and dessert. The problem was that I wanted everything. I can’t remember what I ordered, but I remember being told to eat slowly since my body had to readjust to food. Once again, I slept the best I could, but vitals were every two hours.

Monday arrived, and with that, another day of overwhelming information. A hospital social worker came in to talk to us in the morning, and explained to us the symptoms of Postpartum Depression and why women with babies in the NICU are particularly at risk. She talked with Jack and explained that if he saw any signs of severe PPD to get me to the doctor. We also got information regarding SSI and medical assistance for Justin. I learned how to use the breast pump, as my milk had come in full force. The fact that it was a week day meant no visitors – a welcome change of pace. We visited the baby several times, and I walked partway at least once. The pain was still horrible, but I was finally allowed to get a shower!! I also managed to pull a muscle in my left leg – I had been leaning on it to get up from the toilet while pulling up on the bar on the wall. Jack went home for a short time during the day, just long enough to take a shower and play with and feed the cats. He also stopped and bought me a nice pair of slippers – the shoes I would wear home, as my winter boots wouldn’t go on my feet. He was only gone about three and a half hours, but it felt so much longer. It was the first time I had really been alone since the previous Wednesday. The nurse knew he had gone, so she went over my discharge booklet. Most of it wouldn’t apply, since Justin would be staying in the NICU for awhile. Jack came back, and said he wanted to watch Monday Night RAW, so we visited Justin and returned from the NICU just before it came on. It was nice to do something that we normally did. After the show finished, Jack went to the NICU to check on Justin and then we went to bed.

Tuesday wasn’t much different. I had my staples removed that morning, and found out that my incision was healing nicely. I was finally off the portable monitor. I was given the choice to either go home or stay an extra night. I chose to stay, mostly because I knew when I left, I’d be leaving without my baby. We visited Justin several times. I felt so helpless. All I could do was sit and watch him. Tuesday came and went, and Wednesday arrived – my discharge day.

I knew Wednesday would be rough. The morning nurse told me I probably wouldn’t be discharged until later in the day, so we stayed in the NICU for awhile. I gathered all of our belongings, and we basically waited. I was discharged around 3pm – the start of afternoon rush hour. We stayed in the NICU for a few hours after I was discharged. We were finally allowed to hold Justin. And then it was time to leave. I made it to the car without crying, but as soon as the car door shut, I lost it. I was leaving the hospital without my baby. On top of that, pain was starting to set in. I hadn’t had pain medication since 10am. We got stuck in rush hour traffic, and it took us almost an hour just to get out of the city. It was around 10pm before we made it to a pharmacy. We had to bypass our normal pharmacy because it had already closed, and find the nearest 24 hour pharmacy. So there I was, with my fuzzy slippers, my biggest pair of pants and a large t-shirt, hunched over in pain, in the middle of a Walgreens, filling a prescription for pain medication. I explained to the woman at the counter that I had just had a c-section and my baby was in the NICU and I needed to fill my pain medications. I had to use the bathroom while I was waiting, and I had some trouble getting up because of the pulled muscle.

We finally arrived home. I was in tears for a variety of reasons – I got to see my cats, I was worried about the baby, I was happy to be home…so many emotions. I was under strict instructions to not use the stairs for a few days, so I knew I’d be sleeping on the couch or loveseat. All I wanted was my own bed. Jack called the NICU to check on Justin before we went to sleep. Sleeping totally sucked without an adjustable bed (not that I slept well at the hospital, but it made getting up and laying down easier). I wasn’t comfortable anywhere. I was in pain when I laid down, and I was in pain when I sat up. I woke up every few hours to use the breast pump. I knew the next several weeks would be very long and the added anxiety didn’t help.

 Posted by at 1:35 am
Jul 082013
 

In my last post, I talked all about infertility and my pregnancy. I had a relatively easy pregnancy – morning sickness, but nothing too severe. It was more like an overactive gag reflex. I had a bad round of stomach flu around Thanksgiving, but that was really it.

January went by smoothly. I was really fatigued, but chalked it up to a normal pregnancy symptom. Everything was going well. Until February 6th.

On February 6th, I had my normal OB/GYN 32 week appointment. As usual, I left it up to Jack if he wanted to come or not. His response was the same as the other times – if I felt I needed him, he would come. I told him not to worry about it. After all, there’s nothing exciting about a normal 32 week appointment. For some reason, on my lunch break, I sent Jack a text message and asked him to meet me for my appointment. I’ll never know what exactly prompted me to do that but I’m so glad that I did.

At the start of my appointment, my blood pressure was high. REALLY high. However, it had happened at the last two appointments and went back to normal later on during the appointment. They had me lay down on the exam table and came back a few minutes later to take it again. Still really high. A few more minutes and a third time…still high. At this point, the doctor came in and explained that they had found protein in my urine – a sign of preeclampsia. With that and my blood pressure readings, Jack was given strict instructions to take me directly to the hospital – no stopping for food, no going home and packing.

I cried the entire car ride – about half an hour. I worried about the baby. I worried about myself. I worried about Jack, should something happen to me or the baby or both. I worried about if the cats had food and water at home. I worried about anything and everything I could think of. I could still feel the baby moving, which was a small relief for me. I got to the hospital and got checked in. I was hooked up to a blood pressure machine to take my blood pressure every 15 minutes. And the kicker…I had to catch all of my urine and put it in a bottle for 24 hours so they could get a better analysis of the amount of protein in my urine. Being 32 weeks pregnant, it was A LOT of urine. At the hospital, I was allowed to eat and get up and move around. One of the other small comforts was a nurse that knew Jack and his family. My blood pressure went down a little bit, on the high range of normal. I had no other symptoms of preeclampsia – no blurred vision, no major headaches, no swelling…no seizures. According to my initial blood pressure reading at the doctor’s office, I should have been having seizures.

It was a boring 24 hours. Jack stayed with me. We watched TV and slept the best we could. I had an ultrasound to check on the baby. While we were waiting for the results, I was brought dinner – Thanksgiving dinner. It was awesome. This was on Thursday, February 7th.

I had finished my food and was getting anxious to go home. I knew I would probably be put on bedrest, but I was fine with that. The next thing I knew, I had several people rush into my room. They started setting me up for an IV. I panicked. I knew this wasn’t good, and I knew it meant I wasn’t going home. I had no clue what was going on. My blood pressure skyrocketed to 170s/130s. I was then told (AFTER getting the IV fluids and being started on magnesium sulfate) that I was being transferred to a hospital with a higher level NICU for the baby. I got a steroid shot for the baby’s lungs (I would get the second one the next night) and was transported via ambulance to a hospital a little over an hour away. Jack had to follow in the car, probably the most excruciating drive of his life. He had no clue what would happen to me or the baby. He called both his parents and my parents on the way. I can’t remember if his parents visited that night, or the following night, but they were there when I got a more detailed ultrasound to determine the baby’s growth. I knew the baby should be between 3.5 and 4 pounds. He was estimated to be about 2 pounds. I was completely floored. I was diagnosed (or rather, the baby was diagnosed) with Intrauterine Growth Restriction, caused by the preeclampsia.

Now, it still bothers me how that sort of growth restriction went on undetected. With all of my ultrasounds and appointments, I wonder if there was ever a time when his growth wasn’t on track, and if so, why wasn’t he checked more thoroughly? I will probably never know.

Jack’s family continued to hold out hope that the baby wouldn’t have to be delivered. I knew in my heart that he would arrive that weekend. I was given the second steroid shot for the baby’s lungs around 6:30pm on Friday, February 8th. The goal was to make it another 24 hours for the steroids to have maximum effectiveness. I had been given a choice to have labor induced or to have a c-section. With the growth restriction, the doctors weren’t sure if he would survive labor if it got rough. It was really no choice at that point – a c-section it was. I worried all night Friday, but managed to get a little sleep. I believe I was given Ambien to help.

I woke up Saturday morning, and tried to make light of the situation. I should mention that I wasn’t allowed to get up out of bed, as magnesium sulfate makes your muscles weak. I also wasn’t allowed to eat. So the last time I had been out of bed and eaten was Thursday evening before the ambulance ride. I had already been told that it would be 24 hours after the baby’s birth before I would be allowed to get out of bed and eat. There was a movie marathon on the TV. I turned it on, since the 40 Year Old Virgin was playing. I at least thought I could laugh a few times. I was incredibly anxious about the c-section and what the outcome would be. At some point during the movie, the doctors came in with a buzzer and put it on my belly. They said the baby’s heart rate was good, but he wasn’t moving as much as they would like. He started moving around with the buzzer, and even kicked at it. I continued to watch the movie and tried not to worry.

Around 1:30, I had a flood of people rush into my room. Once again, no one told me what was going on until it was underway. The baby wasn’t moving around. His heart rate was still okay, but not as good as it had been. They were doing an emergency c-section. I clutched to a stuffed bear that Jack had brought. I told him I wouldn’t let go of it, that way they couldn’t take the baby early. He pried it out of my arms. I told him I wanted my mother, or his mother, or somebody’s mother. Our families weren’t there yet. They weren’t supposed to come until about 4. Jack immediately called them and told them they were taking me to surgery.

They took me to the operating room to be prepped and Jack was left behind to dress in his operating room outfit (which, funny enough, didn’t fit and they had to rig it). I cried through the local anesthesia and the spinal block. It didn’t really hurt but it was my response to being nervous. The spinal block worked immediately. I was also given morphine. The medications made me nauseous, so I was given Zofran.

Jack came into the operating room just in time. I asked him repeatedly if the baby was out yet. He didn’t know. I didn’t hear anything. And then finally, after the longest minutes of my life, I heard what sounded like a tiny lamb. Justin was born at 2:43pm. He weighed 2 pounds 8 ounces, and was just 16 inches long. But he took his first breath on his own, which was encouraging. We knew it would be an uphill battle with a lengthy hospital stay, but he had made his way into the world.

More to follow…