Friday, June 21, 2013

Birth - NICU

I spent Thanksgiving holiday alone.  Andrew had left to visit his family in "The Valley" (Edinburg TX) and I had made the decision that it was too risky for me to travel that far.  At the time it seemed overcautious, but I didn't feel 80 kick all of Thanskgiving day, and had mentally decided that if he didn't kick at all that night I would go to the hospital first thing in the morning.  Now, Tricare is very specific that military wives with the type of insurance we use, must deliver at the hospital on base.  So I woke up, called the hospital to let them know I was coming and why (they said fine come on down) took a quick shower, packed a light bag just in case, and drove 45 minutes to the Winn Army Hospital.  While I was driving I had a vision blackout.  Not a true blackout but my vision went all spinny and I couldn't focus on anything.  It lasted about 20 seconds and then was fine.

When I got to the hospital, they put me on monitors, had me drink juice, buzzed 80 with a vibrator, etc trying to get him to "wake up"  except for a few very mild spikes he remained inactive.  I had called my parents and was telling Andrew that I was in the hospital when the nurses came in, had me quickly sign some papers and change into hospital robes.  I had just enough time to text my two sisters to tell them they were getting ready to be aunts before they walked me down into the OR.

Now, up until now I had been as cool as a cucumber.  Even as they gave me the epidural that didn't work, and the doctors poked my legs and watched me wiggle my toes over and over before deciding that I needed general anesthesia, my heart was calm.  When one of the nurses, as I was laying on the table and they were strapping me down, said in a very urgent voice that Adrians heartrate had been 70.. when they took me off the monitor 10 minutes ago, I started to panic and cry.   It hadn't struck me until that point that 80 could be in danger and might not live.  70 is a VERY low heart rate for a fetus, it normally hangs in the 150s.  So I sobbed on the table despite their urging me that I needed to stay still.  It's such a blessing that they put me under, because I would not have been able to suppress the racking sobs had I been awake.  80 was born at 12:08pm Nov 23, Black Friday.  He weighed 3lbs 15oz or 1808g.  His APGAR at 1 min was 3, at 5 min 5, and 10 min 7.  He required immediate resuscitation at birth I was told.

They waited until I was awake to "see" him (I had to have a nurse take pictures on my phone because the anesthesia wouldn't let me focus my eyes) before whisking him 3 hours away to MCG in Augusta GA.  The doctors determined that I had had a placental abruption on the interior of the placenta, so a pool of blood was collecting between my uterine wall and the placenta but I never experienced bleeding because the perimeter of the placenta was still attached.
80 in the transport incubator, the photo a nurse took for me on my cellphone

Now, my experience from here on out was pretty trivial.  Normal C-section post-partum momma stuff so I'll skip it.

Andrew had his flight moved up a day and flew into Savannah the next day (Saturday)  My mom picked him up and they drove to Augusta while my dad stayed at Winn with me.


Andrews first time meeting 80, love at first sight!

poor little guy!  he was writhing the whole time
I was released from the hospital 2 days later.  It was probably a little early for me to be released but the staff at Winn didn't think 80 would live and were anxious to get me up there so I could spend time with him.

Our first family portrait

80 had suffered a grade 3 and grade 4 IVH, he had DIC, his blood pH was 6.77 which is incompatible with life, only a few nurses had ever seen such Acidosis, and none had heard of a baby who had survived it, he also had Hypotension, a partially collapsed lung, and Sepsis to name a few things.

 Our first times holding 80, about a week and a half after he was born.  Still in Augusta

We were told after 48 hours that 80 would probably survive.  We were also told to *expect* such things as ROP, Cerebral Palsy, developmental delays, and other heartbreaking diagnosis that I can't recall at the moment.  I spent an entire day crying in the snack room at MCG after a particularly grim meeting with the doctor we nicknamed "Dr House".

His first preemie outfit.  

His last night before the shunt was installed.  He didn't like being held facing forward, he still prefers to be snuggled.

It was later discovered that he had hydrocephalus, we were transferred back to Savannah, at Memorial hospital and had a VP shunt placed on his 3 week birthday by Dr Thompson (whom we adore).

 80 snuggles with his daddy.  You can see the shunt and shunt tubing very well in this picture.

We rode the NICU roller coaster, Intubation, cannulas, room air, gradual feed increases, then cutoffs, bottle feeding, PICC lines, plasma infusion, pain management... We were fortunate that he never had any serious issues with As and Bs (apnea and bradycardia) and after they sucked all the gunk out of his collapsed lung, he never had an issue breathing or with oxygen saturation.  He did battle abnormally high heart rates until his shunt was installed.  He also went anemic towards the end of his NICU stay.  His hematocrit level was 20.9 to anyone know knows what that means.  The nurses told us that it was pretty damn low and that he should have had a transfusion way before he actually got one.  Andrew and I thought his shunt had failed because his behavior had changed so drastically.

I made this video of the first week of his life


Even as a preemie it was obvious which of us he was going to favor!

 Someone looks like his daddy!

We stayed in the NICU about a week longer than we probably had to because of his poor feeding.  The policy with discharging babies is that they must either be breastfeeding (which he was not, though I was pumping) or be able to drink 40mL in 20 minutes.
milk drunk

When I think back to how much 40mLs is now, its such a small amount!  And in 20 minutes?  It feels like it can evaporate faster than that!  But the truth is we struggled to get him to drink even 10mLs some days.  In fact he never actually made that milestone, we were fortunate to get a nurse who thought we had been there too long and put us in a different program called "Rooming In" where we basically stay for 2 days in a room at hospital with 80, pretending we are at home.  We are the only caregivers for 2 days, they weigh him on the first night, and if he has gained weight we go to the second night, if he has gained weight the second night... we get to go home!  Everything went swimmingly  (except he was circumcised the second night.. that is a whole other story) and we went home on the 7th of January.  37 days in the NICU 6 weeks and 3 days.

Going home!  Just barely 5 lbs

He was due on the 13th so we were very lucky to take him home before his due date!  Even more lucky because Andew left for Afghanistan at 3am on the 9th, so we had a little over 24 hours home as a family before he shipped off.  Better one day home than none!



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