Warning - if you are a first time mom, or faint of heart, you probably shouldn't read this, because it was traumatic (not for me physically, but for him), although rest assured it has a happy ending.
As I mentioned in my previous post, Little Man was a scheduled c-section on September 12, 2001. We got to the hospital around, I think, 7 in the morning to get checked in and get me prepped for surgery. I need to back up a bit and tell you that Trout was an unplanned (but not entirely unexpected) c-section after 19 hours of labor, during which they turned up my epidural for the surgery. She came out fine, but my blood pressure tanked completely afterward, although I never lost consciousness, and in recovery it took several hours and at least four bags of fluid to bring me back to the land of the living, or at least the land of "won't pass out if you stand up." So, our plan to avoid that with Little Man was to give me at least two bags of fluid ahead of time, and to use a spinal instead of an epidural, because they can be more careful with the amount of medicine they give you with a spinal. So on the 12th we went in early so I could get pumped full of fluids. I was excited and nervous, and tired, given that we had watched tv much of the night, and hadn't slept much once we did turn it off. We went in to surgery about 9ish, and by 9:44 my little boy was here. He cried, he had good color, I did great. We thought everything was fine. I got to hold him while they wheeled us from the surgery room to recovery, tightly against my chest. I didn't know that I wouldn't get to hold him again for a week.
I had been borderline for gestational diabetes, so Little Man needed to be monitored for effects of that. I wanted to nurse as soon as possible, so as soon as I was in recovery, the nurse, who was very committed to helping me breastfeed (thanks, Kathy!!) held Little Man to my breast so that he could nurse. He only sucked a bit and didn't really seem interested yet, so we wrapped him up tight and decided to try again in a little bit. About, oh, say 20 minutes later, the nurse decided to check his blood sugar to see if he needed feeding right away, or if we could wait some more. His blood sugar was fine, but when she unwrapped him to check him, he looked "a little blue." She gave him some oxygen, and he pinked up right away. She told me she knew I wanted him to stay with us, but she was concerned about his oxygen level, so she wanted to take him to the nursery to be monitored. We said yes, and away he went.
They got me moved out of recovery and into a room pretty fast - I recovered so much more quickly from the spinal than the epidural. We waited in our room for about an hour or so, and I was getting antsy. People had started to show up to visit and see the new baby. I sent BigDaddyFish down to ask about him, to see how long it would be before we could have him. He was gone a while. When he came back about 45 minutes later, he was empty handed. He said that Little Man did the same thing he had done before, turned a little blue when they unwrapped him and handled him. They had sent him down to the NICU for some tests, to see what was going on. They told us to check back around 2pm.
We waited until 2:30 on pins and needles. My relatives were watching the 9/11 recovery efforts on tv. Finally I couldn't stand it anymore, and send my husband down to the NICU to find out what was going on. He was gone a while.
He came back with a book instead of a baby. The NICU manual for parents.
I immediately burst into tears. I knew it was bad news. BDF told me that they thought he had pneumonia, as there were spots on his lungs. They had him under an oxygen tent, and they were giving him antibiotics. At that time, they thought he would be there about a week. I could handle that - infections are known quantities to me, you take antibiotics, you get better, the end. Little did I know what was in store for us.
The hospital where I delivered has primarily shared rooms, two moms and their babies per room. I was in one of those shared rooms, and I didn't have a roommate at that point. I knew they had a few private rooms, and I requested one, because you have no say who you get for a roommate, and the last thing I needed at that point was a young mom who had a two hour vaginal delivery and her brand new, healthy baby (no offense to anyone like that, I just couldn't handle that at the time). They said they couldn't make any promises, but they would see what they could do.
They took me down in a wheelchair to see him, as I still couldn't get up for any length of time. I remember I vomited twice on the way down, and on the way back. They wheeled me in, I scrubbed up, and they took me down to see him. He was the biggest baby there. Once again, it took one look and I dissolved in tears. His nurse told me he was doing okay, and showed us how we could touch him without agitating him (it didn't happen much - he usually got pissed when we touched him - was probably afraid we were going to stick him with something). I couldn't stay longer than a few minutes, so they took me back.
I had a private room in two hours. I began pumping breastmilk for him around 5pm. Man those hospital pumps are good - I had a Pump in Style at home, but it was a dinosaur compared to that pump in the hospital. I had already been up and walking around at that point - it helped, and I recovered super fast from that section. I never needed anything stronger than tylenol for pain relief (I can't take ibuprophen due to an allergy or I would have been all over that).
About 10 or so that night, after everyone had gone home and I was alone, a nurse from the NICU brought me some precious polaroids of my baby boy. She said that they had to put him on a ventilator, because he wasn't getting enough oxygen from just the tent, and that one of the NICU doctors would be down to talk to me about my son.
It was late when the doctor came, about 11 maybe, long after lights out, and the hospital was fairly quiet except for the occasional squawk from a hungry or irritated baby. The doctor explained that they really didn't know what was going on with my son. He said premies are pretty known quantities, but they have a tougher time with the bigger, full term babies, because they are unpredictable. They didn't think it was pneumonia at that time, but something else, though they weren't sure what. They were giving him surfactant, a substance his lungs need to function and which most of us start to manufacture ourselves when we are born and begin to breathe. He was on a ventilator, and they were watching him. They also had to sedate him because he was a big, strong sucker and kept pulling his tubes out (he was 8lbs. 3oz. at birth - 39 weeks gestation). I think I asked a few questions, it was bit foggy for me and I don't remember some things. They told me I could come down and see him at any time, except when they were doing patient review, even in the middle of the night. I still wasn't ready to walk down by myself then, so I stayed back, but they also let you call the nurses anytime - they are dedicated to individual patients.
Early the next morning, I was strong enough to walk down to see him. He was on a ventilator, there were all these tubes and wires all over him, and he was already starting to bruise a little bit where they had to keep moving his iv lines and other things because his veins were so delicate. Again, I didn't stay very long - it just made me sad and scared, and my presence seemed to agitate him. Every beep of his monitors agitated me.
Eventually, maybe a day or so later, they decided Little Man had something called Respiratory Distress Syndrome, with some complications. The way the doctor explained it to me was his lungs weren't mature when he was born, and when he started to breathe, he wasn't getting enough oxygen, so his body decided he must not be out yet, and it switched back to looking for a placenta to oxygenate his body. Obviously, he didn't have a placenta anymore, so he had something called pulmonary hypertension, meaning there was too much pressure in his lungs for him to breathe. The only treatment for this is life support, but there are a couple of different levels of support for this. First, there is a traditional ventilator, and if more aggressive treatment is needed, there is an oscillating ventilator, which delivers hundreds of puffs of air every minute, and the lungs never fully deflate. If that doesn't work, a heart-lung bypass machine is used as a last resort. The doctors just support the babies, and either their little bodies decide to work properly, or they die. I felt incredibly guilty, thinking if I had been better about my health before I got pregnant and hadn't been borderline with the gestational diabetes, this wouldn't have happened. My OBs freaked out completely when they got the news about the baby - no way at 39 weeks should this have been the case. One of the doctors told me that this is a one-in-a-million thing, but that said, there've been a lot of millions of babies born in this world, and they tend to see this condition more often in white males born to mothers with some form of diabetes. My sugars had been under control all along, never off, completely controlled by diet - I had been religious about following what I should do. The doctors said there was nothing I did that did this, it just happens, and even if we had done an amnio to see if his lungs were mature, it most likely would have been a false positive. I don't know if they told me that to try and make me feel better or because it was true - it wouldn't have been the first time a doctor has lied to me. Either way, it didn't make me feel better. I still feel guilty about it.
I didn't deal with this news about his condition well. I was already strung out about 9/11 and our son's birth, and assumed the worst would happen. The wonderous nurses in the NICU deal as well with the parents of their little charges as they do with the babies themselves. I knew my son was one of the sickest babies in the NICU at that time. He had a wonderful, huge African American nurse named Clarence who just looked so incongruous alongside his little patients, and he told me this. He said "I've been doing this for 15 (17? I don't remember exactly now) years now, and I tell you this - the big babies, they are the sickest babies, but once they decide they're gonna get better, they get better FAST. I tell you, this guy, he's strong, he's gonna be fine." This gave me the only comfort I had at that time.
I continued to pump my breastmilk, and made trips down to see him about four times a day. I never stayed long, because he always seemed to be so agitated when I came down, his monitors always went crazy, even though he was sedated. They still weren't feeding him yet, as he was still sedated; he got his nourishment through a tube into his stomach. I continued to pump and visit, pump and visit, for the next couple of days. It was made harder for me emotionally because my room was at the back of the postpartum unit, and every time I wanted to go see him I had to walk through the whole ward, past the nursery with all the healty babies, past the rooms with healthy moms and their babies with them. Every time my husband or my dad or my inlaws came to see me, they would turn on the tv to watch the 9/11 recovery efforts. Finally I said enough - no more tv. I could only handle one tragedy at a time, and my son was it. At one point he needed a blood transfusion - I asked if he could have my blood, but they wouldn't take mine because they didn't have time to test it (this makes no sense whatsoever to me - he shared my blood just a few days earlier, but whatever). He only took an ounce.
Saturday morning I walked in to see him, and found he was now on the oscillating ventilator. The doctors were usually pretty good about telling me what they were doing when they did it, but this was a complete surprise. I knew that meant he was getting worse. I was devastated. I knew that if that didn't work, he would have to be transferred to Children's National Medical Center for the heart-lung bypass machine. After I recovered from the initial shock, I asked them to let me know when it was "really, really bad" so that I could have him baptized, and they nurses said they would have someone there that afternoon. Part of me died inside then. So, Saturday afternoon, the priest came and baptized him, with my husband, his parents (I think - it was some relative other than us, might have been my grandparents), and I, and the nurses, as witnesses. Then I was discharged, so I could go home to some peace and quiet, and cope with the fact that we didn't know if our son was going to live or die.
Once home, I continued to rest, pump, and love on Trout, and pray, and do anything I could think of to deal with the situation. We drove up to the hospital a couple times a day to take up my breastmilk so it could be frozen and used once he was allowed to eat, and to see him. I remember one night, Sunday maybe, my in-laws had given Trout a bath, and just grabbed a towel from the stack, and happened to grab one of Little Man's towels that I had washed and waiting for him to use. I freaked - in my mind it meant that they were disregarding him in favor of Trout. A gross overreaction, to be sure, they just grabbed the nearest one without thinking. Late that night, after returning from a visit to the hospital, I went into the empty nursery with its empty crib and just screamed and wailed and sobbed until I was completely spent. I honestly didn't know if my son would ever be using that room, and the thought just killed me.
On Monday night, around 11pm, one of the NICU doctors woke me with a call to tell me that Little Man had a pneumothorax, basically a pocket of air outside of his lung, so they had to put in a chest tube (I learned later this means his lung collapsed). At that point, because they had woken me and I was just so emotionally spent, I took the news rather indifferently, and said "Okay, thanks" and went back to sleep. I was beyond the point of being able to feel any more grief at that time - it was all the same to me; all awful.
The next morning we went in to see him in the NICU, and were shocked to find him back on a traditional ventilator, chest tube bubbling away, looking better than he had so far. I was putting my hand on his leg, I think, and talking to him like I always did, and the nurse and I were talking, and she found out I hadn't held him yet. She grabbed him, tubes, wires, and all, and plunked him right into my arms. Luckily BigDaddyFish shoved a chair underneath me, or I might have dropped him I was so shocked. I sat, and rocked, and held my little boy while tears of joy streamed down my face, the first joy I'd felt since he'd been taken from the recovery room. It ranks right up there among the top 3 moments of my life.
From then on, he proved Clarence right. He quickly healed up, moving off the ventilator to just a nose tube in a day or so, then beginning to eat. In the NICU a lot of their babies, mostly premies, have trouble with feedings, so they start out real slowly, only giving 5 ccs of milk at a time at first. Well, Little Man took everything so well, that they started skipping increments, and in no time at all he was taking full bottles of my breastmilk. They also took the chest tube out. Two days later, I was able to start nursing him, although he had some trouble at first while the nasal tube was still in. Once it was out, he latched and nursed like he'd been doing it all along.
Eventually, he was weaned off oxygen, had a couple of days with just room air in his tube, and then got the tube out. He spent three more days in the step-down NICU just being monitored to make sure he was fine. He did great. BigDaddyFish and I took our required CPR class, and at the end of September, we took him home.
The day we took him home we actually had a comedy of errors, but I'll save that for tomorrow, because I'm tired, and this is practically epic already. Little Man is now a happy, healthy five year old, with absolutely no ill effects from his rocky start. In fact, when he sees a new doctor, if I don't tell them which lung collapsed and has scar tissue, they usually can't tell which it is from listening to it. He is the loudest of my three kids, and probably the healthiest.
About a week after we came home, BigDaddyFish, admitted agnostic that he is, pointed out to ME, the practicing Catholic, that Little Man turned the corner once he was baptized. I just smiled and nodded my head.
Sometimes our prayers ARE answered the way we want them to be. My son is daily, living proof.
Happy Fifth Birthday, little buddy. I love you.
I love him too. I just found your blog today through a comment left on carmen's.
What a wonderful mama you are.
my daughter was almost born on Sept 12. she held on for a few more weeks, but I was certain she was coming out. scary, scary times.
And we made it. We all have so much to be thankful for.
xoxo
Posted by: the womom | September 13, 2006 at 03:59 PM
Now if you could just get him to stop choking me, maybe we could *all* breathe normally. :-)
p.s. when do I get a nomme-de-ichthy? Just pick any fat swimmer.
Posted by: Uncle Dave | September 14, 2006 at 11:09 AM