Monday, December 22, 2014

Being a NICU Mom: Life Day-to-Day With Your Preemie





            I was about to be initiated into the mothers of premature infants society and learn what it was like to have a baby in the NICU. I'll be honest: it stinks having to stare at your fragile new baby through plexiglass and poke your hands through portals in order to caress a cheek or hold a delicate pinky. 
           
           
            For the next week, I rose early and packed snacks and frozen bottles of breast milk in the little diaper bag provided by the hospital. Then I took Parker to school and drove to the hospital. Once there, I maintained a daylong vigil in the NICU and returned home later in the evening. The hospital continued to provide three meals a day for breastfeeding mothers, so I stopped bringing a lunch after the first day and enjoyed the bountiful trays of food delivered to the unit. I read, listened to music, chatted with nurses and doctors, and observed—with awe—the dedication and love that permeated that special room.
           
            The nurses taught me how to open the isolette and extend Cory’s bed, maneuver the wires and change his diapers, carefully monitor his urine output, and recognize signs of stress (hiccupping being a prime indicator of system overload). I became proficient at removing him from his little clear plastic home for holding and feeding, first using the nasogastric tube held aloft, then the tube and bottle, then a bottle alone after he yanked the tube from his nose five days into his stay. Two days prior to that incident, they had removed his IV feeding and started relying only on what he would ingest from the tube and bottle. It was still too early to attempt breastfeeding, so I asked the nurse for a preemie pacifier, hoping it might help strengthen his sucking reflex.  I was determined to make a breast-feeder out of my baby, so he could get the best possible start on life, even if the odds were against us. (Preemies typically have weak sucking reflexes, so, once they get used to the ease of bottle-feeding, they resist having to work at breastfeeding.) I thought I’d won a major victory when he sucked viciously on the pacifier for several minutes. But within minutes he tired from the effort and was snoozing so deeply we couldn’t arouse him.
           
            On March 3, four days following his birth, one of the doctors announced that he was doing so well we would let him take the lead at breastfeeding. With much rejoicing on my part, we were successful for three feedings that day. I was ecstatic! 
           
            To compound the sucking reflex problem, the energy requirements it takes to breastfeed can deter preemies from sucking for the amount of time necessary to obtain adequate nourishment. Taking him out of the isolette to nurse was risky, since he still had difficulty maintaining his body temperature and keeping warm. Chris, Parker and I discovered that fact the hard way one night when we kept him out of his warm environment too long, causing him to lose a considerable amount of weight. We were firmly exhorted (chewed out) about it after the staff discovered his extreme weight loss.
           
            Quite simply, we had to look more and hold less. After that episode, when I did remove him for feedings, I pressed his little body next my warm skin and enveloped his exposed parts (which was just about all of him) in blankets. This arrangement almost seemed too comfortable for him, since he’d fall asleep and refuse to waken to continue feeding even when the nurse pinched the bottom of his foot in attempts to “pinch him awake.” That never worked, though. “Boy, he’s a laid back one!” they’d laughed. “You’re lucky; he’s going to be calm.” Little did they know…
           
            Then there was the blare of monitors signaling a potential problem with hear rate, oxygen saturation levels or sleep apnea. The machines monitored breathing, heart rate and other vital statistics every second of the day. Occasionally, a baby’s mere wiggle or position change dislodged a sensor, causing the alarm to sound. The first time Cory’s monitor made a shrill announcement of something awry, I gripped the seat and frantically looked around the room for someone to come running to his aid. Much too calmly for my satisfaction, a nurse calmly checked the leads and turned to offer me a smile. “Whenever that goes off, I always first look to see if they’re moving or breathing. If they are, I don’t get too excited. The machines are very sensitive; they go off all of the time.”
           
            Indeed, they did.  I never quite managed to get used to it, although I no longer felt compelled to bolt from the chair and roughly steer a nurse to his side.
           
            Since things seemed to be moving along so well, Chris and I decided we should shop for a car seat, although we still didn’t have a clue about when Cory would be coming home. I wanted the new super fancy model that allowed infants to recline and then reverted automatically to a more upright position if the car was involved in a collision. Our special baby required the top-of-the-line equipment, so we hunted for the right model and brought home the pricey- high-tech car seat. It looked so monolithic, though, too big for a baby to be comfortable. But then, car seats weren’t designed for comfort.
           
            I continued my daily trips to the hospital, gaining strength each day I was up and walking around. The first day I arrived, however, laden with breast milk and meals, I made the mistake of parking some distance form the door I needed to enter to get to Cory’s unit. This poor planning required me to hike uphill before arriving at the desire location. At one point, I had to stop and lean against a wall, unsure whether I could go farther, breathing heavily and feeling dangerously weak and dizzy from the exertion.  My heart pounded fiercely in retaliation to the stress it was no longer prepared to handle. How embarrassing! I thought. I need a wheelchair just to get to the front door! Without one, I’m probably going to faint right here on the sidewalk, (pant), within visibility of the Life Flight helicopter!
           
            Three months of confinement to bed had taken a tremendous toll on my physical condition. The muscular deterioration and calcium depletion were so considerable that I wasn’t convinced someone my age could fully recover. I was only too aware of how difficult it could be for a woman—technically approaching middle age—to reverse the rapidly declining exponential curve. But at that moment, my goal was just to make it—paraphernalia and all—to the NICU. By taking slow, shuffling steps and frequent breaks, and praying, I arrived, panting heavily and exhausted, but happily at my son’s side.
           
            Chris and I were stunned, but elated, at Cory’s rapid progress. By the fourth evening after his birth, they moved Cory into a real crib in another room—out of the isolette. The final step before releasing him to go home. He looked so diminutive in the cavernous hospital crib, bundled like a bean encased firmly in a blanket pod; tiny knit cap adorning his barely visible head. He looked even more fragile and vulnerable in this setting, particularly because it began to register in our minds that he was going to be coming home with us. Coming home very soon.
           
            And that scared me. I’d begun to rely on the security of those annoying machines; rely on the information they continuously emitted. Without them we were unable to tell what was going on with Cory’s body. The machines that had so scared and repelled me now gave me peace of mind. And I needed them!
           
            Were Chris and I up to the task of caring for a premature infant, in our home? Alone?
           
            One way or the other, when the doctors felt he was ready—which they had told us would be when he weighed five pounds or met his gestational age—we would find out. Right now, he was neither, so I relaxed and dismissed the thought of preemie care happening any time soon.
           
            I shouldn’t have been so complacent…

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NEXT WEEK: Seeing life for the first time after confinement. What I had so taken for granted…
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Until next week,

Thanks for joining me!

Blessings,

Andrea

May all of you be tremendously blessed this Christmas season. I know for many of you, this will be a year full of broken dreams, pain and melancholy memories. I do pray that you find hope and peace in the promise this season brings us and reminds us of, and that you look to the One who is the reason behind and for all of it!

He came to pay a debt He didn’t owe.
Because you owe a debt you cannot pay.
                                                Unknown

Thank God for His tremendous grace toward the world!!!

Merry Christmas!        

photo credit: <a href="https://www.flickr.com/photos/atomicshark/316620916/">atomicshark</a> via <a href="http://photopin.com">photopin</a> <a href="http://creativecommons.org/licenses/by-nc-sa/2.0/">cc</a>