Sunday, August 31, 2008

Show and Tell (with bonus Show and Tell)

Ahem... didn't mean to go MIA, really didn't. The intro post is a bear, but one I will hopefully kill sometime this week. Meanwhile, will the double dose of Show and Tell* do?

Show and Tell the First: Let there be light

Torah (Old Testament for those of you not familiar with the original name :)) commands us to keep and remember Shabbat. Or to remember and keep, depending on which version of the commanding you are reading. So the rabbis told us that lighting two candles for Shabbat was a good idea. You know, to keep and remember, or to remember and keep. Some Jews also light a separate candle for each of their children. I have never done it before, but have been mulling it over for a while.

Last Friday we got home from the NICU only a few hours before sunset. A bit later my sister and brother in law showed up with a feast. Not a virtual feast, a real one. Soup to ice cream kind of feast, where even the ice cream was homemade. And then we made Shabbat.




Show and Tell the Second: American girl


This was Monkey yesterday morning, waiting for her playdate with a classmate. The book is from another classmate, and has had her in stitches for a few days now. A particular favorite, believe it or not, was the "emergency meeting of the Society to Get Rid of Slimy Girls."


*Mel's Show and Tell is the weekly chance to bring out a camera, or a scanner, whatever the case may be. Go see what the cool kids are sharing this week.

Saturday, August 23, 2008

When


Life is so hard when you are a baby. You want to eat, but you want to sleep. It's enough to make you cry. And then there all these contraptions they put you in. Sigh.


Thursday's bili test was borderline, and thus bought us one more day under the lights (since they, understandably, didn't want to see us back for a re-admit). Friday middle of the night test showed a clear improvement, and the one they drew 12 hours after the lights went off was even better. There was also a carseat challenge test, which underscored just how tiny this baby is (though I do realize that he was likely the biggest patient in NICU at the time).

And now we are home. Things still are a little hectic, and I still need a lot little sleep. But we are home. We are home.

Wednesday, August 20, 2008

The view from here

And there was evening...

 

(and late evening...)

 

and there was morning...

 

The sixth* day. And this really is the view from our NICU window.
The view on the inside isn't bad either, most days.

 

Yes, he is still a bit yellowish, and he is in for a bili draw in the morning, along with the CBC. The results of these should tell us when we might be able to spring him from his very plush accommodations and back to our humble abode.


I have thought, when I had the time and the inclination to think about such things, which is to say fleetingly, that I seem to be doing a little too well. My physical recovery has been the easiest of the three labors. And if emotionally I have been walking in circles on top of a rather large powder keg, I have also been able to mostly ignore the stuff under my feet. So you know I was due for a meltdown.

It came last night, prompted by a crazy-making encounter with a nurse who is likely very good, but was just all wrong for me. I came apart in a quiet way where I just couldn't stop the tears for a few hours while madly typing in chat windows. My heartfelt thanks to two people who helped talk me down. You know who you are.

Things were much calmer and much better today, aided as they were by our very own hit parade of most excellent nurses (night, day, and now night shift again). I am OK, though more keenly aware that there are things to deal with, to exhale, to confront. Just not now. Later.


*I cheated-- the pictures are from different days. Sue me.

Sunday, August 17, 2008

Moving day

Thank you a million times for your wonderful comments. I have read every single one, and am planning on reading them at least a few more times. They have been great support as we are learning from experience that things in NICU can be unpredictable.

In the Old Country there is a saying that roughly translates to "do not yell hurrah until you land the jump." It occurs to me now that in declaring that we had nothing to worry about health-wise I had violated that very wise injunction. It's all much-much better now. But yesterday was scary. Well, half of yesterday was scary.

On Friday we were so thrilled with his progress off CPAP that we sort of put the question of the other thing he was being treated for-- increased level of white blood cells, indicating a possible infection-- on the back burner. Partially because he was getting antibiotics already, and partially because that whole breathing difficulty thing seemed a little more pressing and serious. And when they called me in the middle of the night to say that he was alert, seemed hungry, and could try breastfeeding, and we went down, and lo, he breastfed, well, that just didn't seem like a sick baby, you know?

Yesterday morning he ate again, and was alert, if a bit pissy. The kid's got a set of pipes on him, let me tell you. So there we were, getting contact high from him doing so well when they tell us that his CBC was a lot worse, and they would like to do a lumbar puncture to see whether the infection they presume he has has gotten into the cerebral spinal fluid. Right, then.

I asked about how they manage to ensure that babies don't move during the procedure, and the answer was in various ways, including, if they absolutely have to, and in very small doses, morphine. We couldn't be in the room while they did it, and when they called us about how it went the story was that they got enough for the main tests they wanted to run, but not for the quick look-sees, and that they did end up having to give him the morphine.

The scary part(s) came after we got back to see him. For one, he wasn't interested in waking up or eating. At all. For another, a bit later he started having episodes of bradycardia (significantly slowed heart rate) and real, honest to goodness apnea. Neither of these things is good. Both can indicate infection. Or they could both indicate that he was waaay tired from an active morning and resisting the procedure (apparently he put up a rather serious fuss) and/or that he was having a reaction to morphine.

So the evening featured JD quietly freaking out in the chair as I tried very hard to remain analytical as I had a conversation with the pediatrician that felt like an episode of House, only much less cool, seeing as it was my kid we were talking about. The maddening thing is that none of the cultures are growing anything. In the land of microorganisms, as, I hear, is the case in any warfare, knowing your enemy is very important. If we knew what this infection was or where, we could tailor the treatment. As is, he is getting the antibiotics cocktail that covers the most common sources of infection in newborns, and we hope that it does its thing.

At one point I asked the pediatrician whether this thing could get away from us. Not the easiest question to ask, and perhaps worse to answer. She said that she can never say no, because she can never say that to anyone (appreciate the honesty, I do), but that we are doing everything appropriate to the situation. We went over the tricks still up their sleeves, and the situations in which it makes sense to go to those. In the end I had to agree that there was nothing to do but wait out the night and see what the morning tests showed.

Waiting out the night got a lot easier when he woke up with his late evening diaper change. Not turn on the disco it's party time woke up, but enough to indicate that he was hungry, and to go to town on both breasts plus two syringes of previously pumped colostrum. Good stuff, that.

Still, I could see both the doctor and the nurse were still worried. So it was nice to see them smiling as they greeted us at 5am this morning-- white cell count was down slightly from yesterday, and the differential was much better. Meaning we seemed to have caught up with whatever this thing is, wherever it is hiding. And there hadn't been any apneas through the night. The only snag was that his bilirubin levels went up sharply (thought the absolute value was still a non-threatening 10), and so he bought himself some time under the lights.

Today, as I said, has been much-much better overall. He spent a good deal of time sleeping contentedly in his isolette-cum-tanning booth, but he woke up for all the feedings and he ate with determination and appreciation. Every lactation consultant's wet (diaper) dream. His color is improving, so we may be done with the lights as early as tomorrow. Antibiotics are staying for seven days altogether, and, consequently, so are we. We are, again, waiting for morning test numbers, thought with a lot less trepidation than last night.


Nominally I was discharged from the hospital today. In reality, I moved down three floors. I am bunking with my son, in his NICU room. Because it's huge and has a couch that is meant for parents. I have never seen such a thing, nor heard of it before. A NICU where all rooms are private, large, and designed so that it is possible for a parent to be with the baby all the time. And the visiting hours here are 24/7. A pump can also be rolled right into the room, and my attachments for it stay here, right next to the sink that is next to the couch on which I am about to fall asleep for the night.

With this level of care for the whole family built into our experience here, I can't help but think of all of my internet friends who have had no more than a curtain for privacy when sitting by their baby's isolette, who have had to make the drive, back and forth, a couple of times a day, who were limited to a small set of visiting hours. I know this is an expensive set up they have here, and I know not everyone is fortunate enough to have a dedicated donor family like the one that made this facility possible with their gift and now has a fancy plaque out in the lounge to show for it, but damn if not everybody should.

Three weeks ago, when I was in the hospital for PTL, I told JD that if the baby came then (which meant he would be in NICU for at least a week), there would be two hard things. One, when they would take the baby from the room and we would be left there by ourselves, again. Two, when we would have to get into a car and go home without our baby, again.

When the first of these came to pass in the early hours of Friday morning, I think it helped that we were still disoriented from the avalanche labor. Today would've been the day for the second. Instead, thanks to this NICU, I was spared the need to find out how I would handle it. It was rather enough, I believe, to have triggered physical memories of last year with a simple trip to the bathroom, thank you very much.

Only one parent can really room in here, though it doesn't have to be the same one all the time (and both can stay all day), so JD went home. He called me to say that he was uneasy not being with us, and he stopped by again later. But I think me not having to go too cut down on the deja vu factor for him. It's amazing how much a little chunk of well thought out real estate can do for people.



P.S. I am still working on a blog nickname for the new arrival, so a post with proper introductions is to follow.

Friday, August 15, 2008

4:11am

I expected labor to go fast. I didn't expect it to go this fast. We left the house at 2am, arrived on the maternity floor around 2:25. Got the first cervical check at 2:45-- 4cm, 80%, bag ruptured. Delivered at 4:11. Seconds later-- a cry. Righteously pissed off baby, the dream that dared not speak its name, that didn't even dare to paint a self-portrait in my mind's eye, he was suddenly very corporeally here.

He punked out after that. Turns out you really should get all of the liquid out of the lungs if you are planning on using them for breathing. Who knew?

NICU, CPAP-- it all sounds a lot worse than it is. In reality, he had been trying to get the CPAP out for hours, and succeeded finally towards the evening, so now they are just watching. By which I mean measuring and recording. He is on IV sugar solution, but when he keeps his respiratory rate where they want it, I get to try breastfeeding. I have been pumping in the meantime, and feeling my uterus contract but good (all hail motrin! with a side order of per.coset!).

I didn't sleep last night, and only a couple of short naps today. I am in need of a solid sleep, and am failing pretty bad at keeping it at bay in order to keep writing. So I will wrap up now, and hope that putting together complete sentences comes easier in the morning.

Yes, he is still in NICU. But it's a warm and fuzzy NICU, the version where we don't really need to worry about his life, or even his health in the long run. He may have to stay there for a few days more, or he may get to come up to the Special Care nursery that is literally next door to my room on the antepartum floor, but it seems that even I am talking all about the when of going home, rather than the if.

Thank you, all, for being here through my long journey to when. It has meant more than I can express, especially in my current sleep-deprived state. But you can be sure that I will try to, another day.

Oh, and Monkey had been by.

 

Tuesday, August 12, 2008

And what the hell is this?

Only a few short weeks ago I couldn't even process the idea of a live baby. Yes, while I was vigilantly noting every twinge and every kick in the effort to not have a dead one. Logic-shmogic. It says nowhere that I have to be consistent. Oh, I did the bare minimum-- I talked to my boss about the logistics of the maternity leave and I arranged for our wonderful nanny to come back for the days I will have to be at work. If, I kept saying, if.

Beyond that? Nothing. Blank. Couldn't go there. Wouldn't go there. Figured I didn't really have to go there. Oh, wait. One other thing. We talked about the room, about how we won't repaint it. I said I need to change something in there, but not much. It came to me-- the floor. The carpets upstairs are as old as the house-- almost 12 years old. Time to pull and change to fake hardwood. You know, laminate. But my dad said he can do it in a day, while I am still in the hospital. Seeing as he was the one who painted that room for A, finishing it exactly a week before A died, I think he gets to do this any way that works for him. Yes, I could've hired someone to do it, but I am pretty sure dad wants at it, but only after. If, I mean if.

So here's the thing. These days I can, sort of, once in a while, for short periods of time shhhh.... imagine the live baby thing. It started, strangely enough, the week before I ended up in the hospital in PTL. It started with me thinking that at some point I should think about what I want to have with me if I have to be admitted. I came up with three things-- my good camera, my little puppy that I bought in the early days because he reminded me of A somehow, and the doughnut pillow they gave me after Monkey. Shut up. I totally needed it, and I expect to need it again.

Turns out thinking you will deliver in the next couple of days really does a number on you. When that happens while you are hooked up to that lovely heart rate monitor, you might even begin to believe the whole deliver a live baby thing. Well, I did. Started to.

And then we went home. And I was calm for a few days. And then not so much, again. Though most days now I am calmer than I was before the hospital. (Only most-- I can still work myself up but good when something starts to seem fishy.) And suddenly, in these short little intervals when I think in terms of when rather than if, things began to come to me. Like the fact that finding my nursing bras may be a good idea (a long tale of trivial pursuit is skipped here, because I love you and don't want to bore you, but I do have them now, washed and packed), or that I may need to think of clothes. You know, for the baby. To come home in. Right.

I made Monkey's coming home outfit. It was a one piece with snaps down the front and on the legs, plus a fleece one piece with velcro closures for the vulgarities of the spring that is really still winter. Both are in her baby box now. I have said before that I don't do guilt, and as far as general statements go, this one is pretty accurate. But turns out I do it a little bit when it comes to things I do for my kids(TM).

I never made anything for A-- I thought I still had time. And I am pretty sure sewing baby clothes is not in vogue in that nice place that is not just a river in Egypt where I was spending the bulk of my time until just then. In fact, I am thinking this baby clothes thing gets me an automatic eviction notice. Suddenly, though, I found myself thinking that with the reprieve and the whole being at home all day thing I really should make him something.

My doom arrived in the form of Monkey looking through her baby book and box for the first time in a couple of years. She forgot about the clothes I made for her, and upon hearing what they were immediately wanted to give them to baby brother. Ummmm... waaaay out of season, kid. Plus, they are yours, to keep. But you have successfully accomplished your first mommy guilt trip, and on behalf of your unborn baby brother no less. Impressive, yes. But don't go getting used it, is all I am saying.

Here's why this is a big deal-- dead Jewish babies don't need any clothes. All they need is a shroud. Taking up this project meant creating a tangible, physical record of that bitch hope sneaking into my house.

So yeah, she's been hanging around. Oy.

 

That's my A puppy. Here for size comparison. And because he is cute.

 

I think the pants came out huge. It was supposed to be 1 month size (from this pattern). Well, might be good for comic relief.

 

Tuesday, August 5, 2008

This may not be a good idea...

...but I am going to do it anyway. I am going to touch the third rail of polite discussion. Right here, right now. I am going to talk about religion. Or, rather, theology. I am going to try, very hard, to not flame, but discuss. And I am going to ask you, very politely, to please help me out. Preferably also without flaming.

See, I keep running into this one particular view of G-d's involvement in people's lives that is so foreign to me as to make me say, quite honestly, that I just do not get how one can live in the world we all live in and hold this view. And so I hope that maybe someone can explain it to me.

Here is the piece that prompted this particular round of head shaking. I was looking for a quick explanation of the Jewish custom of saying "B'sha'ah tovah," or "may it happen for you in good time" upon hearing of someone's pregnancy. This is the words I myself use because I feel that this avoids the presumption inherent in any form of congratulations. Congratulations, I feel are for when the baby is born alive. For the duration there is only the wishes for that outcome.

So I start reading this woman's story of how she came to appreciate the wisdom of b'sha'ah tovah, but I do not get very far before I trip and fall, and faceplant right into concrete. "Why is G-d doing this to me as I'm trying to bring a Jewish child into the world?" she asks about her difficult pregnancy, and I am starting to see red. Wait, I want to ask, so you think if you were trying to bring some heathen life into the world, it would be totally cool of G-d to do this to you?

But the part that is really bugging me, predictably, is the one about G-d doing this to her. Things get even more dicey, by which I mean completely incomprehensible to me, when, after relating the story of the pregnancy riddled with a number of problems, the author declares all of them to have been no more than a means to an end-- G-d's clever and miraculous way of assuring that her baby was monitored, and thus, saved just in a nick of time by an emergency c-section. The real problem, you see, was the unbeknown to anyone clotting disorder she had. Clotting disorder that would've killed the baby in only a few more hours. And, according to the author, all the other complications she experienced in the pregnancy were nothing but G-d's way of saving the baby.

Like I said, I don't get this at all. First, if G-d was getting involved, this seems like a bass ackwards way of doing it. Presumably, G-d could just fix the problem, or, you know, cause someone to run a clotting panel such that the actual problem was recognized before or early on in pregnancy, and the baby gestated uneventfully to full term and with no need for the somewhat traumatic early birth and NICU stay.

Second, and this is where I get really stuck, this sure looks like a lot of care to expand on this one baby and family. And it seems to me that if one is to accept that the supreme being did expand this much care to this particular baby, one would have to also note that an appreciable number of babies, Jewish and otherwise, were not granted the same level of care. And then one would have to ask what makes them less worthy? What makes their parents less worthy?

I never asked "why?" or "why us?" after A's death. Because to me it seemed like "why not us?" was an equally reasonable question. Bad things happen in the world, in every generation. Catastrophes for countries, peoples, and families. Holocaust was not that long ago. The concept of a G-d who decided to bring that down on each individual person who perished, everyone who was maimed or displaced, everyone who survived only to bear the scars, mental and physical, for the rest of their lives, that concept is not sitting well with me. Never had. On the flip side, ever since Monkey was born, I have maintained that there is no way to deserve to have a child, that nothing we could do would be enough to earn that happiness.

And so I never pray for tangible things, or for events I am hoping for-- I consider that futile. I only ever ask for peace and strength (and maybe wisdom, but that's borderline). I find myself firmly in the camp of "the age of miracles is long past" theology. But, more importantly for what I am talking about here, I find myself unable to understand people who claim personal attention/intervention from on high. Because to me that thought can not exist without a thought for what if? Or for the families where what if actually happened.

I can't understand how the author of this piece wouldn't see that by claiming divine intervention for her child, she is simultaneously saying that others weren't deemed worthy of it. Yes, I am saying that I do not understand how it is possible to not extend (or invert, whatever the case may be) one's thoughts on the matter. And once this thought is considered, the thought that for someone else the baby didn't make it, and there was no miraculous long-term plan in place to avoid that tragedy, well, once that's in one's head, I can't see how one would avoid asking what makes them so freaking special? And maybe I am wrong, but for myself I just wouldn't have an answer. Nothing about me is so exceptional that I can see getting a break of this magnitude, or any magnitude for that matter, while someone else did not.

I also feel, and this is perhaps a little tangential to this discussion, that her insistence on the divine source of her son being alive cheapens the professionalism and care exhibited by her doctors. If they were nothing but G-d's instrument, than it could've been any doctor there, any warm body with a medical degree. To me it is so much more inspiring to think that these were professionals who cared and did their job. And saved her baby's life, and her, from ever knowing things I know.


And yet, I know that hers is theology espoused often and by many. If you share it, or understand it, please explain it to me. Particularly, what I want to know is how is it possible to be a thinking person living in the world we live in and have this theology. I really want to understand. I feel like I must be missing something, some major clue, but I don't know what it is, or where to look for it.

I promise I won't bite, but if you feel more comfortable commenting anonymously, go right ahead.