Friday, May 6, 2016

Happy Birthday, Joey!

I woke to a gray and dismal morning. Wednesday. I'd made it 72 hours since my water broke. The first big prayers for our baby's safety were answered. Now I was free of the IV, off the Mag, and the steroids for baby's lungs were fully effective. I could focus my eyes, use the bathroom on my own and even move about my room. While I was incredibly grateful for all this, my spirit was fighting a cloud of depression.

Newborn, getting him stabilized
My first trip to the bathroom that morning revealed some pink on the giant pad that caught the continuous leaking from my ruptured membranes. I was caught off guard by the sight, but the nurse assured me this was normal.

The smell of rain was heavy in the air. Every person that came into my room mentioned the deluge and resulting greening of their yards and trees. I smiled collegially, trying to picture our own nearly-barren yard and finding it hard to believe what they were saying. From my window, all I could see was a young maple; its baby leaves didn't broadcast the sudden springing of Spring.

Hours old, on the ventilator. My first visit to the NICU
I hadn't slept well and combined with the thick, rain-soaked air, gray sky, and end to the flurry of activity that had filled the last days, I felt adrift.  I moved from my bed to the little couch and held my Bible. I tried to pray, but the nothingness stretching out in front of me held my attention. My little cloister had grown quiet and I wasn't yet acclimated to this new normal. I decided that at some point that day I would make a daily schedule. It seemed both silly and necessary - with nowhere to go and nothing to do, I had to give purpose to my time and ensure that it was filled with prayer.

After breakfast, I had the first of the twice-daily, hour-long monitoring sessions. Baby's heartbeat looked great but indicated not a lot of activity; they ordered another ultrasound. Likely he had just been taking a nap, but a peek inside would give us all peace of mind. I enjoyed every chance I got to see my baby, so it was a welcome distraction.
Holding him for the first time. On the CPAP. I'd just been discharged. I sobbed just after this picture was taken.
Aside from the complete absence of water, everything looked beautiful on the ultrasound. The tech joked that if baby would just pee, she could measure those 7 mL. He obligingly emptied his bladder and promptly swallowed it (a normal thing for babies to do in-utero) which gave us a good laugh. She told me he was measuring roughly 3 lbs, 8 oz, but the machine could be off up to 8 oz in either direction. This was a bit of a shock, as I had been hoping that he was tipping 4 lbs. Knowing that I could give birth at any time, the thought of a 3lb-something baby rattled me.

Lunch was yet another chef salad (pickins are slim for the gluten-free momma, but I do love salad) followed by a visit from the massage therapist, who treated me to a neck and shoulder rub. This was the best part of my hospitalization, but I couldn't shake the guilt associated with being pampered while my baby's life was in jeopardy and my family's lives were turned upside down.

That day, Mark had an all-day meeting to attend, so our kids were being cared for by a wonderful woman with a baby of her own. She graciously wrangled all 5 of them at our house even snapping  pictures of my girls, whose hair she beautifully braided. It gave me peace to know that they were being loved in my absence.

Mid-afternoon, just after the nurse took my routine vitals, I felt a new tightening wrap around my low back and pelvis.  I didn't think much of it, other than that it had happened in case it was relevant, later. Twenty minutes later, and nothing more to note, the phone rang. I was finally able to talk to my sister Kate, who I hadn't been able to connect with up until then. Not long into our conversation, I felt it again, that low tightening. I ended our conversation and alerted my nurse.

Perspective. He's about 12 days old. No more isolette!
She quickly hooked me up to monitors and a began a liter of IV fluid full-speed. The nurse put on a brave face for me, assuring me that it was likely nothing. It would probably stop with the fluid. But the tightening returned again and again, but so low that the monitor wasn't picking them up. Washcloths were stuffed just-so to keep the monitor in contact and I was given a button to push at the beginning and end of each contraction.

Along with the fluid, I was given a sleeping pill. It was a minor intervention done in hopes that if my body relaxed, my uterus would too.  I was also put back on the Mag, not to stop labor, but to protect the baby in the event of an early birth. Still, the contractions continued, slowly increasing in intensity by the hour, always very low and only just uncomfortable.

Mark was still in his all-day meeting and it wasn't one he could leave unless this was the real deal. Unfortunately, no one could tell us if it was or not. The meeting would end at 5. I watched the clock. At five minutes to 5, my nurse finally said, "You better call him now and tell him to come." I waited those 5 minutes, hoping that I would later look back and say, "Sorry I put you through all those false alarms. Remember that first time, when you were in that meeting that I didn't want to interrupt?" I called him and explained that they were transferring me over to the labor ward. They were still hoping things would stop, but taking precautions in case it didn't.

Since I would be back in this room, baby or no baby, my stuff could stay. As I asked for what I wanted to take, one of the transferring nurses handed me my Bible and volunteered a quick prayer over me. Without Mark present as a spiritual support, this prayer from a stranger was a blessing in a chaotic moment.

I was wheeled over to the labor ward where my nurse said "Good luck" and handed me over to a new team. I tried to explain how low my contractions were and how they weren't being picked up well. Meanwhile, the sleeping pill and Mag were making me feel like I was floating in a pool. Still waiting on Mark, and willing my body to stop this foolishness, I floated in my hospital bed, feeling the contractions getting stronger.

Mark arrived not long after and we prayed, gathered our thoughts and got to know our new nurse who, though well-intentioned, was a bit of an odd duck.  She reminded us both of an old-school Community mom. If the reference fails, I apologize.

As my contractions continued to pick up, I kept asking "When? When will we know if this is the real deal?" and over and over again I was told, "We can't know." Trust me when I tell you that this makes managing labor very difficult. In normal labor, you surrender to contractions, relax into the pain and allow it to work towards its goal of birthing a baby. In this situation, my body was doing one thing and my mind and heart were fighting against it. Though I've managed natural birth of nearly 10 lb babies, I would request an epidural if I continued to progress.  I knew that birth was the beginning of the next long step in this journey and I needed to conserve my physical and emotional energy.

Super Baby!
At some point I was checked for the first time since Sunday; I was 4cm. I was progressing, but not quickly and not enough to determine whether or not I would keep going. It was more of the waiting game as my contractions continued.

Around 7pm, I told my nurse that based on how my contractions felt compared to previous labors, if this was a normal labor, I expected the baby would be born in about 3 hours. She looked amused by my comment - clearly thinking I was a little delusional. I admitted that this not being a normal labor, I really had no idea, but just wanted to throw that out there.

An hour or so later, I started mentioning the epidural seriously. The nurse wasn't ready to admit that I was in real going-to-have-a-baby-tonight labor, and tried to dissuade me. I told her that while I didn't want it *now* I thought I'd want it in about 45 minutes, and I knew from experience that it takes about that long from the time you request it until the Dr. arrives. I was right. 45 minutes later I had the epidural.  Just before, I was checked again and now I was 6 cm. It seemed clear that I was right and this baby was on his way. Never have I felt more drugged and more out-of-body but I was able to rest. I wished for sleep, but instead floated on the verge of consciousness, aware of Mark busily working close by, and the strange comfort of the old-school odd-duck nurse in and out of the room.

Days before the big homecoming! Family visit to the step-down unit.
Another check revealed I was 8cm, and preparations began to move me to the OR where I had to deliver to allow room for all the staff present for a preemie birth. Mark suited up in a disposable one-piece white suit complete with hood, put on a mask and suddenly my rock looked unsure of himself and overwhelmed. I was scared of what we would learn when our baby arrived in mere moments. And then I was told to push. I didn't have an urge to push, nor could I feel whether I was contracting, but baby was small enough that a few pushes and he was out. Shortly after 10 pm, 3 hours after my prediction, Joseph Charles Archibald arrived.

Home at last!
They put him on me as they let the cord blood pump into him for a few minutes. He didn't cry, he just lay there, and I just lay there too, trying to trust that whatever was ahead of us, God was in control. Joseph was small, but not tiny; I thought he looked closer to 4 lbs. When they weighed him, I was convinced the scale was broken: our 30 week preemie weighed an impressive 4 lb 12 oz!

The long story of the next 7 weeks of our life with a NICU baby can be summed up:
- 12 hours on a ventilator
- 2 days on the CPAP
- a couple weeks in the incubator
- weeks upon weeks of a feeding tube
- terrible at bottle-feeding
- lots of "episodes" of heart-rate/breathing plummeting which he finally outgrew
- had to be at a 30 degree angle to prevent reflux
- They finally realized he was better at breastfeeding than the bottle so they gave up on the bottle, let me room-in to feed him...

...and 3 days later...

- at 37 weeks and 7 lb 8 oz, we finally brought our little man home from the NICU!

A Kangaroo (given by the NICU) and her Joey

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