Wednesday, May 20, 2015

Three Cheers for the NICU

In my last post, I summed up Olympia's dramatic entrance into the world and casually mentioned that she ended up in the NICU for a week. A bit of a cliff-hanger, I suppose, since I didn't say much about why she was there, how she is doing now, or how her stint in a Neonatal Intensive Care Unit could be a blessing in disguise.

What follows next is a synopsis of why she was there and how she's doing now, since that isn't actually the most interesting part of the NICU story.

Remember how I lamented in the previous post that the neonatologist told me I wouldn't get to have immediate skin-to-skin contact, wouldn't get to breastfeed right away, and Les wouldn't get to cut the cord or let the cord pulse before clamping? That was because Pia had to go to the NICU immediately because the amniotic sac had meconium in it (infection risk - she needed antibiotics stat) and her heart rate was dipping way too low throughout labor and delivery. Not cool. It turns out we have my lazy placenta to blame. The OB said that he suspected I had "premature placental aging"; in other words, my placenta crapped out before Pia was ready to be born, so she wasn't getting all the nutrients and fluids she needed. I am VERY thankful that my midwife decided to err on the side of caution that day at my checkup, and that I had the ultrasound right away, and that everyone agreed to the Get the Baby Out Immediately plan. She was in distress. She was actually dehydrated when she was born, and her heart was struggling to regulate itself. So, she was shuttled over to the NICU right away to start her on monitors for her heart and oxygen levels, get some IV antibiotics, and get a feeding tube to help her get her fluid levels back up.

She had an ultrasound of her heart, and physiologically everything looked perfect. The pediatric cardiologist predicted correctly that her heart rate would stabilize once she was properly hydrated. I only had to bite my nails while staring at the dipping and bleeping heart monitor readout for a few days before the lovely squiggly line was totally in the "normal" range. I was breastfeeding in addition to the feeding tube, so you'd expect that she'd be going through diapers like they were going out of style, right? Wrong. She went into the NICU for her heart and hydration, but she got stuck in the NICU because she wasn't peeing. At all.

Call in the pediatric urologist, get an abdominal ultrasound, and start praying that her kidneys are working. Everything looked just fine, except for this mysterious little blip in her bladder, right where the bladder meets the urethra. The pediatric urologist called it "a bubble of tissue", and told us that these little blobs happen all the time, and usually don't cause any problems unless they are in the exact wrong spot like this one was. It was blocking her urine from passing from the bladder to the urethra and then out of her body. His suggestion was to put in a catheter and see if that would help get things going. They put in the catheter and immediately a large volume of concentrated urine came out. Good start, but she needed to be able to pee without a catheter. They removed the catheter the next morning and told us she had until 5pm that evening to pee on her own, or they would start talking about surgical procedures to correct the blip. If the urine was blocked for too long, it would start backing up into her kidneys and cause all kinds of problems. So we waited. And waited. And checked her diaper compulsively for hours. We took a break for a while and I went up to the guest room to rest between feedings, and sent a text to about 15 friends asking them to pray that Pia would pee. Weird prayer request, right? But when I arrived back in the NICU around 4:20pm, I saw the nurse standing over Pia's bed with a diaper in her hand and a big smile on her face: "She peed!!". I called Les, then texted my friends, then said a prayer of thanks and kissed my pee-soaked baby girl. She just had to keep up the wet diapers for 2 more days, and we could go home. Which she did, and we did. Follow up ultrasounds with the urologist showed that the blip had disappeared. He said "We don't know why the bubbles disappear on their own, but they do some times, and we just celebrate the good news". She's peeing like a champ now.

I went into the hospital on Tuesday afternoon, April 14, and did not leave - didn't step outside or breathe fresh air or feel the sun on my face - for 7 days. I was discharged from the post-partum recovery room a couple of days after the birth, but was moved to a boarding room so I could stay close to Olympia and continue to breastfeed for as long as she was there. How awesome is that? All I had to do was rest, eat, and come down to the NICU every 3 hours to feed my baby girl. Not that it was easy to get any rest, but I tried. Sounds pretty stressful, right? In some ways, it was. But that week also turned out to be a big basket of blessings.

NICU Blessing #1 - I had been so worried about how I would recover from the birth and care for a newborn, especially since Les only got 2 days off from work. Even though it was stressful to have a baby in the NICU, she was certainly NOT the sickest baby in that room. I knew she was getting excellent care. I got to shuffle back and forth between her bed and my bed, and let the nurses work their magic. I didn't have to do much infant care beyond feeding and snuggling and kissing her. I barely even had to take care of myself. The nurses even encouraged me to use the breast pump every day so I could sleep through one night feeding and get uninterrupted sleep. I would not have gotten that at home. We weren't terribly worried about her long-term health once we knew she was stable, so having all that extra help, especially 24-7 lactation support, was a huge blessing.

NICU Blessing #2 - There was one big emotional landmine I had been dancing around since I found out I was pregnant: the gaping black hole of sadness that my mom would not be with me in my first days as a new mom threatened to swallow me whole. I could not (still cannot, if I am honest) process the fact that my parents, especially my mother, would never meet or hold or kiss or swaddle my baby girl. I dreamed about my mom at least once a week throughout my entire pregnancy. As my due date drew closer, I tried to remind myself to redirect my sadness to ask my mom to pray for me and for a safe delivery and for our baby. Most of the time, though, I just cried when I thought of her.

Nothing ever could or ever would replace my mom's presence or her hug or her voice or her crazy love. But I was surrounded by amazing Mom Understudies at the hospital. My labor and delivery nurses were incredible: encouraging, warm, funny, empathic, and professional enough to help me stay focused. The nurses who cared for me in the recovery room truly went above and beyond. One of them even continued to care for me for about 6 hours after I was officially discharged because my boarding room wasn't ready yet. And the NICU nurses, especially one named Lana, wrapped me up in a big blanket of MomCare, and I credit them with easing my aching heart during that first week of mommahood. I joked that I wanted Lana to adopt me, in that way that one jokes when one is totally serious. She did a lot of the things I had dreamed about my mom doing with me: showing me how to care for my baby, helping me take care of myself, laughing with me, hugging me, encouraging me, and reassuring me at every step. In a room full of very sick babies, she made me feel like Olympia and I were the only people in the NICU. My mom was not physically with me, but I believe she helped arrange for a God-sent nurse to be there when she could not.

NICU Blessing #3 - Having a baby in the NICU is stressful. However, if you are me, it is also a bit of a medical-anxiety-reducing Win. Believe it or not, my anxiety is much better now that it used to be, but my anxiety around all things Health and Medicine is still pretty high. One of my new mom fears was that we'd bring home a perfect-looking baby and have no idea that her body was silently doing something insidious, and we would be clueless until something terrible or tragic occurred. Not the healthiest thought pattern, I know. But I'm just telling it like it is. I know that we have little to no control over her health or whatever may or may not be going on in her body, but the paranoid new mom part of me is admittedly grateful that she had an echo cardiogram, a bunch of blood tests, and an abdominal ultrasound before she left the hospital. I know those tests do not guarantee her health or safety, but I feel better knowing that some experts took a good look at her insides before she came home with us. So, thank you, NICU, for feeding into and then allaying this angst-ridden mom's new baby health fears.

Our sweet babe is home with us now, eating nonstop, gaining weight and length, and making up for all those dry diapers by becoming a peeing and pooping machine. I am incredibly grateful for the care we received, for all the friends and family who visited us and prayed with us and for us, and that Pia is healthy and appears to be completely recovered from her grueling first week. Her vacuum-coned head is even nice and round.

Happy and Healthy
I went into the hospital for an ultrasound on April 14 on a chilly spring day, blissfully unaware of what was about to shake down. Les drove our little family home from the hospital a week later, and when we turned the corner onto our street, I gasped with joy to see that the cherry trees and magnolias had burst into bloom in the week I had been indoors. It felt like Nature was celebrating with us and the bright blooms that lined the front yard gardens along our street smiled back at us as we proudly brought our healthy baby home.

And a month after that, we finally got our first family photo!

Olympia looks a bit skeptical