Catch 22 in the NICU

Faith's 1st week has been a rollercoaster ride to say the least and I in looking to God's blessing in it all, we have our daughter home, her perfect health, and lots of expert advice that helped Jerry & I avoid a lot of nervous 1st parent skirmishes.
The minute my water broke & I opted for vaginal delivery over C-section, we didn't know it but because I was GBS positive (see previous note) it was decided that Faith would be in the NICU for at least 3 days on antibiotics while they waited for her blood cultures to come back. When she passed meconium it caused greater concern and meant that she would get an X-ray to rule out aspiration, (which was negative). The cord was wrapped tightly around her neck, causing her to fall into the category of respitory distress at birth. And to top it all off we have conflicting blood types (my type is negative so my body will create antibodies that will fight her positive blood type) so I was given RhoGAM, which led to a mild case of jaundice that kicked in on her 2nd day, exacerbated by the dehydration that results from waiting for a mother's milk to come in.
It's protocol for the NICU to send a social worker to all parents upon admission, & the social worker was very supportive. While the NICU was dealing with all of this they told us Faith would be released Monday the 19 when her course of antibiotics was complete if her culture came back negative. They allowed me an extra 24 hours in recovery simply because Faith was in the NICU, and I faithfully attended feedings and she latched on like a chomp-I mean champ. I didn 't even notice how swollen my feet were until a day later when I took my socks off and I freaked out and asked the nurse for something to help. She just told me I have to stop walking so much. I thought "Yeah right lady! all the other moms get to have their baby in the room with them!
I had a rough time seeing her hooked up to an IV & all those leads with beeping machines and then under the lights because of jaundice that I felt was my fault because they said dehydration contributed to it & my milk wasn't coming in. The reality is that most infants develop jaundice at home but get over it. Faith just happened to already be in the NICU. Jerry thought I was opposed to formula but the truth is I was starting to go numb with it all. My mother's instinct was telling me that there was nothing seriously wrong with my daughter but everyone else seemed to treat me like I was being reckless with her health and didn't care.
Jerry & I spent Sunday racing back & forth for feedings thinking Faith would be released the next day...only to hear the pediatrician tell us that the last neonatologist had not paid attention to some breathing trouble (low oxygen saturation apneas) she had Saturday and Sunday...that Faith would have to stay through Wednesday. I was harmonal, physically exhausted & the thought of 3 more days like this was unbearable so when the pediatrician offered a 2nd opinion we jumped at the chance. We should've known a NICU version of good cop-bad cop was coming. If I had been more level headed I would've thought to call my cousin Jennifer then. But another neonatologist came in and pretty much lectured us that our baby's breathing WASN'T NORMAL without giving us any specifics (as if I were too dumb to understand the specifics) and said that she must stay through 5 more days through Friday the 23rd or sign her out against medical advice. I was too upset to ask that neonatologist for specifics as to what was normal. I didn't want to sign her out because I wouldn't be able to survive if I took her home & something happened in her sleep, not to mention negatively affect her further care in Kaiser.
I pretty much became hysterically upset, and they sent another social worker to convince us to "do what's best for the baby." She signed us up for a CPR class on Wednesday and agreed to ask if the parent room is available for us to stay in. When I went to Faith's next feeding I was exhausted & Jerry was changing the diaper & from around the corner I heard the sound of a LOUD whoopie cushion & Jerry yell "NURSE, HELP!" then I saw poop all over his hand & began uncontrollably laughing and since I didn't have any urinary continence all I could do was continue to laugh and she continued to poop! it projected and splattered the wall of the incubator and I couldn't control either my laughter or my bladder and I was getting worried I was going to rip my stitches while Jerry asked why I didn't come to help...one of the nurses laughed with me (she had seen me hysterical earlier) & said that uncontrollable laughter is better than uncontrollable tears!
In the next two days it was a waiting game and since we were staying in the parent room it wasn't so bad & my mood improved dramatically. Jerry & I had some wonderful new parent moments together & were glad to see her IV heparin lock and came to realize how easy we have it compared to the other parents there. They have other children, have to work, may be single mothers, & their children have truly life threatening ailments. One of the nurses told us not to spend so much time playing with her or we'd exhaust ourselves, but I think it was also because some of the other parents must have had a hard time overhearing us, not to mention my hysterical laughter over her explosive exorcist bowel movement when most of those babies don't have a functioning digestive system yet.
Then Wednesday morning a 4th neonatologist saw her and said her hip was popping which could be a displaced hip (or something like that,) due to her breech birth. I told her that Faith wasn't born breech & she said "oh, then she's probably ok." We asked her about the low oxygen saturation apnea episodes and she said that she hadn't had any since Sunday. As she was talking Faith's oxygen saturation monitor came off and fell into midair but continued to register for about 30 seconds as if Faith's oxygen was going up & down. When I pointed this out, she said she's never seen that before and ordered a whole new monitor. We had seen some premies sent home with a monitor who were still struggling with apneas, so we asked the neonatologist, and she said we didn't need one because she was breathing normally, and then we asked if she was breathing normally, then why couldn't we take her home??!! She said that Faith needed 5 days of observation...blah!
The charge nurse asked Jerry when we would have our stuff out of the parent room, and he asked what other parent needed it. I went back to take a shower and another social worker knocked on the door. We told her we have no problem leaving the room when any other parent needs it, we would just hang out in the waiting room. She asked us if we were homeless and why we had such an abnormal attachment to our baby when so many other parents don't spend so much time in the NICU, and why we have such problems with authority. I should've cut off talking to her but again, I felt as if these people were holding my baby hostage.
We played the race around every 3 hours game until Thursday morning when Jerry asked if the room was available again because I was beyond exhaustion. The same charge nurse told Jerry that there were some parents ready to deliver a premie & he asked to speak with her supervisor...I asked if the parents were delivering a premie, wouldn't they have a recovery room like all mothers who deliver in the hospital? The supervisor agreed and gave us the room again. The nurse also agreed to call me if Faith cried, so I was finally able to sleep 2 straight hours and it did wonders. I knew we were on the tail end of this, my eyes on the prize of Friday when I could finally hold Faith without any leads and no longer have her "rated" every feeding. To be fair to the charge nurse, they have to maintain the babies' confidentiality as I have to maintain students' confidentiality from other parents and it was probably becoming worrysome that we were in there so often able to overhear so many conversations.
Thank goodness my cousin Jennifer texted and offered to speak with Faith's pediatrician and interpret her chart for us to make sure we understood what was going on. She said that our pediatrician was making medically sound though cautious decisions, and it was reassuring to us. The main reason the other neonatologist had said Faith's troubles weren't normal was because they are after 24 hours of life, and that the reason we didn't need a monitor was because now she was showing no further trouble. We were better able to realize who and what we were most frustrated with.
When Thursday night finally came I pumped enough milk to sleep & I wasn't as concerned about her taking formula that we were able to sleep more than ever before she came home. As we were leaving the nurse loaded us up with more free diapers and whatnot than we could carry and as a volunteer to feed the babies came by she got whiplash from shock at how large Faith was compared to the other babies. I'm glad she's home now

Labor of Love for baby Faith

I was almost a week past my due date and as most of you know, trying several things (mostly walking) to start labor because I didn't want to be induced and had a fear of the pain caused by pitocin (figuring I could handle natural contractions better, guess I will have to wait until next time around to find out). My midwife was sure I would go into labor anyway, and I read up on the risks of post date babies-Faith was not going to be large and only 5% of babies that even pass meconium ever breathe it in.

Wednesday night the 14th we got stuck in traffic from that tanker explosion on the 60 and I couldn't walk as much but apparently that's what it took because when we got home my water broke around 9pm. I told Jerry & we went to the hospital. I was frustrated that this was the way labor started because I knew I was bacterial group B strep positive (GBS), which meant even more than most women, the hospital would worry about infection and put me on a time clock: must deliver within 24 hours, I even considered waiting for contractions to start but Jerry wasn't comfortable with that.

This will all be important later but GBS is a kind of bacteria that naturally lives in adults' digestive tracts, and becomes elevated when a person gets a urinary tract infection (UTI). I was positive for it at 35 weeks while I was still working. The symptoms of a UTI are feeling like you have to urinate but not being able to go, so go figure a 9 month pregnant woman wouldn't be able to tell the difference! Dehydration makes it worse and I wasn't drinking much while I was still working. Once I was off work I drank a lot more and started urinating a lot more so I may not have even had it 6 weeks later when my water broke but there was no time to retest.

I had researched and a laboring woman who is GBS positive should have antibiotics to protect the baby 4 to 5 hours before delivery. Of course the hospital wanted to start me on an IV of antibiotics right away through a continuous IV. I didn't want that yet because I wanted to walk around so I asked if I could merely have the antibiotic without the IV and was told no, so I refused the antibiotic until my contractions started, figuring no baby is going to fall out without contractions. The doctor replied "If you want to have a home birth that's your business, but you're in a hospital." She checked me and said the same thing my midwife had said a week before: 2 cm, 90% effaced, baby's head at plus 1. I guess they figured if I refused the antibiotics it was pointless to offer pitocin so they didn't try. I walked around the 3rd floor of that hospital until 3am with Jerry's nephew Eddie & his girlfriend. One doctor commented that I don't even walk like a pregnant woman. Still feeling no contractions, I went to sleep from exhaustion.

At 5 am another doctor took over the shift and woke me up to tell me that I was risking my baby's health by refusing the antibiotics and I repeated my reasoning about the 5 hours before birth IV fluid and she said I could just have the antibiotics through my heparin lock every 4 hours & I said if they had told me that before I would've taken it 8 hours ago! They still declined to check my progress for fear of infection and said they would wait for contractions. Walked again for another 3-4 hours without contractions until at 9 or 10 am the midwife on shift checked me and said I was maybe 2 and a half cm. She also said that she could still feel the amniotic sac so I must have a high leak, like up by Faith's feet, so I asked if that was safer for infection and she was already breaking my sac from the bottom so I hoped that would help labor progress. At this time the fluid was still completely clear-no meconium. I asked if I could still walk while on pitocin and was told no. So I bit the bullet & figured if sitting in a car broke my water when walking wouldn't, maybe relaxing on pitocin will move things along, so I asked for a low dose.

Noon, lunchtime, nothing, please up the dose. 2pm, ok feeling a few contractions, maybe 15 minutes apart, up the dose please, oh wait, it's already as high as it will go? 3pm OH MY GOD MY BODY IS BEING SPLIT IN TWO THIS IS GOING TO BE LIKE THAT SCENE FROM TWILIGHT & MY DAUGHTER WILL GROW UP WITHOUT A MOTHER!!!!! I tried moving, breathing, sitting on a ball, laying down...screaming & music...I remember asking to check my progress because now I was considering an epidural and wanted to be at least 4cm but they refused because of a risk of infection and said that my contractions weren't close enough together. Jerry said they were about 3-5 minutes apart. I remember a nurse saying that it doesn't matter what my progress is because if I can't take the pain I need an epidural...When she changed shifts I remember Grace saying "This nurse seems nicer" really loudly in front of the other nurse... Jerry told me his dad sent a txt joking that I should hold the baby for a few more hours so she could be born on his birthday & I yelled "Then he can come feel these contractions for me!!!"

After that it really goes blurry and I'm told I made a few zingers like when Jerry told me Faith would have my nose I screamed "I HATED MY NOSE IN HIGH SCHOOL!!!" I finally gave in to the epidural because I couldn't figure out why Jerry kept showing me a 3d ultrasound of a baby, slept in the minute or so between contractions, then I got even more confused by the same pic, then spent the minutes between contractions figuring it out and remembered I was in labor. I figured if I was this out of it I needed an epidural. it must have been around 5:30 because when the anesthesiologist came in around 6 and asked me about any health conditions I wanted to show that I still had my mental faculties so I told him I was in labor. Somehow I think it had the opposite of the effect I desired because he laughed along with everyone else. Jerry waited outside the door yelling support through the contractions while the anesthesiologist did a fantastic job because apparently I fell asleep while sitting up before they could lay me down again. Once I woke up enough to talk around 9pm I just felt frustrated to be confined to the bed with no ability to do anything but pray. God teaches us lessons in different ways for different people. I couldn't walk, pee or do anything but relax & let my body work while I couldn't even feel what it was doing (thank God!) We talked with the nurse who apparently had been offered the chance to be on the team that delivered octomom, but declined.

around 11pm they checked me and I was 6 cm...I was so discouraged-14 hours to go from 2cm to 6? But I will say that this is the one thing I learned for my own future reference...for some women being checked & told their progress may be an encouragement, but not for me. I sent a text to my family that they might as well go to sleep and told Jerry to let his dad know that he was going to get his wish about sharing a birthday as long as I didn't take another 25 hours...

So the nurse was going off shift around 3am & did the usual temperature, blood pressure, etc. She checked me (which surprised me because of the whole infection thing). She said "ur ready to have a baby!" & ran out of the room. I rolled my eyes & figured it was an encouraging statement or I was dreaming. She came back in with a cart, 2 other nurses, turned on all the lights & Jerry woke up & asked what was going on & she looked at me as if "U didn't tell him?" so I said, "She said we're having a baby?" so we both looked at her and asked something like "U mean NOW?" & she just seemed frustrated like we were not listening...I texted my sister & mom & Vanessa, Jerry's mom left so Vanessa could come in. The nurse told me that sometimes 1st time mothers have to push for an hour or more but to just push when I felt pressure...then I said "Oh, I've been feeling pressure sometimes and it's been waking me up" The nurse looked at me & shook her head.

I felt pressure & tried my 1st pushes & Vanessa said I was doing well, the nurse seemed surprised I was doing so well and called the doctor. They watched me for a few pushes and said I was doing well but were concerned that my oxygen levels & Faith's heart rate went down when I pushed, so they gave me a mask & put an internal monitor on Faith's head...Jerry said her heart rate went as low as 80.
 I noticed the doctor looked ready to cut an episiotomy if Faith didn't appear so I pushed past the end of the contraction. Vanessa said she could see lots of hair & Jerry tells me this caused him to look. Then the doctor said she had to cut the cord because it was around her neck so I waited, I thought I had to push the rest of her body out but then the doctor said there was thick meconium and pulled the rest of her body out and Vanessa said that she was really long. I couldn't see her anymore behind all the nurses and pediatricians-it looked like there were about 6-8...I just wanted to hear her or see something...Faith's color didn't look good to me, Jerry said he could see her arms move. Then she cried. Shortly after they put her on my chest in a blanket and she looked right at me. I can't even describe what relief & love I felt. Then they whisked her out of the room and some nurse popped up in my face asking me what race the baby was. Again, Jerry & I were completely confused....for all I know we picked Asian. I didn't see Faith again until around 3 hours later under a ton of cables & tubes, and that begins the story of Faith & the Catch 22 in the NICU....Oh by the way, final count: lose a 7 pound baby, a placenta, fluid & I gained 2 pounds since Monday...go figure