Friday, December 23, 2011

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

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