Monday, March 1, 2010

Ellie's Birth Story

Happy 1 Month Birthday to Our Elizabeth!
In honor of the day, I thought I'd finally get around to finishing and publishing her birth story. Pardon me while I wax nostalgic about our little girl's first month. Most people's birth stories usually span about a day, or maybe the 3 or so days they were in the hospital. Since we had such an interesting month that seemed to all run together in one big expansive mess, I just went and wrote up the whole month, if only for my own record-keeping. I'll print it out and put it in her baby book, all sorted out finally.
Ellie's Birth Day, Monday Feb. 1st:
I woke up at 4:00 AM on February 1st with a mild labor pain. I thought, " that a mild labor pain?" and went back to sleep. At breakfast Maddie announced that it was February so now the baby could come!  We explained to her that she wasn't due for two more weeks so it could be any time now, but probably not today. All morning I experienced what felt strikingly less and less like mild labor pains and more like plain-old labor pains. I started writing down the times I felt them and didn't think much of it, just went to my regular OB appointment. I was doing these every few days by at this point. Yaaaay, high-risk! (This involved the non-stress test that we usually failed, the ultrasound that confirmed she was fine anyway, and a quick once-over by an OB. Took about 2 hours minimum.) My OB said wanted to confirm my induction date - except I didn't have one. Oops. Thought we weren't going to induce after all? No, she wanted to induce at 38 1/2 weeks. Ok... let's go for Thursday the 4th. She put me on her calendar.  I said that would be totally cool, except I was pretty sure I was probably having labor pains. Like, right now. And baby #1's labor lasted a few hours at best. 4th may not be realistic, doc.
 I'll spare you the rest of the details of that *ahem!* appointment, but let's just say that the OB confirmed that NO, I was going to make it to Thursday. But she let me go home. I did, we had dinner (Chinese food turned out to be a poor decision, but it had a nice 'last meal' feeling), and about an hour and a half after dinner I was pretty darn sure that it was GO TIME. We called the office and the nurse on duty asked us to come into the office to be checked again instead of going right to the ER. Yeah...this, in retrospect, was my second poor decision. Remembering how quickly I apparently labor, I should have argued and headed right to the hospital. But we dropped Maddie at Nana and Pop's and went to the office. We actually waited in the waiting room and ran into a colleague from school...couldn't tell you who, I was a bit distracted by the OW of the moment. Then it was determined that we were over half-way to that magical moment when, uh...the doctor tells you that you can now help remove your sweet little baby from your uterus, and I should really have just headed to the ER. Oops.
So on the very long trip to the ER at the hospital next door, got admitted, and I got asked if I wanted an epidural. Now, I had Miss M completely naturally. Because I'm stupid and didn't get to the hospital in time. I wanted one badly; I am not the 'natural childbirth' type. But this time ...uhhh - I don't know. Can't I just have the baby and decide later?
Turns out that the doc wanted me to wait 4 hours at least before baby time. Something about antibiotics. Something about - WHAT? 4 FREAKIN' HOURS? I can go natural if we do this NOW, I can't wait 4 freakin' hours! Get me an epidural NOW. I mean, I felt like I could get this kid out and have her ready for Kindergarten registration in 4 hours! Red heads give birth quick, let's GO. I never did get the 4 hours of whatever these crucial antibiotics were (E decided she didn't want them?), but I did get the epidural.  I have to say: I highlyrecommend. You don't get a trophy for going it without, and you still get a baby at the end. And you don't get away pain-free, so don't worry, you'll still suffer for your art.
Ellie was a quicker birth than Maddie, and a way more pleasant experience. She had two 9's on the Apgar, she was happy and looked like Maddie to me. Actually, all newborns look like little old men crossed with lizards to me, but you know what I mean. She was beautiful.
Maddie, Nana, and Pop came to see her and Maddie loved her new little sister. She did say that it was now February so it was baby time. She called it!
Later in my room the nurse noticed that Ellie was breathing quickly and had a slight fever. They checked her into the nursery over night for observation, but they weren't worried. I got some "sleep". Ellie was given back to me in the morning with a clean bill of health. That lasted all of two hours.
Tuesday 2/2:
The neonatologist came to talk to me about her hematocrit (red blood cell count within the blood). He was concerned that it was bit high, but thought it might just be because of the way the blood sample was taken in the delivery room. They took Ellie for more lab tests, and later she was given back to me and the neonatologist came and told us that everything indeed looked normal. Somewhere in this time Nana and Maddie visited, and Maddie got to hold her sister. :-) Bob got back from work and we hung out as a family for a bit.
I called the lactation nurse because Ellie and I were having trouble nursing. Surprise! Again the nurse was concerned that Ellie was breathing quickly again and was retracting - her skin was pulling in at the throat and ribs, a sign that she was having trouble breathing. No wonder she couldn't eat! They took her back to the NICU for observation. Later they came and told me that she was being admitted to the NICU for tachypnia (rapid breathing) and retraction. We went downstairs to see her there Tuesday night. The NICU is an amazing and terrifying place, and the experience of seeing one's little baby hooked up to monitors is not one I'd wish on any parent. And we were lucky; she was one of the healthier babies in there, and definitely one of the largest. There were tiny preemies everywhere, hooked up to monitors. Ellie's monitors watched her heart rate, respiration rate, and blood oxygen level through wires attached to sensors that were taped to her body. They're so reassuring - you can see right there on the screen that your baby is (hopefully) doing fine. But you mess up the wires every time you move the baby, or the baby gets fiesty and pulls them off, and they end up being a giant headache. Until you get home and wish you'd have been allowed to bring the whole contraption with you because now there's no screen telling you they're doing fine anymore.

Later I visited her alone and got re-educated in the usual NICU mommy past-time: pumping. Another thing I wouldn't wish on anybody.

Wednesday, 2/3:
Ellie wasn't eating well (or pretty much at all) and they started her on an IV. Still breathing too fast. Her arm was splinted and she looked terrible. On top of that, her eyes, nose, and mouth were terribly dry, cracked, and painful looking. Hence the vaseline on her face here:

Her mild jaundice was getting worse, not better, and they told us to get ready for her to be there a few more days. Bob took off work and I was discharged at noon, but the nurses told us to stay as long as possible so we could have a room to go to to eat, sleep, and collect our thoughts. They said we could stay till midnight, but we left around 8 after visiting Ellie one more time. We felt helpless and wanted to get things together at home. Leaving the hospital without her felt so wrong, but she looked so bad that we were at least comforted knowing she was in excellent care. It was so strange how quickly we felt her absence. She'd never been home before, but home felt emptier.
Thursday 2/4:
Bob took another personal day and we went in and visited most of the day. They started her on light therapy for the jaundice, and told me to try to feed her as much as possible - she wasn't interested in waking up, let alone nursing. Excess bilirubin in the blood (jaundice) causes lethargy, so we kind of expected that. Held her lots, tried to nurse, and gave her as much love as possible. She was moved to the Intermediate Nursery. At the end of the day her bilirubin was down and her doctor told us he was optimistic that she could go home the next day.
Friday 2/5:
Overnight her bilirubin shot up from a 9 to an 18 and she went on double light therapy (lights above and laying on a light blanket below). I felt terrible because I couldn't help but wonder if she'd have bee better off being left alone under the lights rather than held a lot during the previous day. Bob took another personal day so we could go in together again. We were told not to hold her and to let the nurses bottle feed her only, so she could get more food and pass the bilirubin through her system. Extended jaundice can cause organ damage, and besides, we wanted our baby home desperately - snow was in the forecast, bigtime! Her doctor said that no, she absolutely couldn't come home until her bili was much lower. We were so sad when we left that night, both because we'd had to leave her there again and because we knew it was very unlikely that we could get in to see her the next day.
Saturday 2/6:
We called several times and her bili was down all day, then came back up a little at night. We stayed home and tried to enjoy the snowy day. Didn't really succeed at that.

Sunday 2/7:
We were thrilled to get in there! We were allowed to hold and feed her again. The lactation nurse came one more time for an hour-long session (of frustration) and was very clear that having had bottles all this time wasn't a good thing for the whole breastfeeding effort. Whatever. Still pumping, pumping, pumpking. I freakin' hated pumping. After that long session of attempted nursing Ellie was exhausted and pretty much only woke enough to take a bottle all day - and then just barely, or not at all. Nursing was out of the question again. She slept and slept.

Monday 2/8:
I went in by myself and Bob went back to work. For Ellie, it was more sleep. Not much eating, not much doing anything, but in the morning she was taken down to one level of bili lights, and in the afternoon she was taking off them all together. Her doctor examined her when the lights came off and said to me, "Now have you discussed her heart murmur with her pediatrician yet?" What? WHAT? Oh yeah. Heart murmur, didn't I know? They ordered a heart study and asked the pediatric cardiologist from Dupont to come and examine her. They still wanted her to eat a large amount - most regular babies aren't held to such feeding standards when they leave the hospital, but NICU babies have to be up to such-and-such amount or they won't discharge them. So this whole sleeping and not eating thing was a problem. She perked up later in the evening, though, and looked well. Bob came to visit and we were told that if she continued to do well she could go home "maybe Tuesday or Wednesday". But this time we refused to get our hopes up.  We'd had no idea how sick she was, when we'd had our hearts set on taking her home Friday. Nope, she could stay till she was well.

Tuesday 2/9:
Bob went to work and I went to the hospital. The pediatric cardiologist said her heart murmur was most likely nothing major, just a small hole that is supposed to close at birth but often doesn't. It will most likely close in 3-4 months, and he wants to see her back then to check for it. It turned out that she'd gone back to not eating much overnight and they'd used a feeding tube (ng tube) to get extra breast milk into her. She was better because of it, though. She was looking great and her bili was down again. She was eating more and actually acting like a baby instead a very life-like doll. She was beautiful! The doctor told us she'd have to be off the feeding tube and doing well in every other respect for her to be discharged that day, but she had high hopes. I stressed about every bottle but she did pretty well. The doctor later discovered that she'd had a second feeding tube feeding at 6AM that hadn't been recorded and therefore wanted to keep her longer, but since she was eating all right she wrote the orders for a discharge at 8PM. Bob came in that afternoon, we visited with her and they moved her room yet again to a less intensive nursery, and her nurse in that room was very helpful in getting us ready to go. We grabbed dinner in the cafeteria that had been our kitchen for the past week, came back upstairs to feed her once more with "supervision", and then FLEW out of there - baby and all!

Nana and Pop had cared for Maddie pretty much all week so we could be with Ellie as much as possible and be there to talk to her doctors about her treatment. We felt immensely guilty about not seeing Maddie much that week, and we missed her terribly...but she didn't seem to mind a bit. One of Ellie's nurses, who has so many parents come and go from the NICU, told us this, about the guilt associated with spending all your waking hours in the NICU with your younger child, while your older one is shipped off to someone else: "Your older baby had you all to herself for years in a way that this little one never will. That's ok, but now is your time to give a little bit extra to this child when she needs it." LOVE it, THANK YOU, Kim. (She was my favorite nurse!)

We spent a week at home before Ellie got sick again. When we got home that Tuesday night Maddie was pretty darn sick with a bad cold.

We tried to keep her away from the baby as much as possible - which was so mean considering we teased her for months with this baby on the way and then had the nerve to return home from the hospital without said baby. We washed hands and begged her to cover when she coughed and sneezed and coughed and sneezed again. But soon we were sick too. And we're teachers, our immunity is like steel. We don't get sick with every little bug anymore...this was a super-bug. This was the evil, black-cape-and-mask wearing villain of super bugs. After a little more than one week at home, Ellie had it too. My first sign was that she slept constantly (instead of just 20 hours a day, she was easily clocking a full 23) and shooting green boogies when she sneezed. So cute, green baby boogies.
Thursday 2/18
She wasn't doing well, wasn't waking to eat much, and just didn't look well. I called her doctor and they said to bring her in. The doctor who saw her noticed that she was retracting again when she breathed, and told me to take her to the ER. Up until this point I had held it together nicely. Sicker than I'd been in, well, ever. Dizzy. Sleep-deprived, and still not over the whole NICU thing. I managed to get through reciting her brief but too-full health history to the doctor with some dignity and sense of calm. When she said, "I want you to take her to the emergency room." I pretty much burst into tears. Had I been able to vocalize at the time, I would have explained my dread; that although I knew she needed to go to the hospital, I was terrified they would take her from me and not give her back for an extended period, AGAIN. The pediatrician patted me awkwardly and said, "I know you and your family have been through a lot." and some other doctorly comfort that didn't work.  Then I was on my way. Bob was about 2 hours away at a conference, and I called him to hurry home. I wouldn't have been doing great with all this one my own, being completely well. And at the moment, I felt awful myself. I remember the room spinning while the nurse was talking to me - but not wanting to get myself kicked out of the ER for being ill, I think I held it together nicely. Ellie was seen by a young doctor from CHOP who was working the ER. After 3 or so hours he discharged with the instructions to go home and take care of her "bad cold".
Friday 2/19:
More of the same from Thursday, but we had been assured that she would be fine. "Bad cold". Just  suction her nose, try with all our might to get her to eat to keep her strength and fluids up, and she'd be just fine. I'm embarrassed to say that we all went to Wal-Mart to do some grocery shopping. What? We had no food in the house, and I washed the shopping cart handle off with a Clorox wipe! Friday night she didn't eat and didn't sleep for hours and hours. I tried the vaporizer and humidifier together, steamed it up in the bathroom with the shower, and suctioned the junk out of her nose. Nothing worked, and I felt helpless. But I'd been assured that she was fine, that this was all we could do, and to just wait it out.
Saturday 2/20:
She was a mess. That afternoon we called the doctor again. They said to bring her in, they examined her, and we ended up back in the ER. And this time I managed not to cry, post-pregnancy hormones be damned. For a while. They did one set of chest X-rays, didn't like the way they turned out, had us do another one, and this time they did a test for RSV (Respiratory Syncytial Virus) and it came back positive. Her lungs, however, looked good, and it looked like all was well. Then the doctor started worrying about her heart. (Because this doctor was clearly were trying to kill me with worry.) They wanted to rule out her murmur causing her breathing problems, so they reviewed her chest X-ray with the Dupont cardiologist. All was well again, there was reportedly no connection, but her RSV test then came back positive. OH, so THAT was it!  Yep, but for a baby like her that spelled instant hospitalization. They don't mess around with RSV. In adults and older children it's really just a horrible cold - which is what my whole family suffered from for 2 weeks. In infants it can completely knock them down and take them out. Babies can have a lot of trouble breathing (or in bad cases, stop breathing!) from the congestion and the strain on their lungs, they explained to me. This sounded terrifyingly familiar. Not untreatable, but certainly nothing to sneeze at. (ha ha)  So she was admitted around 11:30 PM (we'd been in the ER 5 hours or so) and they showed us to her room. Pediatrics was completely different than the NICU. You have your own room, your own bathroom, and some privacy! You do all the care and feeding of your child while you're there, and you can come and go as you please, 24/7. If you have an older child you pretty much stay with them all the time, and there's a fold-out bed for you to sleep there. Ellie being so young and sleeping really well at night, I opted to go home at her nurse's suggestion and get some rest. She was in a quarentined area because of the RSV, so we didn't worry about bringing our own germs in much - but we were beyond exhuasted and had another sick kiddo at home.
We stayed in the hospital 3 days. She was put on oxygen to make her more comfortable and she slowly got over the RSV.  She was over the worst of it already, they think, when she was admitted, but you never know when it'll get better. Sunday Bob and I stayed all day and then Monday I went in by myself, Bob joining me in the afternoon.

Tuesday morning I came in to the most beautiful sight: Ellie, no oxygen thingys in her nose. Pink, awake, active, and babbling to the bars of her crib. It. Was. AWESOME! She was discharged that afternoon. I felt like it was almost too soon - are you SURE I'm allowed to take this child home? And nobody's going to come home and watch her breathe for me? Are you SURE?
Actually, she's been fine. She's a great sleeper. (Up once last night. Once. Ate in 20 minutes, diapered, went back to sleep. I'm not counting on a repeat performance tonight, but that's still awesome for a 1 month-old baby!) She's eating well. BUT (oh, there's always a but!) she has some bad reflux. Actually, Sunday in the hospital her lovely nurse Patty asked me if she'd been arching her back, spitting up, screaming for no reason...yes, yes, and yes, but Maddie did that and it's just..."She's a poster child for reflux." They ordered Zantac that day. :-) Joy! Do you know how long it took me to convince Maddie's doctor to try some Zantac for her? Now, the Zantac hasn't been cutting it, but her pediatrician has already altered the timing and the dose to help her, and we're giving it a few more days until she goes on Prevacid and he's thinking about ordering a Barium swallow study. So already we've gotten farther with helping our baby feel better than we ever got with Maddie's pediatrician - not until she was seen by the wonderful pediatric gatro doctor from CHOP did Maddie get that attention. I love it. I mean, I hate that she's uncomfortable, I don't love wearing spit-up, but at least I know there's a doctor who's on the case.

So that's Ellie's birth story. And NICU story. And brief hospitalization for RSV story. Yeaaaah, it's been a long month.

Today is her 1-month birthday and WHAT a month it's been. But we're back in the swing of things and absolutely loving life. THANK YOU to everybody who sent us love and good wishes in person, on the phone, or through the blog or facebook. We love you guys too and we really benefited from the pep talks and hugs everybody sent. Thank you from Ellie, too. XOXO


Anonymous said...

So so sorry you all had to go through that but at least she's home now and totally healthy.


Anonymous said...

Love you all sooooo much. Thank God everything and everyone are better.

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