Saturday, June 12, 2010

in the NICU

Thursday, June 3 and the next 4 days...

I was moved to the Mother Baby unit not too long after delivery.  There I waited for some news about Liam.  Finally around 3 am the neonatal nurse practitioner visits my room.  She gives us news that Liam isn't very active and they are concerned that he has a neuromuscular disorder or disease.  He is very flaccid and physically nonresponsive.  His breathing is impaired so they've intubated him and a ventilator is helping him breathe.  With the little activity in his extremities they've had problems drawing blood from his heels and hands so they've inserted a central line through his belly button.  A mother's worst nightmare.  After a very active baby in utero and 11 hours of labor, how in the world can he be flaccid?  He was kicking me during labor!

We were finally allowed into the NICU to see him.  Jason's Mom (aka Drucilla aka Wicky) and Sam (aka Liam's Uncle Sam) were still with us at 430 am.  The neonatologist was baffled about his condition because all the tests they performed were mostly normal.  She did explain that he had metabolic acidosis and respiratory acidosis which is odd, compensation for each is the opposite's alkalosis.  Basically some of his lab work was off but that didn't explain his flaccidity.  Once he heard Jason's voice he moved.  He was able to hold Jason's finger (which was what he was most looking forward to after birth).
By the afternoon and us being able to see him frequently (not hold him but see him) he started moving a bit more.  His acidosis resolved and we were able to hold him.  I just cried.  My poor baby had tubes and wires.  When I was away I had a snuggie type cloth that I kept in my shirt to get my scent.  At night they draped the cloth over his head for comfort.  It worked!  Each day he moved more and they were able to take out the breathing tube and let him use a nasal cannula.

As the days passed he grew more alert but still not opening his eyes long enough to see them.  He moved all his extremities and began fussing at diaper changes.  By day 2 in the NICU I was able to pump and give him bottles several times a day.  His little body just didn't have enough energy to take to my breast for very long, but we did try.
Day 3 we moved out of the critical area and into a private room in the NICU.  Liam began breathing well on his own and the nasal cannula was removed and the central line from his belly.  Yay!  Poor thing has his mommy's sensitive skin and allergy to tape we think.  It took a few days for the rash to clear up from the oxygen pads on his cheeks.  Daddy got a few chances to feed him and we began to transition him for home life.  I was discharged from the hospital as a patient but given a room to "room in" with Liam.  While the nurses were still taking care of us, we got to be parents and do the majority of his caretaking with guidance from our favorite nurses.
Day 4 the jaundice really set in and our little angel was put on phototherapy with a bililight.  Boy was it cool to look at, and he had great "shades".

Friday, June 4, 2010

A Special Delivery

Wednesday, June 2.

Jason and I quickly ate stale Krispy Kreme donuts before heading to our OB appointment at 0850.  I figured it wouldn't take too long and we could do McDonald's like usual afterward.  I had been on bed rest for a little over a week and ready to go back to work.
Dr. Sullivan saw us first and said I looked good and sure I could go back to work on Friday.  Yay!  We need my paycheck. Then she decided we needed an ultrasound.  Yay, we love those  Jason went to every appointment except the last minute ones and always looked forward to an ultrasound. I figured this ultrasound would include a biophysical profile (BPP).  Liam was so active our pictures didn't come out very well.  He always had his right hand in front of his face when they tried to get good prints.
We go back to Dr. Sullivan's office to talk about the ultrasound and she looks at me and says, "I think we need to have this baby today".  OMG, What?!  Secretly I was wanting that but not even prepared.  We didn't bring the vehicle with the car seat and suitcase.  Holy moly.  She explains to us that Liam scored 6 out of 8 on his BPP, has a dilated right kidney and too much amniotic fluid.  Since I'm right at 36 weeks she thinks it's time.  The ultrasound tech showed us he wasn't really doing his practice breathing like he should and estimated weight was 6 lb 5 oz. Off we go to L&D where I start informing our parents and assigning duties to friends.
 An IV is started with LR and Pitocin and Dr. Sullivan comes over around 1140 to break my water.  Wasn't a pleasant procedure but the constant gush of warm fluid between my legs couldn't be beat.  Every time I moved I flooded the bed.  The poor nurses had to keep coming back to me to change out towels and sheets.  I finally got up to pee and just stayed in the bathroom for awhile letting my fluid drain.  The toilet was so high I could swing my legs.  I liked it there.  Eventually it slowed enough so that I could walk in the hall with a towel clenched between my legs. The contractions kept getting stronger but I persisted.  I did get Stadol frequently but it didn't so much touch the pain as it made me loopy enough to focus my energy on being nice rather than screaming.  I controlled my breathing pretty well considering how dramatic I've been on occasion before. Counted and silently hee-hawed (from McMoyler Method).  At this point my favorite mommy friend and new best friend Sam has arrived, along with both my parents.
 At 1430 I was only dilated 1.5 cm 80% effaced and in terrible pain.  I decided to take another walk in the hall.  When I could no longer stand the pain and walk I returned to my room and leaned over my bed to sway my hips.  Sam showed Jason how and where to rub my back.  I moaned and groaned but kept my mouth clean. :)  Amazing since I know me and figured I would be cussing my husband and anyone that said anything to me about the pain.
By 1500 I was 2 cm dilated but still suffering with each contraction.  Did I mention I don't tolerate pain very well and I have a high tolerance for narcotics?  By 1530 Dr. Sullivan has notified the anesthesiologist and he will be coming to do my epidural soon.  I'm 3 cm dilated but crying in pain.  The epidural is put in 2 minutes or less and I start feeling relief.
The active phase of labor begins and at 1621 I've progressed to 4 cm.  I'm thinking I'll never make it to 10 cm but the epidural has me feeling so much better.  Jason's parents have arrived, as has our best friend Lizzie.  Everyone is talking about this and that and I'm trying to rest.  I remember thinking during the contractions that I want silence.  I managed to take a nap, I think for an hour, but at 1800 I was awake, alert, and talkative. (Some of this I'm remembering, the rest is because Sam and Jason took notes in my journal).  1830 I've progressed to 5.5 cm.  Woohoo, we're slowly getting there.  I've been in labor for 6 hours but I've started losing track of time.
Finally, I get to the transitional phase of labor.  Boy does it kick some booty.  It's 1920 and I'm feeling the pressure from the contractions.  We're getting closer but my contractions started getting worse.  I'm crying, Dad's freaking out, Sam's helping me breathe and poor Jason is so nervous his ears and neck are red.  Dad gets the nurse and Dr. Sullivan.  Dr. Sullivan asks the anesthesiologist to give me a bolus for the pain.  She knows my tolerance and intolerance.  With an epidural I shouldn't be hurting like this. Now I'm having a little less pain I'm saying "It still hurts.  I'm hungry.  Child get out so Mommy can't get a drink!"  I was so thirsty with the driest mouth I've ever had.  Somewhere in all this I started chewing gum that Lizzie bought me.  I mean smacking on some gum.  I apologized profusely to those around me for that because it's a big pet peeve of mine.  By 2003, I'm 8 cm dilated.  I'm finally making good progress but still hurting in my right leg and pelvis.  Now I figure I should listen to my playlist on my phone that I worked so hard to create.  At 2040 I'm 9 cm and crying in pain.  Anesthesiology doses me again and discovers my epidural is kinked.  Apparently in my wiggles to get comfortable and sit straight up I kinked the line.  Oops.  Next time I'll be more aware of that.  It's just hard to readjust yourself when your left leg is completely numb and the right mostly numb but hurting.
I got the urge and began pushing at 2120.  The nurse wanted me to lay back but i can't stand that position anymore for some reason.  I moved the bed up when she wasn't looking and made myself more comfortable.  Let me tell you, pushing is the WORST part of labor.  Jason took my left leg (the dead one) and Sam my right leg and every time I had a contraction I did my best to grab my thighs but I couldn't quite reach without a good push from my helpers.  I couldn't lift my heels. I could feel the contractions and when to push and while the nurse left the room Sam guided me.  I had a hard time holding my breath and felt my pushing was inadequate since I couldn't really feel it.  It hurt my neck a lot to put my chin down.  I relied heavily on someone to count and tell me when to breathe and when to hold.  This exhausting pushing lasted for an hour and a half.  I was getting to the point I didn't have much energy to lift my head much less grab my thighs.  I could feel Liam's head crowning but he just didn't want to come out.  Dr. Sullivan pulled out the vac to suction his head out.  I felt his shoulders pass (and screamed) and then the rest just slipped on out, just like you imagine it would feel. Liam Cael McIlwaine was born at 2242. I was so relieved the pressure was gone. And I didn't notice that Dr. Sullivan wasn't quite smiling and I never heard a cry.  All I remember hearing was Sam tell Jason to go take pictures now.  He was smiling ear to ear.
What I was too exhausted to notice was that my precious baby wasn't doing well.  His Apgar scores were terrible and they did 3 instead of then normal 2.  He was shown to me quickly and then whisked away to the NICU.
A nurse delivered my placenta within minutes of Liam's arrival and Dr. Sullivan proceeded to stitch me up.  Fourth degree laceration/episiotomy.  Seriously, that boy ripped me open.  It took quite a while to put in all the stitches.  When she was finished I was allowed to get up and move around.  I changed gowns and prepared to move to another unit.  Family came back in and said their goodbyes.  I hadn't begun to worry about Liam yet.  The nightmare had yet to be realized.

Tuesday, May 11, 2010

abc wall is FINISHED!

Yay! We finally got all the letters up.  Didn't take nearly as long as we thought it would.
Take a look.  I'm really proud of my letters. :)