Archive | May 2015

First Days in the NICU

When people think of having a baby, they generally picture a very round pregnant lady going into the hospital and coming out thinner with a baby in her arms. She stays home from work (if she works) for anywhere between six weeks to a couple of months, leaving her baby in the hands of a daycare or nanny or trusted relative.

When I went into the hospital on May 13, I had only gained about 10 pounds. I didn’t really look pregnant yet. I hadn’t had any cute maternity pictures taken. I had only been wearing maternity clothes for about a month. When I left a week later, I had probably gained about 15 more pounds in water weight from the massive swelling of my hands and legs. My shoes wouldn’t fit, my maternity jeans wouldn’t fit, and I was only able to walk slowly and hunched over, due to my C Section incision. The biggest difference between me and the stereotypical pregnant lady was the baby I didn’t have in my arms.

Preemies as young as Little Miss Minion don’t become regular full term babies upon graduating from the NICU. They aren’t even referred to in the same age terms. LIttle MIss Minion is chronologically 2 weeks old, but her adjusted age is 30 weeks gestation. This means that she won’t act like a 2 week old newborn, but will instead behave like a baby at 30 weeks gestation. Her adjusted age clock will start at her due date, when she should have been born. In September, her adjusted age will be one month, even though she will chronologically be around four months old. She will not act like a four month old, though, since she only recently will have developed and matured enough to be born, had things gone differently. She will act like a one month old. Her immune system will be much weaker than a full term baby as well, and we were told that the general recommendation is for preemies to avoid daycare for at least a year, and to stay as isolated from the general public as possible. No shopping trips, no restaurant outings, no going to the zoo or anywhere else where there are lots of people. Anyone who will have regular contact with her needs to have all their vaccinations and boosters.

Where the stereotypical new parents have sleepless nights trying to get their baby to sleep through the night, rocking them, feeding them, singing to them, NICU parents set alarms to wake up every two or three hours during the night to pump or to  call the NICU nurses to see how their baby is doing. Did she have any apneas or bradys (breathing pauses or heart rate drops)?

Every day since she was born, Mr Minion and I have seen Little Miss Minion in the NICU. The first step is signing in and verifying who we are. Most of the receptionists know us by sight already, and after signing in, the buzz us through the double doors. Instead of going straight to our daughter’s room, we make a pit stop at the row of sinks to scrub our hands with the special NICU soap for a full 2 minutes. Since my rings haven’t fit me for weeks, I don’t have to bother with removing any jewelry, but all rings and watches should be removed before proceeding, since they are hard to clean and harbor germs.

After drying our hands, we walk down the hallways to the pod where Little Miss Minion lives. There are large monitors on the walls that stream the vitals of every baby in that pod. Nurses’ stations line the center of the pod so the nurses are usually within 15 feet of their patients. Each nurse is assigned between 1 and 3 babies to care for during their shift. When we get to Little Miss Minion’s room, the first thing we do is peek in at her in her isolette, which is a big plastic crib with a domed lid on it. This isolette keeps her warm and semi-shielded from light, since there is a large quilt draped over the top of it. The second thing we do is check the monitor to see if she had any As or Bs and when. The nurse will check in with us, giving us a rundown of Little Miss Minion’s day so far and any changes that were made to her feeding schedule or other details.

Then we sit. We can’t leave the quilt up to see her, since she needs to sleep in as dark an environment as possible to prevent ROP, a preemie issue with too much light that could cause blindness. So we sit, watch the monitors, and spend time with our daughter in the way that has become our normal: sitting on the couch a few feet away, hoping she can tell that her parents are nearby, waiting for the chance to kangaroo with her or to change her diaper. These opportunities only come about every 4 hours, during what is known as “cares.” Doing cares with Little Miss Minion consists of taking her temperature, changing her diaper, doing a touch hold while the nurse takes her blood sugar, and maybe getting to kangaroo her, as long as she remembers to breathe.

Since preemies are so small and not developed, there are only certain ways that they should be touched. Rocking them is out of the question until they are much older. Stroking them lightly is something that stresses them out because that movement and feeling is not something they experience before they are born. And so we learned the touch hold. This is the calming process for a preemie. I would take my hand and press gently on the top of her head while containing her arms with my other hand. It makes them feel secure, like they are back inside the womb.

For about a week, I spent about 12 hours a day up there with her. Mr Minion would drop me off on his way to work and we would go home at night to sleep. I’m not sure what the plan will be once I have to go back to work. I hope to go back sooner than I originally planned so that I can have some time left to spend with her once she gets to come home in a few months. That is why Mr Minion went back so soon.

Today and yesterday, I have stayed home in the mornings, trying to put our house back together after being gone for basically two weeks. The nurses say that it isn’t healthy to spend too much time in the NICU, and I believe them. By Tuesday morning, I was hearing the alarms from the monitors in my head. It isn’t always hers that is going off. If any alarm in the whole pod goes off, it sounds on every other monitor so the nurses know about it if they are in another room. It also sounds on their phones, which they carry everywhere. There is no escaping it.

LIttle Miss Minion’s big accomplishment yesterday was pooping and farting. Since she is so small, if there is a buildup of gas or poop in her stomach or intestines, it can press up on her diaphragm and make it harder to breathe. This is what the problem was yesterday. Her nasal cannula (the prongs that deliver her room air) pushes a little bit of air into her stomach and she wasn’t getting rid of it because she was constipated and the way was blocked. So her stomach got puffy and she wasn’t breathing deeply enough. After some adjustments and several rounds of X rays to make sure that is what the problem really was, she ended up going to the bathroom and fixing it mostly on her own.

Things I never thought I would be excited about: that my daughter farted and pooped enough that she can breathe normally again. That’s life in the NICU for you.

An Unexpected Arrival

This is the story of how Mr and Mrs Minion (not their real last name, due to the fact some people on the internet are creepers) became the parents of Little Miss Minion (also not her real name) and their Type A life exploded into Minion Mayhem.

I’m Mrs Minion. You can call me Mrs. Minion, Queen of Awesomeness, or That Crazy Lady Who Writes Too Much. Mr Minion and I found out that I was pregnant in early December with a due date of August 6, 2015 and we immediately started researching every aspect of having a baby. We shared the news with our families in January, around the time of our five year wedding anniversary.

In March, we found out that Minion was going to be Little Miss Minion, and would be the first girl on Mr Minion’s side in over 130 years. I started to look into writing a birth plan, mostly for myself so that I knew what the options were and partially so Mr Minion could make decisions on my behalf if I was too busy swearing at anything that moved in the delivery room. I have kind of a potty mouth. In the end, I decided that I wanted to go as natural and unmedicated as possible. I signed up for natural childbirth classes at the hospital I would be delivering at and borrowed half a dozen books about Hypnobirthing and the Bradley Method from the library.

At the start of April, I started getting more frequent headaches. I had always gotten migraines and my job involves heavy computer usage, so I brushed it off. Then I started getting migraines that wouldn’t go away. I figured it was because I couldn’t take any of my normal migraine medicines, only Tylenol with a Coke. It started to get harder to focus on the computer screen at work, and I figured it was just my contacts, since being pregnant can change your prescription. I have pretty awful eyesight anyway, so I wasn’t too worried. I went to start registering for my June baby shower and my feet puffed up and turned purpley-red. My feet started puffing up at the end of every day, even though I propped them up.

I don’t remember what made me think of preeclampsia. I read the symptoms and thought, “I have that one. And that one. And that one. And I didn’t think of this one, but I have that one too.” My next OB appointment was in a few days, and I brought up my symptoms. They decided to run some tests, since my blood pressure at that visit was around 130/80, which was the highest my blood pressure had ever been (at the time). It was normally around 105/60. They did bloodwork and had me do a test to see if my kidneys were functioning properly. Too much protein in the results would mean that my kidneys were starting to shut down.

I was at work when the results came back. My doctor, not one of the nurses, called my cell phone and left a message, asking me to call her back. I saw that the OB office had called and went to the bathroom to listen to the message. I heard my doctor’s voice and knew something must have been wrong. SHIT! SHIT SHIT! She never called me herself, probably because she was dealing with people who were sick or having problems. I called the office back and was told that I needed to come to the hospital to be evaluated. I immediately freaked out. I was only 25 weeks. Minion wasn’t ready to come out yet.

As I walked to my car, I called Mr Minion at his work and told him that I was going to the hospital because my bloodwork came back and there was a problem. I drove the short distance to the hospital and signed in, then sat down in the waiting room. Not five minutes later, Mr Minion arrived from his office–a trip that should have taken about a half hour had taken him about fifteen. He wouldn’t tell me how fast he was driving.

After more bloodwork and two hours of fetal monitoring, the doctors decided to admit me for observation. Later that night, the high risk doctor came in and explained that my symptoms and bloodwork showed that something odd was going on with my system. They weren’t sure what it was, but they thought it might be preeclampsia or HELLP Syndrome. Either way, the only way to “cure” it was to deliver Minion. Since I wasn’t showing severe symptoms, they were just going to watch me and Minion very closely. They gave me a round of steroids to help her lungs develop faster, in case they needed to deliver. They did ultrasounds of my liver and kidneys to check for damage, plus ultrasounds of Minion to make sure she was growing OK. After a few days of remaining stable, they released me. My liver enzymes had been elevated, my uric acid levels had been high, and my platelet levels had been very low. I was told that I was officially considered high risk and would need to meet with my OB once a week to do bloodwork and keep an eye on whatever was happening. She was hoping to get us both to at least 34 weeks, ideally 37 weeks. Minion would need to be delivered via scheduled C Section, because labor would be too stressful on us both with my high blood pressure. I cancelled my natural childbirth class, due to start in a few days, and began to reconsider other aspects of my birth plan. Would I get to hold her right after she was born? Could Mr Minion be in the room with me? What if she had problems after she was born? What would happen to me? Preeclampsia can cause seziures due to high blood pressure, as well as severe kidney damage and other lasting problems.

Around the second week of May, after three weeks of bloodwork, OB visits, and slowly elevating blood pressure (averaging around 145/85), I got the call that my protein levels were just under the threshold for diagnosing preeclampsia. The cutoff was 300 and I was at 287. My OB wanted me to start bedrest until the Minion was born. We had 12 weeks to go. I did some more bloodwork that Saturday so that she would have the results by my appointment the following Wednesday.

On my second day of bedrest, I went to my high risk doctor appointment. He said that the amniotic fluid levels were looking a little bit low, but as long as they stayed there and didn’t get lower, it shouldn’t be a problem. The next day, I had my regular OB appointment. I sat down to get my blood pressure reading and it was 155/90. This was a problem. The protein levels, my platelet levels, and the high blood pressure signaled to her that whatever was wrong with me was accelerating. She sent me to the hospital to repeat my labwork and said I should bring a bag “just in case.”

At the hospital, I did repeat labwork and more fetal monitoring while they waited for the results. The doctor said my protein levels were very high and my blood pressure was too high to send me home. They were admitting me. AGAIN, This time, I had to get an IV because they wanted to give me fluids and magnesium, a susbstance that would keep me from having seizures if my blood pressure got too high. The IV took two nurse attempts and a team of anesthesia specialists because my veins were hiding. They also gave me another round of steroids, since the first set had been almost a month before that.

Magnesium, if you’ve never been on it, is not a fun thing. The mag, as the medical team called it, made it hard to focus. I had brought some books to pass the time and found that I couldn’t focus on the words. I tried to read it out loud to myself and couldn’t process the words. From here out, things got very hazy and hard to remember. I was “magged out.”

My OB had come up to the hospital for another delivery and stopped in to see me and explain the plan. I would be on bedrest in the hospital until Minion came. She hoped we could get by a month. The high risk doctor gave us two weeks. Until they decided I was stable, I was NPO-fancy medical term for nothing by mouth. All I could eat was Jello, pudding, and clear juice. After a full day, they decided I could eat after all and let me order some food for lunch. They stopped the mag, and it felt like a heavy pressure and fog were slowly being lifted off of my brain. After I ate, they wanted to draw more blood to see what my various levels were doing. During the blood draw, I started feeling very hot, a side effect of the mag, and very lighteheaded. Almost like I was drunk. The nurses blamed the mag, but I got sick and was put back on NPO in case it was a symptom of whatever was wrong with me. They put me back on the mag and sent in a team from the NICU to talk to us, since the odds were that delivering at 34 or 37 weeks would results in a few weeks in the NICU for Minion.

Since we were going to be in this for the long haul, Mr Minion and my mom went back to our house so he could drop off our car and pick up some clothes for us both. He had stayed with me back in April and wanted to do it again. Neither of us thought I would end up on hospital bedrest, so we were both out of clothes after one overnight stay. While he was gone, I tried to read again, but the mag made that impossible. I texted updates to family members and messed around on Facebook and my baby message board group.

After a while, I glanced over at the fetal monitor and noticed that the squiggly line that represented Minion’s movement was starting to slow down. I called the nurse in and asked if I needed to roll over or something. She had me roll over, then called for a portable ultrasound to check on Minion. She should be moving more than the monitor showed. The ultrasound techs came in and started looking at her. Her heart rate was fine, but it wasn’t going up or down like it should when the babies are moving around. They started the scan, and for 30 minutes I watched as the only thing moving on the scan was the beating of Minion’s heart. They said the mag slowed everything down and made her sleepy, just like it made me feel drunk. The looks on their faces told me that something else was wrong, but I hoped it was something fixable, like maybe I could eat food again and my blood sugar would made her more active. I called Mr Minion and told him what items I wanted him to bring, getting the feeling that I needed to hurry him up because something was going down soon. I didn’t want to scare him, so I left out the part about the ultrasound.

In the middle of the coversation, the high risk doctor came in, so I hastily told Mr Minion that the doctor was there and I would call him back. The doctor did not look happy. “With your blood pressure readings over the last couple days and your bloodwork levels, we are diagnosing you with severe preeclampsia. This last ultrasound is telling us that the baby is being affected by something-maybe your blood pressure, maybe your blood levels. We are going to deliver in one hour. She needs out.”

No. No. This was wrong. She was only 28 weeks. NONONONONONONONONONO. I was in shock. A group of people started filing into the room to get me prepped for an emergency C Section. The remnants of my Type A birth plan combusted. I was still holding my cell phone, just sitting in shock, as the nurses started adjusting things on my IV and wheeling different machines into the room. One of them put a blood pressure cuff on the arm that was holding my phone and the pressure snapped me out of it. “Can I still use my phone? I need to call people.” She said to do whatever I needed to do and they could work around me. I called Mr Minion back and said that they were delivering the baby in an hour. I started texting family members that they were prepping me for surgery in an hour. My blood results were in and I would be able to get an epidural after all, because my platelet levels had risen from around 101,000 up to 165,000. Anything less than about 100,000 requires general anesthesia. I consider this a small miracle, because my platelets had been low for WEEKS now and the normal range is about 150,000.

I felt that things were progressing incredibly quickly and started to worry that Mr Minion wouldn’t make it in time, but then I heard one of the nurses say that the Doctor C was on her way. Based on where Mr Minion was when I called him last, I knew he would make it if they were still saying Dr C was “on her way” and not “almost here” or “scrubbing up.”

They had me move to a different bed for the surgery and put in my epidural. I glanced over and saw my latest blood pressure reading-it was around 180/100. I think Mr Minion showed up around this point, but because of the mag, things are very hazy and hard to remember. I recall thinking that he was very pale and out of breath, later learning that he had sprinted from the parking lot through the hospital up to my room–a pretty far distance for someone who says running is undignified. The epidural made everything feel more real. My legs started to feel incredibly heavy, and they had me sit on the bed with my legs up there before I couldn’t move them at all. The next hour is very hard to remember. I know I must have laid down at some point, because I remember thinking that the ceiling lights were way too bright. They wheeled me down to the operating room and moved me into a table. I remember thinking “Please don’t drop me, I can’t move.” The only thing I could really feel were my arms, which were shaking from nerves and the epidural, and my head. At some point, Mr Minion reappeared at my side, wearing a surgical mask and hat. He says he had to walk behind my bed, so that is probably why it seems like he was gone for a while. The nurses set up the blue drape in front of my face and a few minutes later, Dr C popped her head up from behind it. “I know this is dumb, but I need you to tell me why you are in here.”

Are you effing serious, lady? I remember staring at her, wondering why the hell she was asking me this when it was pretty apparent what was going on. “I’m having a C Section,” I finally said. She asked me what my name was, and what her name was. “Great. Are you feeling ok?” I’m guessing now that she started the surgery while she was asking me all the stupid questions to make sure the epidural was working.

My hands and arms were shaking so hard that they were bouncing off of the table. I had to keep them extended out, and at one point, they were bouncing and shaking very close to the blue drape and I felt someone reach up to the drape and grab my wrist, pushing it further away. Mr Minion started talking me through some of my Hypnobirthing calming exercises to try and get me to chill out. A few minutes later, there was a commotion and Mr Minion told me he was going to see the baby and that everything would be fine. I turned my head to try and see her, but there were too many people in the way. She had her own medical team. Mr Minion came back and asked if I could hear her crying. She had come out screaming, and I was glad the steroids seemed to have worked. I had hoped and prayed that she would take after me and be the biggest, most obnoxious, stubborn baby ever. One of her nurses/doctors brought her over to me all swaddled up with this elephantine hat on her head. It was a regular newborn hat to keep their heads warm, with a cute bow since she is a girl, but all I could think was that she was too small. The nurse asked if I wanted to give her a kiss, so I did, and then they took her away. Mr Minion went with her to the NICU as I got sewn back up. That was one part of my birth plan that worked out–if she has to be taken somewhere, you go with her.

Someone asked if I wanted medicine to make me sleep, and I said yes because I was exhausted. I don’t think it put me to sleep but it did stop my arms from shaking so much. I felt a lot of pulling and pressure from the other side of the curtain. After a while, it stopped and they moved me again, then wheeled my bed down to recovery so they could clean me up and wait for feeling to come back to my legs.

My sister, my friend A from college, my brother in law, and my mom came into the recovery room at some point. I can’t remember if Mr Minion was there or if he was still in the NICU. There is photo evidence that I tried to take a selfie for some reason, even though I’ve never taken one before. Its a pretty awful picture. I had started to swell up from the preeclampsia and surgery, so my face looks even more round and puffy than usual. After a while, they decided I was stable and could go see my daughter in the NICU. They wheeled my whole bed down there and into her room, something that bugged me for a few days after the surgery because I couldn’t figure out how they got me in the room. All I remember about that is that she looked so tiny and fragile.

Little Miss Minion was delivered at 28 weeks exactly, weighing one pound and fourteen ounces and being 13 and 1/2 inches long. They say she will be in the NICU until sometime around her due date, so we’ve got quite a while to wait before we can bring her home. I got to hold her for the first time when she was a day old and Mr Minion got to hold her when she was two days old. Preemies can’t handle much stimulation, so we are only allowed to hold her once a day, if we are lucky. She is two weeks and a day old today, and she is doing pretty well. We get to change her diapers, take her temperature, offer her a finger to grasp while the nurse tests her blood sugar.

We have to ask permission to hold her. She has to be doing well in remembering to breathe and keep her heart rate up. We can’t stroke her hair because preemies can’t handle the stimulation. We can’t talk to her in a normal voice. We can’t rock her. Her room is kept dark to protect her delicate eyes. Preemies are at risk of developing blindess because their eyes aren’t ready for the outside world yet. They need the dark and long periods of sleep to keep developing their brains. Almost everything that happens to them is a stress on their systems. They weren’t supposed to have to know how to breathe all the time, how to keep themselves warm, how to digest milk, how to regulate their heartbeats. All of her nurses have commented about how feisty and sassy she is and what a big attitude she has for such a small person. For her one week birthday, I got her a plaque for her room in the NICU that says “Though she be but tiny, she be fierce.”

There is a monitor in her room that measures heart rate, breathing, and blood oxygen saturation. Its only been two weeks and I can hear the alarms in my head. Its pretty normal for it to go off, since she isn’t used to having to handle all of these body functions on her own. She’s making good progress though. She corrects the problem herself, usually in a matter of seconds. She weighed two pounds and four ounces last night. We just have to give her time to finish growing and developing.

We were told that life in the NICU is a roller coaster. There are ups and downs but eventually the ride levels off and you get to bring your baby home. Until then, we spend as much time as we can with her, hoping to get some kangaroo time with her (holding skin to skin, which has many health benefits for baby and parents) or to get to change her diaper, or just to have her grasp our fingers with her tiny hands for a few minutes. She may be little, but she is most certainly fierce. Minion Mayhem has arrived and changed everything we thought we knew about life, babies, and love.