The Birth of Josiah – Part 2 (the NICU)

Before I delve into trying to remember the blur that is our NICU experience, one thing I forgot to mention in Part 1 was how great I felt. Physically, after delivery, I mean. I didn’t find my second labor and delivery to be any easier than the first (maybe veeeery slightly in some ways), but man oh man, the recovery? SO MUCH easier. From immediately after, to the first couple days after, to the first few weeks after. Way, way easier. I was miserable for weeks after delivering Adela. I sat on her boppy for meals. I couldn’t sit down normally on a chair. I was so, so bruised and swollen and in pain for weeks. Everything took so long to heal. This time, I was pretty sore for about 2 days. Kind of sore for another 5. After that, I was home free. This was a good thing considering all the walking I ended up doing the week Josiah was born.

So let me back up. I ended the story with us being told that Josiah had elevated CRP levels and that he needed to be admitted to the NICU. At that point, that was all we knew. Our nurse warned us that 7-10 days was standard in terms of our potential stay. I was SHOCKED. Seriously, shocked. Even the thought of a day or two more in the hospital was hard to swallow. When I heard that phrase “7-10 days,” my jaw literally dropped, as did my heart, to the floor. Thud. I cried so much. I was exhausted for one, having not slept more than a handful of hours in what was now 3 days. I was shocked. I was confused. I was so disappointed. I was scared.

They wanted to move him immediately. It happened really fast. There was a very serious sense of urgency. Nobody wanted to be responsible for not getting this “sick” baby to the NICU before something terrible happened. The nurse literally stood there with a wheelchair for me waiting while I tried to pull myself together enough to figure out what I needed to bring with me given that the NICU is right by L&D on the exact opposite side of the hospital, literally a mile of walking away. I grabbed the Starbucks paper bag left over from my muffin the day before and threw in my chapstick, my phone, a pair of socks, some gum. That was mostly it. My brain wasn’t working. I hadn’t even showered.

So when we arrived, nobody knew who we were or what was wrong with our baby. They took us to the back row, with all the critical cases. I noticed a lot of incubators. That I didn’t notice more was probably a blessing given my mental state at that point. I was all wrapped up in our own baby’s well-being. The pediatrician met with us right away, but had no idea who we were or what was wrong. Somebody, one of the nurses, said something about a heart murmur. Craig and I looked at each other cross-eyed and waited while all the medical staff talked about Josiah’s hypothetical heart murmur. Then, both of us piped up at the same time that we hadn’t heard anything about a murmur. It took a few minutes, but something actually listened to his heart at some point and determined that he in fact did NOT have one. Another thing that was NOT wrong with him. Great news of course. But still, we were wondering why we were there. Then he pediatrician looked at the x-ray films and pointed out his heart and lungs and said that everything looked great, normal and healthy.  Then he asked about blood cultures. They hadn’t drawn any blood for those, so that was the first thing they did, result to be checked at 3, 5 and 7 days. After that he talked with us a little bit about the elevated CRPs. He didn’t give us much more information than we already had. He told us that they would draw blood over the course of the week (again confirming a mandatory 7-10 day stay) and watch to see if those CRP levels went down (indicating improvement) or up (indicating infection.) And then he said something that really set loose the waterworks on my end. Josiah’s CRPs were a 3.6 if I remember correctly. The doctor told us if they got above 4, they would do a spinal tap so they could run more tests. That was the closest to a freak out I had our whole hospital stay. I didn’t say anything. I just cried and cried. The thought of them putting a needle in my newborn’s spine was more than I could handle at that point. But I did stay relatively quiet, and everyone seemed to give me a pretty wide berth. In fact, I remember the pediatrician looking at me and matter of factly, but also kindly, saying “now is the time for tears.” It was kind of a weird thing to say, but I knew what he meant. He was validating my feelings and I appreciated it.

And then, Josiah’s first NICU nurse put his IV in. She looked at me and asked me pointedly if I was sure I wanted “to stay for this.” I must have looked a wreck. An IV was the least of my worries, however. Of course I hated seeing him stuck over and over again. But honestly, he never cried when they did it. He maybe whined a little once. It doesn’t seem to bother the babies much, and I don’t have a big fear of needles. So of course, I told her that I did want to stay. It was still unpleasant to watch that first IV searching for his microscopic veins. I learned later on that the kindest nurses use a special light to help visualize the veins so they don’t have to go rooting around for one. This first nurse did it by eye and feel, and although I’m sure she’s a good nurse, she bruised the entire top of Josiah’s hand blowing out whatever veins she found. Luckily, Josiah only had to have his IV replaced one time after that. So at least she got a good vein in the process. A lot of the other babies around seemed like they needed replacement IVs much more frequently. Also, later on in the week I asked one of my favorite nurses from our stay there (her name was Donna) why they always ask the parents if they want to stick around before they draw blood and replace IVs. She told me that she’s been body-blocked, that she’s had her hands grabbed and ripped away, that she’s been screamed at and threatened when attempting to place IVs and draw blood. Crazy. You don’t get between a Momma bear and her cub.

Once they determined what we already knew, that Josiah’s heart and lungs were fine, they immediately moved us to the front row – the non-critical cases. We got the end of the row in the far corner in a long line of other parents and babies. It was nice to have a corner. It was the most privacy (of which there was none) one could hope for given the way things are set up in there. But the light sucked. Big time. a few dimmed fluorescent lights. An incandescent desk light here and there. No windows, no natural light. It made taking photos really difficult. A small thing perhaps, but still, I’m a photographer so it mattered to me. No beds for parents. No sleeping of any kind allowed. They actually woke Craig up and scolded him that first day when he dozed off once. (He can sleep ANYwhere. Me not so much.) Breast-feeding is done behind movable screens. I think it must be a liability thing (in case you end up being photographed by other parents with your good bits showing, or just because there’s video surveillance) but they are crazy strict about those screens going up. They didn’t scold me for not putting them up, but whenever it was feeding time there was always a frenzy to put them in place, covering every possible angle. I found it amusing because I’m not especially shy about that. It’s a completely asexual thing in my mind. I guess it was nice to be taken care of though.

Sometime after they moved us, I left Craig with Josiah so that I could go back to the recovery room and pack my things. They were discharging me so we had to get our stuff out. So I did that and talked to the postpartum nurse about the Hanson House. She was kind enough to call for us while we were getting settled in the NICU and they had reserved us a room, the LAST available room. What a huge, huge blessing that room turned out to be! I’m so, so thankful that it was available, that it worked out the way it did. We were able to stay on the hospital campus in a beautiful room a short, five minute, walk to the NICU for the entire duration of Josiah’s stay. So I got the paperwork we needed for that, took a shower, packed our things, called my Mom and mother-in-law with updates, and waited for Dr. Sehwani to visit me and give the final discharge orders. She was so sympathetic when she arrived. Of course, I cried a lot more telling her what had happened. It was nice to have another sympathetic ear listen to my frustration. She promised me that it was all going to be alright.

Then, I headed back to the NICU to swap with Craig. It took a while for us to be assigned to a new nurse, and for a little while I felt like I didn’t really know what was going on. I felt lost. I didn’t know who to ask things for, who would answer my questions. And we were beyond exhausted. I had been up for literally 3 days with maybe 3 or 4 hours of interrupted sleep total. I felt delirious. Everybody was really nice, but things didn’t start falling together until the night shift came on. The NICU closes twice a day for an hour and a half during shift changes, 6:30 to 8:00. When I came back in at 8pm, Josiah’s new nurse, Riama, initiated me into the role of NICU mother. I didn’t know that’s what she was doing. She did it gently, but she did it well. And by the time midnight rolled around, she had educated me about the newborn schedule they like to keep (feeding every 3 hours, 30 minutes max per feeding, then as much sleep in between as possible) and convinced that I need to go get some sleep, eat something, rest, that Josiah was going to be well-tended. I don’t know if I would have left that first night had it been a different nurse. She was just what we needed at that point. So I made sure they had plenty of pumped milk so that I could skip a feeding and get some sleep. Those 6 hours of slumber are probably the most refreshing I’ve ever had. I was a NEW WOMAN when I woke up the next morning to visit my baby before the NICU closed again at 6:30am. I must have looked truly terrible when I left the night before because when Riama saw me walk in, her eyebrows went up and she told me how great I looked (I’m sure I didn’t actually look great, just in comparison to the train wreck I was when I’d left several hours previous.)

After that, we fell into the routine. I was there for at least an hour, every three hours, for feedings. I’d arrive, take his temperature, change his diaper, breastfeed him and then swaddle him up and put him back to bed after some cuddles. A lot of the time I would stay through until the next round. Those first couple of days Craig usually came with me. When he didn’t, sometimes I’d leave to meet up with him for a meal or head back to the room to shower or take care of other things. I walked back and forth from the Hanson House to the NICU many, many times every day. The weather was gorgeous. I’m glad this didn’t happen in the middle of Palm Springs 125 degree summers. Small mercies. We ate at the cafeteria a lot. Over the course of the week we found several great new restaurants for dinner nearby. My parents visited. Adela wasn’t allowed in.

Adela joined us on Sunday night, after spending 3 nights with my parents. It was good to have her back even though she, of course, wasn’t allowed into the NICU. Having her also meant that Craig and I could never go into the NICU together since one of us needed to stay on the outside with her. Craig did an awesome job keeping her entertained since, being the food source, I had to spend a considerable amount more time in the NICU than he did. The grounds are really beautiful, and she had a good time exploring, picking flowers (despite our efforts to stop her), and carting Cinderella around with her everywhere she went. One time when I was hanging out with her on the lawn on the back side of our room the sprinklers came on, shocking and soaking her, and I just so happened to be video-taping the whole thing. Total America’s Funniest Videos moment. 🙂 I can’t believe I got it on video.

The whole experience was an awesome bonding time for our whole family, even though Josiah and Adela didn’t get to spend any time with each other. We did our best to keep them connected, talking to Adela about him, preparing her, helping her be patient until the day she’d get to hold him again. She swaddled everybody during those days of waiting – Cinderella, Mickey, Baby Lady, “napkin baby,” hehe. For some reason every extra clean napkin she could find became a “baby” after she rolled it up and she’d take care of those babies  just like the rest of her stuffed ones. Craig and I both showed Adela pictures and videos of Josiah we’d taken on our phones. And one day I sent Craig and Adela to Michaels, on a mission to pick out stickers and supplies to make Josiah a name sign for his NICU bed. I cut out the letters. She glued them, colored the paper, and stuck all the stickers.

My parents were a great support during the whole process as well. My mom did our laundry and carted things back and forth up the hill. They watched Adela for the first 4 days (my Dad and Tia Carmen took care of her when my Mom was helping me). I don’t know how people go through something like this when they don’t have extended family around. I felt really blessed to have all the bases covered by the people who love us.

I’m not even going to try and do a day by day breakdown of what happened in the NICU. It was a long 7 days, but it was a sweet 7 days. It was waiting. It was bonding. It was sweet. It was heartbreaking. It was a learning process. It was an experience. And I’m grateful for it on some level. I’d be lying if I said that I wasn’t disappointed, upset still even, that we had to go through it. Many good things came of it – our family drawing closer together, feeling the love and support of all the people praying for us, so much one-on-one bonding time between me and my son, time that would have been much more divided had that first week taken place in our home. It was special, a time for just me and him to fall in love, with no responsibilities but feeding him and loving him. That part was a blessing.

The nurses were mostly awesome, and always proficient and nice. I mentioned two of my favorites. Riama was just really nice easy to talk to. I always felt comfortable leaving  Josiah with her, which was awesome because she mostly worked the night shift. Donna was so, so knowledgeable about EVERYthing. She had an answer, detailed and informative, about anything I asked. She was also very kind. Lisa was the lactation specialist, and although I had no problems in that department, I really appreciated her extra efforts to help heal Josiah’s poor little bottom that was so raw from the antibiotics. She actually made a sort of blast shield (hehe) that allowed us to keep him on his tummy with his bum bare and in the air, trying to keep it clean and dry and hopefully get it on the mend. Another nurse, Amber, also took special care with Josiah’s bottom, giving him an extra bath and rinsing him with water rather than wiping with wipes when she changed his diaper. There were many more nurses, but those were the ones that stood out to me. I left the experience wanting to go back to school and become a NICU nurse. Seriously. I just might at some point.

As for Josiah’s CRP levels, they went down every time they tested him. But they didn’t get back to a “normal” level until I think, day 4 or 5. The blood cultures came back negative at 3 and 5 days, which pretty much put him in the clear. We had a real issue at this point with continuing to give him the IV antibiotics for another 2-5 days. We wanted to go home and we didn’t want Josiah getting any more medicine than was absolutely necessary. Craig and I seriously discussed leaving with our son against the doctor’s recommendation. At this point we were convinced that we didn’t and maybe never had needed to be in the NICU in the first place. We had several conversations, with the pediatricians, and with a couple of nurses as well. Donna finally explained it to me in a way that made sense. The blood cultures only checked for infection in his blood. There was still an indication of possible infection (because of those elevated CRPs) that could be hiding out somewhere else, his nervous system for example. And as we’ve all been trained, you never stop your course of antibiotics when you start to feel better or you risk recurrence of the infection. So, we toughed it out and followed Doctor’s orders, just in case that improbable worst case scenario was trying to break the surface of our reality.

All week long they had been talking about a possible release on Sunday (which would have left us in the NICU Sunday to Sunday.) Craig had a really long and patient discussion with the Pediatrician about how that was NOT seven days, but in fact eight days. My husband, the diplomat. I’m so proud of him for handling it so nicely, but firmly. He wanted to get us that extra day at home so, so badly. The next time I saw the Pediatrician on my own, he smiled at me, introduced himself and quipped, “I’m the one with the twisted arm,” alluding to Craig’s conversation with him, convincing him to okay a Saturday, rather than a Sunday release. It worked. We got to go home on Saturday morning after Josiah’s last dose of antibiotics. Another note about the nurses, they were really on top of making sure we were ready to go home. I so appreciated that! I was worried that we’d be cleared to go and then there would be some formality we’d forgotten that would hold us back. But without our prompting, they made sure we had all our papers in order, that Josiah’s mandatory testing was done – another hearing test, which he passed and the breathing test in the car seat to make sure he didn’t have any apnea. And Craig and I made sure we took the baby CPR training that was required of us before we could leave with our “NICU baby.” So, when Saturday morning rolled around, the release was almost immediate. I’d been prepared for a day of waiting around. I think we made some “friends” in there. I felt liked and as though they genuinely cared about getting us out of there as soon as possible.

No parent was in the NICU more than I was. There were a couple other sweet parents (one a young couple of twins that were there almost as much as I was and a couple of other moms.) But I could tell I gained the respect of the nursing staff being there as much as possible, never missing a feeding (aside for one or two at night to sleep for a few hours) and pumping enough extra milk to feed half the nursery. A couple of them joked with me that they wished I could educate the other moms about how to successfully breastfeed, about the commitment it takes (pumping after EVERY feeding, bleck) to increase milk supply the way you need to when you’re in the NICU. There were many great parents and a few other breastfeeding moms, but I was surprised how many of them didn’t even try (they just answered “no” when the nurses asked if they planned on breastfeeding, or tried for a day or maybe two and then gave in to letting the nurses give formula because it was too hard or they weren’t producing.) I wish I could have encouraged more moms. So many people think that they’re the exception, just for lack of education of how it all works, or a little bit of encouragement. I did get to have a long conversation with one girl who sought out my advice in the pumping room. Hopefully it worked out for her. She was really despondent about the whole thing.

I guess the other thing I haven’t talked much about, before I wrap things up, is the star of the show himself, Mr. Joe. I am in love with this kid, I tell ya. I really didn’t know what to expect having a boy, or a second kid in general. It never becomes really real until it becomes reality. Of course I was excited to meet him and I knew the feelings would come, but it is crazy how intensely they hit you once you actually see your baby and get to hold him. Those first few days were incredibly powerful. I would actually get butterflies when I was about to see him. Ah! Babies are so great. My mom has told me many time that when she had Kristy she worried that she wouldn’t be able to love a second child as much as she loved me, then out came Kristy and her heart grew to accommodate another just as powerful love for her second born. And that’s what happens. Love doesn’t split or divide up between them. Your heart grows and increases in capacity to love another one just as much. It’s awesome. He is so, so sweet. That first week especially he was incredibly mellow. He would squawk a little when he was hungry, but that was about it. In general, he was really content, peaceful, sweet. And his eyebrows would go up whenever he saw me. He figured out right away who his Momma, or at least who is food source, was. And he loved me most right away.

Bringing him home and letting Adela hold him again, after a week of waiting, was a blessed experience. The day we came home is a day for the books. It was a great, great day made so much sweeter because we had to wait for it.

Every day I am thankful. I am stressed. I am tired. I’m living in a bit more chaos than I care for, and it does get to me every now and then. But I knew this time around that control goes out the window with the arrival of a newborn, and I’ve embraced it much more this time. I’m still in my PJs today, and I’m not ashamed to admit that’s how it’s been most days these past several weeks. Life will get back to normal, but I’m not in any hurry. It’s already going by too quickly.  And I’m so grateful that even though the experience didn’t play out the way I would have chosen, ultimately we got to come home with a healthy baby. And he is perfection. A whole lot of high-maintenance, sleep-depriving, adorable perfection. I can’t wait to love him for the rest of my life.