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Sunday, May 13, 2012

You make everything NICU

Taking care of five children is chaotic, and writing about time spent in the NICU can be exhausting, so I slipped into a pattern of not getting back to continue the blog.  But a couple of weeks ago, during a field trip to Children's Hospital of all places, I found out that one of the parents in my 2nd grader's class also was a NICU parent.  Even though we didn't get to share but just a few moments, it was clear that she had been scarred deeply by the incident.  It's a common saying that time heals all wounds, but nobody mentions the scars.  It was a bit comforting, extremely comforting really, that I was speaking to someone who knew how I feel and vice versa.

Being somewhat nomadic doesn't help my case, because nobody outside of family has known what we've gone through these past few years.  We moved to Knoxville right at a year ago and it is such a drain meeting new people because you explain who you are, but when you are still reeling from the trials that have been hurled at you, talking about hurt feelings isn't exactly on the topic list. Instead we put on the mask of the person that we would like to be.  That's extremely easy too since many cannot possibly empathize with the NICU parent.  The problem is that to miss out on being understood becomes a hurdle to actual healing.  Sad thing is that when we camouflage our selves that well, we hide from the ones that can truly empathize with us.

Doing what I do, which is working things out inwardly, I put together a slideshow that scratches at the surface of what it means to go through the season of having a child in the NICU.

Tuesday, April 10, 2012

Initial Moments in the NICU

By time a mother is released from Post-Op, a micro preemie has received more medical attention in the NICU than a normal healthy child will receive during their entire childhood.  During the pregnancy, as much as we had been guaranteed that our children would spend some time in the NICU, prior to the delivery of our triplets, I really knew nothing about what goes on.  Earlier in the day, as we were learning that our children would need to be delivered via C-section, we got a visit from one of the NICU doctors who gave us the five-minute explanation of what we needed to know.  That sounds hurried, and yes it is, although five minutes is about all of the time it takes to explain those parts of the NICU that can be understood without a first-hand experience.  Basically it is broken down to establishing respiration through intubation, maintaining body heat via incubation, nourishment via an IV, and maintaining proper body chemistry also via IV. 

The first visit to the NICU is a complex mixture of childlike wonder and trepidation.  The initial room that our children were in was small and just outside the operating room.  This is where doctors and nurses started to care for our children and create the environment as close to in utero as possible. Instead of having an isolet commonly seen on television, the children were in a tray-like bed with a heat lamp.  They used an artifical lambskin to cocoon around the babies to establish a confined space much like a womb.  Each child had their intubation tube coming out their mouth and tethered with a brace that secured to each cheek.  The line for the IV came out their umbilical arteries.  Each child had a heel bandaged from which they took blood for analysis.  Their eyes were covered and the tiny diapers that they wore were grossly enormous on their tiny frail bodies.  There was a pulse/oxygen sensor affixed to their feet that gave off a soft orange glow. All of the items affixed to their bodies extended to some form of medical contraption that beeped or alarmed--ventilators and flow meters, monitors and pumps.  Their beds were covered with stretch wrap to ensure their environment was sanatary.

As we visually took all of this in, our journey in the NICU had began. 

Tuesday, March 13, 2012

Whisked Away, Moments Lost

FYI, as much as I want to tell in my own words the story of our NICU experience, I do want to leave something meaningful to those that may stumble through the information highway and somehow land on this blog.  So if you have some feedback, anything at all, please feel free to post feedback/criticisms/questions/etc. in the comments or email me. 

Anyway, after the weekend and not continuing my story for a couple of days, I am at the point of questioning where I had left off.  Having three children in diapers plus two more, has an effect that you definitely may not remember anything that happened during the current day, let alone three days prior. 

I do believe that I was giving account to the birth of the triplets and left off with all three having been intubated in the NICU, pretty much straight from the womb to their incubator.   The medical necessity rightfully so renders forfeit the parents' first moment with the newborn children.  I have been reading the accounts of other parents having experienced the same and this moment is almost universally described as being one of those components of the childbirth experience that is lost.  Whether by natural childbirth or a non-emergency C-section, mothers and fathers are afforded the opportunity to see their newborns.  (If it's a C-section, the father lucks out as being the first to hold the newborn since mom is still on the operating table.)  As far as bonding with your child, this moment is important.  It is the first time you get to know your child outside the womb and distinguish all the minute features that makes your child an individual.  It has been my observation that the mom is acutely equipped for this moment as they can visualize, isolate, and associate physical features seemingly instantaneously.  Eyes, ears, nose, hair, etc.--it's a visual DNA test with impeccable accuracy.

On the other hand, fathers are ill equipped for that moment.  Speaking for myself, the totality of the moment left me awestruck.  To put proper perspective on things, I have to return to the birth of my oldest child, Madison.  Working for a very small company on a very big project, I had facilitated scheduling of a backup for me so I could take a week off.  This notion was very fitting for my wife as well since she would rather know the time instead of waiting for the natural onset of labor.  We arrived at the hospital very early and by 7:00 am, the doctors had broken the water and my wife was on a steady pitosin drip.  From the moment of waking up and then driving to the hospital and checking in to the moment the water broke, the day was filled with excitement.  Every time a doctor or nurse came in the delivery room there was news.  My wife was dilating beautifully and vitals were fine.  At every turn there was good news and today we were going to have a baby.  After months of preparation--picking out newborn clothing, and bedding, and a crib, and a rocking chair, and painting the nursery five different colors and getting carpeting, and every other thing imaginable that first time expectant parents do--after all of that, this was the moment we were working for.  Today we were having a baby. 

We got to about 7-8 cm dilated and then the next check, still 7-8 cm dilated, and same for the check after that.  The news was that our daughter's head was not positioned correctly in the birth canal which meant that progress had, well, stopped progressing.  Vitals continued to be fine, which was the important thing, but our exciting morning had turned into an afternoon of patience and waiting, followed by an evening of patience and waiting.  The OB to perform the delivery had a very hands-off approach as long as the vitals remained well.  Thus, waiting begat more waiting.  Waiting can be exhausting.  I cat napped through the evening, but without fail, every time I would doze off, that is the very moment the OB would choose to visit.  My wife felt quite certain that the OB thought that I had slept through the entire evening.  Needless to say, we didn't have a child that day.

Early the next morning, after my wife had been in labor for just over 24 hours, things progressed.  "You're doing well.  Just breathe.  OK, push...PUSH....PUSH....PUSH.  Honey, she's starting to crown.  She's got some hair.  Breathe...push."  In and of itself, it is a prelude to the climax, but that moment, the crowning, that's the first time I saw any part of my own offspring....something, someone that I had a part in making.  It's a tearful moment as there's nothing to hold back the wellspring of emotion.  That's the moment that you know the reality of becoming a parent.  Everything up to that moment is just pregame warmup.  All of that was the pregnancy, but this moment, this is birth.  There's a child about to take her first breath.  "Push, push, push, push, PUSH.  OK, breathe and relax.  This is so beautiful honey,  I wish you could see it.  I can almost see her whole head.  Push, push, push, push, PUSH."  And there she was, my daughter Madison. 

While she was misaligned in the birth canal, Madison had her head lodged for hours in that position poking at the beginning of the birth canal.  So when she was born, her head had taken on some shape from being in that position such that one could call it cone shaped.  That coupled with the fact that babies come out of the womb from which they spend nine months in a sack of fluid, not the pink smooth skinned baby we all see on television, but with wrinkles and pasty gray.  At that point, we're a spaceship and Sigourney Weaver away from a classic blockbuster. 

I know, I know.  That's awful.  Mom is thinking beautiful hair and who's eyes she has, and I'm in utter shock thinking that something has gone awfully wrong.  It was a relative eternity before she took her first breath.  Why hasn't she taken her first breath?  So, she's a pasty prune skinned conehead and isn't breathing, something is terribly wrong......oh, there's the first breath.  Now I can breathe.  Oh, OK, cut the umbilical cord?  Sure, the new-dad rite of passage.  Great, severing flesh so Captain APGAR over there can go to work.  Who's going to catch me?

And then a few moments later, mom gets a newborn, with all the pasty stuff wiped off.  And thus the bonding begins.  That's the way it should be.  It was the same for our second child, Kaitlyn.  There was still tears when she crowned.  And a not so long while later, mom and dad were bonding with her.

But when your child (or children) are whisked off to the NICU, that's just unnatural.  The interaction, the imprinting, all that which jump starts the maternal instincts is completely cut off.  As necessary as it is, it is still an entity of being a parent that is missing from the process.  Instead, your child(ren) begin a journey in which they start off relying wholly on medicine and machines to survive from one breath to the next.