Update from the Pediatrician

As a disclaimer, I want to acknowledge that I know many of the concerns I am writing about ain't nothing compared to what many NICU babies and parents go through, and I know many of you would love to only be worrying about these issues, so I just wanted to acknowledge that I'm aware of that and still have many reasons to count my blessings :)

Today we had an appointment with Nick’spediatrician for his two month (actual age) well baby check up. To start with the good news, Nick is up to 9 lbs 6 ounces and 21 inches long, which is great for a preemie! He is ready for a bottle every 2-3 hours, so our pediatrician encouraged me to increase his formula each feeding (I knew he was ready for this but I was nervous to change anything to NICU team put in place.

I would definitely not describe Nick as a happy baby. I explained to our doctor that he spends the majority of the day grunting, straining, and curling his legs up to his chest like he is constipated. He only has about one bowel movement a day, and always seems to be uncomfortable. Given the problems he had earlier this month (the sensitivity to having his stomach examined and the blood work and abdominal x-ray he had to rule out a blockage,) he is being referred to a GI doctor at a different hospital downtown. He will also begin receiving a dose of constipation medicine every day.

Also, I was not totally insane to worry about an eye issue with him. The doctor thinks he has a lazy eye, but is not severe enough to warrant a trip to a pediatric ophthalmologist yet. They are hoping it is something he will outgrow over time, and it will be examined more closely when he has his follow up appointment with the NICU in June.

The part that was hard to take at this appointment was when the doctor began to ask me about his social cues. I know I know I know that this is probably just part of him only being a newborn with his adjusted age, but when she began to ask me about some of his milestones, I realized  Nick never coos, smiles, or makes eye contact with me. He still sleeps all day, and, as bad as this is to say about my baby who has already been through so much, he is just sort of puny. I know it isn't fair to him to compare him to my older children, who hit all their milestones ahead of time and never had any serious issues other than an ear infection here and there, but it makes me worry so much about the long term repercussions of his prematurity that we haven't discovered yet…which of course brings back all the horrible feelings of guilt that I messed up my baby permanently. But, I know there is nothing with Nick that we can't endure, and we have dodged so many bullets so far I have to be okay with having some difficulties at some point. It was just definitely a new experience to leave the pediatricians more concerned than I was when I got there. I am hoping everything with the GI doctor will come back normal and Nick will find some relief, which will hopefully help to make him a happier baby.

Relationships in the NICU

 I am by no means a relationship expert, and Cory and I certainly do not have a perfect marriage, but I have never written about Cory's experience as a NICU dad or how Nick's time in the hospital effected our marriage, so I want to be sure and give that important aspect of the NICU some attention tonight.

Cory and I are a little old fashioned when it comes to our relationship-we met when I was 19, got engaged a little over a year later, and were married when I was 21 and he was 22 during our senior year in college. We were the first of all of our friends to get pregnant, and we started our family at a relatively young age compared to most millenials (I had Annabelle the day before I turned 24.) I have never once thought I was too young to become a wife or a mother, and I think the best part of being married so young is that we were able to create our whole adult life together as a team. Another aspect of our relationship that prepared us well for the NICU is the six years Cory spent as an officer in the Army. The Army put us in different situations, both good and bad, that gave us life experiences unique to our non-military friends that helped us to mature quickly and grow as a couple. These experiences included a nine month deployment, moving five times and living in four different states within six years, and, because of these moves, we have experienced what it was like to show up in a town far away from home where we didn't know a soul and built a life together there. In addition to the toughness our marriage gained from our time as an officer and Army wife, Cory and I work very well together in the sense that we are enough alike want the same things out of life, but different enough to compliment each others' strengths and weaknesses (for example, Cory can drive someplace once and immediately know the route by heart, whereas I still rely on a GPS to get around the town I grew up in, but I could rock a fussy baby into the wee hours of the morning without batting an eye.) We're not perfect and Lord knows he can make me mad, but I have been very blessed in the husband department.

Fast forward to my pregnancy with Nick. Cory had gotten out of the Army for good, and we had moved back to my hometown. As I have described before in earlier blog posts, my pregnancy was difficult from day one. Before any of the major bleeding began, the morning sickness and fatigue I felt between weeks 10-18 or so took it's toll on me (see my Health and Wellness in the NICU post for more details.) I was throwing up at least five times a week, and I would be so tired when I came home from school that I would fall asleep on the couch, and Cory would be left to make dinner and wrangle our two other kids through bath and bedtime. Cory's current job does require him to travel frequently, but, even before my first stay in the hospital, he was doing more than his share of parenting (he even had to wait for me to leave for school in the morning to make coffee because the smell would make me vomit.)   During the days I was in the hospital with the bleeding from the subchorionic hematoma in November and December, and the subsequent weeks of bed rest that followed, Cory had to balance doing all of the parenting, keeping up with day to day necessities, like groceries and laundry, and then do his actual job on top of that. My time in the hospital also happened to fall on the the week before Thanksgiving and in mid December, when our schedules would have been jam packed with different holiday happenings, so me not being able to contribute to any part of our home life was especially difficult (though I did get a lot of Christmas shopping done while on hospital bed rest.) 

One of the most challenging parts of bed rest, other than the tendency to google worst case scenarios and wait for something bad to happen, is knowing that I was making Cory's life so much harder. Yes, I needed to be on bed rest to keep our child safe, but I could see that he was feeling the stress of having to manage everything on his own. After Nick was born, despite the initial fear of not knowing how healthy he was, I think both of us were a little relieved that at least the weeks of bed rest were over, and I could go back to at least physically feeling like myself again. 

Though you would have to ask my husband to know for sure, I know our NICU experience effected us differently. Maybe you could blame it on how immediately and ferociously maternal instincts kick in after birth, or the fact that my abdomen was the one being cut open, or maybe it was as simple as the differences in our personality, but we handled the 53 days our son spent in the NICU much differently. I know my husband approached the NICU much more pragmatically that I did (I think that is actually the understatement of the century.) Despite the inconvenience of Nick not physically being at home with us, and the understandable fear and anxiety that comes with the NICU, I think Cory knew that Nick was too premature to come home, so he would need to be in the NICU until the doctors were confident that he wouldn't have any immediate health complications, and that was that. Heaven knows it wasn't that simple for me. 

For starters, Cory didn't have any guilt about the situation our son was in, and I don't think he ever understood why I did. To him, freak pregnancy complications are just freak pregnancy complications that can happen to anyone, and not something to internalize and obsess over. But, in fairness to me, it wasn't his body that was being stuck with needles and IVs, he wasn't the one being checked repeatedly for cervical dilation and receiving God only knows how many ultrasounds (I think there were at least 10 that I can remember,) and, ultimately, it wasn't his body that dropped the ball and caused a premature delivery. Not feeling guilty or any personal responsibility for the complicated part of my pregnancy alone made our NICU experience much different. 

The best thing Cory did to support me, and possibly one of the greatest things he has done for me as my husband, is that he sacrificed so much time with Nick so that I could be at the hospital with him. Since his work and travel requirements usually prevented him from visiting Nick during business hours, his only opportunity to see Nick would be at night. Literally, every night, Cory would either stay back with our kids so that I could go to the NICU, or he would go to the hospital and come back quickly enough so that I would still have time with Nick. I know the reason Cory did this is because he knew I didn't just want to see our baby, but that I physically needed to be with my son and know that he was being well cared for. 

If I had to give advice to a new NICU dad, it would be to follow Cory's example and understand what your partner needs. Cory knew that I needed to be able to be with Nick as often as I could, but I did need him to assure me that Nick didn't need me to be at the hospital 24/7, and to remind me that we had other kids who needed me too. We took the stress of the NICU out on each other at times, and there were points where I didn't feel like he was as understanding to me as he could have been, but, given the enormous stress of having a child in the hospital for an extended period of time, I think we mostly handled it as well as we could have. So, in conclusion, to any NICU dad who might be reading this post, please support your wife. Anticipate her needs, and be patient enough to allow her to process whatever emotion is weighing the heaviest on her mind today. Don't assume you will experience the NICU the same way, and also make sure that you force her to spend time away from the hospital, even if she hates you for it. Hopefully, she will be equally as supportive. Finally, remember to dwell on what a miracle your child is, and take time, even in the NICU, to count your blessings together.

Two Months Old!

Nick turned two months old on Saturday! Because Nick was born over two months prematurely, he has what is known as an adjusted age. That means, even though he is technically two months old, with his adjusted age, he will behave like the newborn he should be (his due date is next Monday, so I should be 39 weeks pregnant tomorrow.) His adjusted age is what his pediatrician will use to assess his development, because he will be expected to meet different developmental milestones according to his adjusted age (so if most babies switch to whole milk at 12 months, Nick will be on formula until he is technically 14 months.) His vaccination schedule is the thing that will be based on his actual age.
Nick spent almost all of his time sleeping in the NICU, like he would if I was still pregnant, so he acts just like a newborn by mostly sleeping with a long stretch of awake time in the morning. It is nice to know I didn’t totally miss out on all the newborn goodness, and it’s honestly nice to be taking care of a new baby without the post partum soreness and engorgement. His updates for this month include:

Weight
On Friday at the pediatrician, Nick weighed 8 pounds 4 ounces, but I forgot to check his height (#thirdbabyproblems.) He looks just like a normal newborn, and I already forget what he was like at birth when he was so teeny tiny.

Eating
Nick has become a little high maintence when it comes to eating. He basically keeps to the same schedule he was on in the NICU, and is ready to eat every 2-3 hours. In an effort to help with the reflux he has had trouble with since birth,  which was probably causing him to have so many bradycardias,  his neonatologist switched him to Similac for Spit Up formula. He also has a teaspoon of Similac Sensitivity per feeding, and has the vitamin PolyViSol once a day, which he will take for the first year of his life. I still think his reflux is bugging him, because he will pull his knees to his chest, strain, and grunt after feedings, but I’m nervous to change anything the NICU team decided on.   As much as I like his pediatrician, after having to place all my trust in Nick’s doctors and nurses to act in his best interest, it’s a little stressful to hand over his care to a new doctor who wasn’t there for him since (literally) the first moments of his life and are responsible for him being such a healthy baby now (see all previous posts about how I am the #1 fan of OBs and nicu nurses everywhere.)
We had a little bit of a scare on Friday when Nick woke up with a low grade fever. I took him to the pediatrician because he seemed a bit more uncomfortable than normal, and when the doctor pressed on his stomach, he seemed especially irritated. We went back to the hospital for blood work and an X-ray of his abdomen to rule out an intestinal blockage, and thankfully everything had come back normal so far.

Milestones
Nick’s big achievement this month was becoming proficient at drinking the bottle. Occasionally, I will notice that he is drinking too quickly and will tilt the bottle so that it gives him time to catch his breath, but otherwise he is a pro at drinking from the bottle. Also, of course, busting out of the NICU was a big one too 😉

Coming Up this Month
I was talking to my friend yesterday about how wonderful the word normal is, and I think that’s exactly the case when it comes to preemies. I can’t wait for our life with Nick to be normal. I can’t wait to do normal things, like take Nick to the zoo or go to the grocery store, because it puts further distance between us and the NICU. This past week has been full of such beautiful moments with Nick getting to know his siblings and seeing how much they adore him and how perfectly he fits into our family. I am so excited to introduce Nick to more of his extended family who have been praying for him for him all along and getting into a normal routine as a family of 5 💙

Homecoming Day

My baby came home from the NICU this past Sunday, and it was as perfect as I knew it would be. The thing that kept Nick in the hospital so long was the bradycardia events, and the requirement that he go five days without any incidents. He had his last Brady at 3am on Tuesday the 3rd, and before that, the longest he had went Brady free was just over 48 hours. Once we got to Friday without any events, it started to become real that he was actually going to come home. The nurses had told me the stories about babies who go five days with no alarms, but have one right before discharge, which then reset the countdown, but there was no way I wasn’t going to get my hopes up. On Saturday night, Nick passed his car seat test, which is when he sits strapped in his car seat for 90 minutes to make sure his heart could handle being in that position for an extended period of time (which is something that never occurred to me.) That was his last hurdle to pass, and, assuming that he didn’t have an alarm during my the night, I knew he would be coming home in the morning.

The night before was like Christmas Eve meets the moments before you walk down the aisle of your wedding meets searching for your husband among formations of soldiers who have just gotten home for a nine month deployment. I went into nesting over drive (8 weeks post delivery), and stayed up late cleaning and decluttering my house. It is so hard to  describe how exhilarating it was to know that I needed to vacuum because Nick would be doing tummy time on our carpet soon. It’s the little things, like washing bottles to be ready for middle of the night feedings( that I had missed out with him so far that I was only hours away from getting to experience. My baby was coming home.

On Sunday morning; we got to the hospital as soon as daily rounds began. Luckily for us, there were no new admits or other babies getting ready to be discharged, so we were able to begin out processing Nick right away. The neonatologist did one final assessment of Nick, and his day shift nurse went over final discharge instructions. I packed up the blankets, books, and decorations that had made his room feel like home over the past 53 days, and that was that.

I was doing a decent job holding it together until one of the older nurses asked me to evaluate the care we had received during our stay in the NICU, and to name any nurses that had done an exceptionally good job caring for Nick. The depth of the gratitude I feel for Nick’s nurses and the extent with which I appreciate and love them was probably the most emotional aspect of this experience, so of course I started balling. Hugging his main nurses and trying to thank them between ugly, snotty tears was hard (thankfully, I had hand written cards ready for them that did a much better job of expressing myself). Before we left, I gave the basket I had prepared for the NICU staff, and delivered the other basket to the nurses in my old home in the antepartum wing, which had been home to so many tense and scary nights.

 Leaving the hospital was kind of like the feeling you get when you go back to visit your alma mater  and every  inch of  campus brings back a memory. The NICU and the antepartim floor are home to so many vivid and intensely emotional memories, it felt almost sad and definitely very weird to be leaving it behind in our past. After seeing the blood on my OB’s gloves and seeing the reflections of all her instruments used during my c section reflected on the light above me during the procedure, Cory and I are very done having children, so to think that I might only be back in this side of the hospital to visit new babies that I haven’t given birth to is sua strange feeling that I can’t quite put my finger on. We’ve became friends with Nick’s nurses, and I will genuinely miss them and even our doctors as well (it’s also super weird to think I will only see my OB from now on for yearly exams and check ups.)

When I first learned I was pregnant with Nick, I imagined Annabelle and Graham meeting him in the hospital in cute matching brother and sister t shirts. Graham is too young and laid back to ever understand what was going on, but Annabelle never really seemed to get why she couldn’t see Nick right away and why I kept having to go to the hospital. It took a toll on her and led to some acting out and behavioral problems in preschool, so seeing Annabelle and Graham finally get to meet their brother was a beautiful moment that I had envisioned over and over in my head.

Nick’s homecoming was such a special day, but, like everything else in this experience, part of me continues to feel guilty that brought home a healthy, seven pound baby after only 8 weeks in the NICU. The doctor warned us that it may be years before we realize the extent with which his prematurity has affected  him (in terms of a higher risk for autism, learning disabilities, or other developmental delays), at this moment there is a healthy baby sleeping in a bassinet just steps away from me, and I am in awe and so grateful that I have been given the chance to watch him grow.

Health and Wellness in the NICU

Thursday will mark 50 days in the nicu for Mr. Nick and I, and, since my poor little guy continues to have bradycardia events, it looks like the homestretch is going to be a little longer than initially expected. The doctors believe his reflux is causing him to have these events, so yesterday his formula was switched to a kind specifically designed for babies who struggle with reflux related issues. I’m hoping that he will adjust quickly to the new formula, and that this change will be all he needs to get him the heck out of here (re:in time for Annabelle’s spring break next week.)

Since we will be hitting the 50 day milestone this week, I have been thinking about the profound ways this experience has changed me and helped me to grow as a woman and as a mother. One of the biggest lessons I have learned is how it is genuinely important to be  healthy and in shape. 

I’ve always known how important it is to eat well and exercise, but I’ve never seen it pay off as greatly as it has during the pregnancy. Today, I had my routine follow up appointment with my primary OB. He became the second doctor to tell me that he expected me to go into labor when I was hospitalized in December at 22 weeks, which translates into he wasn’t expecting Nick to make it. Last week, one of Nick’s nurses told me with the amount of bleeding I had, I was lucky to make it to 30 weeks, and the only reason I did make it that far was because I’m as healthy as I am. My health could have literally been the difference between life and death for the warm little body currently snuggled on my chest. 

I am fortunate that I have always loved running and can do it decently well. I started running cross country in 5th grade, and ran all through high school and college. It’s my go to when I am angry, stressed,, or sad, or when I just need time to myself. I have done CrossFit off and on when we lived in Oklahoma and Tennessee, and I like the challenge of some of the workouts and can appreciate how quickly you see the results physically, but I’ve never loved it like I do running. However, for all of my life, I’ve always exercised because I had a specific goal in mind, whether that be to loose weight, complete a certain race, or run a certain time. As dumb as it sounds, I’ve never exercised just because it’s good for me. 

Also, like so many other Americans, I didn’t prioritize my health during the school year. My school starts at an ungodly early hour, and in order to shower, get dressed, dry my hair, get both kids out of bed, dressed and fed, drive 20 minutes to school, drop my son off at his sitter’s, and get to school on time to finishing prepping for the day, I would wake up by 4:30 each morning. I always tried to avoid working on school work when my kids were still awake after school, so I would wait until they went to bed around 8:00 at night to begin. By that point in the day, I was exhausted, and all I would want to do was hurry through my school work so I could go to sleep, but, since my husband travels frequently for work, I would still have things like laundry and dishes to do. Like so many other working moms, I always believed there weren’t enough hours in the day to take care of my kids, finish all the things around the house that needed to be completed, and be as good of a teacher as I wanted to be. There definitely wasn’t any time for exercise, and, even though I would try to eat well and cook as often as I could, my eating habits were something that was effected by the intensity of our schedules as well. I will always wonder how greatly the grind of being a working mom impacted this pregnancy, and the toll of trying  to balance everything on my own is one of the reasons I won’t be going back to teaching next year, if ever. I didn’t prioritize my health when I was working, and though I know many working moms certainly do, with my husband’s work schedule and having three kids under five now, I know this would only be more challenging. I will miss teaching and my kiddos greatly, but my health isn’t something I want to ignore anymore. 

So, as a result of all of this, I will be working everyday to be a healthier, more balanced person. Since I am now officially cleared to go back to exercising again, I cannot wait to run (I’ll let you know what running post c section is like!) and I plan to get back into CrossFit again. I’m excited to try hot yoga and some other fitness classes at my gym, and make the conscious effort to make healthy choices for myself everyday: