Tonight, I am going to continue my theme of writing about my time on bed rest to share how I think it affected my two older children, Annabelle (5) and Graham (2), and to share some things that my family and I did that (hopefully) made this experience a bit easier on them. Graham turned two a few days before Nick was born, and I think he was too young for this experience to really impact him, so I will be focusing totally on Annabelle.
My husband and I told Annabelle and Graham that we were expecting baby #3 as soon as we had a positive home pregnancy test, when I was still only 6 weeks pregnant. I know it's risky to tell little kiddos about a pregnancy in the first trimester, especially before the pregnancy has been confirmed by a doctor, but we/I was dying to share the news with our family and knew there would be no way to let our extended family know that a baby was coming without Annabelle catching on. After experiencing the very real and very scary side of pregnancy, I think, in the future, I would wait much longer to tell my kids, but, since I had two easy, drama free pregnancies under my belt, I thought I was immune to any type of significant complications or a miscarriage. Immediately, before I had even heard the heartbeat, baby #3 was very real to Annabelle. She started a nighttime ritual of blowing a kiss to my belly to say goodnight to the baby, and sometimes nestling up to my stomach and then telling me that she felt the baby kick. Back in the early fall, it didn't occur to me not to encourage the bond that was already forming between the two of them, and it gives me anxiety in hindsight when I think about my pregnancy and how devastating it could have been for Annabelle (see my first published article for all my emotional thoughts about that.)
Instead of going through each of my bleeding episodes and sharing how we, as a family, reacted to each hospitalization, I want to make it more cohesive and summarize the major themes/my advise for you:
1. Let your child know what is happening, to a certain extent.
We didn't tell Annabelle about the first bleed that happened in October (because I don't know how you could explain sudden vaginal bleeding to a then four year old without major questions being asked.) In November, when I was kept overnight in the hospital and prescribed my first two weeks of bed rest, we told Annabelle that "Mommy had to go to the hospital so the doctors could take care of the baby." It was during this hospital stay that we learned we were expecting a boy, so finding out that she was going to have a brother did a lot to help Annabelle forget that I was in the hospital. In December, when I was hospitalized again, we simply said that the doctors needed to take care Nick again. Annabelle didn't really question this, even though I could tell parts of her never totally believed that that was the whole story. When I Facetimed with Annabelle in the hospital or talked to her on the phone, she would always ask when I was coming home, and I would just say whenever the doctors were done taking care of Nick, but we wouldn't know when that would be.
Cory and I never felt the need to tell Annabelle more about my condition than that. It took multiple doctors and labor and delivery nurses to explain a Subchorionic Hematoma to me before I sort of understood what was happening, so I couldn't even begin to explain it in a way a four year old would understand. Annabelle is the type of kid who could get an itty bitty scratch on her leg and become hysterical if there was a tiny drop of blood, so telling her I was bleeding would have been a disaster.
On the day Nick was born, after my dad picked her up from school, I was waiting in a postpartum room, and I called her to tell her Nick was born. Since she isn't old enough to really understand why he was born in February instead of April, we didn't explain the details as to why he was suddenly here. Immediately, she wanted to know when she could hold him, so I told her that Nick was born really small, so he would need to grow for a while in the hospital. The NICU is something Annabelle never understood, really. She wanted to know why Nick was still in the hospital and when he was coming home, and she asked daily. We would just tell her, again, that Nick was still too small to come home, and he needed to stay with the doctors until he was bigger (since Nick never had any major setbacks in the NICU, that was the gist of his stay anyway.) I don't know what we would have done in terms of telling Annabelle if Nick did have serious health issues while he was in the NICU, but I think we would have kept it vague. Annabelle is a worrier, and since there is only so much she would be able to understand anyways, I think we would not have shared many details for her sake.
2. Stay Involved!
One of the hardest parts of being on bed rest is there is so little you can do to care for children who are at an age when they are still so needy. My husband had to give all the baths, buy all the groceries, and do all the school drop offs. Even though I couldn't do those big things anymore, I tried to find little ways to help my husband manage all the chaos. For instance, I would have him bring me a load of laundry and I would fold it while sitting on the couch, or he would bring all the ingredients to the table and I would make dinner while sitting at the table. When it came to our kids, I would always sit on the couch and watch them play when they were home from school. Graham and Annabelle never understood why I couldn't run around and play like I used to, and I would say that "I had to sit down so that Nick could stay healthy." That seemed to be enough of an explanation for them. Hospital bed rest was trickier, because I couldn't do the usual things, like reading them a story at night or watching tv with them. Cory would call me so I could say hi to them on the way to school and when they were coming home at the end of the day, but I hated not being able to see them in person. When they did visit me in the hospital, I tried to make it sound fun-I wore these big sleeves on my legs 24/7 that would tighten and release to help prevent blood clots, and I told Annabelle they were there to give my legs massages. I tried to make the hospital seem normal and not as scary as it might have seemed for her.
3. Keep them involved in the NICU!
I can definitely see how having a sibling in the NICU would be a hard thing for a five year old to understand: they have all the anticipation throughout the pregnancy of getting to have a new sibling, and then the baby is born, but they can't see the baby and he can't come home. I found a link on Pinterest that suggested having siblings design onesies for a baby to wear in the NICU as a way to keep them excited about the baby, so I bought a pack of plain white onesies and the kids decorated them with permanent markers. Annabelle loved the thought of making something for Nick, and I took pictures of Nick wearing them to show her later. I would always have Annabelle pick out books for me to bring to the NICU to read to Nick, and, since he was born on Valentine's Day, Annabelle gave me one of her leftover school Valentine's to bring to him. It sat on his nightstand throughout his entire stay in the NICU and is in the shadow box I made of all my favorite NICU keepsakes.
4. Be consistent, when you can.
Teaching 101 tells you when a child comes from an unstable home, the inconsistency and chaos they experience at home is reflected in their behavior at school. You don't have to be a teacher to see the obvious correlation between stress at home an acting out in the classroom. Annabelle went to full time pre-k, five days a week, at the school that I taught at before bed rest began. From the beginning of the year in August to around the time I was first hospitalized in November, Annabelle never had a single behavior problem. Around mid November, Annabelle started to get in trouble more consistently, and, by the time Nick was born, we were constantly getting bad behavior reports. I was hoping that since she started acting out when my hospitalizations began (and by that I mean being too loud, not sitting still, ignoring directions, and occasionally talking back to teachers. So, nothing major, but enough to drive a teacher crazy) that once Nick came home that things would get back to "normal," and her good behavior would return. It didn't. Annabelle is a smart, sensitive, and VERY high energy little girl who, like most children, thrive on consistency and routine. Unfortunately, her school year saw her mommy being in and out of the hospital, mommy leaving the school that we used to go to together every day, her brother being in the hospital for 8 weeks, and then, after all of that stress, she had to adjust to having a new baby brother at home, which is one of those major life events that can wreak havoc on classroom behavior. Cory and I couldn't help any of those situations, but a side effect of this whole high risk pregnancy/NICU experience is Annabelle felt all of this stress, and it affected her behavior in school.
Since bed rest and the NICU are almost always unavoidable, I think the best thing you can do is try to keep things as consistent as possible when you can. For example, if bedtime is at 8:00, bedtime is at 8:00. Even if you can't physically climb stairs and tuck them in, or if grandparents or someone else are watching the kids while you're at the NICU, bedtime can still be at 8:00. Kids are big on routine and structure, so I think holding kids accountable for things like doing their chores or using their manners (things that are easy to ignore when you're exhausted) are little things that can make a big difference when forces beyond your control are turning your child's life upside down.
I hope this helps! Thanks for reading!
Wednesday, May 30, 2018
Saturday, May 26, 2018
Surviving Bed Rest
I've written extensively about my pregnancy and Nick's birth story, but I wanted to write today about the 11 weeks I spent on bed rest with Mr. Nick (I also thought you would enjoy the break from updates about my son's pooping problems and swollen testicle :) ).
My first version of modified bed rest began when I was 11 weeks pregnant, following my first major bleed and trip to the ER. An ultrasound later revealed that the cause of my sudden bleeding was a Subchorionic Hematoma (SCH.) My doctor wasn't overly concerned about the SCH, as it is a relatively common pregnancy condition. Usually (emphasis on usually,) women will experience one bleeding episode in the first trimester, but by the 20 week ultrasound, the SCH will have healed naturally and the mother will go on to experience a totally normal pregnancy. But, since the SCH does slightly increase the risk of a miscarriage, I was put on what is known as pelvic rest. This meant no heavy lifting, no exercise, no sex, etc, and just taking it easy in general, until my 20 week ultrasound.
In a way, pelvic rest was more challenging than actual bed rest. I was still teaching at this point, which meant I was working 40+ hours a week and was on my feet all day. I tried my best to sit as often as possible (which was a rarity even when I was making the effort to since I taught third grade,) and did little things, like calling on students to pass out supplies or carry books for me. My teaching team and principal were wonderful, and let me get away with things like covering my recess duty so I could have an extra 25 minutes to relax with my feet up (my partner teacher even gave me a rolling crate to pull around so I wouldn't have to carry my teacher bag on my shoulder.)
The biggest challenge of pelvic rest was avoiding picking up Graham. My husband travels constantly for work, and is usually gone at least one night per week, but often more like 1-4 nights. He tried his best to work his schedule so he could be the one to lift Graham into his carseat and put him in his crib at night, but there were many times when he just had to be out of state for business and I couldn't avoid lifting Graham. To be honest, I did make a general effort to take it easy, but with lessons plans and assignments to grade, 20+ students to teach, meals to cook, a house to take care of, and two children of my own who needed baths, clean clothes, etc, there was only so much I could avoid doing. Besides, no one-including my doctor-could have ever predicted my pregnancy would have turned out like it did, so I didn't worry too much about limiting my activities.
Official bed rest began following bleed #2, which happened the week before Thanksgiving. This bleed led to my first appointment with maternal fetal medicine. The doctor concluded the SCH was the culprit behind this bleed, and, even though this was my second major bleed in six weeks, the MFM doctor still expected the SCH to heal and my pregnancy to continue like normal. He recommended a week of bed rest to nudge my body along, but he agreed that I could return to work the following week, but remain on pelvic rest.
This first bout of bed rest honestly wasn't bad. Everyone expected this to be my only week of bed rest, and at this point, I still had work to keep me busy and Christmas movies to watch. Three days after leaving the hospital, I experienced bleed #3. This incident is one of the mysteries of my pregnancy which was never explained, because I suddenly experienced an intense pain near where my right ovary is (so severe that I threw up in the driveway on the way to the hospital, and again at Labor and Delivery.) It was the same pain I experienced the night of my mild placental abruption, expect the second time, it was in the lower left side of my back and MUCH more painful. Anyways, this led to another week of bed rest. This was bad timing, as it was the week of Thanksgiving and Cory and I were planning to host our family Thanksgiving at our house for the first time. I felt guilty, because not only was Cory doing literally all of the parenting duties in addition to his actual job, but he was now having to clean our house, do all the Thanksgiving shopping, and make several dishes as well. It was such an uncomfortable feeling that would become familiar during my time on bed rest: not being able to help Cory at all made me feel so lazy and guilty. Cory never got frustrated or blamed me, because 1. Bed rest was for the safety of our child, and 2. I couldn't help it, but still, it was a hard feeling to internalize.
As you know, I went back to work after Thanksgiving, but two weeks later, I was back in the hospital with bleed #4. At this point, because I bled heavily for a full week and my SCH continued to get bigger, my MFM (who later acknowledged he was expecting me to go into labor that week,) recommended being on bed rest until Nick was born. Because it was my first year teaching at my school and I was new to the district, I did not qualify for FMLA (disability coverage,) so at that meant I had to leave my job completely. This was hard for me, but I had so much guilt that I had missed so many days with my kiddos and I knew I wasn't giving them the stability and consistency that they needed.
When I was in the hospital, our MFM doctor had given us a 50% chance of making it to 32 weeks, and had said it was a matter of when, not if, I would go on hospital bed rest in 2018 because of bleeding. In hindsight, this was helpful, because everyone was more or less prepared for me to deliver early, but at 22 weeks, it made it hard to sleep. Since all except for bleed #3 and the big one that would cause Nick's birth, all of my bleeding occurred in the middle of the night, and I would wake up to find my pajama pants soaked in blood. I usually am a heavy sleeper and never have problems going to sleep, but I kept waking up feeling sick and anxious, expecting to find blood. My doctor recommended taking melatonin, as it is a natural way to encourage better sleep, but I never ended up using it because I more or less got used to the anxiety. I spent the next 8 weeks on bed rest until, in February, three days before Nick was born, following bleed #5, our MFM doctor told me I had finally had too many bleeding episodes, and would need to stay in the hospital until I delivered. This ended up being the decision that saved Nick's life, because if I hadn't been steps away from the OR when I had the complete abruption, Nick likely wouldn't have survived.
Though I was far from the ideal bed rest patient, I wanted to share some tips about how I got through my total of 11 weeks on bed rest:
1. AVOID GOOGLE. Lord knows I was not good at this. I had never heard of a placental abruption before, and, when you're sitting on the couch all day worrying about the condition that is causing you to be on the couch, it is so hard to avoid searching google to try and learn more. If you've ever googled "placental abruption stories," "consequences of a SCH," or "what does an ultrasound of a placental abruption look like," you know that 95% of the information on the internet comes from other worried women trying to learn about their conditions. There is a lot of "my doctor said" and "I heard that," but there is so little actual legitimate information. Even the websites that seemed legitimate weren't necessarily helpful either, because it was general information and not tailored to my specific unusual case. Though I did learn more than I ever needed to about the functions of a placenta, reading obsessively about the ways a placental abruption can end just gave me awful anxiety. As hard as it is, try to stick to advice coming from an actual medical professional. I asked my OB and MFM doctors question after question during our appointments, but since my case was so unusual, their answers were usually just to wait and see what my body would do. This leads to...
2. Try to relax. Again, easier said than done, especially when the well being of your child is at stake. When sitting on the couch, I thought every ache and pain was my body going into labor, especially because I would often have cramps (my doctor explained this was probably because of the amount of blood I had in my uterus.) I either had a ultrasound or an appointment with my OB or MFM doctor every week, and I would usually be pretty nervous about what the doctors would find. Since these appointments were my big event of the week, it was hard not to place a lot of importance on them.
3. Stay busy and try to enjoy it! Being on bed rest before Thanksgiving and Christmas was definitely an inconvenience, even though my kids did get some awesome Christmas presents since I had so much time to peruse Amazon prime and different online stores. By January, when I was no longer working, it was hard to stay busy since I no longer had school to work on. But, I figured I would hopefully never have time like this to sit and do nothing, so I tried to enjoy it. I read for fun (which I usually only do in the summers,) and did different little things that I never would have had time for, like dating and organizing all my pictures into photo albums. I'm very type A, and it's hard for me to just sit and not do anything, so I tried to make lists every day to make me feel like I was accomplishing something.
4. Ask for help. This is another thing I'm not good at. We relied on our parents so much during my time on bed rest, but often, especially when my husband had to travel, we just had to have someone to help. When I was in the hospital, my parents, who live locally, would pick up Annabelle and Graham so that Cory could visit me, or would make Cory and the kids dinner, take the kids to school, etc. Again, I hated having to be so dependent on someone else to help care for my children, but I just couldn't do anything about it. Try to remember that bed rest is not a choice, and it's for the well being of your baby!
I hope this helps! Thanks for reading! :)
My first version of modified bed rest began when I was 11 weeks pregnant, following my first major bleed and trip to the ER. An ultrasound later revealed that the cause of my sudden bleeding was a Subchorionic Hematoma (SCH.) My doctor wasn't overly concerned about the SCH, as it is a relatively common pregnancy condition. Usually (emphasis on usually,) women will experience one bleeding episode in the first trimester, but by the 20 week ultrasound, the SCH will have healed naturally and the mother will go on to experience a totally normal pregnancy. But, since the SCH does slightly increase the risk of a miscarriage, I was put on what is known as pelvic rest. This meant no heavy lifting, no exercise, no sex, etc, and just taking it easy in general, until my 20 week ultrasound.
In a way, pelvic rest was more challenging than actual bed rest. I was still teaching at this point, which meant I was working 40+ hours a week and was on my feet all day. I tried my best to sit as often as possible (which was a rarity even when I was making the effort to since I taught third grade,) and did little things, like calling on students to pass out supplies or carry books for me. My teaching team and principal were wonderful, and let me get away with things like covering my recess duty so I could have an extra 25 minutes to relax with my feet up (my partner teacher even gave me a rolling crate to pull around so I wouldn't have to carry my teacher bag on my shoulder.)
The biggest challenge of pelvic rest was avoiding picking up Graham. My husband travels constantly for work, and is usually gone at least one night per week, but often more like 1-4 nights. He tried his best to work his schedule so he could be the one to lift Graham into his carseat and put him in his crib at night, but there were many times when he just had to be out of state for business and I couldn't avoid lifting Graham. To be honest, I did make a general effort to take it easy, but with lessons plans and assignments to grade, 20+ students to teach, meals to cook, a house to take care of, and two children of my own who needed baths, clean clothes, etc, there was only so much I could avoid doing. Besides, no one-including my doctor-could have ever predicted my pregnancy would have turned out like it did, so I didn't worry too much about limiting my activities.
Official bed rest began following bleed #2, which happened the week before Thanksgiving. This bleed led to my first appointment with maternal fetal medicine. The doctor concluded the SCH was the culprit behind this bleed, and, even though this was my second major bleed in six weeks, the MFM doctor still expected the SCH to heal and my pregnancy to continue like normal. He recommended a week of bed rest to nudge my body along, but he agreed that I could return to work the following week, but remain on pelvic rest.
This first bout of bed rest honestly wasn't bad. Everyone expected this to be my only week of bed rest, and at this point, I still had work to keep me busy and Christmas movies to watch. Three days after leaving the hospital, I experienced bleed #3. This incident is one of the mysteries of my pregnancy which was never explained, because I suddenly experienced an intense pain near where my right ovary is (so severe that I threw up in the driveway on the way to the hospital, and again at Labor and Delivery.) It was the same pain I experienced the night of my mild placental abruption, expect the second time, it was in the lower left side of my back and MUCH more painful. Anyways, this led to another week of bed rest. This was bad timing, as it was the week of Thanksgiving and Cory and I were planning to host our family Thanksgiving at our house for the first time. I felt guilty, because not only was Cory doing literally all of the parenting duties in addition to his actual job, but he was now having to clean our house, do all the Thanksgiving shopping, and make several dishes as well. It was such an uncomfortable feeling that would become familiar during my time on bed rest: not being able to help Cory at all made me feel so lazy and guilty. Cory never got frustrated or blamed me, because 1. Bed rest was for the safety of our child, and 2. I couldn't help it, but still, it was a hard feeling to internalize.
As you know, I went back to work after Thanksgiving, but two weeks later, I was back in the hospital with bleed #4. At this point, because I bled heavily for a full week and my SCH continued to get bigger, my MFM (who later acknowledged he was expecting me to go into labor that week,) recommended being on bed rest until Nick was born. Because it was my first year teaching at my school and I was new to the district, I did not qualify for FMLA (disability coverage,) so at that meant I had to leave my job completely. This was hard for me, but I had so much guilt that I had missed so many days with my kiddos and I knew I wasn't giving them the stability and consistency that they needed.
When I was in the hospital, our MFM doctor had given us a 50% chance of making it to 32 weeks, and had said it was a matter of when, not if, I would go on hospital bed rest in 2018 because of bleeding. In hindsight, this was helpful, because everyone was more or less prepared for me to deliver early, but at 22 weeks, it made it hard to sleep. Since all except for bleed #3 and the big one that would cause Nick's birth, all of my bleeding occurred in the middle of the night, and I would wake up to find my pajama pants soaked in blood. I usually am a heavy sleeper and never have problems going to sleep, but I kept waking up feeling sick and anxious, expecting to find blood. My doctor recommended taking melatonin, as it is a natural way to encourage better sleep, but I never ended up using it because I more or less got used to the anxiety. I spent the next 8 weeks on bed rest until, in February, three days before Nick was born, following bleed #5, our MFM doctor told me I had finally had too many bleeding episodes, and would need to stay in the hospital until I delivered. This ended up being the decision that saved Nick's life, because if I hadn't been steps away from the OR when I had the complete abruption, Nick likely wouldn't have survived.
Though I was far from the ideal bed rest patient, I wanted to share some tips about how I got through my total of 11 weeks on bed rest:
1. AVOID GOOGLE. Lord knows I was not good at this. I had never heard of a placental abruption before, and, when you're sitting on the couch all day worrying about the condition that is causing you to be on the couch, it is so hard to avoid searching google to try and learn more. If you've ever googled "placental abruption stories," "consequences of a SCH," or "what does an ultrasound of a placental abruption look like," you know that 95% of the information on the internet comes from other worried women trying to learn about their conditions. There is a lot of "my doctor said" and "I heard that," but there is so little actual legitimate information. Even the websites that seemed legitimate weren't necessarily helpful either, because it was general information and not tailored to my specific unusual case. Though I did learn more than I ever needed to about the functions of a placenta, reading obsessively about the ways a placental abruption can end just gave me awful anxiety. As hard as it is, try to stick to advice coming from an actual medical professional. I asked my OB and MFM doctors question after question during our appointments, but since my case was so unusual, their answers were usually just to wait and see what my body would do. This leads to...
2. Try to relax. Again, easier said than done, especially when the well being of your child is at stake. When sitting on the couch, I thought every ache and pain was my body going into labor, especially because I would often have cramps (my doctor explained this was probably because of the amount of blood I had in my uterus.) I either had a ultrasound or an appointment with my OB or MFM doctor every week, and I would usually be pretty nervous about what the doctors would find. Since these appointments were my big event of the week, it was hard not to place a lot of importance on them.
3. Stay busy and try to enjoy it! Being on bed rest before Thanksgiving and Christmas was definitely an inconvenience, even though my kids did get some awesome Christmas presents since I had so much time to peruse Amazon prime and different online stores. By January, when I was no longer working, it was hard to stay busy since I no longer had school to work on. But, I figured I would hopefully never have time like this to sit and do nothing, so I tried to enjoy it. I read for fun (which I usually only do in the summers,) and did different little things that I never would have had time for, like dating and organizing all my pictures into photo albums. I'm very type A, and it's hard for me to just sit and not do anything, so I tried to make lists every day to make me feel like I was accomplishing something.
4. Ask for help. This is another thing I'm not good at. We relied on our parents so much during my time on bed rest, but often, especially when my husband had to travel, we just had to have someone to help. When I was in the hospital, my parents, who live locally, would pick up Annabelle and Graham so that Cory could visit me, or would make Cory and the kids dinner, take the kids to school, etc. Again, I hated having to be so dependent on someone else to help care for my children, but I just couldn't do anything about it. Try to remember that bed rest is not a choice, and it's for the well being of your baby!
I hope this helps! Thanks for reading! :)
Sunday, May 13, 2018
Three Months Already!
My Nick is three months old already! I wrote about milestones and how Nick is doing development-wise in my last post, but this is his official monthly update :)
Weight:
Nick weighed in at a whopping 9 pounds 6 ounces at his last appointment…which is almost what Graham weighed at birth. People still stop us at stores and ask when he was born, expecting me to say sometime recently, and then always comment on what a little guy he is when I tell them he was born on Valentine's Day. But, he has outgrown all his newborn clothes and moved into size one diapers!
Eating:
Nick is a good eater-he is still ready to eat every 2.5-3 hours or so, and usually always has a good appetite and finishes his bottle. For now, he is still on a mixture of Similac for Spit Up and Similac Sensitivity formula, and receives his vitamin every other day now.
Milestones:
I'm finding that an adjusted age is a hard thing to come to terms with. I know that, developmentally, he should only be acting like a one month old. He basically does act like a very chill newborn, in the sense that he sleeps for most of the day, wakes up when he is hungry, and does a good job when it comes to tummy time and holding his head up. But still, it makes me panic a little to think about how different he is from any other baby born in February. I can't imagine Nick smiling, cooing, or mimicking my facial expressions, like three month old babies should. I'm sure there has been lots of research done on this, but, as a teacher, it worries me about when and how he will close these gaps and catch up to his peers.
Coming Up:
Over the past month, Nick met most of his extended family and all of his cousins, received his first round of vaccines, and celebrated Mother's Day and my husband's 30th birthday. It has been so fun introducing him to so many of the people who prayed so hard for him during my pregnancy and his time in the NICU. Coming up this month, we will be heading to the beach! I am so excited to show Nick the ocean and feel like the NICU is (literally) hundreds of miles away. Also, Nick will finally meet with the pediatric GI doctor to hopefully get to the bottom of his #poopproblems. Thanks for reading! : )
Friday, May 11, 2018
Milestones in the NICU
Tonight, I made the mistake of googling milestones babies are expected to reach by the time they are one month old. Nick will be officially three months old this Monday, but, since he was born over two months prematurely, everything but his vaccination schedule will be based on his adjusted age (meaning he is expected to act like a baby who is just about one month old.) Stupid, I know. I should have learned during my time on bed rest and in the NICU not to google worst case scenarios or listen to advice that doesn't come from a medical professional, and I know "normal" babies reach different milestones at different times and it doesn't necessarily mean anything, but still, I was curious.
According to parents.com, these are all milestones babies are supposed to reach by the time they are three months old:
1. Watches face intently: Nick does not even make eye contact with me. His pediatrician did say he has a lazy eye at his last appointment, so maybe that is why, but even when I am feeding him and his face is inches from mine, he doesn't seem to realize I am there and seems to just look through me.
2. Smiles at the sound of your voice: No. Maybe it is because Nick's constipation is making him so miserable, and maybe this will change once he has his appointment with the pediatric GI doctor and they get to the bottom of what is going on, but I have never seen Nick smile.
3. Begins to develop a social smile: Again, big no on that one.
4. Supports upper body with arms when lying on stomach: Nick is doing a good job with tummy time and holding his head up, but he isn't at the point yet where he can support himself with his arms.
5. Follows moving objects: Another no for this one. He did love the mobile his nurses placed on his isolette while he was in the NICU, but again, he just seems to look through things instead of focusing on them.
6. Begins to babble: No. Nick grunts, moans, and strains all day because he is trying so hard to poop, but definitely no babbling or coos.
7. Becomes more communicative and expressive with face or body: Unless you count grunting, no.
8. Starts using hand and eye coordination: This seems a little advanced for babies that little, but I haven't seen Nick bring his hands to his face at all, or even realize his arms are connected to his body at all.
9. Imitates some movements and facial expressions: No, and I can't imagine Nick doing that any time soon.
Also, according to this website, formula fed babies are supposed to poop around two times a day. WHAT. Nick poops maybe twice a week, and that is after using suppositories and prune juice. So I am not totally crazy to be worried about this.
I know, with his adjusted age, that Nick has two more months until he is expected to be doing all of these. I know that even if he can't do all of these by July, it's not necessarily indicative of a problem. I know I know I know. But still. My biggest concern is that Nick does not seem to interact with me, or even realize I am there. The only time he ever really cries is if he's waking up in the middle of the night and is hungry and hasn't ate for a few hours, or when he's straining and trying to poop. The best way to describe Nick is that he is very expressionless. He's definitely not a happy, social baby, but he isn't a colic or fussy baby. Maybe fixing his constipation will make all of these things fall into place, and, once again, I know in the world of preemies, I am very lucky that this is all I am worried about.
It also makes me really sad to think that, based off his actual age, Nick should be able to do all of these things already. I know this isn't fair to him, but if I were to compare Nick to the other babies born on Valentine's Day like him, they have likely reached, or are close to reaching, all of these milestones right now. When I read this list to my husband, he said "well, they (meaning the physical and occupational therapists from the NICU) said he might be behind." Of course, I know he is right. I know that while Nick was on oxygen and eating from a feeding tube, these babies went home with their parents within 48 hours of being born (!!!), and never had to worry about destats or bradycardias or adjusted ages. Anger was never a big emotion for me during the NICU, even though I can DEFINITELY see why it would be. I think this is because I got to experience two "normal" pregnancy and deliveries, so I didn't really get the feeling that I was missing out on anything (plus, Nick never had any huge health concerns.) But, as a primary grade teacher, I have taught students who had rocky starts to their lives for different reasons, and I know how important these first few months are and how greatly they can impact your for, literally, the rest of your life. I wrote about this in my piece that will be published on The Mighty sometime soon, but the guilt of knowing Nick could be impacted by his prematurity for the rest of his life, and knowing he was born prematurely because my body dropped the ball so massively, makes it really hard to read milestone checklists like this.
Thursday, May 3, 2018
The Day I Took My Son to the ER for Constipation
*TMI warning for lots of poop talk coming up in this post
I don't know if it was Nick's referral to a pediatric GI doctor on Monday that messed with my head and made me worry that there is something wrong with him, but on Tuesday Nick was MISERABLE. He hadn't pooped since Sunday, even after the doctor tried to get things going at his appointment (think vaseline and a finger. Poor guy. Good thing he is a baby and doesn't know I am sharing things like this with the world) on Monday. I tried to give him a bit of prune juice through his bottle like his pediatrician recommended, but he started choking and stopped breathing (major NICU flashback there) until he finally spat it out.
All day, he was grunting, moaning, and straining to the point where his face would turn purple and the blood vessels started to burst around his eyes. He would straighten his legs against my chest like he was trying to stand, and would arch his back while he was straining. Also, what made me especially worried was he was listless-when he was awake, he would just lay limp in my arms and wouldn't react to noise or touch (he doesn't really do that anyways, but still.) I know it was most likely a reaction to the vaccines he received on Monday, but since it was happening at the same time as his constipation, it was making me especially worried.
I was calling his pediatrician's office all day trying to get ahold of someone, but my call wasn't returned until 5:00 that evening. It turned out his doctor was out of the office that day, so the medical assistant who returned my call told me to just take him to the ER instead of prompt care. By that point Nick had finally pooped, and I know I should have taken that as a sign that it really was just constipation and followed up with his doctor again in the morning instead of taking him to the hospital, but I think one of the long term side effects of the NICU is it will be hard for me to tell if my anxiety toward Nick is justified or not. My instincts were telling me there was something wrong with him, and, if nothing else, I wanted a doctor to examine him and tell me I was overreacting and that everything was fine.
So, off we went to the hospital, and, thankfully, we were seen by a doctor right away. I tried to stress how uncomfortable Nick was that day, and explained to him that Nick is a preemie, that he has a referral to a GI doctor, and that he had issues like this that led to an abdominal X-ray shortly after leaving the NICU. The doctor checked his vitals, pushed on his stomach, did a visual assessment of his diaper area, and told me that everything was fine. Since Nick didn't react to his stomach being pressed on and did eventually have a bowel movement, the doctor said it was probably just standard constipation that many formula fed babies experience.
Even if he did have a bit of a why-are-you-wasting-my-time-with-this vibe, our doctor stayed polite and did exactly what I wanted him to do: assessed my baby and told me everything is ok. I'm sure I sounded over protective at best, and he did write a prescription for a suppository to use if needed. I think another lasting side effect of the NICU is I will have a hard time trusting a doctor or a nurse who wasn't part of our care team while in the hospital. I'm sure our ER doctor is very competent, I'm sure he deals with God only knows what on a daily basis, and I don't know anything about emergency medicine, but I immediately got the feeling that he was missing something. I wanted to tell him Nick is my third formula fed baby and my other two didn't come close to experiencing the type of discomfort Nick was feeling today, and I was frustrated that the examine was so brief and would have felt more comfortable if he would have ordered an Xray just to be super sure nothing else was going on. It's not only this poor doctor that I found myself second guessing, but I have the same feelings towards Nick's pediatricians. I do like her-she is very considerate, she has taken the time to call me personally with lab results, and is a mom to young kids herself, which helps. But still. She's not a neonatologist or a NICU nurse, and she wasn't one of my OBGYN's. If any of our NICU team would have told me Nick was just constipated, I wouldn't have second guessed them for half of a second, let alone felt the need to pull up my google search results on my phone and tell them to look again because I've just found 5 other serious conditions Nick could have other than constipation. Our eight weeks in the NICU were so intense, and the doctors and nurses were the ones who experienced it with us. All of the fear, pain, relief, and joy of the NICU are wrapped up in these people, and I don't know if I could ever trust a medical professional who wasn't at his isolette switching his feeding tube at 3:00 in the morning. Maybe that kind of complete trust can only be replicated in an intensive care unit, so maybe it is a good thing I will always be a bit suspicious and will be keeping my google searches handy when it comes to working with all of Nick's future doctors and nurses :)
I don't know if it was Nick's referral to a pediatric GI doctor on Monday that messed with my head and made me worry that there is something wrong with him, but on Tuesday Nick was MISERABLE. He hadn't pooped since Sunday, even after the doctor tried to get things going at his appointment (think vaseline and a finger. Poor guy. Good thing he is a baby and doesn't know I am sharing things like this with the world) on Monday. I tried to give him a bit of prune juice through his bottle like his pediatrician recommended, but he started choking and stopped breathing (major NICU flashback there) until he finally spat it out.
All day, he was grunting, moaning, and straining to the point where his face would turn purple and the blood vessels started to burst around his eyes. He would straighten his legs against my chest like he was trying to stand, and would arch his back while he was straining. Also, what made me especially worried was he was listless-when he was awake, he would just lay limp in my arms and wouldn't react to noise or touch (he doesn't really do that anyways, but still.) I know it was most likely a reaction to the vaccines he received on Monday, but since it was happening at the same time as his constipation, it was making me especially worried.
I was calling his pediatrician's office all day trying to get ahold of someone, but my call wasn't returned until 5:00 that evening. It turned out his doctor was out of the office that day, so the medical assistant who returned my call told me to just take him to the ER instead of prompt care. By that point Nick had finally pooped, and I know I should have taken that as a sign that it really was just constipation and followed up with his doctor again in the morning instead of taking him to the hospital, but I think one of the long term side effects of the NICU is it will be hard for me to tell if my anxiety toward Nick is justified or not. My instincts were telling me there was something wrong with him, and, if nothing else, I wanted a doctor to examine him and tell me I was overreacting and that everything was fine.
So, off we went to the hospital, and, thankfully, we were seen by a doctor right away. I tried to stress how uncomfortable Nick was that day, and explained to him that Nick is a preemie, that he has a referral to a GI doctor, and that he had issues like this that led to an abdominal X-ray shortly after leaving the NICU. The doctor checked his vitals, pushed on his stomach, did a visual assessment of his diaper area, and told me that everything was fine. Since Nick didn't react to his stomach being pressed on and did eventually have a bowel movement, the doctor said it was probably just standard constipation that many formula fed babies experience.
Even if he did have a bit of a why-are-you-wasting-my-time-with-this vibe, our doctor stayed polite and did exactly what I wanted him to do: assessed my baby and told me everything is ok. I'm sure I sounded over protective at best, and he did write a prescription for a suppository to use if needed. I think another lasting side effect of the NICU is I will have a hard time trusting a doctor or a nurse who wasn't part of our care team while in the hospital. I'm sure our ER doctor is very competent, I'm sure he deals with God only knows what on a daily basis, and I don't know anything about emergency medicine, but I immediately got the feeling that he was missing something. I wanted to tell him Nick is my third formula fed baby and my other two didn't come close to experiencing the type of discomfort Nick was feeling today, and I was frustrated that the examine was so brief and would have felt more comfortable if he would have ordered an Xray just to be super sure nothing else was going on. It's not only this poor doctor that I found myself second guessing, but I have the same feelings towards Nick's pediatricians. I do like her-she is very considerate, she has taken the time to call me personally with lab results, and is a mom to young kids herself, which helps. But still. She's not a neonatologist or a NICU nurse, and she wasn't one of my OBGYN's. If any of our NICU team would have told me Nick was just constipated, I wouldn't have second guessed them for half of a second, let alone felt the need to pull up my google search results on my phone and tell them to look again because I've just found 5 other serious conditions Nick could have other than constipation. Our eight weeks in the NICU were so intense, and the doctors and nurses were the ones who experienced it with us. All of the fear, pain, relief, and joy of the NICU are wrapped up in these people, and I don't know if I could ever trust a medical professional who wasn't at his isolette switching his feeding tube at 3:00 in the morning. Maybe that kind of complete trust can only be replicated in an intensive care unit, so maybe it is a good thing I will always be a bit suspicious and will be keeping my google searches handy when it comes to working with all of Nick's future doctors and nurses :)
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