NICUitis

I have been recently diagnosed with NICUitis.  This syndrome is described as severe mental and physical exhaustion caused by extended stays in the neonatal intensive care unit.  Symptoms include manic bouts of productivity followed by extreme fatigue, irritability, headaches, stomachaches, and schizophrenia.

That's right, schizophrenia.

When I think about how my mind is starting to work, I realize that I have an extreme amount of fluctuation in emotions every day as I sit in the NICU from 8 a.m. - 7 p.m. with my pride and joy, Jackson.  One minute I feel like I could cry at the drop of a hat.  The next I can look at my baby's sweet face or funny little dance in his crib and all is right in the world.  Technically, that probably is not schizophrenia, but I am not convinced this is still postpartum-induced either. Therefore, it must be NICUitis.

So many people have commended me and Colin on our strength and positivity.  I appreciate that so much.  We have worked so hard to stay optimistic and look at the bright side.  Really, do we have any other choice?  We can't sit around and be miserable despite the unfortunate circumstances we are faced with.  Also, I have mentioned it several times, things could be A LOT worse.  We spend the majority of our waking hours in a place that serves as a constant reminder of this fact.

All that being said, we are human.  We have weak moments where we start to feel sorry for ourselves.  

Exhibit A: The entrance to the NICU is unfortunately located right outside of the Family Birthing Center. Most days we get to watch brand new parents leave with their healthy term baby strapped in their car seat.  "Must be nice." is our typical reaction.  Such a bitter thing to say.  We often follow up with a good-natured laugh, most likely to convince ourselves we are kidding and truly happy for them.  

Exhibit B: Every time we get in my car we are faced with an empty car seat.  Every time we go home we see an empty crib.  Every time we receive a generous baby gift we wonder when we get to use it.  Enough said.

Today I requested a therapy session with our nurse and neonatologist.  We had an honest conversation about the reality of how much longer I will be experiencing NICUitis.  Yes, Jackson is doing very well and acting exactly as he should be at his gestation.  However, he has lung disease caused by his premature birth and need for CPAP support for a while after his birth.  The doctor explained that the CPAP can cause tearing in the lungs and that can take a while to repair itself.  Also, the fact we live up in elevation can slow that process down.  Every baby is different and does things in their own time.  He needs as much time as it will take to grow out of his lung disease.  I have also been doing some research on HELLP syndrome and I am starting to believe that I was sick longer than I thought and it may have affected Jackson.  My doctor advised us to really start limiting visitors to help protect him from outside infection, which would cause serious issues and a major delayed departure.  As much as everyone wants to meet or visit Jackson and as much as we love to show him off, we need to shelter him as much as we can right now.

The other piece of the puzzle is feeding.  Jackson is a great eater but he is very inconsistent.  He is so eager to eat but then he gets fatigued.  The feeding specialist compared it to being asked to run around the block and then chug a glass of water over and over.  Now try and do that with lung disease.  It would certainly be a challenge.  Jackson is expected to be able to do this 8 times per day.  This explains why he is given a break and is fed passively through a tube when he has eaten all he can on his own (through bottle or breast) or when he won't wake up to eat.  Despite how challenging feeding is, he tries every time I put him to breast four times per day and he consistently grows pretty much every day.  He is a hard worker and a fighter.  I admire my strong little man so much.  Preemies are amazing little people.

Finally, the doctor spoke to me about how to get myself to the finish line.  It is so hard because Jackson is in control and there is not much more I can do to get us home any faster.  He commended me for being here spending my days with Jackson, working hard to pump milk diligently, and continuing to be patient and working on breast feeding.  I was reminded that I am supposed to be selfish right now so I can be as rested as possible, mentally and emotionally strong enough to take care of Jackson, and focused on protecting and nurturing our child.  These are all things I try to achieve, but I spend a lot of time worrying about things that should not be important to me right now.  It's time to get selfish and get my baby home.  I was not intentionally fishing for compliments and reassurance, but it was nice to hear that the doctors and nurses think we are doing a great job as parents of a NICU baby.  

What I really needed was a strong dose of reality.  Every doctor and nurse has an opinion.  I have realized you have to be careful about what you really take to heart.  I have been told on more than one occasion that we are looking at 7-10 days before we go home.  Well, it is very unlikely that is going to happen even from today and it is time to accept that and deal with it.  What we were told from the beginning is plan on taking your home on his due date and feel lucky if you go home before then.  Others have said 36-37 weeks is the time a lot of babies figure everything out and start to progress quickly.  Every baby is different, and Jackson may be a baby that appears very healthy, strong, and advanced.  However, he may need more time in the NICU than other babies to get to go home.  He needs enough endurance to feed by mouth and thrive and until that time he needs to be tube fed in the NICU.  Of course, he still may all the sudden hit a growth spurt and develop enough lung tissue to rapidly progress, but I am going to prepare to be here 2-3 more weeks and feel fortunate if we get home before then.  I think I can, I think I can, I think I can.....

I will just be patient and protective and we will go home when he is ready.  Until then, this is my view...

Daytime Sally

Wednesday was a sad day in the NICU.  Daytime Sally, our favorite nurse, has been called to move on to her next assignment.  She is a traveling nurse, meaning she works for a company that pays her to travel around and work in places that need someone to fill in on a temporary basis.  Sally's time in Bend is up and she is heading home before finding out where her next assignment will be.

We adore Daytime Sally (DS).  She earned this name because we also have Nighttime Sally (NS), sometimes back-to-back with DS.  I can tell you, when it is 24 hours of Sally, it is a good day for us.  We love NS as well, but we have a special bond with DS.  It is natural for this to occur, because we spend more time there during the day and you get to know the daytime nurses much better.

I remember the first day we had DS was pretty early on in our NICU stay.  We would be very careful around Jackson, we certainly felt intimidated to handle him, and we spoke in hushed voices.  "You don't want to overstimulate the preemie." was the saying we lived by.  Then DS came along and dared speak in a normal voice around Jackson.  "This nurse is so loud!" Colin exclaimed after our first encounter.  After whispering and being so careful not to overstimulate, DS might has well have been yelling.

Once we got past the sheer volume of this nurse, we realized she was different, in a good way.  She treated us as if not only did we have the right to know exactly what she was doing to our baby, but that we would actually understand and appreciate an explanation why.  That is when our education began.  DS spent a lot of time in our room teaching us things we need to know to be better and more successful parents for our preemie.  While the other nurses in the NICU are all great in their own way, DS separated herself from the pack by taking the time to really get to know us as people, especially Jackson.

When you have to place your child's well-being in someone else's hands, it can grow exhausting because you spend so much time worrying.  It has grown increasingly important to get to know each nurse as well as we can in the NICU.  If I had to choose one nurse to leave Jackson with full-time, it would easily be DS.  She seemed to have a special bond with Jackson and it was apparent that she cared about him far beyond just coming in and taking care of her nurse tasks.

DS loved Jackson's name.  She always said that there was no way he would not do something great with a name like his.  She would announce, "Supreme Court Justice Jackson William Morrison."  To please dad she would title him, "PGA Tour Champion Jackson William Morrison."  What I loved the most is when she would put all kidding aside and just say most importantly he will grow up and be healthy and happy.  That is really all a mother can ask for, and she knew I needed to hear that.

A few weeks ago, I decided that I was ready to challenge Jackson to nuzzle nurse just to see what he would do.  Nuzzle nursing means you hold the baby down at your breast while they tube feed so they start to associate the feeling of their stomach filling up while they are near the source of milk.  As the story goes, he latched on instinctively and the lactation nurse ran to get a nipple shield.  He ended up feeding like a champ on his first try.  However, we had not weighed him before the feeding session so we had no way to really determine how much milk he took in.  This is against doctor's orders because his milk intake is strictly measured and monitored.  DS was so excited and supportive when she saw what was happening, she immediately told me to let him keep feeding and that she would take the blame for not knowing how much milk he was fed at that session.  It is hard to explain the dynamic between NICU nurses and lactation nurses, but DS was more than willing to get in trouble for not following her orders because what was happening was in the best interest of me and Jackson and our breast feeding relationship.  That was really special to me.

Other nurses are complimentary when they see my milk supply I have been building up for Jackson, but as always DS went the extra mile.  She acknowledged that pumping milk so diligently is hard work and would actually look at my pumping log and commend me for what I have been doing.  When I shrugged it off and pointed out that I am just doing what is best for Jackson, she reminded me that not all parents are selfless.  Again, she takes her job as nurse and goes a step further to create a bond and connection by showing how much she cares and recognizing that what is happening to families in the NICU is not easy.

DS taught us how to advocate for Jackson when we get out of the NICU.  She let us know that we need to be very specific when we call our pediatrician and always have in mind what we are looking for from them.  She pointed out that we will be the ones who really know our child and that if something does not seem right to go with our instinct.  All of our nurses have done a great job teaching us how to perform daily baby maintenance tasks, feed Jackson, and watch him rather than the monitors all the time.  DS has given us skills that we will need to be successful parents for years down the road.  All because she took extra time to get to know us and cared enough to share her wisdom with us.

On her last shift, she shared with us that she likes all of her patients, but that we were special.  She told us we were people she could be friends with.  We agreed that this feeling was mutual.  We will miss you Daytime Sally.

Fathers are Expecting Too.....and Other False Reassurances

**This post is dedicated to the pregnant chicks out there**

re·as·sur·ance

noun

1. 1.

   the action of removing someone's doubts or fears.

   "children need reassurance and praise"

   
   

   Fathers are expecting too.  At least, that is what some books or even sections of your pregnant chick bible (aka: What to Expect When You're Expecting) will tell you as if you and your husband/partner are going to endure this adventure called pregnancy together.  This is a false reassurance designed to remove a woman's doubts and fears that she is in this pregnancy alone.  The fact of the matter is, men are never "expecting" in the same way women are when it comes to pregnancy, so why even suggest it?  

   
   Let me tell you what fathers are expecting.  

   
   

   Fathers are expecting their wives/partners to continue to be a normal human being despite the fact their body has been completely taken over by a new entity, otherwise known as pregnancy hormones.  Fathers expect that despite these profoundly significant changes, which are out of the pregnant person's control, their wife/partner will be the exception to the rule.  She will be the one who has not been handed a one-way ticket to crazy town.  

   
   

   I say this in a very general sense.  I am sure there are some super-sensitive men out there who really do their best to empathize with their pregnant person.  Perhaps they actually experience sympathy symptoms and manage to not make it all about them.  I suppose it is possible for some men to truly understand pregnancy and find a way to join in on the experience emotionally.  However, no man, despite how sensitive they may be, will ever physically experience pregnancy.
   
   Side note: Some of you may be inclined to argue the case of the "Pregnant Man", the most ludicrous way Bend has ever managed to gain national media attention.  Give up now.  The "Pregnant Man" is a woman who underwent hormone therapy but held on to her uterus, arguably the most important feature of womanhood.  She is a woman with excessive facial hair.  Under this argument any pregnant woman, especially those who are hosting a boy in their womb, can make the case they are a pregnant man.  Without a talented aesthetician or a pair of tweezers these women also have beards.  I can attest to this.  Therefore, this argument is invalid and pointless.
   
   I am not saying all of these things about men to be a hater or even sound bitter about how my dear husband handled pregnancy.  I actually feel bad that men do not enjoy the privilege of pregnancy.  Even if you have the most miserable pregnancy and experience every unfortunate symptom and side effect, pregnancy is magical.  There is no greater power in life than the ability to grow another human.  Sure, men play an important role in the process of conception and having their support can make all the difference in the world, but they are simply a bystander for the duration of the pregnancy.
   
   Throughout my pregnancy, I found one of the most profound differences between being the bystander and being the human vessel was the fact that the bystander could sometimes forget about the pregnancy.  Conversely, the vessel NEVER forgets that she is pregnant.  In fact, the minute she accepts the fact that there is life growing inside of her, that fact is almost always in the forefront of her mind (hence, the pregnant brain phenomenon).  
   
   Pregnancy can be physically demanding.  Yes, you are swollen.  Your body is constantly plagued with unexplainable pains.  Unfortunately, you are particularly flatulent.  Of course you have to pee every five minutes; you are so thirsty you cannot stop drinking water but your lovable fetus is sitting on your bladder.  Your baby's toes are running across your ribs like they are playing the xylophone.  Naturally you are starving and need to eat all the time yet your stomach hurts after every meal.  The list of fun goes on and on.
   
   I still say that I would never trade the father and take on the role as bystander.  Despite the fact the bystander gets to go on with life and even live it up if they choose, they are missing out on the miracle of creating life.  They have no idea how much you can love this little person you have never met.  The bystander has to endure months of repetitive conversations revolving around the pregnancy.  Everything is about the baby.  I distinctly remember the look on my bystander's face when the same question about the pregnancy would be asked by someone else and he knew he was going to have to play along with the conversation as if he was not ready to lose his mind.  I can only imagine how brutally obnoxious this must have been.
   
   What about the fact the bystander is expected to be empathetic and supportive of a condition he has no way of relating to?  Most men don't even understand PMS and some even believe it is a made-up condition that allows women to be insufferable every month with no consequences.  How can a bystander be expected to understand pregnancy?  It must be exhausting to have to sit back and tolerate the crazy person their vessel has turned into.  The minute I figured out that I was being a selfish, whiny, demanding turd during my most miserable time in my third trimester I made an effort to be nice to my bystander.  Pregnant chicks listen up: you catch more flies with honey.  Be nice to your bystander!   
   
   They say the woman falls in love when she finds out she is pregnant and the man falls in love at birth.  Could this be true?  
   
   I believe so.  I fell in love with Jackson on Wednesday, January 15th.  Colin fell in love with Jackson on Tuesday, August 6th.  The birth of your child changes everything.  No matter how it happens (and trust me, you have very little control over how this goes down so you can file your birth plan away under "good intentions" now), something transformative happens to the bystander.  The entire time you were pregnant he knew the situation would result in a baby.  What he did not know was how it would affect him when the magical moment finally came.  
   
   Without divulging too many details, my hopes and dreams that my amazing husband would turn to mush at the sight of his son came true.  I am deeply indebted to the perceptive person who took over Colin's phone in the receiving room immediately after Jackson's birth.  They stopped taking photos and switched to video as Colin sat by Jackson's side and had a genuine, emotional reaction as he met his son for the first time.  I go back and watch this video almost daily and weep (remember, I am postpartum) and feel so lucky that we are all finally a family.  I fell in love with my husband all over again when I saw this video and I absolutely adore how excited he gets to spend time with his son every day.    
   
   In the end, I believe that fathers are expecting too, just in a different way.  I do not envy the carefree lifestyle they can live as they wait for the big day.  I would not trade them places for the world.  I look back on my pregnancy and actually feel a little slighted since I did not get to carry to term.  As nice as it is to no longer suffer those third trimester symptoms, I miss pregnancy.  I cherish the time I spent carrying Jackson around with me everywhere I went, especially now that I have to leave him every night.  He is still a part of me and I suspect he always will be.
   
   A special moment between father and son.
   

   

   
   

Potty Like a Rockstar

Jackson certainly does!  He has no problem pooping or peeing whenever he feels like it.  He is like a little Justin Bieber.  If you choose to clean the restroom when he needs to go, he will pee in your mop bucket.  Apparently there is no need to have a diaper on to unload.  I guess you can't expect a baby to consider innocent bystanders when the watergun is loaded and exposed to the elements.  Shame on me for having my finger so close to the feces volcano.  Just because I just put on a fresh diaper does not mean he won't poop immediately after I get his clothes back on.  Hey, it's my fault for not pointing the gun down last time I changed his diaper, so I can't fuss too much when he pees on my stomach while nursing.

This extremely timely and appropriate onesie was given to Jackson by one of my favorite students (not that I have favorite students; I like them all equally of course).  His mom works in the NICU so he has the inside scoop on what is going on with Jackson.  This is a prime example of why I say middle schoolers get a bad rep.  These kids have always really seemed to care about what is going on in my life and they always have my back.  They are old enough to understand, and not too old to be to cool to care.  In the card he wrote, "Good luck with baby Jackson!".  When asked by his mom why he said "good luck", he replied, "Because it's a baby."  Touché young man, touché.

"Because it's a baby."

Jackson presents of all kinds of little mysteries that make this simple statement completely valid.  Why does he bear down and turn red and purse his lips and squirm one minute and smile and relax the next?  It is gas?  Is it reflux?  Is he trying to keep things interesting?  Why does he choose to poop right after I put a fresh diaper on?  Why does he fluctuate his saturated oxygen levels from the mid-eighties to high nineties within seconds?

I guess the real question is, what will we do without all these fancy machines and monitors at home?  In a way it will be comforting to not have alarms going off every time he is struggling a little bit.  If his heart rate drops for a few seconds or if he is not breathing efficiently enough for there to be a high enough amount of hemoglobin in his blood, we are not going to necessarily know.  We will have to rely on the fact we have a breathing baby who is pink, not blue.  How medieval.

It seems that Jackson has turned a corner and we are in the home stretch of this whole NICU ordeal.  He is doing very well and his neonatologists are very pleased with his progress.  Apparently, most babies have one issue that plagues them the most out of the four typical preemie issues they have to overcome to get out of the NICU: lung development, body temperature regulation, growth, and feeding.  Jackson is a lung baby.  He grows pretty significantly almost every day and he is a little feeding machine.  He maintained his body temperature well enough to get out of his isolette and into an open crib.  We just can't get him off his oxygen just yet.  He is being continuously weaned off his oxygen flow and every day we get closer, but we just can't seem to cross that finish line just yet.  Fortunately, they send babies home on oxygen machines if they can do everything else.  Hopefully we won't have to do that; I am so tired of alarms going off every time he is a little low on dissolved oxygen.

Jackson really is doing great.  Yesterday he fed at breast four times and he is well on his way to doing it again today.  Last night he took his first bottle from a nurse.  He has accomplished more than half of his feeding plan (4 x at breast with me during the day, 4 x at bottle with a nurse at night) in a matter of days after putting the plan in place.  If he starts taking a full bottle at every night feeding, and taking a bottle for any quantity he does not take at breast rather than via gavage, we are in business.  Once he can take all of his feedings by mouth we can take out the feeding tube and scoot on out of here.

Daddy got to give Jackson a bath in the sink yesterday.  His umbilical cord has fallen off so he can have a real bath rather than a sponge bath.  Jackson did great and relaxed nicely in the warm water.  He did not get too cold and was able to maintain his body temperature.  Daddy did a great job keeping him safe and calm throughout the process.  Again, we are getting so much great experience having him in the NICU as we are surrounded by all of these professionals.  However, it is time to start thinking about going home.

The doctor told me today that we are looking at 7-10 days at this point if Jackson stays on track.  He is at the precious 36 week mark today, which is the time when most babies start to really excel.  We have been told that there is usually one magic day when all the sudden everything comes together, and this typically happens between the 36th and 37th weeks of gestation.  The idea that he can have good days and bad days and then everything suddenly turns around has been keeping me going.  I really hope that happens for him this week, but if not I am going to be okay with that.  As much as I want him home, it has to be on his time and when he is ready.  It is my job to stick it out with him and be patient.

It has grown increasingly difficult to leave him at night.  I spend all day sitting with him with him skin-to-skin with me because research shows they grow and develop faster this way.  Unless I have something I have to go do between feedings, I am with him.  It is a 10 hour day full time job, but soon it will be 24 hour days so I have to keep that in mind when things seem hard (at least we will be home though).  By the end of the day, I feel like I am ready to go home and relax.  However, I find it more and more difficult every day to walk away and leave him.  I feel like he has matured into a "real baby" and we are more and more bonded so he knows I am leaving him.  The guilt is so overwhelming I can't walk away until he closes his eyes and can't see me leave.  The reasonable part of my brain knows he won't remember this but the new mommy part has a terrible time comprehending the idea that we don't spend 24/7 together.  The nurses here refer to my condition as "NICUitis".  I hear the cure is when the baby goes home.

In the meantime I will treasure the time we have together and continue to spend evenings and nights at home to maintain my sanity.  Jackson will be here, pottying like a rockstar.

Home Is Where the Heart Is

In our case, home is where our dogs are.  Once upon a time, we lived together as a happy family.  Colin, Dakota, Sam, and I shared a loving home in southwest Bend.  Along came pregnancy complications and our family was torn apart.

We have not lived at home for 23 days.  Our dogs have never been away from us for so long.  Yes, we have taken some long vacations, but never any longer than a little over two weeks.  We have left our dogs in someone else's care for over three weeks now.  Granted, very good care with family and friends that our dogs know and trust, but nonetheless they have been uprooted for quite some time.

The first week we were staying here at Ronald McDonald house I went home one afternoon to see the dogs and pick up some things.  At that time, they were staying at our house with my parents.  I felt pretty good about things because at least they were in their own home.  As they sat with me, I scratched their ears, gave them kisses, and sobbed like a baby (I recognize that I sound insane and should be ashamed of myself, but remember I am postpartum).  While they stared at me, confused because I was so upset, I apologized profusely for abandoning them.  We decided when I got back to Ronald McDonald that we needed to go home and stay the weekend with our boys.  As nice as that was, it made it so hard to come back and be away from them again.

Don't get me wrong, we have been so fortunate to have a place here at the Ronald McDonald house.  It has been such a blessing to have a place so close to the NICU with a golf cart that we can use to go back and forth.  The camaraderie we have shared with other people here who are going through similar situations acted as free therapy when we were trying to adjust to our new, temporary lives.  This is a nice place, with nice residents, great volunteers running the house, and plenty of comfortable places in the common areas to relax.  I could not be more grateful for the opportunity to spend the past two weeks here, however, it is time to go home.

Other than the fact I miss my dogs so much it hurts, we need to go home and get ready for the new addition to our family.  Fortunately, I was able to get a lot done this summer before I became ill.  My parents have been so helpful making sure my nursery ideas have come to life.  Generous family and friends have come together and purchased the major things we need to be ready to have a baby at home.  Besides needing to get more stuff done to be ready for Jackson to come home, we need to live in our own home and feel normal again.

The other issue is Colin and I have shared a room for 23 days.  In the hospital, he slept on a less than comfortable roll away and couch for 10 days.  Here at Ronald McDonald, we share one room.  Keep in mind, I have not been permitted to sleep a full night since I checked into the hospital August 1st.  At first, I was woken up throughout the night by nurses who needed to check my vitals, give me medications, or draw blood.  Once Jackson came, I had those interruptions plus now I have to pump for breast milk every three hours.  Now that we are sharing one room, Colin is subjected to the obnoxious sound of my breast pump every three hours.  I don't have another room to escape to so at least one of us is getting a full night's sleep.  Colin has to go to work and function like a regular human being despite being woken up night after night.  He is handling it like a champ, but it is time for him to get some rest so he can provide for our family.

Tonight was our last night at the Ronald McDonald house.  Colin found it amusing how quickly I made the decision that I need to go home.  Actually, I had been mulling over the idea internally for a while so it really was not a rash decision.  I just needed to process the idea and make sure it was the right thing to do.  As we were walking into the house this evening, we stopped at the front desk to ask permission to go home for the weekend.  It hit me pretty hard when the volunteer on duty said she would talk to the head volunteer about it.  The issue is if someone has an emergency and they are from out of town we would need to give up our room and if we aren't here to do that they would have to take our stuff out for us.  Of course, they would call us first and we would come do that ourselves, but I struck me that someone else may need this room more than we do at this point.

We have had a great experience here, but it is time to go home.  I am going to be spending more time in the NICU from now on holding Jackson and getting to know him.  He is much more alert now and has all the sudden matured into a baby who can be fussy and let you know if he does not like something.  Before he was a quiet little preemie who just let the world around him control him.  Now he is much more vocal about what is going on.  If I am going to truly be ready to take this little person home, I need to spend a significant amount of time learning his cues and how he operates.  Also, the research shows that the more "kangaroo time" (or skin-to-skin contact) we spend together the faster he will grow and his brain will develop.

It is time to bust my baby out of the NICU.  I believe that spending more time during the day with him working on feeding and getting to know each other and spending nights at home with my dogs will help me get more rest and put my mind at ease.  Also, being able to pump in a different room than where Colin is sleeping may allow him to get some precious sleep before Jackson comes home and deprives both of us any real sleep for a few months.  When I told the volunteers we are moving out, they were insistent that it is okay for us to go home for the weekend and that we don't have to leave.  We had a great conversation and I helped them understand that is not what my decision was about.  I told them that we would be back to volunteer to make dinner for the residents as others have done for us while we have been here and reassured them that we would bring Jackson in so they could see him.  I felt as if a five ton elephant had just stepped off my chest once I committed to leaving.  A wave of relief washed over me and brought me to tears.  (again, remember I am postpartum)

Home is where the heart is, home is where our life is, home is where our dogs are, and home is where Jackson needs to be.  He is starting to prove that it is time to get serious about getting him there.  We are one step closer to being a family again.

I miss these faces:

Freak Show

I finally had the courage to go to preeclampsia.org and look up HELLP syndrome.  Before Tuesday I was still nervous to know too much about what ailed me at the end of my pregnancy because there was a very slight chance of the illness reoccurring postpartum.  What was so significant about Tuesday?

I am no longer a freak show.

I had my lab work done on Monday and received the results at the doctor on Tuesday.  My liver enzymes and platelet count are back to normal human levels.  To give you an idea of where I was at with both of these when I was at my very worst in the hospital, my liver enzymes were over 400 and my platelets were below 60.  Compare those numbers to the "normal" levels I am at now (liver enzymes are 16 and platelets are over 300) and you can see what the fuss was on the fateful day Jackson was evicted from my uterus.

A wise doctor told me on my second day of bed rest to stay off the internet.  One of the goals we had at the time was to keep me calm so my blood pressure was low enough to maintain a healthy environment for my unborn child.  Using the excessive amount of time I had to research what could eventually happen to me was not going to be good for my mental health.  After all, my labs only showed slightly elevated liver enzymes, lower platelet counts than normal, and no protein in my urine.  We were all hoping that I could sit in the hospital for a month and deliver Jackson much closer to his due date.

Despite my efforts to remain calm and ignorant, concerned friends and family were investigating my illness and diagnosing me on their own.  I was informed that I had something called HELLP syndrome.  This is a life-threatening condition and quite frankly, terrifying to think about.  From the limited information I allowed myself to overhear, I still resisted the urge to look it up.  Part of my doctor's concern was the plethora of bad information floating around cyberspace.  The other part of the concern was that I in fact did not have HELLP syndrome just yet.  I was under intense observation just in case I did develop more than just mild preeclampsia and this was most likely the next rung on the ladder of my preeclampsia condition.

At that point the scariest thing (other than being on bed rest for a month) was the thought that I was going to get more sick before I got better.  The only cure for preeclampsia is delivery, and I was going to hold that baby in until I could no longer physically be pregnant.  It was not Jackson's time yet at only 32 weeks.  However, it was not likely that we were going to term.  The doctors immediately gave me steroid shots to help his lungs develop faster than they would on his own in anticipation of his pre-term arrival.

I made it five full days on bed rest.  My labs were slowly getting worse, but bed rest seemed to really suspend the big event nicely.  I was warned by multiple doctors (you have a different doctor every day) that my condition could worsen quickly, but we still thought for some reason we were going home and I would serve my bed rest sentence on my own couch.  Oh how ignorant we were.

On day six the severe upper abdominal pain was back and I knew something was seriously wrong at 5 a.m. when the phlebotomist came to take my blood.  My labs did not look that much worse at that point so It took until 2 p.m. for me to finally convince my nurse and doctor to take action.  More labs were ordered and all hell broke loose.  My liver enzymes went from being in the 70's to the 400's in a matter of hours.  My doctor later told me my sweet nurse that day nearly had a panic attack when my labs came back and ran into her office yelling "We have to do something!".  I loved that nurse.

Liver rupture is one of the ways mothers are critically or mortally injured from HELLP syndrome, so looking back I can understand now why I had to endure an ultrasound on my liver while we were waiting for my platelet count to come back from the lab.  However, at the time I was highly inconvenienced when they were pressing down on my stomach where it hurt so bad to see what was going on inside.  I am very fortunate that my liver was somehow holding up okay despite the ridiculous enzyme count.

The other way mothers die from HELLP is stroke.  I feel like this was where I was in the most mortal danger.  My blood pressure almost immediately shot up once my labs came back and I was dealing with 200/100 pressure until I delivered.  I have never felt a headache like that and I have no way to explain it other than physically feeling my blood pulse through my brain and the impending feeling my head may explode.  It was so scary and I honestly felt like I was going to have a stroke at any minute.  I have no idea what allowed my body to endure that blood pressure for as long as it did (at least 45 minutes that I was aware of) but I am so thankful that I made it through.

The lab was not working fast enough to get my platelet counts back to the anesthesiologist.  He needed to know if I had enough platelets to give me an epidural and allow me to be awake for the birth of my child.  Also, that was the only way that Colin was going to get to be in the room as well.  As I listened to him get more and more worked up that it was taking so long, I had to find a way to remain calm.  Keep in mind, they were having conversations with me about bleeding to death if my platelets were too low and a hysterectomy if anything went wrong.  Finally my platelet lab came back and it was "night night" time.  There was no way I was going to be awake for the birth of my child.  I would have been very disappointed if I wasn't busy willing myself to stay alive.

As I was lying on the operating table waiting for them to put me out of my misery, the final blow came.  The catheter had to go in and there was no time to numb me.  Imagine trying to keep your brain from exploding from ridiculously high blood pressure and hearing that news.  Not a good time.  I remember focusing on the health of my unborn child and I knew if I could just stay alive he would have a good chance.  After what seemed like forever, it was time to sleep.  The nurse who was previously stroking my head and reassuring me that I was doing great basically choked me to sleep.  Apparently that is how they put you under; as the anesthesia is going in, they put pressure on your throat.  I have no idea what this is all about, but it feels like you are being choked unconscious.  At that point I was just happy to be put out of my misery.

Once I woke up, it was time for the magnesium sulfate (aka: satan's juice) to be circulated through my veins to bring my blood pressure back down to acceptable human levels.  I was not allowed to eat or drink during the 24 hours I had this poison injected into my IV.  All I had for relief was a morphine drip and ice chips.  I got to the point I begged anyone on the hospital staff as well as my own family for more ice chips.  I was so thirsty and hungry I think I was going a little crazy.  Keep in mind, the last thing I consumed was a GI cocktail because everyone was convinced I just had a stomach ache.  After sucking down that chalky nastiness my labs came in and my water was promptly removed.  It was extremely unfortunate timing.

Despite my misery during the 24 hour magnesium sulfate hell, including extreme hunger, dehydration, and my eyes rolling around in my head, I had no idea how bad I actually felt until they turned the poison off.  The first thing I had was saltines and Sierra Mist Natural, and it was the best moment of my life.  Keep in mind, I had finally been allowed to hold my child for the first time mere hours earlier, but I was so drugged up I thought soda and crackers was the best thing I had going for me.  I promptly ordered a meal (grilled cheese, green salad, milk, and a peanut butter cookie) and all was right in the world again.

Each day got better and I was finally able to ask with confidence if it was time to be discharged.  My surgery was on Tuesday and I was discharged on Saturday.  I was pretty nervous to leave because I would no longer have around the clock care.  I think I was really worried that I would get sick again and there would be no one there to save me.  When you are knocking on death's door, it is pretty convenient to have medical staff right there to fix everything.  What was I going to do if it happened again at home?  The nurse who discharged me reassured me that chances were slim that I would have postpartum preeclampsia, but there was a chance.

I am pretty sure my blood pressure is back down now partially because I finally got my labs back and I am a normal human being again.  I am no longer the freak show that causes panic and alarm in the birthing center.  I have lab work that looks like a normal, healthy human being.  It is such a relief to think that other than trying to keep my new baby safe, I have nothing to worry about.

I am not writing this post for sympathy.  I merely needed to make sure I don't forget this experience.  They say you forget pregnancy and giving birth and that is why people have multiple children.  I think I need to read this post several times before considering getting pregnant again.

Best Laid Plans

"The best laid plans of mice and men often go astray".

As carefully as you plan your life, you must always anticipate the sneaky curveballs that will inevitably be thrown at you.  For instance, my beautiful, easy pregnancy was not supposed to end in emergency surgery and premature eviction of my child from his cozy home.  The fact that I ever thought I was in control of my pregnancy is completely laughable, but what does a first time mom know?  Nothing, apparently.

From my limited understanding (and interest) of baseball, a curveball does not necessarily mean you are going to get a strike.  You just have to adjust your swing.  Step up to the plate and hit that curveball out of the park.  Turn a sneaky change of plans into a home run.  Okay, I will stop with the analogies and quit while I am ahead.

Jackson, Colin, and I have officially been in the NICU, or baby boot camp as we call it, for two weeks.  Jackson is two weeks old and we are so busy trying to stay on a schedule and do what is best for him at all times we failed to even celebrate.  I realized he had hit his two week milestone late in the day and threw together a couple of scrapbook pages together to hang in his suite.  That will just have to suffice for now.  We will get to celebrating as soon as we can bust out of here and go home.  For now, we shall take things an hour at a time.

As I mentioned, we are in baby boot camp.  Colin and I have the advantage of one-on-one baby care training with a variety of doctors and nurses.  As professionals have told us, NICU parents tend to go home and be more successful at taking care of their baby because of this intense training time.  Who else but a NICU parent has doctors, nurses, lactation specialists, feeding specialists, respiratory specialists, and occupational therapists at their disposal 24 hours a day?  We are getting used to services that we have yet to figure out how to take home with us when we finally get to leave.

Speaking of leaving, Jackson's neonatologist initiated a plan today to evict us from our cozy little suite in the NICU.  It seems he would like us to leave.  Doesn't he realize we are not ready yet?  We did not have our baby shower.  There are several things we still need to acquire to be ready to host a baby at our home.  We need to come up with a way to pay a NICU nurse to come live with us one one income.  We need an infinite supply of diapers, clothes, pacifiers, and blankets.  Who is going to help us get a fancy machine that constantly tells us what his heart rate, respiratory rate, blood pressure, and dissolved oxygen levels are?  We better get busy!

The plan really just involves us deciding how we want Jackson to feed.  There are two extremes:

• Bottle feed with pumped breast milk or formula full time
• Breast feed full time

I have chosen the road in the middle:

• Breast feed four times a day
• Bottle feed four times a day

This means I have to work up to breast feeding four times per day starting now.  Once we have established this, we can introduce the bottle.  At that point, Colin can take over some of the feedings and be more involved with those special times of intense bonding.  This will also allow me more time to rest, even though I will still have to pump every three hours.  In the meantime, we are inching towards Jackson living in a crib rather than an isolette (only 3 degrees to go) and getting off his cannula.  Once everything comes together, we will get the boot.

So this is it.  The home stretch.  We have been told from the beginning this is the longest and most drawn out phase.  We have to remain patient and let Jackson stay in the driver's seat.  After all, he has been in control this whole time anyway.  Yes, we are under the complete control of a person who is negative five weeks old.  

As I mentioned before, best laid plans often go awry.  I am hopeful but I refuse to get my hopes up.  I asked the doctor for an estimated number of days remaining, yet I am not marking days off on a calendar.  I plan to be diligent about making sure we are doing everything that can be done to ween Jackson off oxygen and his isolette, yet I'm not going to be pushy.  I have learned that I can't plan everything going on in my life, especially when it comes to Jackson William Morrison.

*Yawn*

Controlling mommy & daddy's lives is exhausting!

Milk: It Does a Baby Good

Simply put: Jackson is a milk stud.  The nurse we have had for the past two days has really been advocating for weighing and breast feeding after being told about the success I have been having with Jackson at breast.  The other nurses are also supportive, but they did not seem to believe that he was getting much milk from me and went ahead and gavage fed him.  I was certain he was getting a lot more milk than they were assuming.  After all, I was the one sitting there being milked like a farm animal.

To determine how much milk a preemie is getting, we do a weight before and after.  They can then translate their increase in mass from grams into milliliters of milk they have consumed.  Easy science.  We tried this once before using the scale in his isolette (fancy name for incubator) but it was not accurate considering his weight was less than it was before he fed.

Side note: Don't even get me started on how we are throwing around the word weight when we are talking about mass when we refer to grams.  Everyone knows we find mass not weight in grams, right?  If we want to talk about weight in metrics we actually use Newtons as our unit of measurement.  You would take the mass in kilograms and multiply it by 9.8 m/s/s (otherwise known as the pull of gravity on Earth) and that is weight in Newtons.  I digress.

It was time to get out the super-sensitive fancy scale.  We found Jackson's mass and put him to breast.  He spent the first five minutes latched on, eyes wide open, doing nothing.  This seems to be his routine.  Clearly he does not mind keeping everyone in suspense as he takes his time getting started. (side note: come to find out he is just patiently waiting for the milk to let down)  Once he got going he went to town.  I gave him 10 minutes on each side.  It was obvious he was getting milk because I could hear him swallowing.  Again, he is pretty good at pacing himself by stopping to take some breaths.  Also, he has had no choking incidents so far.  In general, this kid is a natural.

I was told earlier as I was on the phone with lactation to not get caught up in numbers.  The important thing right now is that we are both enjoying the process and that he is learning how to control the suck, swallow, breathe reflex.  She said most people are surprised how little babies actually consume at first and get frustrated.  I believe the exact quote from my nurse before I got started was "Maybe we can get him to take in about 5 ml and we can just gavage the rest.".

Jackson consumed 48 ml in 20 minutes.

He only eats 36 ml of food per feeding when fed via gavage.  That little piglet ate 9 ml more than he is supposed to and let me tell you, I had to pull him off me.  He was not done eating!  Now, I understand some people may be wondering why this is a big deal.  Breast feeding is a natural process and all mammals do it, right?  Here is the thing, some babies and/or moms struggle at first for several reasons.  The two main reasons this process can be difficult enough to cause people to give up (besides the obvious: pain!) are:

1. The baby has to know how to manipulate the nipple into a certain shape and location in the back of their mouth to express milk.  
2. This process takes a lot of work and jaw strength; the baby actually burns calories just by feeding.

So here we are.  I have super-baby.  He is only 35 weeks along in gestation (technically) and he has instinctively jumped a major hoop in the NICU.  The feeding and growing process is the longest phase parents and preemies struggle through to get out of the NICU.  If he keeps feeding at this rate, we may find ourselves coasting through the last phase of this process.  

Here is what we need to do to bust out and go home:

• Jackson needs to breathe completely on his own without any support.  He is almost there but he is definitely taking his time.  The cannula he is on as of yesterday offers the lowest flow of air into his lungs (o.5 L) and he is on 25% oxygen (he needs to get down to 21%).
• He needs to regulate his body temperature outside of his isolette, which it seems he will be doing very soon.  The temperature inside the isolette is being lowered a o.5 degrees Celsius every 12 hours and he is now in clothing full time to help him stay warm. 
• It needs to be proven that he can feed on his own, from breast or bottle, at every session or a certain amount within 24 hours so we can take out the feeding tube.

All of these things are within reach.  The doctor is giving us a 10-14 day time frame as an estimate depending on if he continues to progress as he is.  Jackson gained 66 grams in mass and is 4 lbs. 7 oz. as of Monday evening.  He continues to get bigger and stronger.  Even though weight is no longer a factor when considering the proper time to leave the NICU and go home, we need to see him on track as far as gaining weight.  In conclusion, Jackson is doing everything we need him to do to go home soon.

Now all we have to do is figure out how to take one of our favorite nurses with us.....

Did I mention I feel like a farm animal lately?

 

You Just Wait.....

Sitting my friend's backyard in an otherwise peaceful neighborhood, we could hear the bass bumping from a fancy sound system.  "Know how I know my son is home?" my friend sarcastically comments.  "Your friend who owns the store that sold him that sound system took total advantage of him,  He had a budget of $500 and he spent over $900!"

"Mom, I'm home (duh!) but I'm leaving!" he yells from inside the house.  The back-and-forth negotiations ensue.  He believes he clearly informed his parents of his intentions and should not have to be home until midnight.  His parents do not recall said incident and feel since they have to get up and work in the morning he should be home earlier.

"Be home by ten unless we call you and tell you otherwise and don't say a word about it or you are not going at all!" was the final word.  "You just wait.  This is what you have to look forward to in 17 years." my friend informs me.

"You just wait."

Listen, I am the queen of waiting at this point.  I sit and wait every day to hear that my son has grown, needs less oxygen to breathe efficiently, tolerates his feeding with a reasonable amount of residual in his belly, can go home soon.  I can wait with the best of them.

This typical encounter I happened to be present to witness this evening got me thinking.  What am I waiting for?  What do I hope and dream about for my own son?  I can only hope to do as good of a job raising my son as my friends have, but what do I envision Jackson being like as he grows up?  One thing I have learned from having several friends who have raised their child/children up into high school is that you only have control over your actions and decisions as a parent.  You cannot control the personality that your child is born with.  Every baby is a person with unique personality traits that are just waiting to come out.  What is Jackson going to be like?

"You just wait."

Right now he is the sweetest little person I have ever met.  I mean, seriously tiny little person.  Yes, we are proud he is 4 pounds 5 ounces now and he has grown a full inch in the past 12 days, but let's just go ahead and admit the fact he is pretty darn small.  Most babies at his gestation are bigger than he is.  He has a significant amount of growing to do.  The nurses all seem to agree, he is really cute (duh again!) and feisty.  Will he always be small?  Will he have to fight to keep up with his peers?  Will he always be a feisty person?  Will being a premie make him always a fighter?  Will he continue melt my heart in the years to come just by stretching out and showing me his adorable foot or yawning sweetly as he is woken up from his most recent nap?  Only time will tell.

"You just wait."

Will Jackson come home and be a healthy baby and toddler after this ordeal or will he spend the next several years at the doctor's office?  Will we be nervous parents or chill out and let nature take its course?  Will he be a fussy baby or an easy baby?  Will he throw tantrums in the grocery store but act like a complete angel at home?  Will he be a picky eater or love everything we give him?

"You just wait."

Will Jackson enjoy golf and become a talented player like his daddy?  Will he play competitively and let Colin be a "daddy caddy"?   Will he snowboard like his mommy and daddy and cause us to spend thousands of dollars on season passes and gear each year so we can spend family time at the mountain with the rest of Bend on the weekends?  Will he decide to play sports that we approve of, such as soccer, basketball, and track or will he fight us and want to play football and wrestle?  Will he do well in school and live up to his teacher mommy's expectations?  Will he love reading as much as his mommy and daddy did when they were young?

"You just wait."

Will Jackson be a mama's boy?  Will he love Boston, Blind Melon, and Tool like mommy or reggae and hip hop like daddy?   Will he resent us and pull away in middle and high school?  Where will he want to go to college?  Will he want to go to college?  How will we pay for college?  Will he be a successful adult and contribute something great to society?  With a name like Jackson William Morrison, I think he can do whatever he sets his mind to.  Supreme court justice, army general, even President!

I can't wait!

The miracle of all this is that we have not only made a baby, we have created a person.  Jackson is an individual and we only have so much control over who he is.  It is the old nature vs. nurture debate.  We fully intend on providing a loving and supportive environment for him to grow up in.  We plan to teach Jackson good morals and values.  He will be educated and his learning will be supported above and beyond what he will receive in public school if necessary.  However, Jackson is unique and we really have no way of knowing the path he will choose in life.  All we can do is our best, and wait.

He is worth the wait.

Staycation

Central Oregonians are such fans of where we live we have a little phrase we use when we decide to vacation in our own town.  I am sure this phrase is used elsewhere, but I have never lived in a place where people dared stay in town for vacation before Bend.

We went on staycation this weekend.

What this means is we took a break from our new life and stayed home.  Usually, a Central Oregonian staycation involves a room or house in Sunriver, Seventh Mountain, Brasada Ranch, Eagle Crest, 5 Pine Lodge, or some resort or B&B.  All we needed for our staycation was our house and dogs.  It does not sound like much, but I have to tell you it was glorious.

For two nights we were "normal".  We slept in our king-size Tempurpedic, Sam was under the covers, and we were surrounded by all of our belongings.  My parents were kind enough to take care of our home for the past two weeks, so we did not have a bunch of housework to catch up on.  This allowed us time to go through the boxes of generous baby gifts we have received, get some recycling out of the house, and do a few chores that we left behind when we unexpectedly checked in to the hospital.  Otherwise, we were able to relax in our own home and do some things in town that make us feel normal.

Coincidentally, our staycation happened when Jackson needed a break.  I did go see him this morning and he was wide awake and doing great.  His doctor reassured me that what I was calling a "setback" was really only a "bump in the road".  He explained that a setback would take us backward, but we just encountered a bump and we are going to keep moving forward.  I felt really great about that and stayed a while to hold him with his pacifier while he was fed.  He settled into my arms, sucked away, and fell fast asleep in no time.  I held him in his swaddle rather than skin-to-skin and stared at his precious face for almost an hour.  I love those moments with him and I feel more and more connected to him every day.  Having a baby is incredibly special and I still can't imagine life before I met him.

Meanwhile, Colin got to be normal and golf.  I slept in and snuggled with Sam.  We got some ribs and slow-cooked them all day on the Traeger.  We got together with friends and went to Brewfest.  We had people over for dinner.  Other than a few trips to the NICU, we had a "normal" Saturday.  It was glorious.  I think it is what we needed so we can get through the next few weeks.  Also, perhaps Dakota and Sam don't feel so abandoned and uprooted now.

We had some fun this evening with some of our great new baby gear.  At least Colin had fun.  I am not sure Sam was too into it.

I got to stare at this face this morning.  He looks so different every day.  I am so in love with this little man!!

No Sleep Goggles

Life looks different when you are functioning on very limited sleep.  Colin has a pair of beer goggles we bought him for his 30th birthday.  I feel like I am wearing something similar, but it is a little harder to make a cute pair of glasses that represent "no sleep goggles".  These goggles allow me to look at everything going on around me with a soft fuzziness that takes the edge off reality.  It is almost like when you are so deliriously tired everything is funny and okay.

Like any new parent, I am running on a gas tank that is close to empty at all times.  Actually, I may be running on even less sleep because I have the "advantage" of freedom with my time when my baby is sleeping.  I use quotations around advantage because this blessing is also a curse.  Having the ability to run errands and get stuff done when Jackson is getting his much-needed excessive sleep means that is usually what I am doing rather than napping and catching up on sleep.

I will break it down so my reasoning is understood.  Here is how I think it goes for new parents who have their baby and get to go home:

• Feed baby when hungry
• Put baby down for nap when not eating
• Sleep while baby is sleeping

I actually think most new mommies even get to feed while lying in bed in the middle of the night.  This is one of the best nursing positions that I learned about in our childbirth classes.  It seems like if you play your cards right, you are still getting some sleep even though it is sporadic and dictated by your baby's sleep schedule.

Here is how I am functioning:

• Pump breast milk every 3 hours for a minimum of 8 times per day
• Sleep between pumping times in the middle of the night - this means I sleep from 12:30 a.m. - 3 a.m. and 3:30 - 6:30 a.m. (times approximate)
• Nap occasionally during the afternoon or late evening before I go for Jackson's 11 p.m. care time

From my groggy calculations, I am getting six hours if I am actually falling asleep right when I am done with each pumping session.  Now, this may not seem so bad.  However, please consider that I am someone who requires nine hours of sleep to function at my best.  This means I am losing at least three hours of the sleep time that my body prefers each day.  It is physically giving me no sleep goggles that are blurring my vision.

All that being said, I am doing surprisingly well.  At least I think I am.  I have decided that I must be running on some sort of mommy adrenaline.  The overwhelming love I feel for Jackson motivates me to stay up late enough to go see him at 11 p.m. and pump at midnight as well as wake up at 3 a.m. to pump again.  Everything I do is for him.  He is my world.  All of the sudden I can't imagine life before Jackson.  I am cruising along knowing I am pretty sleep deprived but feeling pretty good anyway.  It must be because I am looking at the world through my no sleep goggles.

We encountered our first setback this evening.  I am hoping how I handled it is an indication of how I am doing both physically and emotionally.  When we went to the hospital for Jackson's 8 p.m. care time and daddy kangaroo time, the nurse let us know we need to give him an extended rest time.  He had a significant brady episode, meaning he dropped his heart rate and it took some stimulation to get him going again.  He then topped that off with a major spit up.  No one can be sure what caused this to happen, but we all concur that he has had some big days.  Breast feeding, photo shoots, several visitors, bath time, extended kangaroo time, the list goes on.  I think the hope is that he just needs some rest and this is his way of telling us.  At least, that is how it seems when I look at the situation through my no sleep goggles.

As worried and distraught as I was to receive the news that my baby did not have a good afternoon, I managed to hold it together.  I don't think getting overly emotional in the NICU is going to make this any better, so I chose to remain calm.  On the bright side, Colin and I had already decided that we are spending a couple of nights at home to take a little break and maintain our sanity.  Our wonderful nurse told us we need to get some rest, enjoy each other, spend some time at home with our other babies (Sam & Dakota), and only come in once per session on Saturday and maybe even on Sunday depending on how he is doing.  We all agreed that 11 a.m. and 8 p.m. makes most sense since it will allow us to get some rest.

Jackson is fine.  He is going to rest and regain his strength and we are going to listen to him and take it easy on him and the amount of activity we engage him in.  We are not going to get him out any faster by pushing him too hard.  I can't let this spoil another great day.  I learned a lot from his nurse and he got his footprints and handprints done.  Our neighbors graduated to a sleep-in (I think that is what you call it) and are staying in a birthing suite for the next two nights with no monitors but all the nurses right there if they need anything.  The next step for them is home!  We are back to having our own NICU suite, which after sharing is so spacious and private.  Jackson has photos up on the wall and a scrapbook page done by the nurses with his footprint, handprint, and birth stats.  The nurses finally had some time to dedicate to making our little man feel special.  It feels pretty great for mom and dad as well.

I found this online when I looked up images for the quote "don't worry".  That is what I am trying to do.  I need to sleep and relax at home while I can and let Jackson sleep and grow.  I would say I am easily meeting all three requirements, so its time to just sit back and be happy.

Now the ultimate accomplishment is to get some solid sleep so I can maintain the warm fuzziness of the no sleep goggles!

Bath Time with Auntie Barbie

I was tempted to skip Jackson's 11 p.m. care time this evening.  I figured I could use some sleep to help increase my milk production.  I have been producing more than they expect from someone who had a cesarean AND a premie, but I am feeling some pressure to start producing more so I can keep up with my hungry little man.  There was one thing that compelled me to motivate myself and go to the late night care time.

Before we left after kangaroo care with daddy at 7 p.m., I saw her.

Auntie Barbie (AB).

Jackson has an Auntie Barbara of his own.  She is Jackson's late Great Grandfather's fiancee and happens to own the house next door to us.  This AB is a NICU nurse.  The NICU nurse.  This evening before we left I actually asked one of the daytime nurses if she could ask the charge nurse if AB could take care of room 8 and I wanted to see if we had gotten our way.

We had AB once before back when we enjoyed our own space in suite 10.  She is a sweet lady from South Africa (Jackson's AB also has an accent as she is from England) who had seemed to take extra-special care of Jackson overnight.  When I came in the following morning, she said in her lovely accent, "Jackson is delicious".  I did not care if she said it about every baby in the NICU, I loved her for it.  She is also a midwife and helped me with some lactation questions I had.  She said "boobies" a lot in her accent, which made me giggle.  AB suggested that that Jackson take notice of the pretty girl in suite 8 named Ruby.  She happens to be who he is roommates with now.  AB cared.

Ruby's mom and dad (our new NICU BFFs) had AB several times before.  They shared that she is a traveling nurse and did not find her provided accommodations suitable so she moved herself into a retirement home and pays for her room and board by volunteering there.  She is the person who made a scrapbook page, footprint and handprint page, and hung photos up in the room all for Ruby.  All the pretty signage hanging in our shared suite displaying special instructions for Ruby's preferred clothing and accessories was made by hand by AB.  Ruby ate best when left overnight with AB.  She was held in her parents absence.  She went above and beyond basic need care.  This is THE OVERNIGHT NURSE of the NICU.

I schlepped my tired butt to the NICU at 11 p.m. and was immediately elated at the scene I walked into.  AB was in suite 8 and it was apparent fun things were happening.  Ruby was about to take a bath and I was pretty excited to watch.  AB immediately started gushing about how big and strong Jackson had become.  She asked when his last bath was.  I was stunned.  "Never." I said.  "Well, we will have to fix that now, won't we?" she replied.

All I have been craving is to get my hands on my darling baby.  He really is "delicious" and completely irresistible, but we have to be careful not to overstimulate him because his nervous system is still developing.  This seemed like the perfect opportunity to finally get to handle him and touch his soft skin.  Boy was it!

AB guided me step-by-step as I gave my baby his first sponge bath.  He still has his umbilical cord piece attached so we can't put him in the tub just yet.  I was overjoyed as I gave Jackson a soapy rub down and completely infatuated with his goofy smile as he enjoyed his baby massage.  AB took over and showed me how to wash his hair for this first time but emphasized that next time I would do that part as well.  She also proceeded to give me a private lesson in how to pick up and handle my baby, including how to respect his soft spots without being too freaked out to wash his head.  She spent several minutes taking photos of me and Jackson.  She asked if anyone had done his handprint and footprint for us yet.  It was the most wonderful one-on-one baby coaching I have had yet.  I knew what was happening was special.  It was above and beyond the call of duty.  I was sad that Colin was not there.

Now we have a clean and presumably happy baby.  AB is in the NICU for the weekend and I am hoping that she can take care of room 8 for the duration of her shifts.  I certainly sleep better knowing he is in her care.  I think he does too.

"My Baby is an Honor Student at NICU"

I could not find a sticker for my car in the hospital gift shop.  They must be out.

Actually, those of you who really know me would probably think I am more inclined to buy the sticker that says "My Baby Beat up Your Honor Student".  I have a bit of a sarcastic side.

Jackson confirmed my suspicions today and proved how advanced he is.  He decided to skip nuzzle nursing, ignore the fact he is only 34 weeks AND still on oxygen, and go straight to breast feeding.  Now, keep in mind this is not a hard and fast rule, but when I was asking our neighbors when I should expect Jackson to actually express milk from a breast on his own, I was looking at a few weeks before we should expect him to do this.  Certainly we should at least expect him to be off his oxygen first before he even tries.

It all started so innocently.  I came in for kangaroo time at 8 a.m. and the feeding specialist was looking at Jackson.  I explained that I planned for some nuzzle nursing time (allowing baby to explore around breast and dropping some milk on skin to encourage contact).  She decided to stick around and see what happens.  Remember from my list of milestones yesterday, Jackson had latched on and held my nipple in his mouth for a while and even tried to suckle on it a bit.  The specialist and I were both hopeful he would respond to drops of milk placed strategically on the breast.  Boy did he!

As she dropped milk on me and in his mouth, Jackson started to follow his instincts.  Pretty soon, he was latched on again!  Just around that time, the lactation specialist walked in and saw what was happening.  She ran to get a nipple shield.  These are used typically until a baby is to to term (until they are as old as their due date) to help the baby get the nipple placed correctly in their mouth and manipulate the nipple into the shape they need to if they want to express milk from a breast.  You see, breast feeding is really not that simple.  We expect a lot from a baby, and this is just the start.

With the nipple shield, it was game on!  Jackson opened wide and latched on properly this time.  Within a few minutes he was taking gulps.  The lactation specialist was showing me how we knew he was feeding by watching his throat take down gulps.  She gave me pointers on how to hold him in the right position and then stepped back to watch us do what was natural.  It was INCREDIBLE.  The bonding that happens between a mother and child while breastfeeding is so special I won't even try to describe it.  I was in awe of how impressive my child is and emotional because of the nature of the milestone.  It was if we had both been waiting forever for this moment and I was so relieved that he was willing to work hard to make it happen.  Both the regular and lactation nurses were so impressed at what was happening they almost forgot that we were not measuring how much he was eating, which is a "no no" at this point and against doctor's orders.

Fortunately, Jackson's nurse was excited at this turn of events and willing to take the blame if the doctor was mad that we did not follow orders.  She pulled the milk back out of his belly (that is not as bad as it sounds; he still has a gavage tube) and measured that he had eaten 8 ml (plus whatever else he had already digested) and was showing no signs of being done.  We estimated that he ate about 13 ml when it was all said and done (I happen to think he ate more than that; he nursed for an hour!) so we gave him 18 ml in his gavage so put him at the 31 ml he was requiring per feeding.

Jackson was not just nursing.  Jackson instinctively was pacing.  This means he figured out on his own to suck, swallow, and breathe.  This process is the most time-consuming process to get a premie through and they must master this to get out of the NICU.  Term babies even have a hard time with this process.  The fact that he was doing this on his own the very first time is really great.  My nurse said lactation nurses don't get excited, and my lactation nurse was excited!  We got permission from his doctor to continue this new feeding process (breast + gavage) once every 12 hours.  Victory!!!!

Despite the fact he was tired at 11 p.m. last night, he fed again at breast.  It was not anywhere near as much, we were both pretty tired.  It was really encouraging that he got right back in the saddle again.  Jackson had a big day yesterday.  In addition to breast feeding, he wore clothes all day for the first time, which means he is tolerating the dressing process each time he has a diaper change and kangaroo time.  He also had his first photo shoot with a professional photographer in the afternoon and did not fuss too much when we messed with him for some family photos.

In my humble opinion, Jackson is a champion in the premie world.  Not that I am biased, but he just seems a little more advanced than what the doctors expect to see at 34 weeks.  Of course, with his genetic pool, how could he not be?

Maybe I will get the sticker that says "My Boston Terrier is Smarter Than Your Honor Student" for now.  No sense starting to brag too early.  I don't want to be "that mom"......

I like my clothes mommy!

Silver Linings

**********WARNING**********

This blog post features content that may be offensive to readers who support negativity.

There are two ways to look at the world.  We all seem to know this is as the glass half empty or glass half full perspective.  I think what people may not realize is this is a choice.  No one is genetically predisposed to be a negative person.  It is simply a choice made to dwell on bad things.  If you make an effort, you can change your perspective and choose to look at the positive side of life.

You don't have to believe that everything happens for a reason, but I do.  If you really think about it, something good always seems to come from bad.  Without darkness we cannot appreciate the light.  We all have to face adversity so we can build character and become stronger individuals.  If we all just sailed through life, how would we ever appreciate what we have?  Shouldn't some things be earned?  In my opinion, yes.

On the surface, Colin, Jackson, and I have suffered through a tragic ordeal.  It is clear that we are not alone.  Many women deal with preeclampsia, premature birth, and loss of the experience of the birthing process.  One in ten babies are born premature and have to spend the first days, weeks, or even months of their lives in the NICU.  In the grand scheme of things, I did get pretty sick but I made it out alive.  Jackson has a fight ahead of him, but he has some advantages that other premies don't have.  

We are faced with a choice.  Ultimately, our mental well-being is depending on how we choose to process what is happening to us.  People who figure out that they cannot worry about what is out of their control tend to live longer, healthier lives because they are not always succumbing to stress.  Likewise, Colin and I cannot sit around worrying about all the factors affecting our lives right now that are out of our control or else we would physically wear out because of the stress.  Instead, we choose to celebrate small victories and focus on the good things that are happening to us every day.

Our family is living on a cloud with a silver lining.  I know, I know.  So cliche.  Don't be hatin' because we have things figured out.  We just realize that this is the best way to play the cards we have been dealt.

Yes, I could have lost my life.  But I didn't and I appreciate life even more now.  No, Colin and I will never see Jackson being born.  However, he made it out safe and what we consider perfect. :)  Of course, we have good times and bad times right now.  You would think we are taking it day-by-day, but we are actually taking it hour-by-hour at this point.  Our marriage is stronger because we are facing this together and working as a team.  Someone is always the buffer.  Someone is always working hard to be nice and considerate.  Everything we do now takes consideration that two other people are affected by our actions.  We are better together because of this.

Our first child has come with around the clock care for the first several weeks of his life.  Well, extremely expensive childcare!  We have lactation specialists helping us figure out breastfeeding for more than just a few days.  Jackson has an occupational therapist that far exceeds what a pediatrician can do for us.  We are getting one-on-one child rearing coaching every day that we are here in the NICU.  The fact we are meeting our baby a lot earlier than most people means we are getting a lot more time with these doctors, nurses, and specialists than most people.  These are silver linings.

Staying here at the Ronald McDonald house means we are coexisting with other people in very similar situations.  We are constantly interacting with people who can empathize with our situation.  There always seems to be someone to talk to about how your baby is doing and how they may have handled a similar situation.  It is built-in therapy.  We also are having to coexist with a family in our NICU suite.  There are so many babies in the NICU right now we have to share a room.  Fortunately, we are sharing with wonderful people who are going through everything that we will go through in the upcoming weeks.  They are about two weeks ahead of us and a wealth of NICU knowledge.  Fortunately, they are fun people and we enjoy talking to them as we share the tight quarters of two families in one NICU suite.  Again, silver linings.

I challenge you to find your silver linings today.  Please post how you turned a negative into a positive today in the comment section.  I would love for this blog to be more interactive.

On another positive note, we had several milestones today:

• Jackson latched on this morning just by being placed near breast
• No more IV!  He is getting all of his nutrients from mommy's breast milk.
• First time in a sleeper - he has graduated from Pampers only to clothes
• Oxygen down to 23% (need to get to 21% to go completely off!)
• Significant weight gain - he is now over 4 lbs.
• Tolerated 4 hours of kangaroo time - half with mommy, half with daddy
• Eyes are opening more often - Jackson is starting to visually observe his little world
• Occupational therapist pleased with his development

Monkey