Monday, February 6, 2017

I Held Dean Today
My eyes glance up at the window of the hospital as we round the corner heading to the parking garage. Three square shapes catch my eye. They’re pictures the kids have drawn for their little bother. It identifies his room for me.
Finding a parking space is a game that’s sometimes rewarding when an opening shows itself right away and sometimes frustrating when you have to circle the garage several times. The time of day is critical because the garage is shared by a medical office and business hours are packed.
I’ve only had to park on the subfloors once. The third floor (FYI there is no second floor just 1, 3, sub 1 and sub 2) seems to be my lucky floor.
When I was bringing the kids to see their mom during her hospital bed rest it was a game to see who got to push what button; the big silver disk that swings the doors open, the elevator up and down buttons and then once in the elevator the floor button.
From the third floor garage you have to ride the elevator down to the first floor lobby. Walk clear across the lobby to the bank of elevators on the north end of the hospital and then ride up to the 5th floor. Right from the elevators takes you to labor and delivery, left takes you to the NICU.
A sitting area and waiting room sit outside a big double door.
A red telephone is your access into the ward. You must tell the receptionist , who sits in an office behind a large window, who you are, which baby you want to see and give the special code number that applies to your baby. Only moms and dads can use the pass code. But they can bring in one visitor. Many times the seating area and waiting room are full of family members waiting their turn to see a baby.
The double doors swing open and you are admitted. There is a place to hang your coat to the right.
A deep double sink is to your left with sponge dispensers on either side. You grab a sponge and peel off the paper covering, squirt foaming soap onto the sponge, wet your hands from the motion activated faucet and begin to scrub. Three minutes of scrubbing your hands and forearms. A light plastic bush is on the back side of the sponge. It helps you get your nails good and clean. Sometimes the water comes out bath water warm and sometimes it comes out cold. A thorough rinse, paper towel dry and then it’s down the hall.
Dean started his NICU stay in the room on the right. It’s considered the triage room where the newborns are stabilized after birth.
Now he has been moved across the hall.
Each room holds eight beds in two bays, four beds per bay.
The bed to the left is empty. We think that baby was life-flighted to Denver. We don’t know a lot about the other babies but their names. The nurses are very good about confidentiality.
A young couple was
by the hand washing station when we came in and now I see them kitty corner to us in the other bay. They are deaf and an interpreter is signing the instructions and information from the nurse to them. It is so fascinating to watch. Sign is a very expressive and beautiful language.
I made a quilt for Dean and it is laying over his isolette with his name in bold letters on the side. I get lots of compliments for it.
Today I have come with Joe. Kaitlin really wants me to get to hold Dean. I haven’t seen him for about 12 days because of the nasty cold I got. I still have a little cough which worries me.
The nurse tells Joe it is time for rounds and she starts to lead him away but he comes back to get me so I can be there.
We go back into the hall going toward the washing station but enter a door on the left. Four people sit on the other side of a kidney shaped table. It’s his Primary care doctor, the PA (physician’s assistant), head nurse and the pharmacist.
They start by going over his stats, born on Dec 11th at 26+5 (which means 26 week 5 days gestational age) now at 32+6 and 43 days since birth, weight in grams 1616 (3 lbs 9 oz), 4 wet diapers, 2 poops. How much food he is getting and how often, his 02 level, Pip and Peep levels, breathing rate. Last time he spelled (deceleration of the heart and breathing stops, if he goes too long he goes limp) talked about doing an echocardiogram because he is not weaning off the 02 as fast as he should and also a chest x-ray.
Joe explained it to me. There’s a duct when a new born baby breathes for the first time that should close. It’s the breath of life a sudden influx of blood enters the lungs, this duct that has been directing blood to other parts of the body now has a signal to shut down and should within the first few hours. But when this doesn’t happen its called Patent Ductus Arteriousis.
In micro preemies that doesn’t necessarily happen so blood is getting rerouted away from the lungs. If the duct is wide open they will need to go in through the back and do a minimally invasive surgery to put a sleeve around the duct to close it. If it’s only partially open they can treat it with medication. We will know the results this evening.
We follow the nurse back to Dean. Joe and I tag team. I take Dean’s temperature and Joe changes his diaper, which is poopy. Joe’s first poopy diaper to change with Dean. He also swabs out Dean’s mouth. These are called his cares and they are done for Dean every 4 hours. The parents get to do it if they are there.
I have been sucking on a cough drop to keep myself from coughing and now comes the crucial moment. The nurse asks if we going to hold the baby and Joe pipes up that Katie really wanted me to get a chance to hold him. I haven’t held him at all yet.
Just then the OT’s (Occupational Therapists) come by and wonders if we want to give the baby a massage.
There is a green leather recliner at each babies station (Joe told me later that some family donated all of them) specifically for the mothers or parents or in this case grandparent to sit in while they hold the baby. The OT wipes the recliner down with an alcohol wipe and I sit in the chair.
The nurse has to disconnect Dean from the monitor. She gently lifts him out of the isolette trailing his oxygen tubes and lays Dean on my chest and then she reconnects him to the monitor.
My eyes start to leak as I feel the weight of that tiny baby lying on my chest. I rub my hand up and down his back and immediately check myself.
It is instinct to stroke, cuddle, bounce and kiss a newborn but preemies should still be in the womb surrounded by constant pressure and amniotic fluid. All the things you instinctively want to do stress out a preemie.
The OTs help me unswaddle Dean and then put a teaspoon of oil in my hand, I rub my hands together until they are nice and warm. I am instructed to put gentle but firm pressure on his back and let his breathes indicate the slow steady slide of my hand down his back. I have his legs cupped in my other hand and pushed up to his body.
I only do it a few times and then they cover him with warm blankets. I just hold him and at first his little head keeps going back so he can get a good look at me. The nasal cannula (oxygen tubing) is taped to his cheeks and his feeding tube is taped to his chin. When he is big enough the feeding tube will go in through his nose instead of his mouth so it won’t be so easy for him to pull out. Because the massage tuckered him out he falls asleep. His little hand reaches up to lay on my skin at my neckline.
He gets his feeding at the same time it’s warm breast milk that has been fortified with additional calories. It’s in a syringe that is slowly plunged, by a machine, into his feeding tube.
Since he has begun to regulate his own temperature a little better they now are able to swaddle him. Swaddling also helps confine his arms. His flaying and stretching catch his little hands on the feeding tube and he pulls it out regularly.
Toward the end of the feeding he gets really uncomfortable because his tummy is so full.
You find yourself watching the monitor a lot. A yellow light flashes at the top of the monitor and a bell dings if his O2 doesn’t stay in the 88-95 range. If his heart rate gets too low a red light flashes and a bell clangs. The yellow light goes off quite a bit but the red light only flashed once while I hold him.
There is a symphony of bells dinging with 8 baby monitors in the room.
When the red light starts flashing and the bell clangs a nurse will call out, “it’s okay, it’s okay”, as she heads over to fix the issue. Usually just a pat on the baby’s back brings him or her back up to normal.
Each nurse is in charge of two or three babies but they are constantly helping each other out.
Dean has two primary care nurses; Jeanette and Claudia.
Jeanette helped take care of Justin when he was in the NICU. She is in her 50s and had no children of her own and has dedicated her life to the care of other people’s children. She even babysits some of the other nurses’ children on her off hours. The nurses work for 12 hours 7 am to 7 pm or 7 pm to 7 am.  So the NICU is off limits from 6:30 to 7:30 am and pm for the shift change.
Claudia has years of experience and is so funny. One night a couple of the weeks ago Kaitlin was doing Dean’s cares and she reported that Dean’s diaper was dry. Claudia fired back, “Time to potty train.”
I tried so hard not to cough but of course that only made it worse. I did cough several times but no one seemed to care.
The tech came in to take x-rays and echo-cardiogram and of course my time with Dean was over. They put him back in the isolette.
We stayed to watch and Joe held Dean’s arms while the girl was doing the eco.
Joe stood for a long time with his arms on the top of the isolette his head resting on his arms just staring down at his son. It was such a tender moment.
I grabbed my purse and we grabbed our jackets as we left. Elevator rides and crossing the lobby to the parking garage.
What an amazing day, I held Dean today!

P.S. Good news the opening is at a one which means no surgery, steroids. Yay!
Bath time