They say every pregnancy is different. I guess they are right. Our preemie Lucas was born prematurely and stayed in the hospital for almost two months. This is the story of our second pregnancy that ended abruptly in the NICU of Northside Hospital at week 30 and six days.
Our Second Pregnancy
This post is meant as sort of a conclusion of my earlier posts dealing with our second pregnancy. It’s dedicated to all those parents out there who either expect their baby to be born prematurely or who have a baby in the Neonatal Intensive Care Unit (NICU) or Special Care Nursery.
Kathy and I read “Baby 411*” when she was pregnant with Isabella, and I remember that we intentionally skipped the part dealing with preemies. We never figured that soon, we would be having a premature baby.
Someone Moved Our Cheese
Fast-forward to December 28th, 2015. During a “routine” ultrasound (routine considering the situation Kathy was in) we were told by the Perinatal specialist that he recommends immediate delivery via cesarean section.
We still had eight weeks until our due date and Kathy, and I will never forget the feeling in the pit of our stomachs when we processed that statement. It felt like tears were getting in line behind my eyeballs, ready to storm out. But somehow I managed to keep them from pouring out. My wife did notice however that I suddenly became a bit “jumpy,” a sure sign that I was nervous.
C-Section And Other Surprises
Our doctor wanted to perform the surgery within the hour, but thanks to a cookie Kathy had for breakfast we got delayed until 1:30 pm. Everything felt surreal as a nurse brought us into the C-Section waiting area. Shortly after 1 pm, the anesthesiologist came to place an epidural, and I scrubbed up.
Then we were brought into the OR, and in less than 15 minutes Lucas was delivered by Dr. Garcia. Weighing in at only 992 grams (2lb 3oz) he looked nothing like what we expected our baby boy to look like.
He did, however, express his displeasure for being forcefully removed, from what he knew as home, by screaming his head off. That was a pleasant sound as it indicated that his lungs were somewhat functional.
A team of neonatal specialists (led by Doctor Drohan, who incidentally looks like Kristanna Loken in Terminator 3, as both Kathy and I noticed later) immediately took care of him and made sure his vital signs were stable.
He didn’t need a ventilator but was put on oxygen using a so-called CPAP to help keep up the pressure in his airways. His APGAR score was eight and nine, which was surprisingly good compared to the two and nine our full-term daughter had.
While Kathy got stitched up, I followed the neonatal team up to the NICU. There, nurses put Lucas in what would become his home for the next couple of weeks: a fully pimped out and air-conditioned incubator with a built-in scale called an isolette. I wouldn’t have been surprised if it had WiFi too.
The NICU at Northside Hospital
The NICU is a busy and exciting place. There are beeping monitors everywhere, and nurses roam around to check on all the babies. We didn’t know anything about what to expect in a NICU. In retrospect, we should have read the book Preemies (Amazon*), which we only started reading much later into our NICU adventure.
But after a few days, you get the drill and into the routine. Nurses are on 12-hour shifts (7 to 7) and work for up to 3 days a week, often on consecutive days. Our baby gets fed and cared for every 3 hours at 5, 8, 11 and 2.
You learn what the numbers and waves on the monitor mean, and you breathe a sigh of relief when the alarm going off is not your baby’s but that of a baby next to yours. You should stay close to your baby’s incubator and not be curious about what’s going on at the next one. But you can’t help but notice other babies’ alarms showing on your baby’s monitor.
Over time you learn the names and pod numbers of your neighbors and you kind of build a relationship with those babies (or at least their pod numbers and names) – even though you may have never gotten a good look at them. I still remember some of the names that we shared Pod F with on the second floor and I felt especially bad for a baby next to us, who appeared to be in more critical condition than Lucas was.
NICU Level 2 vs. Level 3
I don’t know what happened to any of the babies we had as neighbors, but given the incredible track record of Northside Hospital, I can only assume they’re doing well.
Weeks later we met one mom whose name I remembered from our days in Pod F at a NICU parents meeting. She confirmed that her baby was doing well and we were relieved to hear that.
The 2nd floor at Northside Hospital is a Level 3 NICU, where most, if not all admissions arrive. We spent only a few weeks on the 2nd floor before nurses transferred him to the step-down unit (Level 2 NICU) on the 7th floor.
Those few weeks on the 2nd floor are often the most critical ones because you don’t know yet how your baby is and will be doing. Fortunately for us, Lucas was doing well and didn’t have any major complications.
He came off oxygen relatively quickly and started gaining weight after the expected initial weight loss. Besides weight gain, and getting off oxygen, the next milestone was his head ultrasound to make sure he didn’t have any intraventricular hemorrhages. Fortunately, the scan came back clean and so nurses moved him up to the 7th floor.
Later on the 7th floor, Lucas’ eye scan for retinopathy of prematurity (ROP) was his next milestone. Fortunately, also that scan came back without any major issues other than confirming that his retina was still immature.
So Many Questions (And Some Answers)
How Much Time To Spend In The NICU?
That’s the million-dollar question I’m sure all NICU parents ask themselves at some point. The bad news is, I don’t think there is an easy answer. Here is what has worked for us, based on the following circumstances: I work full-time, my wife runs the household full-time (with support from her mom at the moment), and we have a two-year-old toddler (Isabella) at home.
Staying in the NICU 24/7 was out of the question for either one of us. So we decided to split up and visit Lucas in the NICU once a day each. Kathy would go in the afternoon, while Isabella was napping and I would go at night after Isabella went to bed. That way, she wouldn’t get the impression that we’re in the hospital all the time and give her less attention.
We would stay for about 60–90 minutes, enough time to change his diaper, feed him and do an hour of kangaroo care (skin-to-skin). Sometimes, especially on weekends, we would both go at the same time and stay 90–120 minutes. That way, we could enjoy some “normal” time in the evening, have dinner together or watch a movie.
Adjust Your Mask First Before Helping Others
While reducing the risk of our toddler getting jealous, our cadence also allows us to keep up a somewhat normal life. We heard from other moms, who spend most of their time in the NICU. After a while, they started hating that place and got frustrated. I don’t think that makes any sense.
Like they say in an airplane when the oxygen masks drop down: “Adjust your mask first before helping others.” That sounds harsh, I know. But I firmly believe that I am the best parent possible if I am somewhat well-adjusted and happy. I don’t see myself being the best I can be when I’m frustrated, desperate, sleep-deprived or otherwise unbalanced.
Plus, you can only do so much with your preemie, who gets easily overstimulated and should to sleep in peace most of the day.
But whatever you decide works for you, don’t feel guilty if you can’t spend as much time in the NICU as you want or thought you could.
The NICU Is Horrible, And I Can’t Stand It Anymore
For us, quite the opposite is true. Well, we certainly wished Lucas was born full-term and didn’t need to stay in the NICU at all, but that wasn’t under our control. Now that he is in the NICU, we embrace the opportunity and experience.
I can’t tell you how much we learned about perinatal and neonatal medicine that we never thought we would learn. Lucas’ situation has indeed widened our horizon, and I’m glad we got this opportunity, given the circumstances.
Also, in one of my last posts, I wrote about gender disappointment. Since we learned that our second pregnancy would take a slightly different route than we had originally planned, gender has become a non-issue for us.
Don’t Worry About Everyone Else
It’s easy to compare your baby to the one “next door.” Don’t! You don’t know the circumstances that led to another baby’s admission to the NICU so that you could be comparing apples to oranges.
Even if other parents tell you how great their baby is doing, making you feel like yours isn’t progressing fast enough – forget about all that. Some parents tell you what they wish was true and some babies may, in fact, be progressing faster than yours. For example, a nurse told us that black girls progress faster than white boys.
Well, we happen to have a white boy, and I’m OK with that. Can you imagine the discussion I would have had with my wife if we had delivered a black girl? :)
We have heard parents get upset, frustrated or depressed when they see other babies getting discharged before their own. That’s the same as getting upset when you find out that your neighbor drives a nicer car than you do. Jealousy is ugly, that’s all I can say about that.
The Last Few Days Or Weeks Feel Like An Eternity
Nurses keep telling us that the last few weeks or days in the NICU feel like they would never end. So once your baby is stable and has become a so-called “feeder and grower,” it may feel like an eternity until he finally meets all criteria for discharge.
For Lucas that means no more bradycardia and taking all feedings by mouth. As of this writing, he takes four feedings by mouth, and it’ll be a couple of more days until he will have enough stamina to take all 8. Neither of us is biting our nails, nor are we counting the hours until his discharge.
Of course, we want him to come home, but we are also acutely aware of the fact that he is living in an all-inclusive hotel right now, giving us time to prepare for his arrival properly.
Who Moved My Cheese?
I would say we have had a relatively smooth ride so far, considering the circumstances: Low PAPP-A, weekly monitoring, three hospital admissions (over Thanksgiving and Christmas), canceled travel plans, emergency C-section, premature baby and what will probably end up being at least six weeks in the NICU.
While in the NICU Lucas had some intermittent drops in weight and he was longer on caffeine than I expected. Doctors prescribe caffeine to counter episodes of apnea and bradycardia. And while he is a good breastfeeder, his skills on the bottle are still modest at times.
We live only about 25 minutes away from the hospital, and we have had a lot of help from my mother-in-law. So I guess we could have had it much worse. But we could have had it much better too – especially when compared to our first pregnancy.
In the end, it doesn’t matter how good or bad you have it. What matters is to learn how to deal with whatever life throws at you. Remember, someone or something will move your cheese*, and it is up to you how you respond to it.
The Journey Of Our Preemie In The NICU Of Northside Hospital
Having a baby in the NICU wasn’t your choice. Plus, there isn’t much you can do to change that. Worrying to a point where it makes your life miserable doesn’t make any sense.
Instead, embrace the experience, learn what you can and know that nobody can take that experience and those special memories away from you. It’s something you and your baby will share, for the rest of your lives. Or as the parting CEO of Delta Airlines, Richard Anderson liked to say: “Sit back, relax and enjoy your flight.”
I’d love to hear about your experience in the NICU! And I would like to say special thanks to the awesome staff at Northside Hospital Atlanta!