NICU Day 1: (3/9/11) Bug was born at 9:48am, 12 hours after my water broke (PPROM). He was at 34 weeks 2 days gestation, 5 pounds 3 ounces, and 19 inches long. A pretty good size for his gestational age, measuring almost exactly where he should have been! He had respiratory distress syndrome (RDS). The steroid shots I was given weren’t in my body long enough to help his lungs mature. I didn’t see him for a few hours so the NICU could do testing and get him comfortable. I started pumping colostrum that afternoon which Daddy Bug ran to the NICU for me, the first of many deliveries, in hope that Bug would be able to take some soon. My sisters came to visit a little and brought us toiletries, changes of clothes and pjs, chargers for our phones, and McDonald’s for lunch. Not exactly nutritious but it was what I wanted! My parents came later with dinner, Italian hoagies from Primo, something I missed during pregnancy.
The first time I saw Bug after birth in the NICU he was connected to a CPAP machine to assist his breathing and give him extra oxygen, along with an IV, a cardiopulmonary monitor, a temperature sensor, and a pulse oximeter. It was awful, and I cried a little, but he didn’t need to be intubated so I tried to count my blessings. He was given one dose of surfactant to lubricate his lungs and make it easier for them to expand while breathing, a very standard treatment for preemies. He was also given two kinds of antibiotics the first 7 days of his life, assuming that I had an infection that caused my water to break early AND that I might have been positive for streptococcus B. It’s a bacterial infection that pregnant women are tested for in the last month of pregnancy, but I was never tested for due to this whole preemie business. He was also started on an iron supplement in his IV for anemia. When I visited Bug a second time later that night he was off the CPAP and I was allowed to hold him again!
NICU Day 2: (3/10/11) Bug got worse overnight, which is very common for late preemies, especially caucasian males. He was just too tired from fighting to breath. They discovered he had a pneumothorax in his right lung, which is basically a pocket of air in the pleural cavity around his lung. They used a needle to suction out the air pocket, which thankfully didn’t return. They also found he had a PDA (patent ductus arteriosus), which meant that an artery in his heart that usually closes after birth in most babies, was still partially open. That meant his blood wasn’t getting oxygenated properly, further compounding his breathing troubles. He was given three doses of indocin (a medication that helps close the PDA) over the next several days. I believe that Bug was given nasal cannula around this time, was on room air instead of an oxygen mixture. (I get this confused with when Bug contracted RSV and was hospitalized again at 3 months old, but that’s another long story.) I also believe he was connected to a feeding tube at this point but my memory fails me.
I was very touched by how loving my husband was this day in particular – he helped me to the toilet after my urinary catheter was removed, despite the fact that I was a big bloody mess. He filled my squirt bottle with warm water (no toilet paper for awhile!), helped me change into a new set of undies with a big old pad inside (really, the largest pad I had ever seen), and was just completely wonderful. He did the same when I took my first shower since giving birth. Blood. Everywhere. And he was completely unfazed. I am a truly blessed woman to have my husband to take care of me.
We were visited again by my family and our close friends, the Shanes. It was a great distraction, and they were all able to have quick, quiet visit in the NICU with Bug.
NICU Day 3: (3/11/11) Bug’s big issue this day was jaundice, another common preemie problem. He was started on a phototherapy bed and needed phototherapy for the next 12 days for the jaundice to resolve. They think it was just because he was premature and it was prolonged due to him eventually being solely breastfed. (Babies who take formula lose their jaundice more quickly).
The night before I heard a baby crying in the next room over, and its parents taking care of him. I was actually jealous of a crying baby – my baby wasn’t allowed to sleep with me in my room. My big issue this day was that I was discharged from the hospital. I had truly pushed it out of my mind not wanting to think about it; we even scheduled a visit with my father-in-law this day. Clearly we rescheduled when I came to my senses. Even though I was discharged in the morning, we were allowed to stay in the hospital until 7:30pm. It was so awful leaving him behind. I cried several times that day, including when the social worker came by to make sure I had support groups to reach out to and things of that nature. What an odd sensation to have a baby and NOT come home with him. A nice thing about this day was after coming home, I realized my mom and dad had washed, folded, and put away all the baby clothes, sheets, towels, and burpy cloths for us. She even made up the crib.
NICU Day 4: (3/12/11) We visited the baby very early this morning. He opened his eyes very briefly when he heard me talking to him! I don’t recall anything medical in nature happening this day. We were told that he wasn’t experiencing any kind of sleep apnea, which was a relief.
NICU Day 5: (3/13/11) The indocin worked and his PDA closed! Bug would have been given only one more dose, and if that didn’t work, he would have needed heart surgery. We were so happy to avoid it.
NICU Day 6: (3/14/11) Daddy Bug returned to work this day. I wasn’t allowed to drive yet so my dad dropped me off at the hospital before he went to work that morning, and Daddy Bug picked up in the middle of the day during his lunch/travel time between one school and the other. I was dependent on several volunteers to take me back and forth during the work day for the rest of this week. Thank goodness the hospital was only 15 minutes from the house. Bug’s nasal canula were removed! He was finally breathing room air without assistance or extra oxygen. His drops in heart rate (bradycardia) finally stopped today, as well as his drops in his blood oxygen saturation.
NICU Day 7: (3/15/11) We got to hold Bug for the first time since the day he was born! Daddy Bug got to hold him for the first time ever, poor guy. I fed him his first bottle – all those days of pumping finally paid off. My milk had come in just a few days before and I had PLENTY of it. He didn’t drink much, just 4-10 mL or so, but he loved the taste of it so much he smiled. He was moved from one type of bed called a radiant warmer (“fry-o-lator”) to another called an isolete (“incubator”). It meant he was getting better at maintaining his body temperature.
NICU Day 8: (3/16/11) Nothing special this day, just maintaining all the good things that happened earlier in the week. We have a tough little kid. At one point he required his IV to be run through a central line in his umbilical cord stump due to his fragile veins blowing out from the IV, but I don’t recall if that occurred on this particular day.
NICU Day 9: (3/17/11) Saint Patrick’s Day, our son’s namesake’s feast day. Bug wore a cute little hat that Mimi sewed a green clover leaf to. I found out that it was also supposed to be my surprise shower day at work. Bug and I spent the morning doing kangaroo care, where he got to snuggle with me on my bare chest. It was heaven! He started eating breast milk from the bottle every 3 hours taking about 30 mL at each feeding. Sometimes he got tired from eating and had to finish the rest of the meal through his feeding tube.
NICU Day 10: (3/18/11) More maintaining all the wonderful things Bug had done so far, improving his eating and working away the jaundice.
NICU Day 11: (3/19/11) Bug was moved off a phototherapy bed and started sleeping on a phototherapy blanket instead. He still struggled finishing a few of his feeds, getting too tired and falling asleep before he was done eating.
NICU Day 12: (3/20/11) After a feeding, Bug smiled when Daddy Bug gave him kisses this day. The most conservative of our 3 NICU doctors told us this day that if he took his next feeding without any issues, he would have completed 24 hours of regular, complete feeds and is the first of the last few milestones he needed to meet to be discharged!
NICU Day 13: (3/21/11) I was finally allowed to drive myself to the hospital. Good timing, because Bug was ready for regular breast feeding, and I wanted to feed him at least 3 times a day. That meant 2-3 hospital trips a day. I don’t recall now when we started trying breast feeding, but at this point we knew he liked it and was doing a good job. Also, Bug was ready to wear real clothes because the billirubin levels from his jaundice went down to a safe level! I can’t tell you how the simplest things, like being able to change my son into an outfit, could make me so happy. He no longer needed extra heat in the isolete because he was able to maintain his own body temperature when wrapped in his blanket. He completed the 24 hours of feedings and had the feeding tube removed. He also was allowed to ad lib feedings, instead of being reminded to eat, as long as he took in enough at least every 4 hours! We were asked if we had a car seat ready (oh if they only knew our car seat shopping story), meaning he would be going home very soon.
NICU Day 14: (3/22/11) Bug was circumcised this day. I wasn’t able to be there when they did it but the doctor called me before and after so I knew what was going on. Bug was also moved to standard hospital basinet. If he did well and maintained his own body temperature for the next 48 hours, he could go home!
NICU Day 15: (3/23/11) THE LAST FULL DAY!!! Bug did the car seat test that night and, because he pooped, failed it (it caused his heart rate to drop too much). So, $90 later, we were the proud owners of a car bed that we were required to lug baby around in until he was cleared by the pediatrician for a regular car seat. It now sits in my parents’ basement because we were afraid if we donated or threw it out, we would need it for the next child. Daddy Bug and I “nested in” this evening into the next day. We stayed over night at the hospital with the baby in our own hospital room, just like real parents and babies can do the first night baby is born.
Discharge Day: (3/24/11) No issues the night before, except for Bug not knowing why he was sleeping in such a dark, quiet room. The NICU wasn’t a loud place but the whir of machines and air and sounds of the alarms were always in the background. And they kept some lights on even at night, for obvious reasons. After a crazy morning of delays including the discharge nurse being off that day, a lot of babies being born, trying to locate the car beds, installing the car bed in our car, finding a way to pay for it (they couldn’t put it on the hospital bill?), Bug was finally discharged. We weren’t allowed to carry him in the hospital to the lobby per hospital policy, but they couldn’t find a wheelchair for me to ride in holding the baby, the car seat carrier he wasn’t allowed to ride home in was already packed in the car, and the car bed was installed in the car too. Eventually they decided it was ok to wheel him in the basinet he slept in the night before. We then carried him to the car and went home! God was trying to get us to relax and laugh a bit, I’m sure. What was one crazy morning compared to the last 2 weeks?
Bug’s first picture at home, waving goodbye to the NICU!
I can’t express my thankfulness enough for the doctors and nurses in our NICU. Daddy Bug and I had no idea what we were doing and they were patient, kind, even funny when we needed to laugh. While I don’t want to go through this again, I have absolute trust in these individuals and would go there if we had another preemie. We were so blessed to be in their care.
(Go on to Part 3 to learn about Bug’s RSV infection and 5 day stay at CHOP.)