Saturday, January 12, 2013

NICU...

I have mixed emotions in writing about the NICU (neonatal intensive care unit).  On the one hand, there were lots of positive, amazing things about the NICU.  I will be eternally grateful for the wonderful care that Elliott and Sidney received from the nurses during their respective stays in the NICU.  I got to hold both of them for the first time ever in the NICU.  We learned a ton of tricks and secrets about how to take care of babies from the NICU nurses.  The NICU nurses really got the boys on a schedule, which we have learned is invaluable when you have multiples!

But on the other hand, it became very difficult for me emotionally as time went on to have the babes there- I really just wanted them home with us.  And to be quite honest, I think I've emotionally and intellectually repressed most of the details from their time there.

After Jenson and I left the recovery room but before we were taken up to our hospital room, I was given the option of stopping to see the Elliott and Sidney in the NICU if I wanted.  Now this may not seem like too big of a deal, but you have to keep in mind that I was still in a gurney/bed at this point and unable to walk yet, so they'd have to wheel my gurney/bed into the NICU to make this happen.  A part of me didn't want to be a bother or cause anyone to have to do anything special for me.  But the way, way, way bigger part of me was like, "Take me to my babies now!!!!!!!"  So to the NICU we went (thank God again for my sweet nurse Angelique for being willing to make this happen).

When we got there, Elliott and Sidney were in different rooms.  The NICU at Sutter Memorial has multiple rooms (by the time both boys were discharged, they'd been in four different ones!), but the boys were moved into the same room right next to each other within 36 hours.  Even though they were in separate rooms, they looked kind of the same in regards to all of the stuff attached to them.  They were attached to monitors that constantly checked their vital signs (heart rate, blood pressure, respiratory rate, temperature, oxygen saturation), so there were multiple probes/stickers attached to them for that.  They both had IVs, so more lines for those.  They each were requiring the noninvasive CPAP machine ( (hereafter known as "bubbles" as the oxygen actually bubbles as it goes through water), so those were hooked up to their noses.  And because they were hooked up to the CPAP, they had to have orogastric tubes as well.  The orogastric tube is inserted through their mouth, down their throat, and the end of it sits somewhere in the stomach- not pretty, but necessary.

And they were placed in beds that our friend Jen liked to call "baby jail".  They were actually pretty cool machines.  The babies were in Giraffe incubators (Giraffe is the brand; check them out online!), which have the capability of regulating the environmental temperature and humidity and are great for taking care of NICU babies.  The babes were basically enclosed in the beds as they had side walls and a top on them, hence "baby jail" (they are actually way cooler than I'm probably making them sound).

It was hard to see the babies in their "jails", but it was pretty obvious when looking at them that they needed to be there.  Both of them were breathing pretty rapidly (especially Sidney) and they just really needed the interventions that the NICU could provide.  Even though I was on my gurney, the staff moved things around so that they were able to get me close enough so I could touch the boys through the little armholes on the sides of the incubators.  

They looked so big and yet so fragile all at the same time.  It makes me a little teary right now to think back on that experience, but I think I handled it well enough at the time.  I was so excited to see them a little bit better and a little bit closer than I had gotten to during the delivery.  My boys!!  Even with all of the junk attached to them, they were absolutely beautiful.  Just beautiful and perfect.  

It was hard not to be able to hold them yet like I could hold Jenson, but I actually wasn't too bothered by that and let me explain why.  Because I knew that the boys needed the extra help that they were receiving, I didn't want to do anything to upset them or disturb them- I could wait if that was what was best for the babes.  But here's the real reason why I was able to handle it and not be too upset about the situation:  things could have been so much worse.  

Throughout the pregnancy, both Jason and I had been bracing ourselves for worst-case scenarios.  And to have those worst-case scenarios fall by the wayside after the boys were delivered and were as relatively healthy as they were?!?  I shouldn't have been anything but grateful.  After all, there are so many parents in this world who would give anything for their baby to have as few problems after delivery as Elliott and Sidney had.  It would be easy to mourn for them not getting to be with us after delivery like Jenson was able to, but we chose to celebrate the fact that Elliott and Sidney were as healthy as they were.  Those two little peanuts were working their butts off to get better and healthier in those incubators, so how dare I be anything but grateful?  I've tried to keep this saying in my heart for a while...

Don't pray when it rains, if you don't pray when the sun shines.
-Satchel Paige

And so even though it may have seemed like the duration of the boys' time in the NICU was "rain", it truly was "sunshine" compared with what it could have been and I was saying prayers of thanks for that sunshine.

One of the things that I will probably carry around in my emotional baggage for awhile deals with the boys even having to go to the NICU in the first place.  A small part of me feels like I failed Elliott and Sidney because they had to go there.  Yes, I know (intellectually speaking) that the vast majority of triplet babies usually spend at least a little bit of time in the NICU, so this was just par for the triplet course.  But I can't help but think that maybe if I'd just eaten a little bit better, rested a little bit more or in a different position, hadn't worked so long, taken better supplements, etc, etc... maybe they wouldn't have had to go at all.  Wishful thinking, neurotic thinking really, but I can't help but feel like there was something more I could have done for my little peanuts during the pregnancy to prevent them having to be separated from Jenson, Jason, and myself during that time.


Elliott came off of the bubbles with 36 hours and then I actually got to go skin to skin with him while sitting in the NICU.  He seemed so huge compared with Jenson (those 2 pounds seemed like a HUGE difference!).  With the tubes and wires still attached to him, I was worried that I might do something to disrupt or upset them, necessitating them to have to be reinserted/reattached and cause him more discomfort.  This is where you really get to see the skills and talents of the NICU nurses in action.  His nurse that day helped me get situated so I could hold him, and then she got him arranged so that she was just able to place him into my arms... magic.  I just wanted to hold him forever.

Sidney came off of bubbles a few days later- he definitely needed a little more assistance at the beginning.  Holding him in my arms for the first time was wonderful and scary all at the same time.  Because he'd needed help for longer, I thought of him as being more fragile than he probably was.  But this is the miracle of babies- they are actually much more resilient than we give them credit for.  Sidney demonstrated this in the most wondrous of ways.  The first time I put him to the breast in the NICU to just see if he could latch, my little munchkin just latched right on like a champ with almost no help at all from me.  Of course the obvious joke here is that he was such a great eater when he was in my tummy (he was the biggest of the three boys after all!), so why wouldn't he be after he was born?!?

Elliott was discharged from the NICU to come home only one day after Jenson and I were discharged.  Sidney had to wait one more week... yucky.  Here's the story:  around 2am on the morning that Elliott was discharged, Sidney had what is called a bradycardia episode.  Basically, bradycardia is when the heart rate drops below an expected range.  To my understanding, it's not necessarily unusual for the average newborn to have them, and we just don't necessarily know every time they're having one because they aren't always attached to a vital signs monitor.  They are usually a reflection of the baby's brain/body making the normal adjustments to life outside of the womb.  The important things are that when a newborn has them, that they are short-lived (the brady episodes, not the baby!) and that they self-correct themselves without the need for interventions from medicine (meaning the baby is able to bring its heart rate back into the normal range on its own).

In Sidney's case, there were good things and bad things.  First, the good things.  His brady episode was short-lived and the nurse never had to do anything to correct the heart rate.  Sidney did it on his own!  The bad thing- he was on the vital signs monitor, so we knew for sure that he'd had one.  The other bad thing- he was already in the NICU when it happened.  At Sutter Memorial, they have a policy where if a NICU baby has a brady episode, they have automatically given themselves a seven day clock.  They have to stay in the NICU on the monitors for seven days to be monitored for additional brady episodes, and any during that time will cause their "seven day clock" to be reset.  Once they've had one brady episode, they have to go a full seven days without any more brady episodes in order to be discharged.

Multiple brady episodes (or ones where the baby is unable to bring its heart rate up on its own) could be a sign of some underlying problem, so hence the monitoring to see if this was just a normal baby thing or an unhealthy baby thing that would have required additional testing.  Thankfully, Sidney never had another brady episode while on the monitors during the next seven days, so he never reset his clock.  Jason and I would go and visit him at least twice a day, and each time we went we kept reminding him NOT to reset his clock.  "Be a good boy and no bradys buddy!"  Thank God he listened, or I probably would have been personally admitted to a psychiatric unit!

It got a little frustrating towards the end of his seven day monitoring period because it just felt like he didn't need to be there anymore.  He was looking and acting just like Elliott and Jenson, who were already at home with us.  But the doctors were certainly not going to relent and grant him an early discharge.  When I wear my healthcare professional's cap, I totally understand why.  But when I put on my mother's cap, I was torn.  Yes, I want you to make sure my baby is okay.  But on the other hand... give me my baby!

Sidney ended up being discharged home from the NICU on Jason's birthday, exactly one week after Elliott.  The doctor arrived at the hospital at 7 AM that morning, and I was at Sidney's bedside at 6:55 AM just waiting for the doctor to come around and discharge him.  By the time the doctor came to the bedside, Sidney was dressed and ready to go and his bag packed- all we had to do was put him in his infant seat and go... a little antsy, weren't we?!?  When Jason woke up that morning, I was so excited to give him his birthday presents- a mocha and his baby newly discharged from the NICU!!  Jason has told me that it was the best present ever.

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