Monday, July 30, 2012
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A Patent Ductus Arteriosus or other
wise known as a PDA is a blood vessel that is present in all babies while still
in the womb that does not close within the first few hours of life.
Ductus arteriosus is a blood vessel that is open while the baby is in the womb,
that allows blood to bypass the lungs and allows blood to flow from the
pulmonary artery to the aorta. When the baby is born, and the umbilical
cord is cut, the baby takes a few large breaths, which cause the lungs to
supply the oxygen. The lungs expand, the blood vessels relax and receive
more blood flow and the ductus arteriosus usually closes on its own. When
the ductus arteriosus does not close on its own it is known as Patent (meaning
open) Ductus Arteriosus or PDA. When the PDA does not close it allows
oxygen-rich blood from the aorta to mix with oxygen-poor blood from the
pulmonary artery. This can strain both the heart and the
lungs.
On average PDA is a fairly common
congenital heart defect that is diagnosed in the United States. Although
the condition can happen in full term babies, its more common in premature
infants. It is also twice as common in girls as it is in boys.
Here are some signs that a baby may have a PDA:
- Fast Breathing
- Working Hard to breathe
- Shortness of breathe
- Premature babies may need to be put on a ventilator, CPAP machine or nasal cannula due to a PDA
- Poor feeding
- Poor weight gain
- Tiring and wearing out easily
How
a PDA can be diagnosed:
Typically a Doctor or nurse can hear a
heart murmur that is the result of a baby's PDA. A heart murmur is
an extra or unusual sound heard with the heartbeat. There can be several
reasons and many causes for a baby or child to have a heart murmur that does
not mean they have a PDA.
After a Doctor or nurse suspects a PDA
they will then order a Echocardiography (heart echo) or an Electrocardiogram
(EKG) to take a look at the baby's heart. The Echo is an ultra
sound that can detect the size of the PDA and how the heart is responding to
it. The Echo can also tell how the treatment is working. During an
EKG the will place electrodes on the baby's chest (arms or legs) to measure
heart activity. The EKG traces the activity of the heart onto paper for
the doctor to see the rhythm, speed of the heart beat and whether the heart is
enlarged.
Treatment
for a PDA:
For a full term newborn with a PDA that
is showing no signs or symptoms the Doctors will usually try and give it
time to close on its own and monitor the PDA with doctor visits.
However if a PDA is still present after the newborn stage, it generally will
never close on its own.
For a premature baby a PDA can
go two different routes, it can either be causing one or several of
the symptoms we talked about earlier which would mean the baby would need
surgery to close the PDA immediately. If the baby is showing minimal to
no regression signs from the PDA then the doctors will take a wait and watch
approach, where they will monitor the baby's symptoms and PDA very closely
while still in the NICU. A PDA if given time, will usually close on
its own in a premature baby but there are some instances where a baby will be
discharged from the NICU with a PDA and have to follow up with their
pediatrician as well as a pediatric cardiologist to monitor the PDA. In
most cases if it does not close between 6 and 12 months then they will either
do surgery or a procedure to close it.
The reason why they can not let a PDA
go, usually past the age of 1, without it closing is because it puts a child at
large risks for contracting an infection called infective endocarditis (IE)
which is an infection of the inner lining of the heart chambers and valves.
3 ways
to close a PDA:
- Sometimes, although it is happening less and less a doctor will treat the PDA with medicine in hopes that it will close sooner without surgery. Doctors will often use Ibuprofen or Indomethacin to treat premature babies to help close the PDA. However those medicines are showing to have many side effects that can effect the kidneys, so Doctor's have started to use this approach less and less. Also these medicines have to be administered within the first 7 days of life for them to be effective.
- If a premature baby is having distress with their lungs or heart due to the PDA then a doctor will have to perform a PDA ligation surgery. During a Ligation surgery the baby is put completely under and intubated. During the surgery a small incision between the ribs and the ductus arteriosus is tied and cut. This surgery can be preformed at any age.
- Lastly is the Cardiac Catheterization Procedure. If a full term newborn makes it to 6 to 12 months with its PDA then usually a doctor will opt to perform a Cardiac cathererzation procedure. The baby or child is sedated and catheters are placed into the blood vessels in the groin and fed up to the heart where they take pictures of the ductus arteriosus with dye. They will then use either a coil or flexible device within the ductus to "plug" it.
My daughter Nora was born at
25weeks 5 days and she was diagnosed at 1 week old with a PDA. We were
lucky due to the fact that Nora has had minimal complications so far with her
PDA. There were a few times in the NICU when Nora had to go up
on her oxygen because they thought that her PDA was causing her heart
to shunt ( oxygen-rich blood from the aorta to mix with oxygen-poor blood
from the pulmonary artery). Nora also had a hard time coming off
her oxygen, but she was finally oxygen free 2 days before discharge! However
she still needed the oxygen for feeds so we were sent home with
oxygen. Doctors said this was most likely because of her Chronic lung
disease but also because of her PDA still being open.
When Nora was first diagnosed
with her PDA it was considered small and minimal and when she contracted an
infection a few weeks later, her PDA went from small to large. The
Doctors have kept a close eye on it, but she was discharged from the NICU
at 39weeks 3 days and her PDA had not closed. It is now considered
small-moderate in size. Nora also has high blood pressure, which her
Pediatrician wants to make sure is not being caused by her PDA so we have been
referred to a Cardiologist. Nora is now almost 6 months actual and
2.5months adjusted and we will be seeing a Pediatric Cardiologist in two weeks,
6 days after her 6month birthday. Judging from everything I
have read and heard it sounds like Nora's PDA is past the point where it will
most likely close on its own. Her Cardiologist could still give it a bit
more time, but we will have to wait and see what he decides. I am still
not sure because of her being a preemie and still being so little, whether she
will have the ligation surgery or she will have the catheterization
procedure. Although a PDA can be very serious, it is also very common in
premature babies and usually has no long term effects if treated appropriately.
To read more about Nora's story
or to follow her PDA outcome you can go to my blog at:
In researching for this post I have
used the following articles:
Friday, July 27, 2012
About halfway
through our NICU stay both twins were diagnosed with reflux. Blake’s was
solved mostly by keeping him up right after feedings, and pacing him.
The closer we got to their due date the better things got for Blake.
This was not the case for Addison.
They first tried her
on medicine, Prevacid, but that didn’t work. Next they tried adjusting
her feedings so that they would run slower over a period of a few hours.
That didn’t work, so they tried pushing her feeding tube down further,
past her sphincter muscle and in to her intestine, bypassing the stomach
all together and in hopes of stopping the refluxing. She was still
having Brady spells and refluxing but not as bad or as frequent. Her
case was so severe that they did not even want to attempt oral feedings.
At this point it was
decided that she would be transferred to another NICU where there was a
GI doctor on staff and would have her evaluated for a G-tube and Nissin
Fundoplication. The Nissin Fundoplication is surgical procedure to
treat reflux. During the procedure the surgeon would wrap the top part
of the stomach around the bottom of they esophagus and stitch it into
place, which reinforces the closing function of the sphincter muscle,
thus preventing reflux.
We were very
hesitant to put our baby under the knife for any reason, and while we
waited for her transfer I started researching the procedure and looking
for other’s experiences. There were a lot of mixed reviews about the
procedure which only left me more confused, nervous and undecided.
When Addison
was finally transferred to the new hospital, we had to wait a few days
to meet with the surgeon and come up with a plan. First thing he wanted
to try was moving her feeding tube back to her stomach and see how she
responded, it was clear she still wasn’t tolerating it, even though she
was still on reflux medicine. He also wanted to run a pH Probe to just
how much reflux she was having and how often, but to do that they would
have to stop her medicines and risk an increase in the reflux and
potential aspiration. The surgeon was very hesitant to do the pH Probe
due to the overwhelming volume she was already refluxing with meds, and
cautioned us and we were left to make the decision. Seeing her in pain
and choking on formula over and over and needing to be suctioned several
times a day… we knew our only option was the surgery.
On 6/13/11, Addison
underwent surgery and they were able to successfully perform the Nissin
Fundo and place her G-tube. To be honest things were very rough for a
few weeks after surgery, and again we questioned why we did this to our
little girl. The surgery itself was successful but afterwards she stayed
intubated for almost two weeks and ended up with yet another staff
infection, these were things we were prepared for but not expecting. The
Neo who sent her to surgery reminded us of where she started (she had
always been sick from a respitory stand point) and told us point blank
to expect a decent intubated period post op. The reflux certainly didn’t
help her already fragile airway.
After those first
two weeks post op, things did get MUCH better. I spent my days learning
how to care for her G-tube and how to feed her. All while managing her
twin brother who was already home and waiting for his sister to join us.
When she came home things went well, but I must admit, I had a very
strong love/hate relationship with her G-tube initially (and some days
still do). But as the weeks went on and she got bigger and stronger and
healthy I knew we made the right call for her. We did experience
retching (where she would gag a little but couldn’t bring whatever was
causing it aka reflux, up), but that too got better over time and we
learned some things triggered it.
She is now almost 18
months old and is still primarily G-tube fed, but otherwise doing well.
She is no longer in pain from her reflux and developmental is not too
far behind. Had we not done the surgery it’s hard to say how much longer
they would have kept her in the hospital waiting for her to out grow
the reflux.
Tuesday, July 24, 2012
For Part 1 of this series, click here
HOW IS GER DIAGNOSED?
HOW IS GER DIAGNOSED?
If your infant or child has any of the above
symptoms and you are concerned that she may have reflux, talk with your pediatrician
about having her evaluated. GER may be diagnosed by a single office visit, or a
referral may be needed to a pediatric gastroenterologist for further
evaluation. Your doctor or specialist will review your child's symptoms,
determine if her weight gain is appropriate, and possibly order special tests.
These tests may include an upper gastro-intestinal X-ray (UGI), a milk scan, a
24-hour pH probe, or an endoscopy.
My son was sent back to the NICU
(ugh!) and it was there that they started to run some tests on him. He was seen
by the Speech Therapist/ Feeding Specialist to see if it was his suck, swallow,
and breathe. It wasn’t. I told them that he was obviously uncomfortable and I
was convinced it was reflux. They don’t like to put babies on reflux meds but I
really pushed them to figure out what was going on. He went in for an Upper GI
(UGI) and they found that within a mili-second of him swallowing, the food came
back up and down over 7 times. Thankfully, he wasn’t aspirating (where the
liquid food comes back up and goes into the lungs). So it was then we got our
diagnosis of “severe reflux”.
TREATMENT:
Treatment of GER varies from simply
thickening formula, to medication, to surgery. Your doctor may begin with
thickening the formula and suggesting that your baby be in an upright position
most of the day, especially after eating. Try to hold your baby without putting
pressure on her abdomen. Burp your baby frequently (every 1/2 to 1 ounce) and
encourage her to suck on a pacifier between feedings. This helps to keep the
esophagus in motion, pushing anything in the esophagus back into the stomach.
If an infant is in pain, has slowed or
stopped eating, or has apnea or bradycardia that is caused from reflux, more
aggressive management needs to be done. Medications such as Zantac or Tagamet
or Prilosec that decrease or block the production of acid, and/or medications
such as Propulsid or Reglan that improve digestion, may be prescribed. These
medications are often used in combination with one another.
Most children will out grow GER by one year
of age. As children grow, their esophagus becomes longer and the stomach
naturally begins to wrap around the muscle at the top of the stomach.
My son had been put on Allimentum
formula prior to his initial discharge because of suspected Milk Protein
Intolerance. This seemed to help his reflux as well because often times reflux
and MPI go hand in hand. I stopped pumping, which for preemie moms and preemie
moms with reflux babies can be an extremely difficult decision. He was also
already on a low dose of Zantac. With the new diagnosis, we were to thicken his
formula with 1tsp of rice or oat cereal (alternating) per ounce of formula. He
was also put on Prilosec and Maalox (as needed). He was to be kept upright most
of the day. We got a GI specialist on our team and we checked in with him
monthly and adjusted his medications as he gained weight. He was very important
because a GI specialist will dose your baby at the highest dose as opposed to a
Pediatrician who tends to be more reserved.
I wish I could say that it fixed
everything immediately. It didn’t. We played with his medications and the
thickened feeds to find the right balance. He lived in a Moby Wrap or his
Fisher Price Rock n Play (please get one if your child has reflux, you will
thank me!) or his swing or his car seat! It took months for the pain to stop
when he ate but I can say that by the time he turned 1 adjusted, he was off of
all of his medications and we hadn’t been thickening his food for months. My son’s
reflux was one of the most difficult things that I have ever endured and it
wasn’t even me with the pai
ADDITIONAL INFO:
I mentioned that babies spit up. They do spit
up and if you have a happy spitter then there isn’t a real reason to put them on
medication for reflux. I would still talk to the pediatrician about it to let
them know what is going on and to check weight gain. The medication does not
STOP the reflux, it only makes it more comfortable for them.
The other thing I wanted to call attention to
is something called silent reflux. It can be scary to not know that your child
is refluxing. It is harder to detect because they aren’t spitting up. But here
are the symptoms for silent reflux:
•
poor weight gain or rapid
weight gain
•
gulping with a painful look on
the face
•
sour breath, wet sounding burps
•
persistent or chronic cough
•
frequent hiccups
•
sudden burst of painful crying
•
painful wakeups from sleep or
poor sleeping habits
•
poor feeding habits, possible
feeding aversions
•
neck or back arching during or
after feeding
•
excessive fussiness, crying or
colic
•
demands to be carried
constantly
•
red or salmon colored throat
•
blood in the stool or spit up
These last two signs are possible
indicators of Barett's Esophagus. The risk of Barett's Esophagus is slightly
higher with silent reflux because there is generally more damage to the throat
with silent reflux in infants, although it is still a fairly low risk.
HELP:
Having a child with reflux can trigger many
emotions. It is normal to feel anger, frustration, and sadness. Sometimes it
helps to talk with those who can empathize with you and understand your
feelings and concerns, such as other parents of children with reflux. You'll
need support to make it through these difficult days. A national parent support
group called PAGER (Pediatric Adolescent Gastroesophageal Reflux Association,
Inc.) can help you find any further assistance you might need. Their website
address is http://www.reflux.org or they are located at PO Box 1153,
Germantown, MD 20875-1153, (301)601-9541.
OR
E-mail one of the Resource Blog creators and
they can get you in touch with me!
(Information taken from: http://www.prematurity.org/baby/reflux-maroney.html
and http://www.pollywogbaby.com/refluxandcolic/silent-reflux-infant.html
)
Monday, July 23, 2012
Each week the Preemie Resource Blog will look at one issue that effects preemies and their parents.This week we will discuss reflux, one of the most common issues among premature babies. Read Stacy's story about her son's struggle with reflux.
REFLUX
Reflux is one of the most common but
least diagnosed issues with preemies. I’ve found that many doctors do not want
to start a medication regimen for preemies in the NICU. What that means is that
many babies go home and continue to suffer out loud or in silence.
If you have ever had reflux or
heartburn, you can imagine what a little baby is feeling every time they eat. I
remember crying 8-10 times a day- every time my son ate. It was heartbreaking
to have to feed him when he was in so much pain. Then the spitting up got
worse. I was told; “babies spit up.” This was not a baby just “spitting up”.
WHAT IS GER?
“GER is Gastroesophageal Reflux. Gastro means
stomach, and esophageal refers to the esophagus, the tube inside the throat
that connects the mouth to the stomach. A muscle at the top of the stomach
(also called the Lower Esophageal Sphincter or LES) naturally opens and closes
to allow swallowing, burping, and vomiting. Refluxing occurs when the stomach
acid and partially digested food flow back up through the LES into the
esophagus. All children and adults will naturally reflux throughout the day,
especially after eating. However, if the muscle opens too frequently and
refluxing occurs too often, complications can develop.
Premature infants have an increased risk of
developing GER. There are several medical conditions that can cause reflux, but
in preterm infants, the most common causes are immature muscles and abnormal
breathing from chronic lung disease. If the lower esophageal sphincter is weak
or underdeveloped, it can remain open when it should be closed, letting the
stomach contents flow back up the esophagus. When an infant or child breathes
abnormally because of chronic lung disease, the muscles used for breathing work
harder. As these muscles work hard to breathe, they can pull on the muscles
near the top of the stomach, stretching the sphincter and causing it to remain
open.
When the stomach contents flow inappropriately up
into the esophagus they bring acid from the stomach. As the acid irritates the
tissue inside the esophagus, it becomes inflamed and reddened. This condition
is called esophagitis. Esophagitis is painful, similar to the pain of
heartburn. This is why an infant will refuse to eat or stop eating - she is
protecting herself from the pain of the acid touching the damaged tissue. If
the reflux is severe, the stomach contents may go high enough into the
esophagus to be aspirated or spilled into the lungs causing choking, color
changes, frequent respiratory infections, apnea (breathing slows or stops)
and/or bradycardia (slowed heart rate).”
SYMPTOMS:
As I said, “babies spit up” but reflux is much more
than that. Here are some common signs and symptoms:
•
spitting up frequently (more than
2 times a day);
•
fussy often throughout the day
(specifically before, during or after eating)
•
refusing to eat,
•
fighting eating;
•
taking only small amounts of
formula or food, regardless of the amount of time since the last feeding;
•
back arching during feedings;
•
bradycardia;
•
choking or apnea during or after
eating;
•
skin color turns pale or grayish
during or after eating;
•
poor weight gain; and/or frequent
respiratory infections.
Many parents say, "She acts like it hurts to
eat" or "It just seems like she is in pain."
My son would spit up every time he ate, even if he was held upright for
an hour after he ate. He refused to eat and would only eat a small amount every
2 hours. He would arch his back and cry and scream. It broke my heart because
he was a happy baby when he wasn’t eating or refluxing. Although his weight
gain was slow, he was always gaining so the doctors weren’t concerned. But
mother’s intuition told me that it was more than just spitting up. Eventually, my son spit up so badly that he stopped
breathing and my husband and I had to bulb syringe him until color came back to
his face. It was after that point that we finally got our diagnosis.
For more on reflux--how is it diagnosed, treated, and other how helpful information--click here
Friday, July 20, 2012
After two years of infertility, multiple methods of advanced reproductive technology (ART), my fourth medicated cycle which was a converted one from IUI to IVF was successful. At my six week ultrasound, I found out I was carrying twins!
My pregnancy had some concerns. At seven weeks, they were concerned with Baby A’s yolk sac and its viability. However, a viability ultrasound at eight weeks showed this to be a non-issue. Then, at nine weeks, I started bleeding. I was diagnosed with a subplacental tear / subchorionic hematoma. I continued to bleed for eight weeks and it was a long, stressful time during my pregnancy. Finally, at week 17, it stopped and I breathed a sigh of relief. From that point on I was glowing! I felt like a million bucks, everything looked excellent with the babies on my ultrasounds, and I was so excited to be pregnant and enjoying my pregnancy to the fullest.
On Thursday, January 19, 2012, I was lying in bed watching the news and I thought I peed my pants. I literally got out of bed laughing because I couldn’t believe I was doing that kind of stuff at only 25 weeks. I took my pants off and noticed it was more than just a dribble – and then I went into the bathroom and I was gushing fluid. I knew right then and there that this wasn’t urine and that my water had broke.
I called down to my husband and told him we had to go to the hospital. He came running upstairs and couldn’t believe his eyes. I was hysterical but he grabbed me my phone so I could call the OB office and they told me to get to the hospital as soon as possible. My husband was literally frozen with fear – he was walking in circles and trying to secure the house and the dogs and I just lost it, grabbed my keys, and got into my car with him chasing behind me. I couldn’t wait one more second and just HAD to get to the hospital.
So, yes, I drove myself the 37 miles to our regional hospital all while on the phone with my mom, grandmother, and best friend (and fellow preemie mom) Julie. I made it in 30 minutes. My mom met me there and my husband soon followed. When I pulled into the hospital, I saw what I thought was the valet guy and literally hopped out of my car and handed him my keys. I didn’t care whether he was actually a valet or if I just gave my new car to some random guy in a red coat. I walked as fast as I could with a towel between my legs and made it to the birthing center where my mom was waiting. Note: it was a valet and I still have my car.
They started me on monitors for both babies heartbeats and contractions and they did a test that confirmed it was, in fact, amniotic fluid. I had suffered from preterm premature rupture of membrane (pPROM). The OB came in and did an ultrasound which did little more than confirm both babies were still breech and she did a physical exam and found that my cervix was still closed. I was apparently contracting, but didn’t feel them at all – I was 3-4 minutes apart when I came in! I was immediately given a steroid shot (the first in a two shot series) and they started me on magnesium sulfate to stop the labor. A neonatologist came in to talk with us and we were essentially told that at 25w4d gestation, the babies had a 50/50 chance of survival. We were heartbroken. But, the team of doctors (OBs, MFMs, etc…) were going to work as hard as possible to keep me pregnant for as long as they could.
I was then moved to a room in the birthing unit where I was monitored very closely. I was given an ultrasound Friday morning that confirmed it was Baby Girl’s sac that had broken and it was a full rupture. Her fluid level was considered “low”, but she wasn’t showing any signs of distress. In addition to the magnesium, I was given two antibiotics to ward off infection and because I tested positive for group B strep earlier in my pregnancy. That first night / morning is a blur to me – I wasn’t allow to sit up at all, had to urinate in a bed pan, and was literally left to lie in bed and do nothing. I was given three goals to try and make and they were:
- Goal #1: second steroid shot (Saturday at 1:30am)
- Goal #2: steroid series considered complete (Sunday at 1:30am)
- Goal #3: 26 weeks gestation (Monday)
I was moved to a new room in the birthing unit on Friday and I stayed there until Sunday morning. Again, I was closely monitored and completed the magnesium and steroid series successfully where I stopped contractions and it looked like labor was held at bay for the time being.
Sunday morning I was stable enough that they moved me to the maternity special care unit where I would stay until I delivered the babies. We didn’t know if that would be a few days or a few weeks, but we were hoping for the latter. I was allowed to finally get up, only to use the bathroom, and I could shower for five minutes a day. It was a lot of freedom compared to how I was monitored at the birthing unit. So many friends and family visited with me throughout the days I was in the hospital and on Monday night my mom came to watch the Bachelor with me…the last show I would watch before becoming a mom.
Before my mom left the hospital for the night, at around 10:00pm, the amniotic fluid that was leaking turned pink. The nurse came in and checked the babies and they sounded good and they hooked me up to the TOCO to check for contractions and there was nothing. The nurse spoke with my OB and they said that it can happen where the fluid changes colors and it was considered “normal”. At around 2:30am, I was having these lower abdominal pains – almost like I needed to have a bowel movement. I got up to try and go a few times but nothing happened. I finally called in the nurse and she checked the babies and both sounded good. She put me on the TOCO and it wasn’t registering anything. Then I was getting those lower abdominal pains more severely and I finally asked her to move the TOCO lower. Well, I was registering large, sustained contractions and so she called my OB once again. The OB came down to my room prior to her next c-section and did a “digital exam” to see if I was dilated and guess what? She looked up at me and said, “I can say I feel two little feet”. I about died. I was approximately 6cm dilated and Baby Girl had essentially kicked her feet through my cervix!
It was then like a scene from a movie – while they were rounding people into my room, I called my husband and we both knew he’d never make it. They made one attempt at an IV in my room and my OB finally said something along the lines of “we don’t have time for this – she’s got to go NOW”. I was then flying through the hallways – I was so scared that I was physically trembling. I went right into the OR and there wasn’t even time to give me a spinal so I was put under general anesthesia and that’s the last I remember before waking up in excruciating pain in recovery.
On Tuesday, January 24, 2012 at 3:19am I gave birth to two beautiful preemies:
- Colton Christopher weighed 1lb, 13 oz and was 13 inches long
- Keltie Grace weighed 1lb, 9oz and was 13 inches long
Both struggled mostly with breathing issues throughout their NICU stay. Other challenges presented themselves such as a pneumothorax (Keltie), nephrocalcinosis and hypertension (Keltie), bilateral hernia repairs (Keltie), severe reflux (Colton), aspiration of thin liquids (Colton), and retinopathy of prematurity or ROP (both babies). Keltie was discharged from the NICU at 100 days. Colton remained there an additional six weeks because of his spells which were related to his severe reflux – he was discharged at 142 days.
So – that is the birth story of our twins…or, as we refer to it, Keltie deciding to break her sac and then sticking her feet where they don’t belong. I can’t even begin to explain the amount of love I feel for these two peanuts. It actually overwhelms me at some points. They’re absolutely beautiful and fought long and hard to get to where they are today. I’ve learned to appreciate the small things – things that “normal” parents likely take for granted such as seeing their faces for the first time, touching them for the first time, their first poop, their first 1ml of breast milk feeding, overcoming breathing issues, etc… We are lucky to have them home with us – it’s wonderful to have our family together under one roof. More information about their NICU experience can be found at: http://project26weekpreemies.wordpress.com.
If I could write a book
about my life over the last year, I’d have to title it “Barefoot and Pregnant:
a bed rest story”. Though the title is
somewhat tongue-in-cheek to match my distinct sense of humor, there is nothing
funny about my story. And for much of
the last year, it has been really hard to be thankful. And last year at this time, I wasn’t.
For those of you who
don’t know me, I’ll start my story a year and a half ago as a bright-eyed
Pollyanna and a newlywed. My husband and
I always wanted to have kids and planned to start building our family a year
after our wedding. So when the time came
to start trying, we read the pregnancy books, researched all the cool baby
gear, and prayed that we’d be blessed with a healthy little baby 9 months later.
But that isn’t what
happened.
After about 4 months
battling extreme morning sickness and fatigue, we lost our baby girl, Frances. I was at my doctor appointment before my
planned trip to visit my mother for her end-of-October birthday the day we
discovered I’d miscarried. My husband
and I were devastated! I took some time
off of work, and we both cried a lot. I
was very angry at God for taking my sweet baby away from me. So I was decidedly unthankful last Thanksgiving.
Two months later, I
discovered God was giving us a second chance.
I was pregnant again! My husband
and I were cautiously excited. We’d
planned to try for another baby, but it happened so soon. My body just wasn’t ready to support another
life. Two weeks after my positive test,
the trouble began. I was put on strict
bed rest to prevent not only my baby’s death but my own as well. As my first trimester came to an end, I was
rushed to the hospital because I was starting labor due to a placental
abruption. My doctor told me I wouldn’t
be pregnant in the morning. But my son
and I are fighters, and we survived. In
all, I spent 6 terrifying months lying in bed, including 6 long weeks in a
hospital bed praying the baby would just “stay in one more day”. I was angry at God for putting me through
such a terrifying ordeal and angry at all the people who just didn’t understand
what I was going through.
My beautiful son,
Anthony was born 9 weeks premature, weighing just 3 lbs. 12 oz. He spent 6 weeks in the NICU and came home on
oxygen and an apnea monitor, but he was finally able to eat and breathe on his
own by then. At 4 months of age, he is
now thriving and weighs more than 12 lbs!
While I still have a
tough time dealing with the horrors of the last year, I’ve come to realize that
gratitude is a process. I am still angry
at God a lot of days. I feel like my
babies and I are being punished, though I don’t know what for. But in all that anger, I’m thankful,
too. As my confirmation students can
tell you, I believe most bad things happen so we can appreciate the good. So without much further ado, here is what I’m
thankful for this Thanksgiving:
I am thankful for my
husband who selflessly put his life on hold to care for me and our son.
I am thankful for
friends and family who shared stories of their own angel babies, too beautiful
for earth.
Who brought us pre-made
dinners, cleaned our house, or even just came for an afternoon visit. Who prayed every night or even just one time
that we would get through our crisis and that everything will be ok.
I am thankful for
doctors and nurses who took the time to ensure my needs were met, not just
medical needs, but more personal needs as well, sharing stories about their
lives, the doctor who brought his terrier in to visit me, and the nurse who
searched the whole hospital to find me the Garden Salsa Sun Chips I was craving
that day.
I am thankful for the
women on my message boards, who shared their strengths and even their
weaknesses and made the time a lot more bearable.
And most of all, I’m
thankful for my son, Anthony. Every
morning, his bright smile gives me a reason to get through the day. His cries remind me that someone needs
me. And his sleepy head on my shoulder
tells me I’ve done my job of mothering well.
So I guess I am
actually grateful to God, grateful because He put all these people in my life
because He knew that I’d have to go through this and that I couldn’t get
through it alone.
 |
| Tony, one year. |
My birth story is a sad and scary one. I had no trouble getting pregnant, both times
conceiving in less than 2 months. But
keeping a fetus alive, proved to be a nearly impossible task for me. I had horrible morning sickness and fatigue
with my daughter. They overshadowed the
joy I felt expecting a new baby and left me feeling extremely guilty for not
enjoying her more during her albeit brief life when I delivered her, already
deceased, at 18 weeks gestation. I’ve
never known such darkness in my life.
Nothing brought me comfort.
Six weeks after delivering her, my second round of test
results were back with an almost certain cause for the late miscarriage, a
septate uterus, which had apparently corrected itself according to my MRI. So my perinatologist and OB/GYN gave me the
all-clear to attempt another pregnancy and assured me I would not experience
the same issues or be put on bed rest.
(I had asked about the bed rest because a close friend had spent several
months bed ridden with her first child.)
I was desperate to put the bad feelings behind me.
We started trying that night. I went back to work from maternity leave the
following day.
Nineteen days later, exactly two months after learning my
daughter was no longer alive inside me, I tested positive for a second
pregnancy. In sharp contrast to my first
pregnancy, I was terrified rather than elated.
Were we ready? How could I love
another baby as much as I loved my daughter?
What if this one died too? You
can’t replace a baby.
But I was happy to have a second chance. This time, I’d be a better mom.
Two weeks later, I hemorrhaged.
The on-call doctor didn’t seem to care that I was bleeding
and pregnant. “This happens
sometimes. Most of the time it is
implantation bleeding and does not cause a problem. But if it is a miscarriage, there is nothing
we can do about it,” she told me matter-of-factly, as if she were talking about
a lost book or something. I left her
office feeling helpless. But she had
prescribed pelvic rest, and that I could control. So I did my best to take it easy and wait for
the bleeding to stop.
When I followed up with my OB at my dating ultrasound the
following week, she reiterated the on-call doctor’s diagnosis and
recommendation and said to call if it happened again. It did the next day-- a week after the first
time-- and again a few days later. No
doctor seemed to care. My perinatologist
agreed with both OBs at our scheduled meeting a week later, after all, I was
only 7 weeks pregnant and miscarriages are common around that time. Three days later, it was like someone had
turned the faucet on…I bled for an hour, saturating pad after pad. The phone nurse seemed very nonchalant about
the bleeding when I called around 10:30 PM and asked me to make an ultrasound
appointment in the morning. When I
arrived, they rushed me to the perinatologist’s office for the ultrasound,
after which I was given the bad news: I had a subchorianic hemmhorage, and I
would be on strict bed rest from the time I arrived home until it healed, which
in most cases takes about 1-2 months time.
It didn’t heal.
At 13 weeks, I had been hemorrhaging less often than in my
early weeks of bed rest, so I was allowed to modify my bed rest to take the
stairs a couple times per day and take a reasonable shower. (On strict bed rest, I got 5 minutes, which
isn’t really long enough to do anything other than wash my long hair.) That Wednesday, I had the worst pain yet,
coming and going and squeezing my torso with immense strength. All I could do was scream from the pain. I called the OB because surely something was
different. My husband rushed me to the
clinic for an emergency ultrasound. The
technician was doing regular clinic hours that day, thank goodness, but she was
my high risk ultrasound technician usually.
She was surprised to see me and even more surprised by the shrieking I
was doing. (They wouldn’t even let me
sit in the lobby because I was scaring the other patients!) She had a nurse run to get the on-call doctor
shortly after beginning the exam.
This
could not be good.
The doctor did a quick pelvic exam upon arrival to the
small, dim room. All the healthcare
professionals stepped out of the room together afterward. My husband, our unborn baby, and I were alone
in the very scary ultrasound room—the same room that had brought us happiness
just seven weeks earlier at our dating ultrasound. When they returned, the OB said the words
etched in my memory, “Your placenta has abrupted. Your uterus is as hard as a rock. You will not be pregnant by the morning. I’m scheduling a D&C for tomorrow.”
“Like hell you are!”
I screamed, “His heartbeat is 156!
And I’m far enough I can labor through it, so that is what I’m going to
do. This is NOT my first miscarriage!”
“If we allow that, you will most likely bleed to death.”
“Well then, I guess I’m going to bleed to death because
you’re not taking my baby!”
“We’re not going to let that happen.” And the doctor excused himself to give us some
privacy to deal with the emotions. At
that moment, I stopped caring about the pain.
A strange calm washed over me as I resigned to bring my baby to life or
die trying. We called our pastor. And they admitted me to the hospital attached
to the clinic.
A few hours later, full of IVs and resignation, I was
approached by the same doctor. He
delivered the best news of the day, “There’s still hope.” My contractions had stopped, the bleeding had
eased, and the baby still had a strong heartbeat. When pastor arrived, we shared the good news
and prayed. I was released the following
day, prescribed strict bed rest until delivery.
As the weeks progressed, the hemorrhages happened less
frequently but more intensely. I would awaken
in a pool of my own blood some nights, so I began sleeping on a towel. We rushed to the ER several times as I
cramped violently and passed blood clots the size of my fist. When this would happen, I typically vomited,
became light-headed, and got to the floor as quickly as possible to avoid the
dangerous fall that would come if I lost consciousness. I cannot describe the terror I felt crawling
back to the toilet, plastic cooking spoon in hand (don’t worry, this was its
final purpose in our home) to scoop the clot out of the toilet and check for
gray fetal tissue. No one can ever get
used to that.
But things were looking up.
My perinatologist felt that by 19 weeks, I did not need to be seen every
week anymore. I dropped from weekly
ultrasounds to every 3 weeks because baby was growing and developing
nicely. When Viability Day came at 24
weeks, we celebrated with sparkling grape juice.
The morning of my 25 week appointment, I awoke in the early
morning as a large clot punched through my cervix. “I’ll be admitted today,” I told my husband
as I returned to bed. So he made
arrangements to take me to my afternoon ultrasound. We were in the perinatologist’s office all of
a minute after the ultrasound. We had
discussed this possibility before, so all he had to do was reiterate what was
happening.
My hospital room was clinical and lonely, but it was a
single room, something I’m eternally grateful for. I know that I could not have handled a happy
nursing mother bedding next to me; I could barely handle hearing the healthy
babies cry in the hallway. We had a
lovely nurse at check-in who made a deal with me, “As long as you stay
pregnant, you get cheesecake.” I was
once again hooked up to IVs and monitors, and I received a round of steroid
shots preparing for imminent delivery in the next few days.
Three weeks later, I was still pregnant and still in my
hospital room, the closest room to the OR.
By now, I had decorated and befriended many members of the hospital
staff. A “chain of love” in green, cream,
and pink (the only colors available on the craft cart for some reason)
festooned my walls, one link per day of bed rest so far and one link for each
day I hoped to stay pregnant. I looked
forward to my hot lunches, since I’d spent most of the last few months eating
peanut butter and jelly sandwiches and cereal.
Don’t get me wrong, I had plenty of days I was angry and did not want to
talk to the staff or visitors, but I did my best to stay positive. The pet therapy program helped a lot. I would get random visits from various dogs
during my stay. But I kept holding out
to meet the pony—that’s right, I said pony!
 |
| "...that's right, I said a pony!" |
Now at 28 weeks, I’d been complaining that the blood didn’t
seem like blood anymore, too clear and too constantly gushy. So my nurse did a test for my water being
broken. (I’d battled low fluid for a
long time, so no one was concerned before this.) Barely a minute into the test, which is
supposed to take several, she confirmed that I was leaking amniotic fluid
pretty heavily. So I got more IVs, more
steroids, and more scared.
Again, I avoided having the baby when everyone thought I
would. After a week, my perinatologist
let me have the IV ports out again until necessary and gave me the best news
I’d had in a while, “If you are still pregnant a week after your water breaks
without infection, there is a good chance you can make it to 34 weeks. That is as far as I will let you go, though
because at that point the potential detriment will outweigh the potential good
of staying pregnant.” So we continued.
Three weeks later, my husband brought me Olive Garden
takeout to celebrate our second anniversary.
I turned down my hospital dinner, including the cheesecake that was to
be my dessert. That night, I went to
sleep with some nasty indigestion and a loving husband kissing me goodnight and
heading home.
In the morning, I still had the indigestion when I woke up,
so I waddled to the bathroom. That
brought me no relief, so I called the nurse.
It was early, about 2 hours before shift change, so she got there fairly
quickly. “Let’s put you on the monitor,”
she suggested. After about an hour, she
came back to check on me and said she wasn’t concerned because she didn’t see
any contractions. But I felt worse, so I
asked if the on-call OB could stop by.
He had just finished a delivery, so he came in a little while
later. I stayed on the monitor while I
waited.
He had come to be one of my favorite on-calls because on
weekends, he would sometimes bring in his terrier, a spunky little pooch with a
skull-and-cross-bones scarf. I think the
dog was as excited to see me as I was him.
He did not have his dog with him that day, though; it was a
Tuesday. He put his hand on my belly and
watched the monitor. Soon I was crying
from the pain; then it eased. Again
crying, then eased. “You are having
contractions,” he said, “I don’t know why they are not registering on the
monitor.”
“Am I in labor, then?”
I asked. I had been texting my
husband since I woke with pain, and I needed to text him soon if I was in labor
because otherwise he would leave for work.
“It’s almost shift change.
I’ll let the next on-call check for labor. He should be here in a few minutes.”
I texted my husband who had already taken off work because
he was so concerned by my messages. He
was there before the next OB arrived.
Sure enough, when the next OB did a pelvic exam, I was 4 cm dilated and
90% effaced. “You’re in labor,” he said.
“Give me some drugs,” I said, “I’m having a cesarean because
baby is breech and want to be in as little pain as possible.”
He made me wait while he got an ultrasound machine to
double-check baby’s position. Yes, baby
was still frank breech, as if to stop my body’s numerous attempts to end the
pregnancy early.
Soon, I was shaved, prepped with IV ports, and briefed on
what would happen in surgery. My OB met
us in the OR. I was grateful for the
release from my bed prison, despite my concerns for my baby’s health and
well-being as a 31 week preemie. The
surgery went quickly. My husband almost
didn’t make it into the room in time for the actual birth.
My son, Tony’s
cries were the most beautiful sound I’d ever heard! Many preemies don’t cry right away because
their lungs aren’t fully developed, so I was a little surprised and extremely
grateful he came out crying. His weren’t
fully developed either, but the steroid shots helped to mature them as much as
possible. “Tony, be brave! I need you to be brave! I love you!” I called to him. He was attended to by a team of neonatal
specialists who showed him to me momentarily before whisking him away to the
NICU while my doctors stitched me up and sent me to post-op for a few hours.
 |
| Tony at birth with his new friend, Pooh. |
Waiting to see him was hard.
My husband followed him to the NICU and took some pictures until the
NICU staff asked him to leave the room while they intubated the baby. He came back to visit me and show me
pictures, answering all my questions about how he looked and smelled as well as
what was happening down the hall in the NICU.
Tony weighted a whopping 3 lbs. 11 oz. and was just shy of 16 inches
long. I did not get to visit him for an
eternity—ok, a couple of hours of post-op—and I when I did, I was wheeled to
the NICU still in my bed as the epidural wore off. He was beautiful! And he knew my touch.
I could only stay with him for a short time because he
needed his sleep, and I needed to pump.
While I was in between visits with Anthony, the pony came for pet
therapy, as if she’d waited to meet me, so she could celebrate with me.
Having a baby in the NICU was tough. After 6 months of bed rest, my muscles had
atrophied. Any mother who’s had a
cesarean can attest that the first few days are full of intense pain at the
surgery site, but I could barely walk 100 feet before the surgery. My nurses encouraged me to walk my wheelchair
down to the NICU to regain strength. I
would walk as far as I could and get a push the rest of the way.
I held Tony for the first time on his third day of
life. He was only on the ventilator for
2 days, which was the main reason we were not able to hold him the first 2
days. Holding him was incredible! But I cramped up really badly from the
oxytocin release and had to stop after only about 15 minutes. My husband held him that night.
Over the next six weeks, we had our share of ups and downs
but mostly positives. We tried
breastfeeding around two weeks old (33 weeks gestational age), which was a mix
of emotions. Tony knew exactly where his
mouth should go, I’ll always remember the sweet look on his face as he looked
up at me, mouth agape, as if to say, “I’ve got my mouth in the right spot;
where’s my milk?” Alas, he just could
not get enough suction. We had some help
from nurses and lactation consultants, but he just did not get the hang of
it. After about 2 weeks of trying, we
decided to try a bottle so that we could take him home when he got the hang of
eating. He did much better with the
synthetic nipple, though he was able to suckle my breast for a few minutes
before we left the NICU. He did not
successfully nurse without a nipple shield until he was 3.5 months old (1.5
months adjusted age).
He was put on CPAP after the ventilator for a few days
before going to a nasal cannula that stayed until he was 6 months old (4 months
adjusted age). He hated the tubes
attached to his face and would try to pull them off. He did this until the cannula came off. I hated having to put it on him.
He spent about two days under the phototherapy lights
because his bilirubin levels were too high.
He had an orangey color. And he
wore a little eye mask that made him look like a movie star tanning while he
was under the light. He was in an
isolette at the time to reduce the amount of stimuli around him to help him
sleep.
He had lots of tests to make sure he was healthy. He had ultrasounds on his head to check for
bleeding; thank God there was none!
Several times, the respiratory therapists tried to take him off oxygen,
but his blood oxygen levels always dropped.
And he had a chest ultrasound because of a heart murmur. His hearing test came back normal, and he
passed his car seat test.
Near the end of his NICU stay, he had an eye exam, which was
horrible! I was asked to leave the room
while the ophthalmologist did the exam because he cried so much. When I came back, Tony was limp and
unresponsive. He had had his
circumcision and the chest ultrasound that day as well. The neonatal team tried to assure me he was
just tired, but he was not acting like he normally did, even tired. This is probably my worst memory of the
NICU. I picked him up and held him while
the nurse jabbered at me about who knows what.
I was angry that he was so unresponsive—what had they done to my sweet
little boy?! “Please leave us,” I
implored the nurse. I held him close and
kissed him. When the doctors came in, I
was still pretty upset. They had
scheduled too much for my little guy.
And he would not eat, which was our last big hurdle before he came
home. I did not want this to set him
back. His feeding tube had been removed,
and now they were threatening to replace it for a few days. I was devastated and angry, so I told the
doctors why I was upset. They said that
they’d do what they could to make sure Tony could come home as soon as
possible. And the home health nurse
brought us our oxygen concentrator and taught us how to use it and our apnea
monitor.
The next day, we were able to room in with Tony. It was a long night, since the apnea monitor
we had received turned out to be faulty and false-alarmed numerous times
throughout the night. Within a few
hours, we had to disconnect it and use a hospital monitor because the alarms
were so frequent. My husband and I were
so scared every time. But otherwise, the
room-in went well, and we received a new monitor the next morning.
We stayed until early afternoon that day, a Saturday in
mid-August. We filled out our paperwork,
said farewell to the nurses, doctor, and other staff, and packed up all the
stuff we got to take home. It was
emotional taking him home for the first time.
We were happy to have him close to us but very scared to bring him home
in less than perfect health. The first
night, no one really slept in our house.
We were too nervous, and Tony was in the newborn phase, waking to eat
every few hours. But we eventually found
our groove and learned how to care for him calmly and rationally.
 |
| The chain of love around Tony's room. |
As a one year old, he is still behind on some things
developmentally, but he is happy and well-adjusted. He pulls himself to standing, communicates
his needs and wants, and loves to watch the monkeys at the zoo. He even blows raspberries on my legs, like I
do to his belly. This sends us both into
fits of laughter. And I don’t know that
I would change our story as awful as the memories are because I know I’d
appreciate him very differently without all the difficulty in getting him here. Our chain of love now bedecks his bedroom, a
daily reminder of how far we’ve come.
Wednesday, July 4, 2012
Birth Story One - Norah
My first daughter, Norah, was born at 34w2d due to severe
pre-eclampsia. I had a fairly uneventful pregnancy. Around 30 weeks I
began to have a lot of swelling in my hands and legs, but figured it
was part of being pregnant in the summer. At my 34-week appointment, I
was surprised to discover that my blood pressure was elevated and I
had protein in my urine. My OB sent me to the hospital for monitoring.
I was diagnosed with severe pre-eclampsia and was induced the next
day.
The induction was far from the birth scenario I'd envisioned. Instead
of walking around and keeping myself distracted, I was stuck in bed
(mostly on my left side) and told to minimize stimulation to keep my
blood pressure low. I had wanted a natural birth, but the only part of
that plan that happened was no epidural. After 11 hours of Pitocin, my
OB said Norah wasn't handling contractions well and we'd need to do a
c-section. She left the room to arrange it, but Norah had other plans!
I felt a quick change from painful contractions to a strong need to
push. She was born after only 10 minutes (approx 3 contractions) of
pushing. She was 4lbs 11oz and 17.5 inches. I got to hold her for a
minute before she was taken to the NICU. Unfortunately I had issues
with retained placenta and had to have an emergency D&C under general
anesthesia, so I wasn't able to see her again until the following
afternoon. My husband, who was amazing through labor, was able to be
with her. It was very hard emotionally to be separated from my sweet
baby. My blood pressure remained high while I was in the hospital, so
I had to take it easy. I nearly laughed when (months later) I noticed
that my discharge instructions said "home to bedrest with bathroom
privileges." Not exactly feasible when you have a NICU baby!
Our 23-day NICU stay was uneventful - no breathing issues, jaundice,
or serious health concerns. Norah just took her time figuring out how
to eat so she was fed through a tube that went through her nose into
her stomach. I had no idea that the suck-swallow-breathe instinct
isn't developed until around 37 weeks. Sure enough, that's right about
when she caught on. We gave her bottles to get her home faster and she
never looked back, so I pumped for 8 months.
Now Norah is a vibrant, curious girl of nearly 3. She loves to read,
dance, and pretend to be a princess. She has always been small for her
age, but otherwise you'd never know about her rocky start to life!
Birth Story Two - Emily
As a stark contrast to the first time around where I conceived immediately, it took 14 months to conceive our second child, Emily. I was watched more closely from the beginning, but felt confident in my odds of having a full-term pregnancy since my OB estimated I had a 20% chance of pre-eclampsia again. We found out during my first pregnancy that I have a bicornuate uterus (heart-shaped), so I knew I had some risk of pre-term labor and a breech baby, but I wasn't terribly concerned.
Once again, I had a rather easy pregnancy during my first two trimesters. We were excited to find out that Norah would have a baby sister! At 30 weeks, I had a scheduled ultrasound to check baby's growth. This is when things started to fall apart. We were shocked to learn that baby was measuring about 3 weeks behind, particularly since her measurements were right on track at 20 weeks. In addition, she was breech and my amniotic fluid level was at 7 (8 and above is normal). I was put on strict bedrest and was referred to a maternal fetal medicine specialist. Over the next 5 weeks, I continued on modified bedrest and had weekly biophysical profile ultrasounds. My fluid levels improved and stayed in the 8-9 range. Emily passed every BPP with flying colors, but didn't grow very much and changed from SGA (small for gestational age) to IUGR (intrauterine growth restriction). Bedrest was a huge challenge, particularly with a toddler! I would get sore from laying on my side and felt quite lonely since I was used to being on the go and seeing friends often.
On a Friday around 34 1/2 weeks, my blood pressure began to creep up so I was sent to labor and delivery for monitoring. It improved when I was resting on my left side, so I was sent home on strict bedrest for the weekend. When I saw my OB on Monday, my blood pressure was better but my fluid levels had dropped to 6.7. I was sent home but told to come back the next day with packed bags. On Tuesday, my blood pressure was up again, I had protein in my urine, and my fluid level had dropped to 5, so I was sent to the hospital to be induced that afternoon. My OB thought conditions were favorable for induction/vaginal delivery since I was already dilated to 2cm and Emily had flipped to head-down the previous week. However, after a few hours of Pitocin, Emily wasn't doing well with contractions - experiencing elevated heart rate between contractions and decelerations during contractions. My OB recommended a c-section and we agreed that was the best option. A short time later, Emily was born, all 3lbs 8oz / 16.75 inches of her!
Despite some anxiety about the c-section experience, Emily's birth was much less traumatic than Norah's birth. Part of this I attribute to lots of prayer and lots of confidence in my OB's judgement. I also think my previous preemie/NICU experience helped me to be a better advocate for myself. And even though she was tiny, Emily acted every bit of her 35 weeks gestational age! She began looking for food right away and my OB asked the NICU staff to allow me to breastfeed in recovery. This was an amazing experience and she did so well!
Emily's NICU stay lasted 14 days and was uncomplicated. Like her big sister, she was a feeder/grower the whole time. We worked on breastfeeding, but decided early on to focus on bottle feeding to get home sooner. Again, the NICU was a very hard place to be. With a child at home, I always felt guilty for being away from one of my children. My husband and I have amazing parents and siblings who pitched in to help with our toddler while I spent time with Emily in the NICU. I definitely had at least one NICU meltdown after a failed attempt at breastfeeding. I'll never forget the kind nurse who noticed and brought me a box of kleenex.
Once Emily came home, we began to work more on breastfeeding. Our lactation consultant used to be a NICU nurse and she was an invaluable resource as Emily and I learned to be patient with one another and finally (around 8 weeks old!) succeeded in breastfeeding! I'll always be proud of both of us for sticking with it!
Now Emily is 3 months old and is a very happy, laid-back baby. She melts my heart when she finishes nursing and looks up at me with a smile on her face! And even though she started at a mere 3.5 pounds, she has some cute little rolls on her thighs!
After having 2 preemies, I'm almost entirely certain that our family is complete. This definitely brings feelings of sadness since I never got to have a normal 3rd trimester and childbirth experience. I'll never know what it's like to think "this is it - I'm in labor!" I'll never get the excitement of being discharged from the hospital on the same day as my baby. Instead I have a special set of skills. I can change a tiny diaper of a baby through the holes in an isolette while keeping the attached wires out of the poop. I can speak in terms of cc's and mLs. I have weighed diapers, taken countless temperature readings, and charted food intake for months on end. I love my girls fiercely and know they are a gift from God. Being a preemie mom is hard, but I hope it's given me more empathy for other moms and patience for my children.
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