Wednesday, July 24, 2013

About a Boy, part 2. Also known as Virtual Insanity

Let me begin by saying that the NICU is a place where miracles happen. 
I have seen too many wonderful people do amazing things in the NICU to ever doubt that the people who work there are angels and saints.

And now that I've said that, I can also tell you that the NICU is @#!*% on earth.
He just found out he's NICU-bound. Not. Happy.
Everyone in the NICU has a very important role to play. 
First, NICU nurses. Most of them are the salt of the earth, as good as it gets, the best and the brightest. And each and every one I have met is like the cliche General in a war movie-- Kind eyes, heart of gold, gruff manner, and endless stories to tell, all with a similar theme: "I have seen and done it all. And you are not the first." This demeanor is surely meant to reassure the NICU parent (more on them below).

The doctors in the NICU are like hospital Deity. Often referred to in reverent tones, all-knowing, but rarely seen in the flesh. Finn's doctor called me every morning at 8am to brief me on Finn's condition, but I only spied him in his physical form twice as he made his rounds. I nicknamed him Dr. Pepper because he would rattle off conditions and diagnoses at me without stopping for breath and condensed a would-be 15 minute conversation into two and a half head-spinning minutes of pure medical jargon and best case scenario timelines that were never met. Naturally I presumed his speed and optimism were products of his doctor diet: just as mere mortals are mostly water, his body mass was 2/3 caffeine.

Then there is the NICU parent. As a NICU mom you are riding a constant wave of highs and lows, not helped in the slightest by the post-pregnancy-hormone-freak-show that besets all new moms. But NICU moms are driven to new heights of crazy. There is no baby to cuddle, no reassurance that sinks in, and no satisfaction. Nurses and doctors greet you with grim faces, soothing tones and detailed descriptions of the best case scenario.
They use phrases like "Any day now..."
As a NICU parent, "Any day now" is not your friend.

When Finn entered the NICU it was with endless "any day now" reassurances
"Everything is fine. His breathing is just a bit more labored than we would like. I'm sure it's nothing. Any moment/hour/day now he'll be back in your arms."

**Side note: I have started and stopped this blog entry about fifteen times now. I think it's safe to say that even now, more than three months later, I still find Finn's ultimately successful stay in the NICU an acutely painful experience. I had hoped to breeze through this one, but I am struggling- sorry if this post is a bit more depressing than delightful...**

Finn's would-be brief NICU trip began about an hour after he was born early Saturday morning. Within an hour he was hooked up to breathing equipment called a CPAP. The CPAP bubbles up from a vacuum basin of water and blows humid air into the nose in a more forceful way than a traditional oxygen nose cannula.
The truth about CPAP: Looking at this still makes me cry.
  But as the day progressed, Finn's breathing did not. On Saturday night, a small hole was discovered in his lung. This hole was not a deformity, but had formed as a consequence of lung immaturity-- My poor little guy's lungs just weren't quite ready to breathe on their own yet. The doctor quickly inserted a tube in the left side of his rib cage to release air that was escaping into his chest cavity from the hole in his left lung. 

Because of the tube, Finn was in a good amount of pain, so he was placed on an IV of nutritive fluids (so his body was spared the burden of digestion) as well as morphine. With the air being let out of his chest, his lung should have been able to expand properly as he breathed.
But breathing became much too tiring after a while.
Avery meets Finn.

On Sunday night I got the call while I was resting in my room:
 Finn had stopped breathing for five minutes.
Nurses had tried to stimulate him into breathing on his own again.
Nothing had worked.
Doctors worked quickly and Finn was intubated.
He was now on a ventilator (a machine that breathes for you).

The pain and trauma of first labor, then surgery, NICU admittance, constant "breastfeeding" dates with plastic bottles and a giant yellow boob vacuum, blood draws, an endless parade of people with charts coming to poke and prod at my incision and lady parts, and watching my new baby stuffed and sewn like a living taxidermy project were too much already. I am not (too) ashamed to say that this call broke me to pieces.

I was wheeled down to the NICU where nurses repeated the information I was given on the phone slowly and more than once. I wasn't listening very well. All I could think was, "It's getting worse. He's not going to make it. He's not getting better. He's not getting better." Over and over.
I sat by his teeny tiny clear plastic bed and cried.
Robot lung.
 Those post-delivery hormones are no joke, friends. 

The final player in the cast is the starring role: Baby. Finn didn't open his eyes for days, then he would open just one, and then both, but only for moments at a time. It took nearly a week for him to open them long enough for an onlooker to get more than the merest peep of his peepers.
Breathing, eating, surviving-- They all went the same way. It took time, he worked up to it, and then, suddenly, he caught on. He was surviving.
Carter, Finn. Finn, your worst nightmare.
 By Tuesday night things had turned completely around. Doctors felt confident that he could be taken off of the ventilator and was put back on CPAP, and then an oxygen cannula, and then room air. His chest tube was removed- his body had healed the tiny hole and his lungs were expanding fully. He was slowly given little bits of milk, and then more, and more, through a tube that traveled into his nose, down his esophagus and into his stomach as IV fluids were weaned. And then he got to try to eat on his own once a day, then twice, as his digestive system was worked up to full feedings. He had turned a corner and he never looked back.

Now, I have dates and details for Finn's progression, but the thing that really sticks with me was the timid uncertainty and blazing hope that accompanied each step forward. God is in the details, and the details that stand out are his weak body growing stronger, healing, learning, and finally taking over the responsibilities it was created to perform.The NICU really is a place for faith and miracles.

My three NICU babies- Av (top left), Carter (top right), and Finn.
I'm sorry if this is a weepy retelling of NICU events, because there were a lot of fairly happy and easy times (and at least one billion blessings) in the NICU, too. After the corner-turning on Tuesday there were hours every day spent holding and rocking and feeding and introducing. My mom (bless that lovely, lovely woman) was there for more than a week after Finn was born, taking care of my family while we did the hospital thing (for five days!) and then the traveling-back-and-forth-between-home-and-hospital thing. Adam (uncle extraordinaire) came and went daily along with neighbors and friends who assisted with blessings and brought gifts and happiness.

 One of the brightest spots of the NICU days were when the girls came to visit. They learned to wash their hands while singing Twinkle Twinkle to be sure to kill all of their mutant little kid germs, would have their temperatures checked, and then were cleared to come in and adore their new brother. Finn's big sisters were (and are) so in love with him that it rendered one incoherent with giggles just to be near him (Avery) and the other so uncharacteristically reverent and shy that I worried  about alien abductions (Carter). They would whisper and coo at him. They would put their finger in his palms and smile from ear to ear to have their hand held by Finn. They would interpret his every movement and sound to mean something very significant and important ("He likes me!" "He wants me to hold him!" "He is so happy!"). They were smitten.

On the night that Finn came home it was late at night about two weeks after he was born. I found the sitter on our couch and the girls like this:
They had tried so hard to wait up for him! They are the sweetest big sisters you will ever meet. 
Adoration at home.
Anyway, the NICU is best told in pictures, I think, because the hours are long and the visits too brief and the terms complicated but it's all love and hope and happiness in the end. Here are just a few of my favorite NICU shots. And here's to never, ever going to that awful, blessed place again!



Bethany said...

I still can't even really imagine. You guys went through so much! It's awesome to see Finn doing so well and getting so big. Sad, but awesome. :)

Tim and Katie Jean said...

I adore this post even though im blubbering like a crazy person. Love you and your adorable fam.