Total Meltdown

Around 10am this morning as I was waiting for the doctors to do their rounds, Ian's nurse came and told me that someone else was moving into the demo room I had been staying in. There are only 2 demo rooms in the NICU. She said I needed to move out by 2pm and suggested I call over to the RMH to see if they had a room available for me. I immediately knew that going to the RMH was not an option for me. Considering the travel time between the two places as well as how swollen my feet and calves are, I would get almost no sleep if I stayed there and came over to nurse Ian throughout the night. They were then suggesting that I stay at the hospital until Ian's 11pm feeding and then go home and return in time for his 8am feeding. This would mean I would miss his 2am and 5am feedings. They thought I could use the sleep and also could then spend time with Nadia. This plan was also completely unappealing to me as Nadia would be asleep almost the whole time I'd be at home, and I really don't want to miss two of Ian's eight feedings. Establishing his ability to nurse is what is most important to me right now. I wasn't keen about giving him the bottle today, but they can't do the 2 hour carseat test with an NG tube, and I figured that I would discontinue the use of these ASAP.

The only two plans that seemed like options I'd consider were #1 to take Ian home today - AMA (against medical advice) or #2 to continue to stay in the hospital and just sleep in the lounge in between feedings. I was strongly leaning towards option 1 because of the fact that Ian doesn't seem to be receiving any medical care aside from being weighed at 2am and having blood drawn at 5am. I figured I could take him to the Pediatrician tomorrow morning to be weighed and have bloodwork done. Other than that I was providing all of his care - changing his diapers, feeding him, etc. I don't believe the NICU schedule is conducive to nursing. It's set up for bottle fed (formula) babies. If Ian were at home, I wouldn't let more than 2 hours pass between the start of one feeding to the next, and if he wanted to be nursed more often than that, I would do so. Here I am restricted to feeding him once every 3 hours. I am producing plenty of milk. When I pump for 10-15 minutes after feeding him, I am getting 60ml of milk, and they consider 50ml to be a full feeding. I am producing more than that AFTER having nursed him for at least 10 minutes. The problem is that many times after nursing vigorously for 10 minutes, he falls sound asleep. This is to be expected for a preemie. Nursing for 10 minutes is a lot of work for the little guy! Babies usually only are able to nurse once they hit 34 or 35 weeks. Preemies born earlier than that can't even attempt to nurse until they hit this stage. The bottom line for me was that I thought taking Ian home today would be better for him (more chances to nurse him), better for me (much less stress and more sleep), and better for Nadia (who misses her Mommy very much and of course my missing her terribly is part of my stress). I called Caryn to cancel our lunch plans and then called Paul to ask him if he would support my decision to bring Ian home AMA and also if he could come to the hospital as soon as possible. He said that he agreed with bringing Ian home so we worked on finding someone to watch Nadia.

Our social worker called me on the phone and thus began the efforts of the staff and medical professionals to convince me to go home this evening. I started packing up and cleaning the room, and I did a lot of crying. Between the hours of 10am and 4pm I was crying more often than not. Paul's dad came up to watch Nadia, and after Paul got a shower he drove to the hospital. Thankfully the doctors were very late in getting to our room so Paul got there before they did. I listened as they gave their report until the head doctor said that they expected Ian to be discharged in 48-72 hours. I immediately walked into the bathroom, shut the door, and started sobbing. I would have tried to hold it together had I been alone, but I decided to leave it up to Paul. After they all left, Paul and I talked for a bit and then I nursed Ian one more time since our departure was imminent. We took my stuff out the room to a lobby and talked about our options. Paul was no longer interested in taking Ian home today.

The reason the doctor gave was that there hadn't been enough time for Ian to prove he could maintain his body temperature albeit the only time Ian had trouble with his body temps was when they had his isolette too hot and he developed a fever from being over cooked. Basically he thinks that babies who come into the NICU at this stage should stay at least 2 weeks so in this doctor's opinion if Ian is discharged on day 11 (Tuesday) that would be "ahead of schedule." Obviously there are differences of opinion between the doctors as the doctor who was in charge of Ian Tuesday through Friday thought that Monday was a very reasonable time for Ian to be discharged. He scheduled Ian's first Pediatrician appointment for Tuesday morning, and that appointment will take place the day after he's discharged. I had assumed that since we had been put in the demo room on Thursday that this weekend was a viable possibility for discharge, and I had been prepared to be here until Monday until they told me I'd have to leave the demo room today.

Before this becomes an epic long post, let me say that Paul and I both agreed that the best option was for me to spend the next two nights in the hospital. I have a toothbrush and toothpaste and some snacks with me. I am a homeless bag lady for two days. Thankfully I had showered and blowdried my hair this morning as I won't be getting another shower until Tuesday evening. Hopefully I can get some sleep in the lobby this evening as last night wasn't a good night (they did Ian's hearing test at 3am for example). I finally stopped crying and got back into the mode of thinking I CAN do this. The end is in sight. I can do anything for just 2 more days. I do hope that I never spend another 11 days in the hospital apart from my husband and one of my children. I am trying to think about Nadia as little as possible. It's so hard when Paul tells me new words she's said and such. I feel like I've missed so much, and I feel like a horrible mother who has abandoned her 17 month old daughter. I'm being forced to choose between my children, and given Ian needs me for his physical sustenance - he wins out over her. Okay I can't write about this any more as I've started crying again.

Please, please, please pray that Ian will continue to gain weight. I can only imagine the meltdown I will have if his stay is extended beyond Tuesday. If his next 2am weigh-in goes well, he will be moved to a bassinet this evening. One good thing that came about from my sobbing was that the doctor is allowing me to nurse Ian as often as I want to do so. They said if I was going to spend the night at home that they'd feed him my milk through the NG tube (they put it back in while we were trying to decide what to do). We are going to limit the bottle feedings as much as possible as the doctor agrees that this might interfere with future nursing success. After we made our decision we came back up and I nursed Paul once before we went to dinner at Friendly's. After we got back, I nursed Ian again. Then I took a break and was able to watch the last 30 minutes of the Steelers game in a lounge. It was the first time I had watched any tv in over a week. After giving Ian a bath, I nursed him again. After finishing this post I am going to try to take a little nap as I haven't had any naps today. I also didn't get much grading done. I definitely need to do more grading of exams tomorrow. Please pray for my emotional and physical stamina. The hospital is such a stressful place to be, especially when you've been by yourself for 4 days. I had only seen Paul once in the past 5 days. One reason I like the demo room is you only hear your child's alarm and crying. Now when I'm with him I'm hearing nonstop alarms and crying of many other babies. It really exhausts and stresses me out.

Paul is an outstanding dad, but he has a hard time being the sole caregiver for an extended period of time. He hasn't been able to accomplish anything else while taking care of Nadia such as taking a shower, going to the grocery store, or accomplishing things on the to do list I gave him. Ian's room still isn't painted. I suggested he take Nadia to Sarah's house tomorrow. I am sure Nadia had fun with PopPop; today was Paul's dad's birthday. Hopefully spending time with Nadia was a fun way to spend his birthday. Paul was concerned if his dad knew how to change Nadia's diaper. Usually both of his parents come up together, but Paul's mom is sick so she stayed home.