Ups and Downs

Today was an emotional rollercoaster for me. In reality the "highs" were bigger and more important than the "lows," but unless I force myself to remember that, it feels like it was an awful day. I am sitting here on a bed in the Ronald McDonald House as I was discharged from the hospital this afternoon. My mom asked my doctor this morning if the fact that my hemoglobin is still really low was a valid reason to keep me there another day, but he just told me to keep taking the extra iron. He's hopeful that since my level hasn't fallen recently that soon it will start to trend upward. My mom left the hospital about 7am. I was on my own most of the day. I had made two trips to the NICU myself yesterday (walking) albeit never a complete round trip until the middle of the night when I was delivering milk (walked there by myself one time and walked back by myself another). I also had been getting up out of the bed by myself to pump throughout the night so I felt I was ready to be independent. I wanted my mom to be able to go home and watch Nadia so that Paul could study for his exam. When I gave birth to Nadia, I was never on my own whether we were in the hospital, Ronald McDonald House, or demo room in the NICU, but in light of Nadia not being able to come to the hospital I felt it was necessary for me to function independently today.

The amount of walking I ended up doing was a drastic increase from my two trips to the NICU yesterday. I woke up this morning without any ankles, and the swelling of my feet got much worse over the course of the day. The swelling still isn't as bad as it was after I had Nadia (as then it went from my toes to the top of my thighs), but I have to say my feet and ankles and calves are very swollen and HURT. I am back to wearing either Paul's socks (mine are too tight) or sandals. Since I was discharged I have been wearing sandals which is certainly not something I've ever done before in 20 degree weather. The sandals barely fit so I need to be grateful that at least they fit! I also need to be grateful that Paul was wise enough to realize I'd need them as I falsely assumed my sneakers that I wore to the hospital on Saturday morning would still fit. I just tried sleeping for a little bit, but I was too cold. I lack the energy to put the sheets on the bed, but I found it very uncomfortable to be horizontal anyhow. I think I'll need to sleep sitting up tonight. One plus of my brief attempt at sleep was that the swelling went down enough that I could put Paul's socks on without them feeling like they were cutting off all my circulation. I also am now wearing my winter coat and have turned on the heat. I can't seem to figure out how to adjust the thermostat in this room. It's either an ice box or a sauna. I think I'll just need to alternate between turning the heat on and off throughout the night. I woke up shivering so right now the sauna mode is appreciated. I am still grateful my swelling isn't as bad as in 2008, but I'd appreciate prayers that it would go down ASAP as walking is painful enough due to the incision.

The resident told me this morning that he was going to remove my staples today, but the attending physician overruled that idea in light of #1 my low hemoglobin and #2 the fact this is a repeat c-section. He made my appt for Monday, but I asked if it could be switched to Friday (in the hopes that Ian will be discharged before Monday). That appointment is now scheduled for 3:30 on Friday afternoon. Last time I didn't fill the pain med prescriptions, but I did fill them this time (didn't cost me a penny to do so). He didn't give me that many Percocet though so I will be weaned off of those farily soon.

This morning I headed to the NICU around 9am (when the doctors start their rounds) with the plan that I would stay there until they came to see Ian - no matter how late that was. On Sunday and Monday they were at his station around 11am. Sunday we missed them because I had to go to the bathroom and my nurse tried to get them to switch the order (since none of the other babies in his pod had parents there that morning), but they didn't and I couldn't hold it any longer so we missed them. I did get to talk with them on Monday morning. Yesterday I waited until noon and had to give up on seeing them, which is why I was so determined today. After I had been there over 2 hours, I heard Ian's nurse saying to another set of parents that they could go back to their room and he'd call them when the team came into our pod. That seemed like a great idea as I was hungry and needed to go to the bathroom. The nurse promised me he'd call my room and that I wouldn't miss the doctors this time. So I was in my room for awhile.

The phone never rang so I assumed the doctors hadn't been around yet. However, when I went back I realized I had missed the doctors - again. I immediately burst into tears. They should have been tears of joy because the reason I knew I had missed the doctors was that Ian was still on his CPAP when I left, and now he was off of it. Seeing how distressed I was, a lactation nurse tracked down Ian's doctor who came and talked with me. I asked him if I could try to nurse Ian today since he was off the CPAP. He said I could although he wanted me to wait a few hours to make sure Ian could breathe without the CPAP. The nurse told me to come at the 5pm feeding. He said they wouldn't feet Ian until after I attempted to nurse him. I was very excited at this prospect! The nurse hadn't let me hold Ian that morning. I had held him some the previous three mornings.

My mom came to the hospital in the afternoon with a bag of things I needed (clothes for example), and she also brought Nadia so that I could spend some time with her. From Saturday through Tuesday I had only spent about 10 minutes total with Nadia (about 5 minutes on both Sunday and Monday). Unfortunately, she couldn't find a spot in the parking lot so I had to come down outside the hospital building wearing nothing but a hospital gown, robe, and socks. I went back up and got dressed, delivered milk and a boppy to the NICU, and then headed back down to the van so we could drop off my prescriptions and go check-in at the RM house. We spent some time in the play room. Nadia enjoyed exploring their collection of toys. Then we (my mom, Nadia, and I) headed to McD's for an early dinner as I needed to be with Ian by 5pm. It was my first time out of the hospital since Paul & I checked in at 4am on Saturday morning.

When I arrived at the NICU, I saw that Ian was already in the middle of a feeding (part formula and part my milk). I was taken aback as his nurse had promised me they wouldn't feed him until I had nursed Ian, and I wasn't late. The new nurse had no knowledge of the plan. She then questioned whether Ian was up for an attempt at nursing because he had a fever. They did bloodwork to see if he had an infection. I noticed that Ian was now in an isolette. They didn't realize this was a change, and in fact, thankfully, this proved to be the reason he had a fever. They had the temperature turned up too high for my little guy! He must take after his dad in that regard. :-) I was told that if he didn't have an infection I could nurse him at 8pm.

The NICU is closed to visitors 4 hours a day, and one of those hours is between 7-8pm. I went to the pump room and pumped at 5pm and 7pm and tried to rest a bit on a couch in a lobby until 8pm. I arrived back at his bedside at 7:55, and his nurse wasn't there. I waited until 8:15 and then asked if someone else could help me get started with nursing my son. The NP on duty told me that she had no knowledge of the plan for me to attempt to nurse Ian. She said it wasn't noted by the doctor in his charts. Her compromise was that I could attempt to nurse him only if I was "dry" (meaning she wanted me to pump again right before having contact with Ian). To say I was disappointed and frustrated would be an understatement, but since I hadn't held Ian all day I agreed to the plan. She told me to pump for 15 minutes and said they'd hold off on his feeding until I came back. I came back within 15 minutes only to find that he was in the middle of a feeding. I am amazed I didn't burst into tears. It turns out this was his third nurse of the day. She knew nothing of the plan, and the NP didn't say anything to her after talking with me. I eventually did at least get to hold Ian. It was my 4th time holding him, and it was the first time I held him without a CPAP and such. It was great to stroke his dark hair and such.

As of last night he weighed 5lb 11oz. His bilirubin was up a little so he was definitely still under the lights. His plumbing is definitely working, so hopefully that will help bring his count down. I changed one of his diapers earlier in the evening. I had just cleaned him up when he started pooping again. I caught all of it in the wipe so at least his blanket wasn't soiled. It's tricky to change a diaper when your arms are going through two different holes in an isolette. Changing his diaper again showed me how tiny the little guy is as I had changed a poopy diaper of Nadia's a couple of hours earlier. What a difference!

I had planned to return to the NICU every 3 hours this evening, but in light of this plan to pump before attempting to nurse, I decided to just pump in my room and put the milk in the freezer during the night. I'll bring it over to the NICU in the morning. My mom got me in a good pumping routine. During the first 24 hours she was with me, I pumped 13 times! I am now producing enough that I am putting the milk in a bag rather than syringes. There is a shuttle that runs between the hospital and RM House until 9pm. After that they call security to come get you. Security took FOREVER. If my feet weren't so swollen, it would have been much faster to walk there. I might be rethinking nursing Ian throughout the night while I'm at the RM House. I doubt I'd get any sleep whatsoever. I think that will have to wait until I'm in the demo room (presuming that's my next stop before we go home). Hopefully we can be moved to the demo room sometime in the next couple of days.

The high points of the day - spending time with Nadia, being able to hold Ian, and seeing Ian without the CPAP or arterial line are what I should focus on. I admit I had this feeling of - I can't take this any more - earlier this evening. I was thinking about the fact that others get pregnant easily and then also are with their babies right from the start. Getting pregnant isn't easy for us, and so also it seems we can't just take our babies home right away. However, it all depends on your point of comparison. There are so many babies in the NICU who spend months there before they go home; their moms have to wait MUCH longer to experience holding them, nursing them, etc. I am grateful that hasn't been the case for Nadia or Ian.

The NICU is a hard place to be emotionally. I struggle with being with Nadia when she gets her immunizations. The NICU experience is like going through that many times a day for many days. For example, once today they were pricking Ian's heel to check his blood sugar (why I don't know as his levels have all be perfectly fine) the nurse made quite a mess - there was blood all over his foot, on the sheets, etc. Ian was wailing and pushing himself up (he was on his belly). After she put the strip in the machine, I was comforting Ian and telling him it was all done. The nurse said no it's not as I didn't get enough blood on the strip. I wanted to scream. It hurt my heart to watch Ian scream while she pricked him again. This may all seem very overwhelming at the moment, but I know in a few weeks or months it will long be forgotten. When I hold Ian, it's hard to remember when Nadia was this size, and she's only 17 months old! This too shall pass. Hopefully tomorrow Ian will begin the process of learning how to nurse. The little guy doesn't know what it's like to suck or swallow yet since his food just goes straight to his belly through a tube.