NICU Drama

My recovery after the c-section continued to go well. By that evening I had stood up for a couple of minutes.

The following morning the pediatrician showed up bright and early at 6:30am to check Julian out. He heard a slight heart murmur but noted this was fairly common with newborns and fixes itself within a day or two. By mid-morning I was walking and able to get my catheter and all remaining tubes and monitors taken off. The nurse had suggested I walk around a little more so around lunch time Jaeger, my mom, Julian, and I all took an excursion to the outside balcony. The weather and view was spectacular.

As part of standard procedure, the hospital wanted to run a battery of tests on Julian to make sure he was doing well. Jaeger and I stayed out on the courtyard and mom took him back to his screenings. When Jaeger and I arrived back at the room we discovered Julian had failed his pulse oximetry screening. This screening is used to catch congenital heart defects.

BCH has a nurse practitioner onsite from Children’s Hospital that rotate in 24 hr shifts1. The on-call pediatrician had our nurse consult with her and they decided to repeat the test to make sure it wasn’t a fluke. The nurse practicioner also listened and heard a faint murmor. To do the pulse oximetry screening, they hooked up one probe on Julian’s right hand and one on his left foot. The hospital was looking for both to be about the same level and also for them to be in the mid 90s range. Julian also failed the repeat.

Thinking that possibly he just had a stuffed up nose, they got out an industrial suction device and tried to suction out his nose. It did extract some mucus and they were hopeful that was possibly the culprit. For a bit it looked like he was going to pass the screening but after a while they concluded he was still failing.

This changed everything. All of a sudden we were moved from our standard recovery room to a “special care nursery” suite. The move was surreal. I had researched BCH’s NICU prior to picking the hospital because I half expected to end up there due to preterm labor. BCH’s NICU setup is very nice as each suite contains a private room for the baby and an adjacent room for the parents to stay. The parent’s room has two doors, one to the outside hall and one directly to the private nursery. The nursery also has a door to the hallway.

Mom and Jaeger worked to pack up our stuff from our first room and I went with Julian to the special care nursery where they immediately put an oxygen hood on him and started doing all sorts of tests. Julian was not pleased. The echocardiogram took the longest but he also had an x-ray and many blood-test related pokes. It took about 2 hours for them to do all the testing. During most of it I stayed by his bed, let him suck my little finger, and babbled incoherently to him trying to keep him calm. The surrounding medical staff got to here all sorts of things about our family while I was desperately trying to come up with subjects to talk about.

After all the tests were done I sat in the in-room recliner/rocker and they gave Julian back to me to nurse. This time Julian had 3 ECG probes, a probe to monitor his oxygen, and then oxygen to breath from. At one point they briefly contemplated putting an IV in his umbilical cord but one of the nurses suggested we first try breastfeeding and move to the IV if it looked like he needed additional nutrition. As it was, all the cords were a horrendous tangle to try to keep straight. Not surprising, Julian wasn’t excited by any of this and tried to breastfeed for about 3 hours straight. Unfortunately, his latch wasn’t great and I didn’t shift him from side-to-side as much as I should have due to all the tethers he had attached.

During the afternoon results started trickling in from the various tests. The cardiologists down at Children’s Hospital had reviewed his echocardiogram and pronounced his heart normal. The x-ray showed some fluid in his lungs which hospital staff believed was probably the results of him not getting properly wrung-out during his c-section delivery. Ever since Jaeger has been threatening to invent a wringer for c-section babies.

In any case, the pediatrician wanted him to remain on oxygen until the pulse oximeter consistently showed him in the mid-90s. So, our remaining days at BCH were in the “special care nursery” section of the postpartum wing.

That evening as I was nursing Julian my left nipple started bleeding. The shenanigans in the afternoon had been too much for it. We started supplementing what Julian was getting from me with donor breastmilk from a bottle to give him more milk and give my nipples a bit of a break.

Since Julian was in his own nursery instead of right by our bed it was trickier to get up to feed him. Our first night in the NICU suite Jaeger would hop up and determine why Julian was crying. If it was a feeding issue, he’d come get me and help me out of bed, otherwise he took care of it himself. It was very helpful to be able to lay back and wait to see if I was needed.

Standing for two hours my 2nd-day post c-section turned out to have been a bit much for me. My feet ended up dreadfully swollen. My last c-section I had mainly used ibuprofen but I did end up taking Norco once a night for a couple of days. I was still doing really well recovering but physically it was a bit slower than last time due to the additional strain I had been putting on my body. In spite all all of this, I still felt much more clear-headed and more optimistic than I had the first time.

Other than the initial stress, the NICU experience was really good. While it is appalling to see all the monitors attached to such a little baby, there was also the comfort of knowing that everyone will know as soon as something goes wrong. The nurses were obviously very experienced and were a lot of help.

While at BCH I saw a lactation consultant every day. With Calvin I had tried a supplemental nursing system (SNS) and absolutely hated it. As a result, I was pretty resistant to trying it with Julian. In fact, on my birth preferences document I explicitly stated I did not want to use a SNS. However, on the third day when a nurse suggested I try the SNS I took a moment to reconsider. My feeding experience with Calvin was a disaster in every respect. However, even though something wasn’t quite right with Julian’s feeding, he was sucking correctly. So, I agreed to give it a shot. The nurse called the lactation consultant and we set it up. It turns out the whole thing works much better with a baby that knows how to suck.

My recovery continued to be excellent. My OB said I would likely be discharged on Thursday. We could stay in our hospital room as long as our baby stayed in the NICU. However, the pediatrician said he’d probably discharge Julian the same time I was and just send him home with his own little tank of oxygen.

On our third night Julian screamed in the middle of the night for about 2 hours. It’s unclear exactly why. However, the upside is it appears to have cleared out his lungs. That night the nurse was able to wean him off oxygen. In fact, when I woke up, his oxygen was detached. I thought it was a mistake till I saw there was a note that the NICU nurses were running a test to see how he did without any oxygen. This time he passed.

The pediatrician stopped by and cleared Julian to take home without oxygen!! The whole discharge process took longer than I expected but finally, on April 2, we were able to bring Julian home!

Julian is now nine days old and continues to do really well. Breastfeeding has been a bit challenging but nowhere near the scale that it was for Calvin. Julian has been sleeping exceptionally well and at the moment all members of our family appear to be sane.

Photos related to Julian.

  1. They have a little room with a bed and TV when they aren’t needed.