Friday, July 30, 2010

26 weeks...

*sorry, this post is emotional, reflective, and detailed, but I've been needing to write it for about five years, so I understand if you don't want to read the whole thing!*

I turned 26 weeks yesterday! By the end of next week I'll move out of my second trimester and into the third!!!! Yikes!

26 weekers are amazing little people. I don't want to have one, but I do admire them. They're feisty and are way more aware of what's going on around them than anyone will ever credit them. They hear, cry, respond to pain, wrap their whisper-thin fingers around their ventilator tubes and try to yank them out...they're crafty little boogers. They have spunk and personality. But they're still oh so fragile. Any amount of stress - even a brief crying episode - can have devastating effects on the fragile blood vessels in their brain, and crossing the line from "turning out okay" to living with a lifetime of challenges can happen as quickly as you can say boo.

One of my favorite people on the planet was a 26 weeker. She's been on my mind a lot today, and I don't know why, except that I maybe am just breathing that subconscious sigh of relief with every day that passes by...and now I have an image in my mind of a 26-weeker who turned out healthy and thriving and well.

But she's not the one who turned out healthy, thriving, and well, unfortunately. Her twin sister did. I'll call them Maddie and Sonja.

Maddie and Sonja were born at an outlying hospital. The hospital was equipped to stabilize the twins but, without the backup of a Level III NICU right there, could only do so much before the transport team arrived. They did what they could, and what they did was appropriate. The girls had breathing tubes inserted in their airways and were being ventilated with a hand-operated mechanism.

What no one knew was that Maddie, while looking like your average 26-weeker on the outside, was far from one on the inside. She had a defect where she had a tiny connection between her trachea (airway that leads to the lungs) and her esophagus. Essentially, while she was being ventilated, not only were the air and pressure entering her lungs, but also her stomach.

Basically, her stomach popped like a balloon.

The course for her was set. She lived a life like no other person I can imagine or describe. I, like many other nurses, was too intimidated by her problems to take care of her. I took on her sister Sonja as a primary nurse, looking on at Maddie's bedside with a shudder. She had a tube coming out of her stomach to a water bottle to provide enough back-pressure to provide the ability to ventilate her extremely immature lungs. She was on a high-frequency ventilator for longer than I can remember (for some perspective, we as adults breathe 10-20 times a minute...babies breathe between 20-60 times a minute...a hi-fi vent will deliver between 400-900 breaths a minute, in rapid succession, to minimize pressure trauma to the lungs...it kind of sounds like being ventilated by a lawn mower).

Her story is long and convoluted. Maddie lived far longer than she had any business living, with the issues that she had. She survived heart surgery to repair a common, well, not "defect," but common "thingy" that preemies have. She survived surgery to have a feeding tube placed below her stomach into her intestine...and then survived that feeding tube puncturing her intestine and essentially being "fed" into her abdominal cavity, the subsequent infection, and then the surgery to repair that. She had infection after infection after infection, feeding difficulty after feeding difficulty. She could never be fed from a bottle because the connection between her windpipe and her esophagus still needed to be repaired.

Maddie was an absolute Christmas tree, with the less-than-lovely ornamentation of a NICU patient: a long-term IV line in her scalp where she received IV nutrition 24 hours a day, the wound where she still had a tube coming out of her stomach, a feeding tube in another part of her abdomen, extra IV lines in her hands, arms, or feet for antibiotics or whatever else we needed to give...she was beyond fat from months in the NICU, being fed mega-doses of calories but never having much opportunity to develop the muscle tone that other babies are able to develop. The IV nutrition that was keeping her alive was also wrecking her liver, leaving her jaundiced.

Essentially, Maddie was fat, yellow, had a bad haircut (we shave a lot of hair from those babies' heads to have access to their veins), weird stuff inserted in weird places on her body, and she had a bad attitude.

And I LOVED that baby.

Maddie had a wonderful family, but they had a handful of other kids (in addition to Sonja, who eventually went home after a few months) and couldn't be with her as much as they would have loved. So most nights I had Maddie all to myself. We had a great relationship. By the time I picked her up as a primary - after Sonja went home - she was a few months old, breathing on her own, and in an "open crib" (as opposed to those plastic boxes - isolettes - that the littler preemies are in). When I came on for report, she'd hear my voice and twist her chunky little body around so she could see me. We had our little routine, which included what I called the nightly eruption of "Mt. St. Maddie" because her foul temper would take over the entire room as I assessed her, cleaned her, and changed her dressings. Then I would set her in her little baby papasan, set it on vibrate, and sit on the floor next to her while I charted so she could keep looking at me.

Every morning at 2am we had the chance to snuggle. You don't get many chances to snuggle NICU babies. They're not exactly in much of a position to be interacted with like normal babies. Snuggling Maddie was...exciting...with her tricky array of accouterments. I'd have to drape her scalp line over my shoulder, her other IV over my arm, and clutch her back-pressure bottle from her stomach between my legs as I sat in the rocking chair. But then we'd rock, and I'd play with her hair and tell her how beautiful Miss Jenny thinks she is, even if she was fat, yellow, and grumpy.

Maddie wouldn't make eye contact with me. Or with much of anyone. Many NICU babies won't. But one night, as I sat with her, she fixed straight on my eyes and wouldn't look away. Another nurse grabbed the unit's camera, set up a sheet behind us, and we had a "photo montage" so we could capture the moment...this yellow little basketball staring at me with huge brown eyes.

Maddie "barked" when she wanted attention. I'd be charting at another bedside across the room, and she'd peer at me through the jail-bar-like slats of her crib and yap - a sharp, raspy "MEH!" to get my attention. So now I had a fat, yellow, and bossy baby on my hands.

Ah, but things started happening, things that any NICU nurse can predict for a life like the one Maddie lived. Her story becomes even more long and convoluted and I'll leave it at that. She needed surgery to repair her defects, but the procedure was life-threatening for her. She got sick from the IV nutrition she was receiving. Her wound in her stomach would never heal, and the doctors were tired of me chasing them down every shift asking what more I could do...because, there was very little anyone could do. She was a medical and surgical atrocity, basically. Her dear parents knew what was ahead. At 4am one morning, her mom asked me to tell her as honestly as possible what I thought would happen, and I told her...and she quietly conceded, "That's what I was thinking, too."

During one of the worst nights of my life, I spent roughly ten hours with about six other doctors and nurses trying every last effort to keep this baby alive. I was exhausted and apologizing profusely in my spirit for making her endure things that not one of us would ever want to endure, given the choice.

Maddie had her surgery as a do-or-die effort to close off the airway-esophagus connection once and for all. And that's when they found the truth: she had hundreds - HUNDREDS - of these connections, interlacing two parts of her body that snuggle like buddies next to each other in all of us but were never, ever meant to communicate in such a way. She was sent back to the NICU. Shortly thereafter, she put her foot down and said no more, and now she's whole in heaven, God be praised.

Maddie's story rocked me. We all do our best to maintain a professional distance, but every once in a while - maybe once in a career, even - one patient's heart weaves into our own. I have so much respect for Maddie. I wish I could have treated her with even more dignity, but we had to do what we had to do...babies don't exactly come with living wills for what they do or don't want to have done in the event of a crisis - and many of those babies are one crisis after another. Their parents and families dance the tenuous shuffle between grief and horror and hope, sometimes from one minute to the next, and we as nurses have to remain objective and truthful and supportive of their decisions.

So all that to say, as I feel this little person moving around inside of me, I know what he or she looks like, I know what he or she is capable of, and I know what he or she would endure to have a chance at life. And that is awesome, in ever literal sense of the word. These little people are amazing and deserve so much respect. God has made them more fearfully and wonderfully than we can ever imagine.

So "Maddie," I still love you, and Miss Jenny thinks you're beautiful, and I can't wait to hold you again someday on the other side of heaven.

And Little Bird, you stay put, alright? Good things await you on this side of heaven!

Thursday, July 22, 2010

Glory baby...

My first due date is approaching. My Glory Baby was due this Saturday.

Before I got pregnant with Little Bird, every Saturday I experienced a little bit of grief, thinking of how I would have been one week farther. After I got pregnant again, I started to lose track, but always had a general idea of how far I would be. Then it snuck up on me: a few weeks ago I was at a c-section for a baby who was early-ish, and when I was perusing the mom's prenatal for some information I needed, my eyes shot to her due date: July 20th. And suddenly I was like, "Oh my word. I would be term right now." And it felt kind of sad and weird.

And then...there's this lady who walks by my house every day. She has a two-year-old boy who was a 34-weeker that I took care of in the Special Care Nursery. She and her husband were THE most darling couple, and we still chitty-chat if we see each other.

Well, she had another baby this past weekend. I was working in the Special Care Nursery (known not-very-affectionately as "The Cave" because, quite often, people forget that you're there because it's separate from pretty much everything else), and the nurse in the Well-Baby nursery had to run to the bathroom or something, so she carted in this lone little baby from the nursery for me to watch while she was gone. So in comes this day-old, DARLING little baby girl...I peered at the name tag and it was this lady's baby. She was due on the 26th. It kind of hit me: this is exactly what my baby would be like right now (well, not exactly, but you know what I mean).

There was no one else in the Special Care Nursery with me (well, no one over four pounds, that is). I picked up this baby girl and she got kind of ticked. But I snuggled her and talked to her and she settled down and fell asleep. And I sank into a recliner at one of my bitty's bedsides and held her and just sobbed. I can't explain why, and I probably don't need to. I needed to hold that baby and grieve.

I purposefully took vacation time starting this Saturday because I intentionally want to make the weekend of the 24th full of good memories to celebrate the life that would have been.

Meanwhile, I do have to say I have nothing but praise to God for how good He's been to us. Granted, He gave us another child right away, one who thrives and kicks and tumbles and is growing (or at least making ME grow) at an alarming rate! But we don't just praise Him for what He gives us; we praise Him because He is sovereign and He gives AND he takes away, and while the "taking away" part stinks, it can be an act of mercy...and clearly was what was best for that baby. I love that baby and I miss it; Little Bird is not a replacement but is a tremendous grace.

...but baby let sweet Jesus hold you
Till Mom and Dad can hold you
You'll just have heaven before we do
You'll just have heaven before we do

Friday, July 16, 2010

The Nana Chair

Here is our first major gift for Little Bird: a glider from Nana Sarah and Gramma Sue!! We love that it doesn't take up too much space, the pattern at first was not what caught my eye, but the more we looked at it the more we were like, "Hey, it matches our living room colors perfectly!" and promptly scooped it up.

Thank you Mom and California Mommy!

Tuesday, July 13, 2010

I can't help it...

When I saw a laboring woman walking in the hallway with her fabu hospital gown, pushing an IV pole, with a BLUE TOOTH in her ear, I about fell off my chair. That is just too funny.

Monday, July 12, 2010

Overwhelmed

I think part of the reason that I haven't written many posts lately is that I'm overwhelmed. And not in the way that you would think. I'm sure one would expect me to be overwhelmed at the thought of having a baby, the ups and downs, the unexpected, the oh-my-goodness-I-have-no-clue-what-I'm-doing-ness...but that's not really the case. It's more that I'm overwhelmed at all the thoughts I have running through my mind, things Matt and I would like to see our home and life look like as our family grows etc - and I fear that if I flesh through those thoughts out loud (so-to-speak), The Opinions will come resounding back.

You know what I mean. The Opinions. Lord knows I have plenty of them! But so does everyone else. And in few other arenas are opinions more staunch than in the area of having and raising children. I know I'll have mine. So I'm throwing myself in the pot with the rest of humanity, mind you.

As an aside, a fun observation in the sociology of delivering/handling babies is one of the, shall we say, "perks" of my job. But that's a totally separate topic, and one about which I hope to graciously write someday. Graciously being the operative word! hahaha!

Anyway, I remember when Matt and I were newly engaged, and Valentine's Day was shortly thereafter. He sent me a beautiful bouquet of roses at work...and while there were many "awwww's" and "how sweet's," I was taken aback at how many MORE were like, "Yeah, don't get used to this, because it'll stop once you're married" followed by an exchange of knowing looks. Huh. How encouraging.

It's kind of the same way now: "Yeah, well wait until you have kids....THEN ________."

I totally understand - as much as I can cognitively understand - that things will change. Radically. But that's what we WANT. We're not having a baby to gratify ourselves. We totally get - again, as much as we're able to "get it" without being in that boat yet - that God will use this child to challenge every capacity that we have. But what a glorious thing! We'll dive headlong into this, knowing full well that this is one large part in His plan for our sanctification. He's giving us this kid to raise in the fear and admonition of Himself, and I pray that we'll be faithful in diligently sowing the knowledge of the Lord into his or her heart. There will be major - MAJOR - challenges along the way, ones that we expect and others we don't. But every day of this child's life is written in His book, and his or her path is joining ours, and we'll take each day as it comes and rely completely and utterly on His grace.

But on a much more, um, basic level....holy cow, there are so many little thingies to think about and decide upon, and everyone wants to know what you think or plan to do, and in many cases, as soon as you answer, you get the "Oh, well, that's what YOU think, BUT..." response.

*sigh*

So, here I join the ranks of women who for centuries have felt like bumbling fools in motherhood, and I just am going to smile and decide that that's simply the way it's going to be! I won't be able to please or impress everyone (and perhaps not anyone, oh my!), and I'll have to stuff my pride every day and resolve to remember that not every move I make will wreck my child's life!

Sooooo......

No, as you well know, we didn't find out the baby's gender. Everyone has a major opinion on that, but it's a minor and personal and inconsequential thing, so I say go for whatever you think is more fun! Personally, the most fun deliveries I attend are the ones where it's a surprise. And knowing what "it" is wouldn't really change the way I would decorate or the stuff I would buy, because what if I buy very gender-specific stuff, and then next time we have the opposite? Now I have all this pink or blue stuff, and I'm having an un-pink or un-blue person, and either I will subject them to a gender-crisis at an early age, or have to buy all new stuff. No way, man. And I like a little suspense, don't you? ;)

No, I prefer not to be induced or have a c-section, but if that's what happens, it's what happens. I admire and respect people who have lengthy birth plans and know exactly how they want each stage to be as they labor and deliver, but that's simply not me. And I know full well that the longer your birth plan, the more likely it is that it'll be trumped. I'm just sayin', that's what usually happens. It's not about what I want, it's about getting this person out safely, and if that has to happen through my nose, then that's that. I would prefer to wait to go into labor naturally (of course), because babies who are exposed to that cascade of labor hormones that naturally occur have better outcomes. Did you know, for instance - I have to be a nurse here! It's too fun! - that it's NOT the "squeezing" of the birth canal that clears the fluid out of the baby's lungs? No! It's the hormone cascade that occurs during labor that signals to the baby's body to start reabsorbing the fluid while it's on its way out. And that is one of the many reasons why so many babies who are born by elective c-section tend to have more complications. One day they're in their tub, and next thing you know they're being yanked out with no warning. Way unfair, man. Granted, if we have a breech baby or something, that's the way it is.

On the flipside, if this kid is still dangling from my rib cage and my body is refusing to start labor, I won't go too far beyond my due date. There comes a point where there can be even more complications if the baby's in for too long, and I don't want to mess around with that either.

Epidural or not? Epidurals come with their own set of risks. Laboring without one comes with its own set of risks. I like to think I'm hear-me-roar, but I'm quite certain I'm not. It will be a game-time decision.

Breast or bottle? Of course I would like to breastfeed.

But I've stood in many, many, many, manymanymanymanymany rooms next to moms whose babies would. not. breastfeed. Most people think that breastfeeding is so natural, that as soon as the baby is born, violins strike up in the background and voila!!!!-breastfeeding occurs. I'm here to say, it doesn't. If you were one of the very, VERY fortunate moms for whom this was the case, you are very, VERY fortunate indeed. But I think I've said this before:

I would rather stand dripping wet in a snowstorm chewing on broken glass while a bear gnaws on my face.....than fiddle and fiddle and fiddle with a baby who will. not. breastfeed.

This is a very flammable subject, mind you. Breast IS best. No denying that. BUT - and this is a big BUT - it simply does not work every time. It just doesn't. Everyone has different anatomy, every baby has a different shaped mouth, and sometimes, it just doesn't happen the way you really want it to and it totally stinks.

So, knowing that, if it doesn't happen the way I want, I'll formula feed and admonish myself against feeling guilty, unloving, and inadequate, as so many moms do feel when breastfeeding doesn't take off. I'm not saying that I'm the poster child for all things gone right, but I was formula fed (probably from a leaded glass bottle too!!) and I have no allergies, am bonded with my mom, rode a bike, learned to read, graduated from college with honors, and am a quite healthy adult. So it's not the end of the world!

I will work two days a week. I have awesome health insurance and we'll keep me and our kids on it. I'd love to be a stay-at-home mom, yet I know I'll look forward to the creative and intellectual and social outlet that work will be. Maybe someday we'll decide together that being a stay-at-home mom will work out best for us. Today is not that day. We're a team and together we'll do what we both need to do to keep our game going. I'm sure I'll get some flak for being a working mom (you'd be shocked at the daggers that can be lobbed at working moms, unless you've seen them firsthand), but it's a decision we're owning.

We're using cloth diapers. As exclusively as humanly possible. I know what kind I want to use, and everyone who uses cloth swears by the kind they use and it's overwhelming to get every (very kindly and well-intended) opinion. So I'm settling on what I want, and I'm owning that decision! :)

Our kids will go to public schools. At one point I just knew I was going to homeschool, and then we decided we'd really like to send our kids to Christian schools, and then we felt that as part of our vision and what we feel our calling is as we raise our family, public schools it is. I admire parents who home-school and am beyond impressed with how their children turn out - academically AND socially. Christian schools are amazing and I love the mission and purpose of a Christian education. Public schools are an arena where a family can have vast influence, and that is where we'd like to pour our energy. We might change our minds, or another opportunity will arise. But as of right now, that's our intention. And we're owning it.

My registries are kind of slim because, well, there are a lot of things that either I can't fit into my house or I know I most likely won't need. I'd rather find out I need something down the road and have to go out and buy it, than have a house filled with stuff I think I need but really don't. I feel kind of silly and slightly embarrassed as my two dinky pages print out on my Target registry...and I felt very silly and quite embarrassed when I registered at Babies R Us, and after two hours handed back my scanner and the lady looked at it, raised her eyebrows, and said, "Well, you can come back a few more times and add more stuff to it." A FEW more times? I don't have time to drive to the other side of Grand Rapids and troll the aisles for more stuff, nor do I have space in my house for more stuff!!!! I already flunked registering! *sigh*

So these are the things that overwhelm me. It kind of comes down to a fear of man, really. What if I deliver and get an epidural, will people think I'm, like, less of a woman? What if breastfeeding doesn't work out - I have friends for whom it didn't, and they get raised eyebrows and underhanded remarks as they pull out a bottle of formula...will people do that to me, too? Will people think that because I'm returning to work that we must not trust in the Lord enough to provide for all of our needs? And......argh.

I can't worry about what other people will think. I just can't! We're going to raise our children in the fear and wisdom of the Lord. That's the best I know to do. The other stuff is just....stuff. And I will own that until my dying day.

Sunday, July 11, 2010

Oh. My.

A week or two ago, Matt came home and exclaimed, "Whoa. You really look pregnant now."

I took it as a compliment. I know that's what he intended it to be.

But yeah, I looked in the mirror and was like, You have GOT to be kidding me. Last Saturday (fourth of July weekend) was my first fairly uncomfortable day, and thankfully my friend Mary warned me about this "round ligament pain" that I woke up experiencing on Saturday morning, and it lasted through much of the weekend. I just felt like I was...getting bigger. No other way to explain it. And as you can see...yep, I'm growing all right!


So yah, here I am at 23.5 weeks (eeks!!! I've taken care of 23 weekers! I know what they look like and what they do and they can be spunky little critters!) and I feel quite good, thank the Lord! I've gotten some decorations for the room, started my registries (still need to tweak them though) at Target, Babies R Us, and Ecobuns.com, and am just trying to be diligent in methodically getting stuff ready so I don't have one big freak-attack in the last month.

I'm sorry I haven't blogged in quite some time. It seems lately like on my days off, so many things come up and I'm scrambling to get them done before the sun already goes down again, and I'm on my way back to work the next day. I'm trying to be super-fruit-picker-and-freezer, so as fruit comes in season I'm heading to the u-pick farms and stocking up. I'm trying to clean and organize stuff and foresee the little things that I'll need to buy or complete as the weeks quickly tick by. And I'm trying to be available to my precious friends and church, for when those last-minute needs come up...my days are numbered where I can just drop everything and help babysit, clean a house, or fill in for some other random need! So I'm not trying to be a blogging delinquent!! I promise I will blog soon with more of what's going on with us lately, etc.