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Month: December 2019

Doing Time in the Neonatal ICU

‘What hurts you, blesses you. Darkness is your candle.’ —Rumi


It is hard to believe it is already December. I can’t think of a time when I felt as though so much had happened in the space of 12 months as it did this last year. My husband and I recently ‘got away’ which means we left our Au Pair with the kids for one night, escaped off to a nearby remote island for a night alone.

On our journey I felt as though it was the first time I could breathe in a long time. I had gotten caught up in the ‘doing’ that occurs with life, that I completely forgot to reflect, to process all that happened this last year. I realize now that I also wasn’t writing as frequently, which has made me feel as though all my thoughts and feelings have been bottled up, waiting for an opportunity to come out.

Last December I had to stop working because I was at risk for placental abruption. I had some bleeding after a shift one night, needed to be in the hospital for a week as I waited to see if it returned. Fortunately it did not, but I was stuck in this strange place, of no baby yet, feeling relatively ok, but needing to slow down. The mere fact of taking time away for my own rest felt unnatural and unnecessary, but when I considered the possibility of tragedy, it was the only option.

Unfortunately, I did not make it to 38 weeks. On December 16th we had friends over for dinner, and just before they left, I went to the bathroom. In the bathroom, blood seemed as though it was pouring out of me. I could hardly control it enough to be able to get to the dining room, to tell my husband and friends we needed to go to the hospital. By an amazing coincidence, my friend is a doctor, she works in the emergency department of the hospital I was headed to, and boldly and calmly drove me to the hospital.

If any of you are familiar with Seattle geography, know that getting from Bellevue (where I live) to Seattle (where my hospital was) can be a feat. You have to drive over water to get there. I believe she is the only person who would have done that drive, all others probably would have made me call an ambulance. But ER doctors are gutsy. They weigh risk/benefits and worst case scenarios in their heads all day.

I tried not to panic, remembering what my own doctor had told me, that if I started bleeding, it was MY blood, not the baby’s, which had a weird calming effect. At least I could be comforted with the knowledge that my baby was not bleeding out. The time it took to get to the hospital seemed like an eternity, but we arrived and I was not soaked in blood, or fainting from loss of blood either.

I am always so surprised at the amount of ‘non-surprise’ or calm that the labor and delivery unit has. I thought for sure I was in trouble, but when I arrived, they put my in a room, to have me wait 20 minutes or so until I was fully evaluated.

What most people don’t understand, at least those who have never given birth, or those who have had seemless, uncomplicated pregnancies and deliveries, is that we as women are closer to death during this time than any other time, at least until we are older and actually dying.

Pregnancy and childbirth is scary. There is also no guarantee that you or your baby will come out alive. We walk this fine line of wanting a family, feeling invincible as we carry an additional human for 9 months, but then are faced with some very scary health conditions like pre-eclampsia, placental abruption, and others. I know women who have had uterine ruptures, causing them to be in the ICU for blood transfusions, I have known women with heart failure and sepsis, and I have known countless women who have lost babies to miscarriages or even as tragic as having a stillborn. We walk this journey with our spouse, but also alone, as the growing of the baby is inside only our body.

I was terrified. I also had a bit of PTSD from my last pregnancy (in which I also had some bleeding, baby had a very high heart rate, and I did not progress when the physicians tried to induce labor). The last thing that happened before I delivered my firstborn was that his heartbeat was lost. I was wheeled very quickly and unceremoniously to the OR as I fought back tears, calculating in my head the amount of time it would take to get the baby out. I figured that if there was truly no heartbeat, my baby would have significant loss of blood to the brain, and there was a very real possibility that we would be delivering a baby with no brain function. In the OR prior to starting with the C-section, they checked again and baby’s heartbeat was back, loud and stronger than ever. We continued with the C-section and baby came out screaming. I was extremely thankful, but acutely aware at how close tragedy had been.

This time, I thought we were prepared. Baby was 33 weeks, the bleeding had stopped upon arrival to the hospital, and it was going to be a planned surgery the next day. I am a pediatrician, so I know what 33 week babies are like. I knew things would be ok, maybe we would even be able to go home relatively quickly (1-2 weeks maybe?)

What I was not prepared for was the combination of the unique stressors. It was December, so Christmas was looming. I also had a 2 year-old at home, who didn’t have the capacity to understand what was happening. I also had never experienced being in the hospital for days on end…..as a patient.

What came next was three weeks of hell. Baby Cole was delivered via C-section, which is major surgery. Ambulation was painful and challenging. I was instructed not to drive or lift anything heavy. Couple that with needing to pump every 4 hours to keep up milk supply, figuring out how and when to be at the hospital, but also to try and be home for my toddler.

The NICU became our ‘home away from home,’ but I hated every minute of it. I remember as a resident in the NICU not seeing moms very frequently, also judging the fact that they weren’t there the exact minute the medical team came by to round.

As a mom, I hated the medical team, for rounding without me, feeling like I was a bystander as they cared for my infant. I disagreed with the initial refusal to let me hold him on the first day due to his “tubes and such,” and that it was “too hard” to put him on my chest.

When I was scolded for being ‘too loud,’ as my husband and I lovingly whispered about his nose, or his little hands, I lost trust in the team, as I felt inappropriately reprimanded. This worsened as baby Cole progressed, quickly becoming the ‘least sick baby’ in the unit.

I remembered those days of seeing 33 or 34-week babies as a resident, dismissing them for their lack of pathology, blithely talking about how they are just ‘feeders and growers,’ and totally not understanding their parent’s stress. Those babies do FINE. Looking back, I am embarrassed by my lack of compassion.

Baby Cole WAS doing fine. But the stress, the emotion and the total lack of support I felt by the medical team, and those around me, definitely took its toll. Nothing in my world was making sense. My toddler hated me for not being around. My baby was alone for most of the day, and I felt as though I was doing everything wrong. I felt like a terrible mother.

Coming home from being at the hospital, my son would run away from me, coming back to the hospital, the nurses made snide remarks about how they couldn’t believe they hadn’t met me yet. Or that I should know fresh breast milk was the best. Or that they are sorry, they fed the baby before I got there, even though I moved heaven and earth to be there for the 3 pm feed.

I was frustrated that every day I was told how to feed the baby differently, or to try or not try to breast feed because it would take all of his energy. It was like they purposefully told me conflicting information every day.

I remember having these achingly sad thoughts of my poor baby alone in his bassinet, and wondered why I couldn’t be trusted to take care of him at home. He was just a feeder and a grower, right??

I also felt like being a doctor was a liability, as if by having a degree automatically put me in the ‘difficult patient’ category, although I had done nothing to deserve such a label. I was just a mom, trying to make it work, missing my baby, feeling deficient that I couldn’t just make it all better, and feeling to my core that everyone was working against me.

Baby Cole spent 21 days in the hospital. We took him home on January 6th, 2019.

I thought that once we were home, everything would be normal. Some things were, no more traveling to go see the baby, no more pumping and freezing, transporting, and making sure that my older son had someone taking care of him. But we also had to start all over again, we were integrating a new person into our family, so our routines changed, the way we traveled changed.

He was a different baby because he was premature, and I felt more anxious. I worried about how much he ate, about putting him down to sleep without me right next to him. I worried about taking him out in public because I was more worried about him getting sick.

Since I had to take time off at the beginning of my pregnancy for the bleeding issue, my ‘at-home’ maternity leave was cut short. I went back to work exactly 6 weeks after he came home from the hospital. I felt robbed of the time that should have been spent snuggling with my baby, and will forever be frustrated by the lack of compassion from the ‘system.’ In addition, sleep-deprivation ruled my life at this point, as baby was waking up every 90 minutes, so my ability to handle life’s obstacles was greatly diminished.

There were things that were good. We matched with an Au Pair, Melissa, from Colombia. She brought a joy and compassion to our lives that I was unable to provide at the time. I feel so lucky she was the person to come into our home less than a week after Baby Cole came home. When I cried after I spilled an entire container of breast milk, she and my husband cried with me, knowing that it wasn’t about the breast milk. She also consistently offered to take the baby at night, so I could get some sleep.

I also have found that in challenging times, my husband and I grow closer. We definitely feel friction and struggle, but in the end, our bond is stronger. I think we love each other more as we see more clearly we are each trying our best, and that matters to us. I also think that we realize there is no one in the world we would rather go through such hardships with. Things can be awful, but awful can be enshrouded with love, care, and empathy.

So here we are, the last 12 months was a blur, filled with many heart-breaking lows. 

I’m happy that the year is coming to a close and I am grateful that life is much easier than 12 months ago. I am also grateful for the experience, as I think it will forever make me a better doctor, mom, wife, and friend.

This morning my one year-old woke up crying, way too early, around 530. I brought him into bed with me, stroked his head as I sang to him and fed him a bottle. My 3 year-old came in soon after, slipping himself between my husband and I. We listened to “Let It Go,” at my older son’s request, and for the moment, I realized, this is happiness.