Saturday, February 26, 2011

Ryan's [second, and hopefully last] Hospital Stay...

On Tuesday, February 21st, we had a check up at the clinic to check on how Ryan was doing and to make sure he was recovering from the jaundice. Over the weekend, we had noticed that he wasn't eating as well and that he was looking a bit more yellow again. Jake was unable to come with me this time, so it was just me and Ryan. We saw Dr. Engstrom again for this visit. She was surprised to see how yellow that he looked and sent an order for the lab to come draw some blood for a billi check. I waited for what seemed to be forever and a day... finally she came back and told me that his number was even higher than it was the previous time that he had been re-admitted to the hospital. This time, she said, she wanted him to go to Children's Hospital. She really didn't give me any other option which made me think that this was more serious than the previous time. She was also really concerned because he had not gained any weight in the last ten days [since he was discharged from the SCU] and was [obviously] still below his birth weight. She wondered if he had something "internal" going on and wanted him to see a GI doctor in addition to being under the lights. So she sent me over to Children's Hospital.

I, of course, got lost on the way there, and that added stress upon stress... having to go through this AGAIN, having a crying, hungry baby in the back seat, not knowing where I am... ugh, it was not fun and I broke down in the library parking lot where I called Jake for help.

When I got to Children's, I went to the ER as I was told to do. After checking in and waiting for 20 minutes, the triage nurse checked him out and asked me a bunch of questions. She took us back to a small room and told me to undress Ryan. She got a billi blanket and we laid him on it on his back and wrapped him in a blanket. I was then able to nurse him and hold him.

By then it was about 4pm. Jake was finally able to come, after getting off of work and going home to get some things. The next 4 hours were absolute torture. Every nurse or doctor that came into our room was a different person. I understand how an ER works, and that it is a "team" system, consisting of several doctors, residents, medical students, etc... but all I wanted, all I NEEDED, was some stability and it felt like I wasn't able to fully understand what was going on because everyone was saying something different when they came into the room. The doctor ordered a full set of labs to be drawn... that equals out to be a "lot" of blood. They also decided to try and start an IV to keep him from getting dehydrated. 8 words: WORST day of my life as a mother. They tried for about 3 hours to get an IV into him... I don't know how many times he was poked, or how many different nurses tried. It was so hard. I could not leave, but it broke my heart to stay and hear the sobs coming from his little body. I had never heard him scream so much.

They finally gave up and sent us upstairs to the NICU. They also tried to start an IV on him, but were unable to. They said, "If we can't do it, nobody can, because this is what 'we do.'" They told us that we could just supplement him with formula instead of giving him an IV to make sure he wasn't getting dehydrated... I was thinking, "Gee, thanks for not telling me this 4 hours ago... I think we would have chosen the formula rather than him getting poked a million times." I was already dreading the treatment we were getting there... the first nurse we had in the NICU was rather short with us. As time went on, though, either my attitude towards the hospital changed, or we got nicer nurses... I think it was both. We were able to "room in" with him in the NICU... he was in an isolette in our room, and we were able to sleep there on a small, pull out couch.

They let me nurse him every three hours for half an hour... but they "watched the clock" a little less than the nurses as his previous hospital stay. After discussing what was going on with the doctors, the lactation consultant and the nurses... they came to the conclusion that he was jaundiced again because he was being a "lazy eater." He nursed well... but he was satisfied with such a little amount of breast milk that my milk never really fully "came in." He was giving us all the "right" signals, though, that he was getting enough... pooping, peeing, being content after feedings, waking to eat when he was supposed to, etc. I also felt physically like he was getting enough to eat, because I was full before and felt empty after he nursed. I felt absolutely awful when they told me this... I felt like I had failed as a mother because I couldn't even read my baby.

Tuesday went, and Wednesday came. The hours dragged on. Like last time, I anxiously awaited the time I was able to have with Ryan... but I was very thankful we were able to room in with him, because I was able to do more of his cares than I had been able to do at the previous hospital. They let me take his temperature and do some of his vitals, change his diaper, etc... all things they would have done themselves had we not been able to stay in the room with him.

Two of my friends, Sage and Tina, came [at different times] to visit on Wednesday. I really appreciated them coming... it was so nice to have a friend to talk to. Tina was really able to help take my mind off of things and I don't remember having laughed so much in a long time. Sage brought me a Vanilla Iced Nirvana [my favorite coffee drink at Dunn Bro's]... she was my hero that day. :]

Jake was, again, such a huge support... I think the hospital stay made him "enjoy himself" more as a dad, if that makes any sense... at home, the night time feedings were "all me" because I was exclusively breastfeeding. I felt like I could handle it, so I just let him sleep. But in the hospital, and now here at home, I have to nurse Ryan, bottle feed him some formula or previously pumped breast milk, put him to sleep, and then pump... every three hours... so Jake has been helping me, taking over the bottle feeding aspect, and that frees me up a little bit more. Being more involved has really helped him bond... I've obviously wanted him to bond more with Ryan, but there's only so much a dad can do when the mother is breastfeeding. Anyways...

Thursday came; his number was still too high for them to be comfortable sending him home, but they were thinking probably the next day. My mom brought us Chipotle for lunch, and we had a surprise visitor from church; the children's pastor came and talked with us for a while, and prayed for us before he left.

Thursday night, the doctor decided that we could take him out from under the lights for a "test run" to see how he did. Then they would check his billirubin in the morning to see if it had rebounded. It was SO AWESOME to be able to hold him whenever we wanted, and nurse whenever he wanted to... he wasn't on their 3 hour "schedule" anymore.

On Friday, his billirubin was down significantly... below ten, what the doctor wanted it to be at before they sent us home. He also weighed 8lbs 3oz, one ounce more than birth weight... and 3 ounces more than when he was admitted to Children's. After filling out all the paperwork, we finally were able to go. It was so exciting, but yet surreal again... here we were, taking our baby home from the hospital for the third time... can it be the last time, please? I was happy to be going home, happy to have 'normalcy' again... but I was scared... and I still am a little scared... because Ryan had seemed fine before, but really wasn't... I'm just afraid of that happening again.

Our first night back at home was fine... except for the fact that my pump wasn't working the way it should be. I had been using the hospital grade one in the hospital, and this one didn't seem to be working as effectively. After talking to the Breastfeeding Resource Center at the hospital, Jake finally figured it out... the 'face plate' on the front of the pump hadn't been snapped on tightly [because you-know-who *cough* Jake *cough* was playing around with it the day before...]. It seems to work fine now, and although I'm still not able to get a lot of milk, it's some. It's better than nothing.

My goal is to pump enough so that my supply increases and that I can exclusively breast feed again. I don't think formula is "evil," but I have always wanted to breastfeed my children because it's the best thing for them... the benefits are endless. Plus, the bonding time is absolutely precious. Now that he is back up to his birth weight, hopefully we can increase the amount of breast milk he is given as a supplement, and decrease the amount of formula.

[food coma! It's pretty dark, but his content, sleeping face after nursing is so precious... I, on the other hand, look like a mess... but hey, it was 2am!]

[toasty and warm underneath the therapy lights... he likes to sleep all sprawled out.]

Thursday, February 17, 2011

Ryan's Hospital Stay

On Monday, February 7th, a home health nurse came to us for a “post partum check up.” Her name is Kim, and she was one of my nurses who took care of Ryan and I in the hospital when Ryan was born. She was there when we were discharged on Saturday and was very surprised that the pediatrician was letting us leave, because Ryan appeared to have jaundice. I was questioning myself whether or not we should request the billi test again, but also felt like we should trust the doctor’s judgment... even though part of me didn’t feel like he was very thorough. When she came to our home for that appointment, she still thought he looked very yellow. We were going to Ryan’s first actual “check up” the next day, but it was nice to have her come to us and check on how we were doing. She said we were both doing really well [minus the possible jaundice], and she would probably call us tomorrow to see what the pediatrician said at the appointment.
Our appointment was at 10:30 on Tuesday, the 8th. We saw Dr. Engstrom, a female doctor that I really liked. She did the basic “check up,” and then agreed that Ryan looked quite yellow. She ordered some labs to be drawn, and Ryan got a prick in his foot to draw some blood for the tests. He did really well with that… he is a comfort sucker, so sucking on my finger kept him calm. I think him being calm helped me, too.

While the tests were being done in the lab, Jake, Ryan and I went to the cafeteria for lunch. In the middle of lunch, the nurse came to find us; she said the doctor wanted to talk with us before she saw her next patient. When we got into the room, Dr. Engstrom explained that Ryan’s levels were high and that she really would like to re-admit him to the Special Care Nursery to go under the billi lights for treatment. She explained a little bit about jaundice and how it worked, and after I shed a few tears, Jake and I decided that it would be the best option. She said he was borderline, and had given us the option to take him home and use a special “billi blanket” with him; but it would have had to be delivered to our house [and that would have taken a while], and he would have had to be ‘hooked up’ and on this blanket for 22 hours a day. She thought that might be too stressful for us, to keep him in one place for so long, so she suggested staying at the hospital.
We were sent straight upstairs, back to the maternity care center that I thought we had left “for good” on Saturday. It was weird to be back. We went to the “baby ICU” and met with our first nurse. She was very gentle with Ryan as she explained what was going on and what we could expect. Seeing Ryan in the incubator with the foam “sunglasses” on, covering his eyes from the blinding blue light, was really hard. He squirmed and fought laying still until sleep overcame him, and finally he rested. 

The nurse explained that I would be able to nurse him for half an hour, every three hours. She said that since my milk was not yet in, they may have to supplement him with formula to prevent him from getting dehydrated. Jake and I definitely wanted to avoid this route as much as possible, but knew that if it had to be, it had to be.
We were able to stay in the hospital, in a room almost directly across from the SCN. We were told that this room was free of charge for us to use, but if a laboring mother came in and needed it, we would be “booted.” I prayed that wouldn’t happen.

We sat with him for some time in the ICU, and then went to our room for a moment alone. I think that’s when the tears really came; Ryan had only been “with us” for 5 days, but “with me” for 9 months, and I felt SUCH a void in my heart. Jake was such a rock for me, just letting me cry, holding me, and praying. When I felt like I could pull myself back together, we went back to the nursery for Ryan’s first feeding. It was the shortest half an hour of my life; I felt as soon as I put him to my chest, that the nurse said that we needed to put him back in the incubator. Breastfeeding, to a new mom, is a challenge in and of itself… it’s a natural thing, but it doesn’t COME naturally. It takes practice… and I felt like half an hour was not nearly enough time for Ryan to get what he needed.
Jake and I decided that we should go home to get a few things since we would be spending the night. I didn’t want to leave, but I knew there was “nothing” I could do at the hospital for the next three hours and that some fresh air might do me good. I cried the whole way home but tried to leave Ryan in God’s hands. He’s better off there, anyways.
We quickly grabbed some things, and then the phone rang… someone from the MOPS group prayed with me over the phone. A little later my friend Abri called, and she said she and her husband were going to bring us lunch the next day. We then headed back to the hospital… and didn’t make it very far before we got stuck in a snow bank [in the driveway]. Jake got out the 4-wheeler with the plow and started digging us out. I was watching the clock like a hawk, praying and praying that we would make it back in time for Ryan’s next feeding. Then, to the frustration of both of us, something happened with the plow on the 4-wheeler and we were unable to use it [Jake was later able to fix it, but not at that time]. So he got out a shovel and started digging. FINALLY we were on our way. 

Dr. Engstrom came to our room and apologized for earlier. She said she had felt like she hadn’t explained things well enough and just kind of “sent us on our way…” so she wanted us to ask any questions we had or if we needed things to be explained better. It was very nice for her to stop by again; you could tell she really cared about us and Ryan.
We made it back in time to nurse Ryan, right on schedule. The nurse suggested that we should try to get some sleep. We went to our room and tried to rest, but sleep didn’t come easily. I was anxiously awaiting the next 30 minute window I got with my baby boy.

During one of the night time feedings in our room, Ryan was sleepy and wouldn’t latch on. I broke down and cried… Jake called the nurse for a little help. She came in and said, “It’s actually kind of nice to see some tears… you were acting so stoic.” I tried to not let her comment bother me; just because I didn’t cry in front of her didn’t mean my heart wasn’t being ripped apart. She helped him get latched on and by the time the 30 minutes was up, he had actually nursed only a total of 5 minutes. The nurse said that she thought we should try to supplement him with some formula because he was obviously still hungry. I tried to not feel like a failure… 30 minutes is such a short time, and my milk was not yet in. We decided that we wanted to avoid using bottles as to avoid confusion for Ryan, so we went the “finger feeding” route… a small tube that was attached to a small bottle, was taped to one of our fingers which Ryan sucked on. He was fed a little bit of that, enough to satisfy him, in the incubator while under the lights,
The night slowly passed by, and finally it was a new day. Both Jake and I were cautiously optimistic about going home that day. I felt more at peace about being there, because I knew that it was for the best, but I couldn’t help wanting to take my boy home and get back to “normal” life. The morning and afternoon came and went… a different pediatrician finally came along to examine Ryan and talk to us. His numbers were still too high for them to be comfortable with sending him home… so a second night at the hospital it was.
A  nurse helped me with a “nipple shield…” a small, silicone nipple that was placed on me to give Ryan something easier to latch on to. He never liked putting his tongue down to nurse, so it was hard for me to get him latched on… but the shield helped a lot. Since I have MA, I was given a breast pump and I used that after every feeding to try and make my milk come in faster. I was able to pump just a little bit each time, and they used that in place of formula when they finger fed him. They still had to use a little formula, but the less and less they had to use, obviously the better it is.
The 2nd night seemed better. Although there was another time during a feeding that Ryan wanted nothing to do with it, and I had a really hard time with that. I felt like nursing Ryan was the ONLY tangible thing I could do for him, and I felt like that was being taken away from me.
I met with the lactation consultant on Thursday morning, and she helped me figure out why my pump didn’t seem to be pumping very effectively. Finally it seemed like my milk was coming in and I was able to pump some more than I had been able to previously.
Ryan had some labs drawn that morning, and when the numbers came back, the pediatrician decided that we could go home. “Funny” tangent… this was the same doctor that sent us home on Saturday. He pulled back the curtain in the nursery and said, “Oh, I’ve met you before, haven’t I?” Uh, yeah. Hopefully we won't be back this time...
He showed us the jaundice chart; it seemed that Dr. Engstrom didn’t want to scare us when she re-admitted Ryan on Tuesday, because the level he was at was WAY higher than just “borderline.” I’m glad I didn’t know that before.
We were finally able to leave around 11am on Thursday, and we took our baby boy home. One week later, he still looks “yellow,” like a perfectly tanned little baby… but he acts completely normal… he is nursing really well and is alert often. He gets mad when he’s bathed or when he’s getting his diaper changed; “good” things, because being lethargic would be “not good” signs, as jaundice babies are really sleepy all the time.
Those two days/two nights in the hospital were really hard for us as parents, but it helped us rely on Christ for strength to make it through that time. Being a parent kind of gives me a better picture about how Christ feels about us, His children… the overwhelming love I feel for Ryan is just a grain of sand compared to how much the Lord loves and cares for us. It’s good to be reminded of that, especially when we feel like He is so far away and unapproachable. 

Wednesday, February 9, 2011

Ryan Joseph's Birth Story

{ Ryan Joseph }
born Thursday, February 3rd, 2011 at 9:10am
8lbs, 2oz – 21 ½ inches long

We’ll start from Wednesday, the 2nd. I was 40w3d and feeling like I was never going to meet the baby. I had been having several possible “signs” of upcoming labor during weeks 37 and 38… but during the 39th and 40th weeks, I felt like I had gone backwards.

I had an appointment with my midwife, Linda, that afternoon, and we talked a little bit about an induction and how that would take place. If baby had not come by that weekend, I was to go in on Monday for a non-stress test and ultrasound to check on baby to make sure that he/she was okay. If baby had still not come that week, I was going to be induced that next weekend. I don't think I would have shown up for the induction... but that's another topic ;]

Linda swept my membranes during a check of dilation. I was still a little over 3cm dilated; same as the previous 3 weeks. Linda talked to the baby and told him/her that she was on call on Thursday night. She gave baby a little pep talk and said that she would really like to meet him/her. She told me that sweeping the membranes would either put me into labor... or do nothing. I was expecting the latter.

Jake and I spent the evening together, talking and processing through emotions… I was upset at the thought of being induced and did not want to go that route if possible. We prayed and asked that the Lord be glorified in the delivery, no matter how it was to take place.

We went to bed around  9pm. I laid awake in that “half asleep” state, just thinking and trying to rest. I was having some cramping but they didn’t feel like contractions. Around 12am, I noticed that they were getting more intense. I didn’t time them because whenever I started to time contractions in the past, they always went away. So I laid in bed and relaxed through the contractions as much as I could. They were uncomfortable, but very tolerable.

I got in and out of bed several times, going to the bathroom and getting something to drink. I ate some toast and wandered around the house. Around 3:30am, I woke Jake up because I didn’t feel like being alone. I still wasn’t convinced that anything was happening, but I knew I felt kind of miserable and I wanted some company. Jake insisted that we start timing the contractions and I finally said “Oookay.” I told him I wanted to take a bath, so we filled the tub. I didn’t last long in the tub… I was just uncomfortable and hot. I started throwing up so many times that my throat was getting a little raw feeling, and I was feeling very “shaky.” I kept trying to drink fluids and keep them down.

Jake was putting a few last minute things into the hospital bag. I, between contractions, was checking the handout sheet of “How To Know If You are In Labor” several times because I was still worried that maybe I was wrong. We called the on-call midwife around 4:00am and let her know what was going on. At that point my contractions were about 5 minutes apart, lasting 45-65 seconds. She said that we could come in if we wanted to or stay at home longer. I told her that we would stay at home for some time and then call when we were on our way.

The contractions were about 3-4 minutes apart at 5:30am minutes apart when we decided to go to the hospital. Jake had already started the car so it was ready to go. We had to stop for gas on the way there, and Jake decided he needed coffee, too. :] I had a few good contractions in the car and was wondering what the people pumping gas next to me must have thought as I was reclining completely back in the front seat of our car.

During our drive, I told Jake that everyone else was driving faster than him and THEY didn’t have a wife in labor! He was trying to be careful with the bumpy roads, but I wanted him to drive a little faster, "but don't speed!" When we pulled into the hospital 25 minutes later, I said to Jake, “What if I’m not in labor?!” Jake kind of laughed at me and said, “Laura, you ARE in labor.”

We went to the Emergency entrance since it was after regular hours and met with a nurse. "Can I help you?" she asked. "I'm in labor," I replied. "Ooo-kay," she said, giving me the "are-you-sure-about-that" look. She called up to the maternity care center and a different nurse walked me upstairs, and I was admitted at 6:15am. They got me settled in a room and started to put the monitors on. My midwife had always had a hard time finding baby’s heartbeat during my appointments, so I was dreading that this could take some time. 10 minutes later, they finally found the heartbeat and were able to monitor it and my contractions for about 20 minutes. I kept asking the nurse how much longer I had to be monitored… being in bed was extremely uncomfortable for me. The midwife who was on call checked me, and I was 4cm dilated. She said that she didn’t know how quickly things would move along, but that she expected me to labor for some time.

Another nurse asked me if I’d like to labor in the bathtub, and I said yes, so she started filling it. It was an immediate relief to my aching body. I laid in the tub on my back until a contraction came, and as soon as one was starting to peak, all I could think to do was to basically squat facing the side of the tub and hang myself over the edge into Jake’s lap. He was so encouraging and supportive. As soon as the contraction ended, I laid back down into the water. I was starting to fall asleep between the contractions. I remember nodding off several times and almost falling over into the water.

At 8:38am, my water broke. It felt like a big “pop” inside of me, and instantly I felt a ton of pressure and felt like I had to push. The nurse casually said that she was going to go get the midwife. The midwife came in and said that she was going to check me. I laid back in the tub for her to check me. She said I was completely dilated and that I needed to decide RIGHT then if I wanted to have a water birth or a land birth, because the baby was coming really soon. I could not decide and remember saying, “I don’t know what to do!” So she decided to set up the room where I was for the delivery.

She asked me how I wanted to deliver, and I said, “Any way but on my back!” They set the bed up for a modified squatting position, where I was sitting on the bed but leaning back. Jake was right by my side, whispering encouragements to me and rubbing my neck.

I started pushing at 8:42am. The pushing itself wasn’t hard work, because I didn’t feel like I was doing it; my body just took over. The hard part was the pain that came with each contraction. They felt so different than the contractions I had been having before, and they hurt. It was a strange feeling to have pain and relief at the same time. My midwife told me that his head was coming out and asked if I wanted to touch it. I hesitated, and then did. I wasn’t in a contraction at that time, so I must have been feeling humorous as I greeted my little “walnut head.”

Another contraction came and a good portion of his head was out at this point. He was still posterior which caused a lot more pain, but surprisingly, I had not had any back labor. One more contraction came and as my body was pushing, my midwife kept telling me, “Easy, easy!” and I said, “I’m not doing it! I’m not trying!” Baby decided to be born that second, so with that contraction and one push, the rest of the head and body slipped out. The midwife literally had to catch the baby in her lap because it came out so fast. It was 9:10am.

Baby was immediately placed on my chest and covered with a blanket. The nurse sucked out some of the fluid from the lungs and gently wiped the little body. Someone in the room asked, “So what is it?” and the gender was announced… a BOY! [of course Jake and I already knew that (hehe), but I was very relieved that baby had not been playing tricks on us].

I don’t remember what happened in the few minutes that happened immediately after birth. I was so in awe of this little one laying on my chest… I did it, it was over… and our baby was finally here! Jake was instantly in love with his little boy.

The placenta was delivered a short time later, at 9:21am. It felt weird but was painless. 

After about an hour of looking over our baby and spending some skin on skin time together, he was weighed and measured. 8lbs, 2oz... he probably would have weighed a few more ounces if we had weighed him before the explosion of poop he covered me with. Such a good sized, healthy baby... kind of surprising with how "small" I was.

It didn’t take long for him to start rooting around, and he started breastfeeding not long later. I still could not believe that he was finally here. We finally decided that we wanted to stick with our original name, Ryan Joseph. We had been playing around with a few names the few previous days since we "weren't sure." Ryan just seemed to fit him. It was neat to finally be able to call him a name, a real name.

That first night in the hospital, before we went to sleep, Jake and I just stood in front of his bassinet, completely in awe of the blessing God had entrusted us with. We felt an overwhelming sense of love, but also a very big responsibility. We prayed for Ryan, that he would grow into a godly man who has a passion for the Lord… and also for us, that we would be the model of Christ that we were called to be as parents.

I can’t even describe the emotions that run through my heart when I just look at him. I absolutely love being a mom. I love the feeling of being needed when he cries for me at night. When I talk to him, he completely stills and looks right at my face; it just melts my heart. I’m so excited for the journey ahead!

Thursday, February 3, 2011

Ryan Joseph is here!

Welcome, Ryan Joseph! 

February 3rd, 2011 - 9:10am
8lbs, 2oz - 21 1/2" long