Day 6 – NICU tour

I learned a lot today! Let’s see what I can remember.

This morning I was told that I am in fact NOT bed bound, so I was very excited to be able to take some walks today! I had to wait until my nurse confirmed that by getting an order from one of the doctors (I could have just made it up, after all), but eventually I got to leave my room and take three separate walks around the floor. Yay exercise!!! One of the residents also told me it would be fine for me to do some gentle stretches and exercises, but when I started asking about specific things to try to clarify exactly what is ok she said she would find out more specifically and let me know. There was a mention of getting a physical therapy eval, but I’m not sure if that was just an idea or something that’s actually going to happen. So hopefully tomorrow I’ll be able to do a little more. My back and legs are really getting stiff. I asked Nathanael to bring my yoga mat, just in case :o)

Oh I was also told sometimes doctors will write orders allowing patients to be escorted outside in a wheelchair for a little bit. That would be nice! Fresh air! I’ve been coveting the rain all week, and especially the warmth and sunshine we had on Sunday! I’ve said to several visitors and nurses as I’ve gazed out my bolted-shut windows, “I want to feel the rain on my skin…” And it’s only been almost a week. Ha.

Someone had mentioned to me that if I went into labor before a certain point, they would give me magnesium for the baby’s brain. I may have written in a previous post that it was for the baby’s brain development, but that’s incorrect. I just inserted that in my own mind to try to fill in gaps in my knowledge, but I didn’t realize it until getting a further explanation later. It’s to prevent bleeding in the baby’s brain. If I go into labor before 32 weeks they’ll give me magnesium to protect the baby’s brain. The statistics about outcomes that I listed in my Days 1-2 post from my conversation with the neonatologist were outcomes for babies born without any brain bleeding. If there is bleeding in the brain, the percentage of good outcomes goes down, but it’s actually still pretty good. He said a 27 or 28 week old baby born with bleeding in the brain had an 80% survival rate (I think… This conversation was days ago). But anyway, hopefully I’ll go beyond 32 weeks and we won’t have to worry about that! I also heard from another mom that the magnesium itself can cause complications for me so it has to be dosed very carefully; and another person said it makes Pitocin less effective, so in the case of an early induction that wouldn’t be great. I plan to look into more about the magnesium to have a better understanding just in case. It’s so easy to think “Oh I won’t worry/learn about that because it won’t happen to me,” but then things happen like your water breaks at 28 weeks gestation and suddenly a lot of things are happening or could happening that you thought never would.

Oh, I forgot to say yesterday but I got my IV trap out! Happy happy day!! They were planning to change it yesterday (it can only stay in for like 4 or 5 days at a time; they typically keep one in place just in case I suddenly need medication or fluid or something), but the doctor decided I’m “an easy stick” and apparently not high risk enough to need that precaution in place. I am so happy to have full use of my left arm/hand again!

I asked today how this whole situation will potentially impact future pregnancies, and if I’ll automatically be considered high risk. I didn’t get much of an answer, just that it’s likely I’d be put on some kind of progesterone treatment. But no explanation beyond that was offered. I’ll ask someone else another day and see what additional information I can get. If I’m labeled “high risk” for all future pregnancies, I’m pretty sure that means I can’t deliver with my midwives. It would also definitely rule me out as a candidate for home birth (at least with the one midwife we interviewed about home birth prior to this pregnancy when we were considering it). Those are unwelcome restrictions. But we shall see.

The big highlight of the day today was that Nathanael and I got to go up and have a tour of the NICU! It’s so much bigger than I anticipated! They have five or six “pods” (I lost track) that vary in the number of beds in them and the level of intensity of the quietness and equipment for caring for the babies. The smaller the baby, the quieter they keep their environment to more closely mimic the womb. There was a baby in there who is 28 weeks (about Hope’s age now), and I really wanted to get a good look at her to have an idea how big hope is, but I couldn’t see anything but her feet. Her feet looked like normal newborn feet to me.

The nurse who gave us the tour was SO kind and patient and answered all the questions we could think of. She said babies typically stay there until they reach their due date or get very close to it. To go home, babies have to do four things: reach a certain weight (the neonatologist from last week told me these four things… I think he said the weight is 4lbs 8oz?); be able to coordinate sucking, swallowing, and breathing and get all their nutrition by mouth; regulate their own crib temperature (body temp when not being held or under a warmer); and… breathe on their own? I’m pretty sure that’s the fourth thing. As in, breathe on their own all the time, without having any “spells” which is when they briefly stop breathing because it’s not a job they’re used to yet.

When I mentioned that I’m no longer breastfeeding Ella the nurse explained that given this situation that’s a good thing since that would compromise my milk for a teeny baby (it wouldn’t be the same fatty colostrum a preemie would need). She talked about how they prefer for their babies to get as much of their nutrition from mom’s milk as possible, and they use IV fluids if necessary, like if the baby is just way too small to eat or the mom is having trouble with pumping, etc. She told us that if I do make it to 34 weeks then Hope would most likely be ready to eat by mouth (that surprised me for some reason). And they encourage both parents to spend as much time in the NICU and do as much of the care themselves as possible. They have a couple of suites across the hall where they have the parents stay for a couple of days before discharge so that the parents can have the baby with them and take over all the care for the baby while still having nurses available if they need help. That basically creates the “rooming in” experience parents typically have now in the hospital with full term babies so that they can get a good idea of what to expect when they take the little one home without being totally alone yet.

Today’s tests have all gone well. I never did have a sonogram yesterday. By the time they had time to come do it it was the middle of the night, I was sleeping (and they let me keep sleeping!), and I was going to have today’s in like six hours anyway. Hope was sleepy during the sono again today (the second time she’s really been out like that during it) but the dr said he saw everything we needed so we got a good score. I’m still leaking. Nobody on the staff seems that concerned about it. I’m starting to relinquish my obsession with the fluid leaving my body and feeling like I need to pinpoint what causes it to happen or not and whether it’s good or bad when I don’t leak. The dr in fetal testing said the baby is still making fluid (I thought I made the fluid. It’s actually baby pee at this point. I think I made it earlier in the pregnancy before her bladder was developed and functioning), and there’s enough in there. When I asked if there’s anything I can do to help her make more he said no. It seems likely to me that if I’m really well hydrated then she would be more hydrated via the umbilical cord and therefore pee more…? But I don’t know if that’s a thing.

Another highlight today was having a couple of conversations on Facebook with moms who have been in similar situations, either PROM or bed rest or NICU/preemie parenting. It’s so encouraging and helpful to hear from other women who have done this and are thriving. I appreciate their willingness to share the hard things as well as what helped them. Thanks mamas!

Time for more monitoring and then off to bed. Here’s hoping for a good night’s rest. Last night I got 8 hours of interrupted sleep instead of only 4 or 5! It was glorious. This was the first day I was able to fall asleep pretty quickly after my 5-6am meds and vitals and blood draw and rounding from a resident.

Another day down! We’re almost to a week!

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