Hospital Day 1 and a Little NICU Knowledge.

From some of my previous posts you already know that I had no intention of having pain meds for birth. I obviously wasn’t expecting a C-Section. In my wildest dreams I never expected this to happen. That Sunday afternoon replays in my head in slow motion all the time and I still marvel at the quickness of what happened.

The first night in the hospital is kind of a blur. For whatever reason my throat was coated and I couldn’t clear it. I had asked for a cough drop or cough medicine but no one could seem to determine if I was allowed to have it or not. They kept telling me they wanted me to cough. I tried explaining that I wasn’t coughing – all I wanted was something to break up the gunk coating my throat. All night I would hold my incision (helps control the pain) and try to clear the stuff out but it never worked.

I also itched like crazy. Whether from the anesthesia or the meds, my whole body itched and prevented me from sleeping comfortably. They had put my legs in some air boots that compressed them to make the blood flow which alternately felt good and caused them to itch like mad because they were sweating inside the boots. At one point I asked the nurse to take them off for a bit because I couldn’t stand the itching. Plus I had to sleep on my back which I don’t do very well. Then add the nurses coming in every 2-3 hours to check me and that first night I probably only got 1-2 hours sleep total.

They want to get you up and on your feet as soon as possible but I was still surprised when they came in the next morning to remove the catheter and have me go to the bathroom on my own. I was so weak and still drugged that I almost passed out. Trying to traverse the short distance between the bed and the bathroom was a great feat, especially with the IV stand. The next time I tried it I didn’t call a nurse and just had my husband help. The nurse seemed surprised a little while later when I told her I had done that.

I went to see my baby for the first time that Monday. Sunday night I was just in too much pain and too drugged to make the trip. They wheeled me and my IV to the NICU and I was able to put my hands into the portholes on his bed and touch his head and hands. I remember tearing up at the sight of my sweet little boy. I realized several days later that my husband wasn’t even there when I saw my little one for the first time. He had had to run back to pick up my mom from the house and make a trip to Babies ‘R’ Us to finish purchasing the crib and to get me some nightgowns that worked with nursing (for pumping purposes). I know I asked the nurse that day when I would get to hold him. She told me I had to be less groggy to do so. I can tell you I felt a desperate need to hold him as soon as possible and knew I had to do whatever I could to be able to be more alert so they’d let me. I’m glad I was able to Kangaroo Care with him because it would be two days before I was able to hold him again after that night.

Kangaroo Care is done with mom or dad holding the baby skin-to-skin. That first night I was wearing a nursing gown which had the bra-top style band so they literally just shoved him into the top of my shirt. He laid there against my chest, full C-Pap machine, IV, cords and all. It was so hard to see his little face at that point with the full “Beer Hat” on.

{Side note: The C-Pap machine ran oxygen, humidity, and air pressure (“flow”) through his nose. The machine was so bulky that it pushed his nose up and gave him a piggy nose. I decided it looked like one of those beer hats that you put the beer on either side and the straws go into the mouth. The Dr. called it a snorkel. I’m concerned that my first impression was a beer hat. End side note.}

Holding him was amazing. It was crazy to me that they’d let me hold this little person who was hooked up to all these wires and machines. But they say the best thing a parent can do for their baby is hold them skin-to-skin. It helps with brain development, helps their breath and promotes more milk in the mom as well as promotes better eating in the baby. There are many benefits to Kangaroo Care and they believe in it highly. Aside from pumping and giving him breastmilk, it is something that only TJ and I can do for him. Others holding him  (which wasn’t allowed until later) isn’t the same as mom and dad doing it.

The other option for touching the babies is called “Hand Hugs.” This is done through the portholes in the isolette (nicer word for incubator) and basically consists of putting on hand gently on the baby’s head and the other on their feet and creating boundaries for them. This is not only important touch again but helps comfort them when they are restless or they are having an assessment done.

Speaking of assessments. The babies have assessments every 3 hours. Baby G’s assessment or “Touch Times” schedule is 3-6-9-12. At these times they check his temperature (digital thermometer under armpit), change his diaper, listen to him breathe, and give him milk. They also check to see how much residual milk is left over from the previous feeding. At the 9pm assessment they also weigh him and two nights a week give him a bath.

Something else you should know about is getting into the NICU. Everytime you come into the NICU from outside the hospital you are required to scrub in for 3 minutes. This entails taking a little bristle brush (think of an old corn silk remover brush), loading it with soap, and scrubbing your hands and arms up to your elbows for 3 minutes. While I was still admitted I only had to use Avagard (heavy duty antibacterial solution) on my hands. Everyone else, as long as they hadn’t left the hospital, had to scrub in once and then just do a quick wash and use the Avagard everytime they left the NICU and came back. Then, once you are in the room with him you are supposed to use Purell every time you touch anything that’s not him. Touch your phone? Use Purell. Touch your face? Use Purell. Change his diaper? Use Purell. So by the end of the day our hands are dry and scaly and our arms are raw from scrubbing. But they are necessary evils in order to see him and keep him safe and healthy.

There are 3 rooms in our NICU. Basically they are stages of care. The first room is generally where all babies start out. Each nurse has two babies they are responsible for as the babies require more care and attention in this room. The pods are set up with L-shaped walls and because we were in the front side of the room we also had another angled wall that helped with sound and protected us from being exposed to the door and the nurses station. It was very cozy. We basically moved into his pod (#4) and decorated his white board and the angled walls. I was able to pump in his pod and kept a bag there for my robe and one of his blankets. The next room they call the Glass Room because the front walls are all glass. The room is much more crowded and only holds 6 babies. Two nurses are assigned to this room and they each have 3 babies to look after. The Glass Room is hard to maneuver because the pods all radiate out from a center station like spokes on a wheel. There is a lot less room for each baby and a lot less privacy. The final room which is called the Intermediate Room is the room where they send the more stable babies as each nurse here has 4 babies to look after. These babies are usually on less machines and need less attention. The next step after this room is home. Obviously this is just a little glimpse of what happens on a large scale.

The nurses in the NICU work 12-hour days. That means the full time nurses only work 3 days a week. The NICU is open to parents pretty close to 24 hours a day with the exception of 6:30-7:45 am and pm. This is when they do their shift change and the nurses chart and pass off information to the next nurse. The only other time the NICU is closed is if they are doing certain sterile procedures on one of the babies. Some of the babies have primary nurses. These nurses request primary status on a baby and then, for the most part, they are scheduled to have that baby every shift they work. While in the first room Baby G’s neighbor was Baby Z so we got to share his primaries,  Nurses T and MJ several times. Primary nurses are good because then all they ever see is that baby and whoever his neighbors are. So essentially if babies are neighbors for awhile, all the babies benefit from the primary. Our primary nurse was Nurse R, Baby G’s very first nurse. She is the one who was there when he came to the NICU. She is a wonderful Godly person and cared for Baby G with gentleness and attentiveness.

So my posts are a little backwards, but hey, I’m still writing stuff down, right? That’s what counts… right??

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