« Circ du no-way | Main | Gee, why didn't I think of that? »

01/03/2005

Why we are not in the car right now

When you give birth in a hospital under ordinary circumstances, you usually have the opportunity to room in with the baby during your stay so you can get used to taking care of him under the helpful supervision of the nurses. At this hospital, the baby stays in your hospital room in a convenient wheeled cart. (I assume this is so you can imperiously bark, "Whisk him away! Off with his fuzzy round head!" when you and he have a difference of opinion about just how much noise one tiny person should be allowed to make.)

When you have a child in the NICU, you don't have the same chance. But many NICUs, including this one, have made provisions for new parents who need that support. Here there's a parents' room within the unit, complete with full bath, Murphy bed, and an "occupied" sign on the door that everyone from the janitor up pointedly ignores. If anyone has been scarred for life by the sight of me laboring pendulously over the breast pump, they deserve what they get for not knocking before entry, and I do not apologize. You hear me, man-from-building-engineering-who-came-to-change-the-light-bulbs?! I do not apologize.

So Paul and I loaded the car, moved out of the hotel, and took over the parents' room on Saturday. Charlie's little cart was wheeled in with us. At last his monitors were disconnected and we became the thrilled and terrified caretakers of a wireless baby boy.

It was wonderful.

We woke, fed, and diapered Charlie on schedule. (The warning, "Never wake a sleeping baby," doesn't apply to premature babies — since their hunger doesn't reliably awaken them, you have to do it for them to be sure they don't miss a feeding.) We got up a thousand times when he gurgled to peer anxiously into his sleeping face. We watched him make comfortable sucking motions in his sleep. He did well. He slept and he ate and he grunted and squeaked, making very little fuss except during grievous indignity of a bath. In short, we were normal parents — I know what you're thinking, Tertia, you asshole, so wipe that smirk off your face right now, young lady — and he was a normal newborn.

Yesterday the nurse came in wheeling a monitor — or as my friend T. would say, wheeling in a PLOT DEVICE — just like the one he'd been attached to out in the main area. He should have been plugged in the whole time, the nurse explained, instead of being allowed to go without monitoring — hospital policy, since he was still, after all, a patient on the unit. So after several hours of being a cordless rechargeable baby, Charlie was plugged back in.

It is almost impossible not to watch a monitor when it's giving you feedback of that nature. But I was determined not to: Charlie was fine, breathing well, pink and well-oxygenated. I mostly ignored the screen; there's no need to watch the moment-by-moment numbers, especially since these monitors are equipped with enough alarms and flashing lights that you think you're in Las Vegas hitting the motherfucking jackpot when one of them detects an anomaly. The moment one goes off I start swiveling around on my stool looking for a leggy waitress to bring me a free but watery (but free!) drink.

Charlie's didn't go off, and hadn't in any meaningful way since December 24.

Last night, while I stayed with Charlie, Paul went back to the hotel, finished loading the car, checked out, picked up dinner, and filled up the car with gas. He got back in time for the 8 o'clock weighing and feeding, after which we tucked Charlie in and settled in for the night, Paul behind his dinner and I behind the breast pump.

And then the monitor alarm began to sound. Motherfucking jackpot.

The flashing indicator on the monitor went from "slowed heart rate" to "severe bradycardia" almost instantly. Bradycardia is a slowing of the heart rate, generally defined in premature babies as a rate of fewer than 80 beats per minute. Charlie's breathing had slowed dramatically and his heart rate had dropped. Paul jumped up and stimulated Charlie, which brought his heart rate and breathing back to normal very quickly. Charlie's heart rate is normally in the 130s and 140s; at his slowest, he was down to 58 beats per minute.

Bradys (and they are so endearing that they need an affectionate nickname) go hand in hand with apnea and are common in premature babies due to immature respiratory centers in the brain. They usually occur simply because of this immaturity, but can have other causes, too — scary things like illness, infection, and seizures, in addition to less alarming and transient causes like the strain of a bowel movement, or reflux, which Charlie has.

Bradys will also fuck up your plans but good. For the most part, a hospital won't discharge a premature baby until he's gone a certain number of days without any spells of apnea or bradycardia. There are exceptions, and then the baby will go home on a monitor. Charlie is not one of these exceptions. His episode last night reset the clock, buying him at least another five days in the hospital.

Once we'd spoken to the doctor, we said good night to Charlie, gathered our belongings from the parents' room, and retucked the Murphy bed back into its cabinet. We trudged out to the car carrying Charlie's car seat and the bag of clothes I'd packed for him to wear home. We came back to our hotel — where Paul had checked out only a couple of hours before — and moved back into the very same room, before it had even been cleaned.

Comments