Discharged!

When the doctors left yesterday afternoon, we were told that if Xander did well overnight with his oxygen saturation, we'd be discharged first thing in the morning. It had been emphasized to me the importance of a visit to his pediatrician as soon after his discharge as possible. Anticipating that we'd be going home on Monday, as originally planned, I had scheduled this visit on Tuesday morning, as I already had Joel's 18 month checkup scheduled that day. So I told the doctor about the appointment, and asked if we'd be able to make it. He said to go ahead and keep the appointment, and as long as Xander did well through the night, they'd get us out in time to make it.

James joined me at the hospital after putting Joel to bed at home. We were a little anxious for a little while, as Xander's oxygen kept satting around 88%, when the doctors wanted him in the 90s. We kept talking to him while he slept, and continued praying that he would breathe well. By the time we went to bed, he was hovering in the low 90's. The only time during the night that he dropped was when I changed his diaper. Something about screaming his little guts out seemed to interfere with his breathing for a few minutes...

One of the doctors on our team visited us early this morning, before we'd gotten up for the day. He confirmed that Xander had done great overnight, and pending a final check by the attending physician, we'd be discharged around 8:30 or 9am. James had to leave for school before that time. I had already asked my mother to pick us up in the morning, so that she and I could take the boys to the pediatrician.

I packed up all our stuff (amazing how much we'd accumulated in our week stay!) and pumped one last time. Incidentally, once we were officially discharged, the nurse brought to me all the breastmilk I had pumped during the week, and I was stunned by how much there was! I now have an awesome stash.

The doctors wanted Xander to get his hearing test before the official discharge, so I had to wait for that. The nurse finally brought him back to me around 8:45, and then we sat...waiting...anxiously watching the clock...praying that nothing would end up keeping us there...

The team came in at 9:10am. The attending physician briefly examined Xander and pronounced him ready to be discharged. I got the "new mom" instructions, and things to watch for. Then they left to give his official discharge orders. The nurse came back in, removed Xander's IV and security anklet, and then we were free. I quickly dressed him, buckled him into his carseat, and we were out of there!

It has been the absolute best--snuggling my baby at home, with my little family all around. It is such a relief to be done with our hospital stay. We're still praying for Xander's good health. I feel such an incredible gratitude for my sweet baby, my husband, my mother, and for all the friends and family who have sent thoughts and prayers our way. <3

Pediatrics: Monday

James returned to school today. I just have to say again how grateful I am that he was out of school last week. It was such a blessing not to worry about him missing classes, or conversely, having to deal with all of this on my own if he had chosen to go to class. It made it a lot easier to send him back to school today.

When our medical team came on their rounds this morning, I was disheartened to learn that they thought it pretty unlikely that Xander could go home today. I'd been told Monday evening as our target discharge. But the team (attending physician + med students) were concerned because Xander has been so up and down with his oxygen needs.

Basically, I was told that if we could successfully wean him off oxygen by lunchtime and keep him off throughout the day, we might be able to go home tonight. But that was "very optimistic" and it was more likely that we'd be spending another night.

When they left, I talked with our nurse, and she was totally onboard with trying to wean Xander off his oxygen. So over the course of the morning, she turned his oxygen down by degrees, and we had indeed gotten him totally off oxygen support by lunchtime.

Xander smiles in his sleep all the time. Sooo cute.

He did great this afternoon. His oxygen saturation hovered in the low 90s, so not quite as high as hoped, but within the parameters the doctor had set for him. His heart rate and respiration rate stayed consistent, and he didn't show any distress. I'll admit, I totally got my hopes up.

One of the med students was keeping tabs on Xander this afternoon, and he seemed hopeful that we could be discharged. But after speaking with the attending physician, he came back and told me that they were going to keep Xander one more night, to monitor him off oxygen throughout the night.

I am so bummed. I know one night is nothing in the greater scheme of things. But after a week of this, I am sooo ready to be done. Sigh.

On the bright side, my amazing mother extended her stay until Saturday. It's been a big stress on my mind, especially with Xander's discharge up in the air, because she was supposed to leave on Wednesday afternoon. But she's amazing, and is going to stick around to help us get Xander settled at home before she goes. Hopefully my dad can survive a few more days without her. ;)

Hopefully in the morning we'll be busting out of this joint. Keep your fingers crossed!

Our weekend in Pediatrics

On Friday, our sons met for the first time.

Honestly, Joel was not super interested in the baby. He looked him over briefly, then proceeded to explore every cabinet and drawer in the room. He was also very interested in the play area down the hall. They have balls and cars. Much more interesting than that squishy thing Mama's holding. :)

The weekend was pretty quiet, medically speaking. Xander's oxygen needs went up and down several times, and late Saturday night he seemed to be struggling a bit more to breathe. But that resolved on its own, thankfully, though it was very worrying at the time.

I have to make a note here about engorgement: It sucks. My milk came in hardcore on Thursday, and by Friday morning I was referring to my breasts as rocks. I got to visit with a lactation consultant on Friday morning, and she gave me several things to help ease the discomfort. She did tell me that this was probably something that I would just have to suffer through--albeit not so bad--for a few days before my body settled. Not going to lie, it was pretty amusing to have an entire head of cabbage delivered to our room shortly after the consult. I got some funny comments from nurses and others who visited. But I think the cabbage leaves actually did help!

Anyway, our days took on something of a routine. James and I spent the nights at the hospital. After spending the mornings with Xander--snuggling, nursing, pumping--we headed home in the afternoons to refresh and spend time with Joel. Then we returned in the late afternoon to the hospital.

It was hard. When I was with Xander, I missed Joel. When I was with Joel, I missed Xander. When I was with Xander, at least I knew that Joel had Grandma to take care of him. But leaving Xander was hard, all alone in that big hospital room. I know the nurses enjoyed snuggling him. But I still felt guilty, especially because breastfeeding is so important to me. Even with pumped milk, I felt guilty for leaving him with a bottle. It was awful to feel so torn between my babies.

We're hoping to be released Monday evening after Xander's last dose of antibiotics. I cannot wait to be done with this particular trial, and be able to be home as a family.

NICU Day 3 / Transition

To my surprise and delight, when I went into the NICU at 8am on Thursday morning, I found Xander off oxygen and IV fluids. The nurse had taken him off about an hour before, and he was doing great!

James came to the hospital shortly thereafter. We were told that if Xander continued to do well off oxygen and IV fluids, that he would probably be transferred out of the NICU and into the regular pediatrics unit, where he could finish his 7-day course of antibiotics. After visiting with Xander for awhile that morning, James took me home for a few hours to refresh and spend some time with Joel.

Side bar: Last Saturday, partially as a diversion from STILL being pregnant, and partially as something we'd already been planning to do, we went to For Garden's Sake (a charming nursery that we fell in love with this summer) to pick out a shade tree for our yard. We fell in love with this Shumard Oak, which James planted on Thursday afternoon.

While at home, we got the call we'd been hoping for--Xander had been moved to pediatrics! Yay! We finished with the tree, then returned to the hospital.

Unfortunately, it seemed that the move had upset the stability Xander had achieved in the NICU. We were pretty disappointed to find him back on oxygen support by the time we arrived.

Still, the children's unit was a HUGE improvement, especially when it came to OUR comfort. Xander had a large private room, with a bathroom and shower, and a pull-out couch. Also, the policy for visitors was much more relaxed. In the NICU, only 2 visitors were allowed at a time, which had made it virtually impossible for Joel to come. So we planned for Joel to visit the next day.

James had planned on sleeping at our house that night, while I spent the night with Xander. But I'll be honest, I had a total emotional breakdown that night. I think the weight of everything happening, plus the postpartum hormones hitting me, contributed to me becoming a weepy mess. So James ended up driving all the way back to spend the night with me. I have the best husband in the world!

NICU Day 2

Wednesday morning James and I went to the hospital. To our relief and joy, Xander was no longer under the oxy hood. It had been replaced by a nose cannula for his oxygen. But this meant we could hold him, and I was able to breastfeed. It was such a relief to snuggle with our chunky monkey!

Unfortunately, because of his continuing need for oxygen support, we learned that he would indeed be staying for at least a week. The main purpose of the week was to run a full course of antibiotics. It was disheartening to hear Xander would be staying so long, when we'd hoped to take him home the next day. But of course his health was most important!

Wednesday afternoon I brought my mother to the hospital to visit. She was sure a happy grandma! I have to say, my mother has been our saving grace this week. With her here to watch Joel, James and I have been able to spend most of our time at the hospital with Xander. While it's certainly been hard to be away from Joel so much, at least he's got Grandma doting on him at home, which I think has mitigated some of the hardship for him.

That night was an adventure. I was given a sleeping room in the NICU. I had made a feeding plan with the nurses, to breastfeed Xander every three hours. So I set alarms on my phone, and every three hours that night, I got up, shuffled through the hallways to Xander's pod, and fed my baby. I wouldn't have had it any other way, though by the 5am feeding, I definitely felt like a zombie. I continued to pump periodically, so that Xander would have milk for when I wasn't there.

NICU Day 1 (Part 2)

In retrospect, I have to be glad that Xander came late. Last week, James happened to be on fall break. Of course, this time was supposed to be spent on his major writing assignment. Fortunately, his professor was very generous and gave him a week extension. Because not a lot of schoolwork happened during the first week of Xander's life. And I don't know what I would have done if James had not been there with me.

It was determined on Tuesday that he had indeed aspirated meconium, and based off his chest x-ray, the doctors were fairly certain that he had developed pneumonia, which is a common result. We were told that he was definitely going to be there for two days, but might end up staying a week, depending on his response to the treatment.

Xander spent all of Tuesday under the oxy hood. I asked, mid-morning, if there was any possibility of holding and maybe nursing him. At that point, I was told, it was important to maintain his "oxygen environment" under the hood, which meant no.

We were given a boarder room--basically somewhere we could crash and keep our stuff while at the hospital. This was helpful, as there is basically no free space in the NICU. There's barely room to pull a couple of chairs up to his little bedside.

The lactation consultant visited; she showed me how to use the hospital breast pump, and advised me on hand expressing my colostrum, since the pump isn't super effective at getting the thicker colostrum out. Although, it's been fantastic to use since my milk came in. SO much nicer than the little manual pump I have at home.

Late that evening, our home teacher came to the hospital to help James give Xander a priesthood blessing. To be honest, I'd never met our home teacher before, and James had only met him this past Sunday while in nursery with Joel. But I think it stands as a testament to the wonderful community of the church. We were so grateful that he came. The blessing brought James and I a great deal of comfort, and I felt that Xander's breathing seemed less labored afterward.

We decided to check out of the boarder room and go home that night. I knew that I needed rest, which I wasn't going to get much of there. Between waking Monday morning and that point Tuesday evening, I had only had about three hours of sleep, and had delivered a baby in the midst. But it was seriously one of the hardest things I have ever done, leaving my baby at the hospital and going home without him. It just broke my heart.

NICU Day 1

Xander was born at 9:28pm Monday night. It took a couple of hours for us to get settled in. By midnight, James and I had finally laid down with the baby to attempt some sleep.

It's impossible to rest, however, when you've got a little baby between you who can't sleep. Xander's breathing was rapid, and as time passed, it grew more and more labored. The nurse had checked him before leaving us for the night, but we finally brought her back in around 3:30am. She didn't seem very concerned, but acknowledged that he was breathing too fast, and called in the midwife. After her examination, they decided to deep suction him, supported with oxygen.

He did have a lot of amniotic fluid in him. But even after the deep suction and a good bit of time on oxygen, his breathing had not improved. It was such a struggle for him. Our midwife decided to call UNC hospital, who sent over a team to examine him. We were warned at that point that it was likely we'd be going to the hospital.

The UNC team arrived shortly and spent a few minutes examining the baby. They decided to take him to the NICU. James and I rapidly threw our things together. I was given this whole new reason to be grateful for not tearing. After Joel was born, I could barely walk to the bathroom for the first couple of days. There's no way I could have gotten up, dressed, and climbed into an ambulance mere hours after delivery.

At the hospital, we were shown to a waiting room while Xander was assessed and set up in the NICU. I just wept. The doctor eventually came to us there. She talked us through everything that might be going on, the most likely being meconium aspiration--that Xander had breathed in his first poop during his birth. They were going to start him on antibiotics, get a chest x-ray, start him on IV fluids, and keep him under an oxygen hood to stabilize his breathing. She advised us that Xander's condition was not overly serious, and simply would take time to assess and treat.

We were soon taken in to see him. We had been warned that the NICU can be overwhelming, which was absolutely the case. The room is full of equipment and sounds, and there is a constant air of worry from the parents and visitors. It's impossible to fully relax there, with the incessant barrage of beeping, bubbling, hisses and whispers.

Xander was in a warmer, under the oxygen hood, with an IV and a bunch of other wires. The oxy hood looked like an astronaut helmet. The hardest part that first day, besides the uncertainty, was not being able to hold him or breastfeed. We could touch him, but not being able to hold him was awful. I felt totally bereft of this little life that so shortly before had been safe in my womb.

And so the waiting began. Or rather, changed. We'd been waiting for his arrival. Now we were waiting to know what was wrong, waiting to know what would happen, waiting to know when our sweet baby could come home.

Birth story: Baby X

I thought I had it bad with Joel, who was born a week late. I tried to prepare myself for Baby X to come late. I had my mother schedule her flight out six days after his due date, knowing it was likely. But in spite of all my "preparations," I grew more and more disheartened as I passed 40 weeks. My mother arrived, and still no baby. 41 weeks, still no baby, and no signs of labor. My midwives started preparing me for a possible induction at 42 weeks, which was NOT what I wanted. Needless to say, there were many prayers and tears over the past few weeks!

After nothing and more nothing, I finally started having some contractions on Sunday evening. They were sporadic and light, but they were something. Monday morning, October 12th, the contractions started to seem a bit more promising. I had a non-stress test scheduled at noon, to check the baby's heartrate and make sure he was doing well. I figured if my contractions progressed, I'd get checked while we were there. When it came time to go, James and I went ahead and packed up the bag with my labor supplies and the infant car seat--just in case.

We headed to the birth center--the Women's Birth and Wellness Center in Chapel Hill. The NST took FOREVER. I was hooked up to the monitors for nearly two hours. (The test is supposed to be 20 minutes.) First of all, Xander was a wiggly monster. Secondly the nurse couldn't get him to react well to stimuli, which is one of the major things that determines his well being. I know it was necessary, but it was still majorly frustrating! Especially because I was having contractions the entire time.

We visited briefly with the on call midwife, who gave us some options. We decided to go get some lunch--we were starving!--and then come back to get checked. It was about 2:30pm when we got back to the birth center. The midwife, Allison, checked my cervix. To my utter astonishment, she announced that I was dilated to 7-8cm and had bulging waters! James and I were totally stunned, but elated that I was having a baby at last. I was admitted and we got settled into our birthing suite.

We went for a couple of walks around the grounds, then labored in the tub for awhile. The contractions stayed pretty consistent, getting a bit stronger. It was about 5pm when I requested another cervical check. It's not routine for them to check, but I wanted to know if I was progressing, to be able to pace myself. Allison determined that the baby's head had dropped a fair bit, but I was still at about 8cm. That was a little disheartening. She suggested changing positions--all fours, or on my knees over the edge of the tub--to help him move into position.

So we kept working. James and I were left mostly to our devices, except for a nurse coming in every half hour to check the baby's heartbeat. It was not quite what I had expected, but I actually rather liked it. It might have been different if this was my first delivery. But James and I knew what to do, and it was nice to just do it, the two of us. I labored all over the place--multiple positions in the tub, leaning on James, standing and bracing on the sink, and later others. I loved the freedom to do what my body wanted to do.

I think it was just before 8pm when I had James bring Allison in. She watched me through a contraction standing, then suggested I try the birthing stool. I had never used one before. It really increased the sense of pressure. I labored there for awhile. When things got more intense, Allison suggested moving to either the pool or the bed--she wanted a gravity-neutral position for the next part of my labor, in the hope of avoiding tearing like I had done previously. So I moved back to the tub.

Contractions got much more intense. I didn't actually feel the urge to push. I felt pressure, but nothing like the urge to bear down like I remember feeling with Joel. But it felt like time, so I just started trying to push, to see what happened. And it was definitely time!

Pushing took what felt like ages. Xander was positioned at an odd angle, so I had to change my position several times. My water broke there in the tub. Shifting during that part was agonizing. The worst was when Allison said she wanted me to get out of the tub and move to all fours on the bed. At several points along the way to the bed, that seemed like an impossible request. For several contractions I stood at the edge of the bed. I thought my legs were going to give out! He crowned there; Allison suggested lying on the edge of the bed, saying that movement would probably pop him out. She wasn't far off. I lurched rather awkwardly onto my side. Lying on the corner of the bed with one leg up in the air, I gave two more pushes and out he came!

His cord was very short--they could only get him to my tummy, I could only see the top of his head. They ended up having James cut his cord right away so we could move. But while still in my awkward edge-of-the-bed position, I suddenly expelled about a pint of blood. James was a bit alarmed! Apparently it was just the result of my placenta shedding, and the placenta itself soon followed. But I hardly noticed most of that, because I was enraptured by my beautiful baby!

That full head of dark hair makes me so happy. He's got long Holley fingers and toes. Of course his size was immediately noticeable--a little while after the birth, they took his measurements, which were astonishing--9lbs 15oz, 22 inches long, 15.75" head circumference. The best part was hearing that I pushed out a baby just shy of 10 pounds with NO TEARING. Hallelujah! And I can tell you, there is a world of difference in how I feel postpartum.

We got settled in. James went and got us a pizza. Xander nursed for the first time. Once we were all cleaned up, measured, fed and squared away, we attempted to get some sleep.

Unfortunately, that's where things went downhill. But that story shall continue in another post. I would like to remember my triumphant delivery of Alexander Lee Holley independently of what followed. It was a wonderful, empowering birth.

To be continued...