Saturday, August 26, 2006

7 Days in a Hospital

Authors Note: This is the second post in a series about the birth of my daughter, Kaitlyn. The first post described the day leading up to her birth and can be found here.

Just a few minutes oldFriday, Aug 18
Kaitlyn wasn't alive but a couple minutes when the nurses and attending folks informed me she would have to be taken off to the Neo-natal Intensive Care Unit (NICU).

I follow Kaitlyn from the birthing room to a private little room inside of the dark and quiet NICU. I had to ask if I could hold her for a minute before they started hooking up leads and monitors. Begrudgingly, they agreed.

Thankfully, I was allowed a couple minutes before gently handing my baby off to others. I type this more than a week later and it still makes me sad to think I had to hand her to anyone but Kristi.

The first few hours after the birth consist of me escorting family members back to see Kaitlyn. We can only have two people in "The Unit" at a time. Throughout all the trips back and forth the nurses, and there were at least five that I saw, were trying to find a vein in Kaitlyn to administer IV fluids. Poking, and poking, and poking. Hands, legs, feet, arms. With every family member it's a new nurse trying a new spot. Sandy leaves the room. Barbara looks away.

They cannot find a good vein yet because she doesn't have much fluid in her, and they cannot put fluid into her until they find a vein. So they poke my baby again. They don't want to put the IV into the vein in her head unless nothing else works; it's just too disturbing for parents and relatives to see.

Kristi comes to see the baby a few hours later. It's after 3 AM I think, maybe 4 AM. Finally the IV is in. Our baby is on a breathing machine, CPAP. She has an IV with Antibiotics and saline fluid with Dextrose. A light and sensor combination is wrapped around one foot to measure 02 levels in her blood. She has three leads attached to her chest. Another one attached to her stomach; this one under a little gold duckie.

The problem, the key problem, is our baby is breathing too fast. Instead of 40 times per minute she is panting at 100 times per minute. Think of how exhausting that would be. I'm told she doesn't need extra oxygen, not yet, but she needs the breathing machine to keep pressure in the lungs so they don't collapse. Her blood gases are a little off too, but not enough we need to worry about them now.

I get to bed about 5 AM and wake about five hours later. I slept through the doctor visit, again.

She's stable. She needs the pressure for her lungs, but not oxygen; this makes the nurses happy. Her blood gases are better. We cannot hold her, not while the CPAP is attached. The day becomes a blur.

Daddy wants his girl to go to PurdueSaturday, Aug 19
Another late night, another late wake-up. Kristi doesn't feel good. Most ladies are told to walk around after giving birth (isn't that a funny phrase, "giving birth?"). Not Kristi; her blood pressure was 100 over 50 yesterday. It's still too low today. Instead of walking she has a wheelchair; without it, she would fall over.

We see the baby some. A few people stop by to visit, it's nice they could come by.

Kaitlyn is doing better. Blood gases are fine, the pressure in the CPAP has been reduced. Antibiotics and fluids are still being administered by IV in the foot. The culture they are growing to see if the antibiotics are even necessary is negative so far. We really aren't sure what the problem is.

The likeliest issue is that she didn't and cannot get rid of the fluid in her lungs. This will go away with time. The next likeliest issue is that her lungs are under-developed. This is seen as "probably not true" because she would be getting worse instead of better if it was true. The third potential problem is an infection, hence the use of antibiotics.

Sunday, Aug 20
We were given the orders from Kristi's substitute doctor, we can check out and go home today. With a baby just downstairs it's a mixed blessing so the question is when will we actually leave. We've talked with our nurse, Yvonne and she said something like, "It's Sunday until midnight, you can leave when you want. Let me know when you want to leave. "

Kaitlyn is doing better, thank goodness. The culture is negative so far, so we can stop the use of antibiotics. Also, she's off the CPAP (breathing machine) and just on a nose canula. That's the little tube they put under the nose to give people oxygen. So yes, she did not need any oxygen yesterday when she was getting pressurized air, but today she does. I'm not sure why that would be, but you've got to trust the doctors. The great thing about this change in air supply is we get to hold her now.

As you can see from the picture, Kaitlyn is under a couple of bright spotlights and wearing purple shades. The lights are how babies get treated for high bilirubin, the stuff causing jaundice in babies. For us this is caused by a confluents of events; a liver that is not completely developed (common in all babies), bruising from the birthing process (fairly common in natural births), lack of bowel movements (caused by the use of an IV instead of regular feeding), and random chance.

We left the hospital around 6:30 PM. Kristi's not feeling well yet and we're going home to rest.

Monday, Aug 21
Kaitlyn is still subjected to the lights and a nose canula. She's getting better, they have reduced the amount of oxygen they're feeding her through the canula and today we start trying to feed with a bottle. She was fed formula yesterday, but because of all the tubes and sensors it was fed directly through a tube into her stomach.

We spend all afternoon in Kaitlyn's little room and late into the evening too. Kristi is tired and should be resting, but she wants to be here, with her baby.

For dinner we at with a support group for parents who have children in "The Unit." We heard the stories of a children who "graduated." I cried as I listed to a parent talk about the joy of her daughters and the pain she felt when other people looked aghast at pictures her tiny babies. The struggle to maintain her relationship with her husband and Herculean effort to support and nurture her children. How she celebrated all the tiny victories of her children's growth.

I know so little about this kind of suffering. My girl will be home in a few days not a few months, and this gives me an assurance they can only dream about. I am, we are, even in this time of less than perfectness, still blessed.

Tuesday, Aug 22
I really like this picture. The expression is so cute. You can imagine she is thinking so many things. A developmental expert might tell me she's practicing her muscles, but to me she's a beautiful and inquisitive girl exploring her world.

We're doing well; the doctor is very pleased with our progress. I asked the doctor to rate how serious Kaitlyn's condition was on a scale of 1 to 10, where 10 means it's a very serious situation for the NICU. The doctor said, "Let me answer a different question. How concerned am I about her? Zero. I have no concern that she won't get better and be healthy." Wow, isn't that great news?

Since we are doing so well, that means we can go home somewhere between two and five or more days. The key is she needs to maintain her progress and have no new or reoccuring issues come up for the next few days. We'll keep our fingers crossed.

Wednesday, Aug 23
Today we moved from The Unit to "Baby Steps." Baby Steps still requires people know the password to come visit our baby, but it means she is making lots of good progress. The big difference is that babies in the NICU are being monitored for their conditions, while over in Baby Steps the concern is maintenance and growth.

For us, this means we want Kaitlyn's bilirubin levels to decrease without use of lights or any other treatment. We also want her to continue to breath and maintain her heart without any problems occurring. Actually, it's okay if a problem occurs, it's that Kaitlyn needs to self-correct the problem within 20 seconds without any outside intervention.

As the good doctor said to me yesterday, they tend to over-monitor babies and this just induces more concern than is warranted. Babies at home have the same kind of problems, but without all of the fancy monitors they recover on their own and parents don't go through the heart-wrenching feeling when the monitors start beeping. The picture above is Kristi looking at the monitor when it beeped a heart rate warning. It was actually just a monitor issue, but it's hard to stop looking up when it's beeping about your baby.

Thursday, Aug 24
Maybe, just maybe, we can home tomorrow. We were told yesterday it would be Saturday at the latest, but this is getting better. In honor of the special potential the nurse suggested we give Kaitlyn a bath.

Everything went well with the bath and we only stayed at the hospital for a bit today (less than six hours). This is great because Kristi has not recuperated from the delivery yet. We're going to go home and get some extra rest. Not a lot of rest, but extra compared to what we've been getting lately.

Friday, Aug 25
We call into The Unit every few hours to see how our baby's doing. This morning when I called the nurse said, "She's doing great. The doctor hasn't written the orders yet, but you can take her home today."

I was so excited I almost told the nurse, "I love you."

We started getting ready to go to the hospital, but with the extra phone calls we started making it took a couple hours to get out the door.

Once at the hospital it took some time for the nurse and the doctor to get free enough to talk with us, but who cares? Really, we're going home today, why should we care about a few extra minutes?

And so ends our week in the hospital. And if you didn't know this already, you can click on the pictures above to see a larger version. Thank you all for your concern, thoughts, and prayers.

Wednesday, August 16, 2006

Introducing Baby Davidson

We are proud to let you know about the birth of our beloved daughter,
Kaitlyn Leigh Davidson
Born Friday, August 18, 2006 at 12:13AM
Weighing 6 lb, 4 oz
19-3/4 inches in length

Author's note: The following story is the birthing diary I kept during our stay in the hospital. I finished telling the story of the experience, but some of it was not typed until after the event. At the end I was busy participating rather than typing. The story is continued in Part 2, talking about Kaitlyns time in the NICU.

Wednesday, 10:43 PM

We're at the hospital and Kristi has changed into a gown. Not the hospital gown, because the nurse has agreed Kristi can wear her own for the night. Tomorrow will be a different story.

The nurse's name is Caroline and she seems friendly. In fact, I have been very happy with every staff member we've run into here.

I'm running into a bunch of trouble with Cingular's wireless card so far, so we'll have to see how long I can keep the birthing diary going.

11:26 PM
Kristi has had a couple mild contractions, so mild she didn't know it until Nurse Caroline looked at the monitor and told us. Kristi's blood pressure is 146/83 and the baby's heart rate is steady at about 140.

Registration just called and I have to go down and fill out some forms.

Thursday, 12:10 AM
The contractions are coming pretty regular now that Kristi knows what to feel for (and I can see the peaks on the monitor). I'm sure this will make the doctor happy. In our meeting with the doctor she told us contractions prior to checking into the hospital would help the process go smoother.

12:54 AM
Kristi has given blood, she is hooked up to an IV with saline drip only (no drugs), and the good nurse Caroline is having her sign a whole bunch of consent forms. I also received instructions on how to read the little monitor and Kristi's contractions are running four to four-and-a-half minutes apart.

We have our first request for pictures, but even though I have camera, I do not have any software to load the pictures. This will be a text only story.

1:35 AM
Contractions are still going well, the nurse is asking a bunch of miscellaneous questions, and Kristi was just given Ambien to help her sleep.

So, in case you haven't figured it out, Kristi & I are in the hospital to deliver our first child, a baby girl. She is 37 1/2 weeks pregnant, which is full-term according to our doctor. Maybe later I'll write about why we're really here this week instead of waiting a bit longer for the blessed event.

Anyway, part of the "induced labor process" involves softening the cervix. For reference purposes, the cervix is generally thick and stiff like the end of your nose. During labor the cervix softens and becomes pliable like your lips.

2:58 AM
We've been watching some video tapes of I Love Lucy and Kristi has finally turned over to go to sleep. I just received this email from Martha

You two get some sleep. You've got a long day ahead of you tomorrow and then the first night with the baby. This is your last night to get some sleep, take our advise.... HIT THE HAY! It will be years before you get the opportunity again!
I've got some work to finish up so I'll be up for a bit more, but this is my last entry for the night. I'll talk to y'all in the morning.

4:20 AM
Kristi just paged the nurse because her contractions, which are now varying between every two and five minutes are quite a bit more painful. I finally convinced Kristi to accept some pain medication. She's worried about the baby, but it seems to me that she and the baby will be better if there's less pain.

She did fall asleep for a minute while I was typing, but then the next contraction started and ... you can fill in the rest of the story from here.

6:35 AM
Well the pain medicine didn't get administered until close to 5 and we've had a bunch of nurse visits since then. The pain medication has done wonders for Kristi and she has calmed down quite a bit.

The plan for when to introduce which drugs has been changed and the nurse has come in a half-dozen or more times since the medication started. The end result is Kristi has not slept for more than 5-10 minutes at a time yet. I'm done with my work for the moment, so I'll make the bed and see how much sleep I can get. At the moment, my expectations are pretty low.

10:10 AM
Quick update... I woke up at 9:55 and a bunch happened while I was sleeping. The doctor has been bye to visit while I was sleeping (an hour ago?) and she is expected back any minute. Kristi is dilated to 1.5 cm, the doctor can feel the babies head(!!), Kristi is 80% effaced (I'll explain that later), and when the doctor gets back she is going to break the water sac.

10:27 AM
The doctor is in the house...

11:45 AM - Quick
Kristi is doing great. Dilated to 3 cm. Epidural is in. She's about to take a nap.

11:46 AM - Long
I'll answer some questions from comments and emails a bit later.

Okay, so what's been happening since the doctor's visit? The doctor came in smiling and thinks Kristi is doing very well. The doctor said we're dilated to "a tight 3 cm." This is good because Kristi could not get an epidural when dilated less than 3 cm.

The doctor also broke Kristi's water during this exam. [Fluid was clear, which is good] The problem with this is contractions become significantly more intense (painful) after the water is broken. Pain before was rated a 5 or 6 or 7 before, it was rated a definite and tearful 10 after the water was broken. We only went through 3 or 4 contractions at the new, intense level before Kristi agreed to expedite the epidural.

Of course, it took some time to get the right people in the room and insert everything. Kristi did a great job and it struck me it must be more than the mind-numbing pain, but the whole idea that even as it lessens she knows it is going to come again in just two or three minutes. It adds a whole element of torture, the knowledge of impending pain, to the event.

During this period we also changed nurses from Tara to a tag team of Julie and Krisha Crisha (who is apparently still in training).

12:50 PM
I just had a mediocre panini sandwich for lunch. Kristi had a catheter inserted. She is only allowed to eat ice chips and popsicles, so she's a bit hungry right now.

Kristi's blood pressure is running high (143/72), but it is not very high compared to some of the peaks we've hit in the last 14 hours. Kristi has been hypertension medication for as long as I've known her to control her blood pressure. We spent a few night here in the hospital right at the end of June while she was 31 weeks pregnant due to her BP.

At the time the doctor was pretty sure we were going to be delivering the baby within days, a week at most. Of course the doctor's worry only added to Kristi's stress and BP, increasing the chances we would deliver early. To say I was frustrated at the doctor's mismanagement of Kristi would be a significant understatement.

Of course, it worked out okay in the end; by staying on strict bedrest Kristi was able to keep the bun baking for an additional six or seven weeks.

The doctor's due in a few minutes so I'll give you more info in a bit.

1:00 PM
Sometimes I look at her and cry. I really do love Kristi. I know it drives her crazy that I don't show much emotion except for when watching romantic comedies (we don't see commercials anymore since TiVo), but looking at her sleep now, or watching her walk down the aisle, touch me deep in my heart. I don't know how to express it, but the catch in my throat and the tear in my eye will have to be enough.

1:20 PM
Doctor update: Kristi is now completely effaced (cervix is soft), but she is only dilated between 3 and 4 cm. The doc upped the pitocin level to strengthen the contractions and increase the dilation. When asked when the baby would come the doctor said, "I have no idea." At least she's honest.

Next doctor visit will be a bit after 3 PM.

2:00 PM
Okay, time for a couple more updates. I forgot to tell you the doctor can feel the baby's hair. Isn't that just cool?

Answering some questions: The drug we were given after we arrived to soften the cervix is Cytotec (PDF alert). Typically women get two treatments of Cytotec, four hours apart. To our nurse's surprise the doctor ordered three treatments for Kristi. Due to "life happens," she only received one treatment and then went on Pitocin at 6AM when I was just going to sleep.

To the people asking if I'm a dad yet, the answer is "No." But you can bet your bottom dollar I ain't gonna be blogging in the middle of that. I love y'all, but I'll be busy holding Kristi's hand not typing about the actual birth. And no, I will not attempt to do both at the same time; don't ask.

It's funny, Kristi would never let me bring in a camera crew, but writing about for the experience you and your neighbor is just fine. She doesn't get how wide the reach of blogs are. (As an example, old friend Nnamdi sent email congrats from Africa.)

And for those of you who are new to this "blogging thing" I recommend you click on the comment link below. Doing this will let you read the comments of other people and enter your own comments. I do get your emails, but this post and the comments will survive much longer than my email archive. *sigh*

2:45 PM - Quick
The nursing team just came in to insert an internal monitor just to make sure they get accurate readings of Kristi's contractions and the baby. Everything is looking good and we have 5 cm dilation.

3:45 PM - Long
Hmph. About 3:10 the nurseing team comes rushing in and surrounds Kristi. She had 6 contractions in 5 minutes and the baby didn't like that. By way of communicating the baby drops her heart rate from about 140 to the 80s. Right away the team is cutting off the pitosin and adminstering a shot of Terbutaline, or Terb. The baby calms down right away and while blocking my view they have put an oxygen mask on Kristi.

Kristi is thinking I need to get my mind off this keyboard and onto her. I'm wondering where the doc is and the nurse gets her on the phone (but not the phone in the room; is this a bad sign?). While the team is wandering around the doc says she'll come by the room in 10-15 minutes.

Kristi is holding up well and I'm holding her hand. The contractions have not stopped, but they have started coming at a regular frequency. The baby's heart rate is good again.

After reviewing the situation the doctor says it's time to restart the Pitosin and build up the levels slowly. Dilated 5 to 6 cm, which isn't enough yet. (Did I tell you the goal is 10?)

And while typing all of this I've talked to Fred & Sandy. They're leaving our house and going to head this way. Kristi is feeling the contractions a bit more and they have sent in the guy to give her a booster shot through the epidural. They don't want to give too much because they want her to be able to push when the time comes.

4:30 PM - Misc.
Kristi feels like she has spent the whole day sleeping, but I know my honey, and this is not a good sleep. She is up every few minutes with a feeling, a pain, someone's entering the room and poking or rolling or somethinging her.

Kristi is starting to get a bit pissy about me blogging instead of giving her attention. I do jump when she speaks, but between the micro-naps and interuptions I do this. I am wondering if the typing isn't a substitution for feeling. If it puts off anxiety I'm okay with the swap; what did anxiety ever buy anyone?

Uncle Rick says the dogs are going to fall from grace, which is so true as to not be worth mentioning it. With the exception that Kristi doesn't realize it yet.

My mother called from Town East Mall. She may have gotten the directions to the mall from Kristi, but there is no chance Kristi gave these particular directions in relation to the hospital or the pregnancy. Maybe we shouldn't have given the directions out so long ago, but Kristi was trying to prepare her parents and mine.

I expect to see Fred & Sandy, Mom & Jill in the next 30 minutes or so. I know Sandy was worried this morning. She called right when Kristi was feeling one of the contractions where pain was dialed to 10. I can not yet imagine what it would be like to hear your daughter crying from pain in the background, but it gives me pause to even consider the thought.

The doc won't be back for another visit until 5:30 or 6.

5:50 PM
All the visitors are here and we're sitting around gabbing. Well, Kristi's half-asleep, but the rest of us are chatting away. The doctor's due soon. The 5PM BP medication is stuck downstairs in the pharmacy so the nurse is on an errand to get. Nothing big, just keeping you up to date.

6:15 PM
The visitors have gone off to have dinner and they'll come up for another visit afterwards. The doctor was here for about 10 minutes. Kristi and the baby are still doing great (her word), but Kristi has not dilated any further past 6 cm. The new order is to restart the pitosan (which I thought we did last time) and build up to the same dosage level we had previously. The doctor does not plan to be back for another 2-1/2 hours, but is somewhat hopeful the baby will arrive between then and 12 midnight.

Kristi is napping, and if the interuptions slow down a bit it just might be a good one this time. I probably won't post an update for a bit unless something changes.

6:40 PM
Just a comment, but it pisses me off when the nurse throws the door open and loudly asks, "How we doing?" Everyone tells us she should get more rest, but she is besieged by events that preclude a good rest. I know I am being protective here, but couldn't the nurse walk in and check to see if the patient is resting? And then maybe checking the machines and charts without waking her?

Author's note: The following two updates are recreations of lost updates.

7:30 PM
Hey, this new nurse, Amy, is all about the business. She just walked in and told Kristi we're going to have a baby tonight. Gotta change my shirt.

8:15 PM
We're gonna start pushing, might have a baby in two hours, gotta run...

Author's note: All the updates below this point were written after the fact. I've tried to keep the timline, events, and thoughts true, but I'll ask for a little forebearance if some unintentional license was taken.

8:20 PM
Dilated to 9 - 9.5 cm (still). The room is changing as they take apart the bed and get it set-up for delivery.

Q: Where's the doc? A: At dinner

8:45 PM
We're in a slight holding pattern; still not dilated enough yet. Seems like we're going to wait for 10 cm after all. Kristi is yelling at me about the computer, again. I wasn't even looking at it!

Q: Where's the doc? A: Dessert??

9:30 PM
Doc is in the house. We're close enough to 10 cm that the next time we have a contraction we're going to push.

9:50 PM
I can see why men were not allowed in here. I have no idea what I'm doing. I'm trying to encourage Kristi, but I know her and she has already tuned me out. Really. Like she just put her hand over my face and switched half-way through the contraction to putting her hand across my throat. I guess she doesn't want my encouragement. :-)

10:15 PM
Uh oh. Kristi is ready to give up. She says it hurts and it's hard. (No shit, they call it labor.) They count to 10, or almost, because Kristi doesn't push past 6, sometimes 7 in the count. Seriously, she can do it, but they need to push her more. She won't listen to me.

10:30 PM
She hurts. She says it every time. The pain is up on her left side. They don't want to open another bag of epidural solution because is $500 per bag. Like I care.

I think you have to be numb to people's suffering to be a nurse. Really. They just don't seem to care about her pain. It's a practiced indifference. Like the rest of the day they were just acting when they acted concerned.

10:30 PM
We have another nurse. She's the head nurse tonight and I don't remember her name, but as far as Kristi's concerned, we can call her Nurse Ratched. She just had a talk with Kristi. Now my wife is pushing to 10, sometimes 11.

10:45 PM
Kristi wants Lee. Anything for Lee. She really wants some more drugs. The real issue is, if you make her too numb, she will not have enough control to push. Honestly, she calls for Lee like a lost lover. It's kinda funny.

11:05 PM
The doctor shows me the baby's head. It's sticking out and I can see her hair. I want to cry. This is so special. I cannot show my tears to Kristi; they'll distract her from pushing.

11:15 PM
The doctor plays with the baby's hair while Kristi is pushing. She's pulling little bits of stuff out of the hair with her gloves on. It's pretty funny.

I say it seems like time is flying. it does for me, this is exciting. The doctor and Nurse Amy look at me like I'm the spawn of satan. Kristi doesn't even notice me.

11:25 PM
Nurse Ratched wants to have the baby tonight. Apparently she promised this to Freddie out in the hallway. We went so long I kinda want 12:01AM. I'm not sure why, maybe because it's a cool time of day.

Doc asks if Kristi wants to use the vacuum to pull the baby out. Kristi asks me what I think. Nurse Amy asks me why I get a say in the matter.

11:40 through 11:50 PM
They just called in half the hospital. Two more people just showed up and started getting the baby bed with lights all ready with blankets. Here comes Lee, the doc makes him stand away and out of Kristi's sight (haha). Here's comes another one. This is gonna happen.

11:55 PM
We're going to have just a couple more pushes. The hospitals clocks are all off. They match the computers but the computers are slow. What the heck?

Friday, 12:03 AM
Let's use the vacuum. It's time to get the baby out.

Friday, 12:10 AM
"Get the camera, get the camera!" Everyone's shouting at me. I just wanted to hold onto Kristi. Damn, where's the camera?

Friday, 12:15 AM
I'm taking pictures with one hand. Holding the phone up (speaker-phone mode) in the other so the grandparents can hear the baby cry.

They can hear my baby. That's my baby!

Author's note: And thus ends the first part of my story. You can find the next part of the story here.

Monday, August 14, 2006

Almost Empty Musings: A New Look

It's time for a new look, so Almost Empty Musings has undergone a facelift.

The idea comes from Thomas Marban, who has a great screen blog of more than 4500 different design ideas. I choose to blatently steal the new look from back-word. It's got a clean look and I thought I could handle the design implementation.

If you look at the bottom of the page you'll see I didn't quite couldn't figure out how to keep the whole menu / footer section centered. Please don't hesitate to drop me a line with the solution to my coding garbage.

Update (8/15): I still cannot get the menu below to operate correctly. (Apparently CSS doesn't handle three columns very well.) And in the meantime I've botched the Blogger header bar at the top of the page.

Update (9/18): I cannot take the unfinished design any longer. I've changed to a template available at the link in the page footer.