Sam had such a long day yesterday that I couldn't see him during the day.
He had a transfusion early. And shortly after I posted yesterday, I called the NICU to check on him, and got some unsettling news: they could not place the new PICC line after hours of trying. They also found a colonization of MRSA (pronounced mersa) in his nose.
MRSA is a bacteria that lives on our skin. This particular type is resistant to certain commonly used antibiotics, and is fairly common in hospital settings such as the NICU. Since it's just a colonization and not an infection, he is not in any big danger, but he is now on isolation. All nurses and visitors have to wear gowns and gloves while tending to him. I can still (thankfully) do kangaroo care, I just have to be very careful to wash/sanitize my hands before and after touching him to avoid spreading it to the other babies.
I write about that fairly nonchalantly now, but let me tell you I was NOT so nonchalant when I first heard the news. I immediately thought I did something to make this happen. A little research, and a chat with the nurse and his doctor finally put me at ease.
With all of that, at 11:00 at night, I drove over to the NICU to see him. I really just wanted to lay eyes on him and let him hear my voice - let him know that Mommy is here, whether night or day, regardless of what happens to him.
When I arrived, the nurse offered me the opportunity to do kangaroo care, which I of course agreed to. I thought maybe since he'd had so much happen during the day, he'd be too tuckered out to be held.
I was wrong.
Sam settled right into my chest, and customarily grabbed my finger, which I was finally able to get a picture of.
He did really well for this session, only having one major desat and one apnea episode, in which his respiratory rate dropped too low (sometimes they forget to breathe, especially when they're sleeping). I tapped his foot a few times and he started breathing again. His saturation level and heart rate stayed up too, and the nurse did not have to run over too many times to check on him. He fell asleep in my arms and I could have sworn I heard him snoring, if that's possible.
During this session, I became far more aware of how big he actually is. It's a weird perception - in photographs, he looks larger than he is. When you see him in the incubator, he looks tiny. But when I hold him, I realize he's rather long and has a little weight to him. He doesn't feel as fragile as he looks.
He only cried a little when I put him back down, then kicked around and yawned a bit. I hope that holding him soothed him and he was able to sleep well.
He is doing well today so far, and they will start feeding him again tonight. Yesterday he weighed a whopping 640 grams, which is about 1.4 lbs. It's a huge jump, but that's great! He feels a bit chunkier too, and I can see his limbs starting to fill out.
I want to talk a bit about guilt, and to explain how I feel I'll need to go to the beginning of our ordeal. It's by far the heaviest emotion I deal with daily, and started before I even had him, at my 20 week appointment when we learned that my cervix was funneling and that I was at a high risk of delivering prematurely. All I could think of was what I had done to make that happen: had I moved around too much? Been under too much stress? Was it the files I lifted at work? Taking public transportation, sitting up too much?
Then I started bouncing in and out of OB Triage with various scares, such as contractions and pain. I'll never forget, at 22 weeks, a doctor looked me directly in my eyes and told me that if I delivered that week, they would not try to save my son since he wouldn't be technically viable yet. The guilt and fear hit like a ton of bricks. I was hospitalized for a few days, pumped full of medication, then placed on modified bed rest. I admit, I probably did a bit more than I was supposed to on bed rest, but I still tried to take it easy. For the record, the doctor told me that if walking around was all it took to have him, it was going to happen anyway. That did NOT make me feel better.
At 23 weeks I made it to my steroid appointments, and breathed a tiny bit of relief. In the state of Illinois a baby is considered viable at 23 weeks, but it's clear the chances of survival are slim. I prayed and prayed that Sam would stay put for a long while more. I was already dilated 1 cm at this time.
The night I saw a gush of blood and felt my water sac falling out, one day shy of 24 weeks, my heart sank lower than ever. I knew it was almost all over. I was rushed to Norwegian via ambulance, where I begged for two hours to be transported to my own hospital Illinois Masonic. Once at "home", I was again pumped full of medication, and the nurses adjusted my bed so my feet were elevated and my head was down, hoping gravity would help keep him in. My OB/GYN looked at me and said, "you are not leaving this hospital pregnant". I died a little inside. All while this was going on, doctors were discussing doing an emergency C-section because Sam was breached and tap dancing on my opening cervix. I was dilated 4 cm by this point - and at such an early gestation period, that could have been enough for him to be born. Through luck and probably some hardheadedness on Sam's part, he flipped head down, and I narrowly avoided the C-section by just a few minutes. The doctors gave me an ultimatum: either induce labor to avoid another breach, or stay drugged up as long as possible and see if we could buy more time. More guilt.
12 hours later, I felt pains down low, but the contraction monitor didn't pick up anything. The fourth time I felt it, I cried out, and the nurse called in the high risk doctor to do a quick ultrasound. Sam's head was already in the birth canal. I had no time to even think before the lights were on, delivery crew was mobilized, and my legs were up with instructions to push. Within 10 minutes he was born and being rushed to the NICU. His father was en route to the hospital and wouldn't arrive for another 30 minutes - I couldn't even keep Sam in long enough so Jay could see the birth of his first child. More and more guilt piled on.
I'm sharing that story because I want to show that the guilt started long before Sam arrived, and I barely had a chance to confront or deal with it. I realize that a lot of stuff was out of my control, but that realization did not stop the guilt. Now I feel more and more guilt every day. I am terrified that my touch will hurt him, if I hold him he will not tolerate it or do worse, that I'm not pumping enough when I sleep too long through the night. I feel guilty that when he cries I can't comfort him. I feel guilty that his nursery isn't ready yet. I feel guilty for being angry that I didn't get to have a baby shower before his birth, or take professional maternity photos. I feel guilty for the sharp twang I feel when I see other pregnant women's bellies and think, "I'm supposed to still be pregnant". I feel guilty for not taking better care of myself. I feel guilty for feeling guilty all the time.
As with grief, I've determined that the guilt will probably never end or go away completely - but that one day it'll lessen in intensity, until the next thing happens that I will feel guilty about. I take some comfort in knowing that this comes with the territory, even if it feels irrational, and that helps me take it in stride.
All said, though, my baby is really kicking butt and taking names, and for that I am ever grateful.
As Sam continues to fight, so shall I.
