Hard Week in the NICU

This last week has been hard in the NBICU.  We lost 3 patients.  This part of our job never gets any easier.  Andrew, Rio and Amaris may be gone but they will never be forgotten by their families or by us.  Their families will never be forgotten.  The babies go to join Jax, Gabriel. Aaron, Bridget, and unfortunately many others.

This week I was taken by surprise when one of the families came back and gave me (and everyone who had taken care of Rio) the following story.
A wise man was accustomed to taking walks on the beach every morning, thinking of ways to change the world.  One morning, he passed a boy methodically picking up starfish off the beach and throwing them into the water. He asked the boy, "Why are you doing this?" The boy replied without looking up, "It's low tide," he said, "and all these starfish on the beach will die out here in the sun." The mans smiled. "But son, this beach stretches on for miles and miles and there are thousands of starfish.  Do you really think you are making a difference?" The boy grabbed a star fish, gently tossed it back into the water and then looked up at the man. "I made a difference to that one."
They finsihed the story with saying this was their way of saying thank you for making a difference in their lives and the life of Rio.

This really touched me in a way that I can't really explain.  Often when having to help families say goodbye to their babies I feel a sense of failure.  I often feel like I let these families down.  There unfortuneately is not always things that can be done.  We try our best and sometimes it is not enough.  Instead of feeling like I let them down, this family reminded me that for whatever time they had him I and other members of the NICU team had made a positive impact on their lives.

So the lesson reinforced to many of us this week, is to take time to hug and love those close to you, because death can be sudden and unexpected.

Traveling with Baby!

So this past week I embarked on my first trip solo with Jack.  We set off to my visit my grandmother and grandfather and introduce Jack to his cousins and great aunts and great uncles. I was terrified to be perfectly frank. 

Being me I procrastinated until Sunday to start looking for tips etc, and to pack.  Did I mention that Sunday was my fourth 10 hour shift in a row? Yep add on to that Jack was sent home from daycare on Thursday with his another cold/fever and you have a mommy on the verge of a breakdown.

Luckily one of my coworkers and friends was working in the stepdown unit with me and she has traveled much farther with her young children, to Canada.  So I picked up some handy tips from her and was feeling pretty good again.  Then I googled traveling with infant and got a little scared.  The information out there ranged from the extreme of don’t do it ever to travel and be proud, babied cry etc.  I went home from work, and finished packing by about 10pm and got ready to get up at 4 am.

So up I got getting ready and the car packed before waking up Jack.  I got him dressed and we told Daddy bye and headed off.  Our trip got off to less than a stellar start with a minor traffic accident on the way to the airport.  I was shaken but neither of us were hurt and I believed the car to be driveable.  So I get unloaded at the airport.  I manage to juggle the luggage, the carryons, the stroller, the carseat, and the baby.  Still shaken I attempt to maneuver my way into the airport by myself.  I get part of the way there and lose the luggage for like the fifth time.  A nice stranger came up to me and said he would help me get my bags to the counter.  I could not thank him again.  He said no problem, he and his wife had traveled with an infant before.  I thought to myself, man this trip is looking up!  Then as I was checking in as people passed me I started to hear people say things such as God hope he’s not on our flight. I was like really?  He’s still asleep in his carseat.  I tried to ignore it but after hearing it close to 2 dozen times I got a little paranoid I mean up to this point he hadn’t even let a peep out yet.

Then the travel gods smiled on me.  There was another mom traveling solo with a 5 month old little boy.  Forget that he was twice the size of Jack I was just excited that I wasn’t a pariah alone.  We ended up sharing a three seat.  The flight attendant said well if someone wants to sit here one of you will have to move.  I asked him if he really thought someone would want to sit with us and he laughingly said no.

Jack did pretty good sleeping until landing in Houston.  I never thought I would regret the fact that Jack didn’t take a pacifier.  Then came the landing in Houston where I couldn’t get him to swallow or suck enough to pop his ears.  All of a sudden here was the baby that everyone worried about having.  He was miserable, screaming and carrying on.  Then all of a sudden you could tell his ears had popped and he let out the hugest smile. The mom sitting next to me said that even though there were bumps that she would consider my first trip a success.  Her praise made me feel so much better about embarking on the journey alone. 

There would be more ups and downs on the trip but no matter what I knew that it would be ok.  Some people would always prejudge moms traveling with babies, and some people would always be there with an encouraging word.

Happy Half Birthday!

Wow!  Six months has flown by! Gone is my little baby and emerging is a growing little boy.  No longer are we immobile.  Now we scoot, roll, and babble up a storm.  I know that we are in for it once the babble turns to words. I have learned so much in the last six months and can't wait for all you have to teach me.  

National Neonatal Nurse Day

Today is National Neonatal Nurse Day.  I have worked with a lot of amazing neonatal nurses and nurse practitioners in the last almost 10 years.  One thing true of all of them is their fierce dedication to the tiniest of patients.
 As a NICU nurse and nurse practitioner, I was secretly scared my whole pregnancy that my baby would end up in NBICU.  I was scared to have a sick baby - in part because of all that I have seen working in the NBICU.  However, the one calming thought was that my baby would be in great hands if he was in the NBICU.
Throughout my pregnancy I had a couple of scares with preterm labor, gestational diabetes, multiple failed stress tests, early onset of contractions and cholestasis of pregnancy.  Jackson, being stubborn (like his father) decided after multiple scares that he did want to come early and my water broke at 35 weeks.  However, Jackson being Jackson changed his mind and I ended up with a c-section under general anesthesia.  The first 3 hours of his life is literally a blur as I took awhile to be lucid after the c-section.  My husband dutifully went between the recovery room and the NBICU and told me the story of his birth and admission multiple times (apparently).  I was blessed in that Jackson did remarkable, was never on oxygen, and started eating as soon as I came over from the recovery room.  We were discharged a little over 48 hours later from the NBICU.  I was so relieved as a parent to know that there were such amazing nurses watching over my little guy. 
Throughout my years in the NBICU there have been countless families that have touched my life and shaped my practice.  Now that I am a parent I am even more in awe of all the families go through during their stay in the NBICU and after almost 6 months pumping I have a whole new respect for our moms. I can honestly say that for all its moments good and bad every family has taught me something about compassion, nursing, and neonatology.  So today when we take time to say thank you to all the neonatal nurses I also want to say thank you to all the parents who let us take care of their precious babies and let us into their lives at such a difficult time.

 

 

 

Jackson Cooper Grassham in the NBICU on 3/17/2012

 

 

My little cool guy almost 6 months later!

 

The End of an Era

As a first time mom I was nervous about breastfeeding.  My job as a neonatal nurse practitioner added a little bit more stress because I knew how important it was especially since Jack would be going to daycare.
Then Jack wouldn't nurse.
He had been born a little early at 35 weeks, so I was super paranoid about making sure he ate enough so I started to pump and give a bottle.  I still tried to nurse but it got harder and harder and then there was reflux.  Now as a neonatal nurse I have been puked on a fair number of times and I thought there was no way I could be surprised.  Note to self - NEVER EVER EVER say you can't be surprised. 
Jack would have such bad reflux that I could feel it come up and he literally would have projectile vomit that cleared a good 3 feet. 
I was shocked.  His vomiting was so impressives that my stepson said we should sell tickets to see Jack.  I was like what?  He went on to explain that we could feed Jack turn him towards the crowd and say wait for it, wait for it,  and then let Jack spray the crowd.  I didn't know whether to laugh or cry because my step son was right.
It wasn't the laundry I minded it was the screaming and the clear pain that he was in.  Then I would try to breastfeed him and you would think I was poking him with a hot poker.  With the reflux, we found that in addition to the medicine if we thickened with rice cereal he no longer resembled a human puke canyon.
So I pumped,  and I pumped, and I pumped.  While I stayedd home I pumped every 3 hours.  I had a decent amount of milk in the fridge.  Then I went to work.  In a job where lunch and bathroom breaks was not always guaranteed, I was determined to continue to pump.  So I became a multitasker.  I could pump, type my notes, and eat lunch.  Then the dreaded happen - I started getting less.  Jack was 4 months old and I wasn't ready to quit.  So I took the herbs, the teas, woke up to pump in the middle of the night.  My milk came back and I was ecstatic.
Then came Labor Day.  We were in Colorado visiting my brother.  I was pumping and not getting much and then my stepson accidentally knocked over the bottle spilling what little I had.  I was so upset I thought I was gonna have a breakdown. I remember looking at my husband and thinking I can't do this anymore.
I was devastated.  I felt like a failure.  Not inly had I not been able to nurse my child but I didn't make it to my goal of 6 months.  But you know what, after I accepted that I was not gonna be able to keep doing it I felt relieved.  Finally, I could relax and enjoy feeding the baby, playing with him and not obsessing about my milk.
My husband told me something that really made it better - he said you have worked so hard and you have done the best you can.  I am proud of you.  It seemed like I was off the hook.  Who knows, maybe next time it will be different - either better or worse.  But I am convinced that I gave it my all.
Bye Bye Pump. 

Mourning

The hardest part of my job, is finding the right words to say when I have to tell a family that we can do no more to save their precious baby.  After a particularly hard weekend, I have looked for some poems on line that share some sentiments I want to keep in mind. 


A million times I've missed you, a million times I've cried.
If love alone could have saved you, you never would have died.
To some you are forgotten, to others just part of the past;
but to me who loved and lost you, your love will always last.
It broke my heart to lose you, you didn't go alone,
for my life went with you -sweetheart- the day angels called you home.
For things on earth didn't matter, but now I feel so alone,
My heart will always be broken, my life will never be whole.
We might be parted for awhile, our hearts will always be together
for one day soon we will hold hands again forever.
~Unknown


I have not turned my back on you
So there is no need to cry.
I'm watching you from heaven
Just beyond the morning sky.

I've seen you almost fall apart
When you could barely stand.
I asked an angel to comfort you
And watched her take your hand.

She told me you are in more pain
Than I could ever be.
She wiped her eyes and swallowed hard
Then gave your hand to me.

Although you may not feel my touch
Or see me by your side.
I've whispered that I love you
While I wiped each tear you cried.

So please try not to ache for me
We'll meet again one day.
Beyond the dark and stormy sky
A rainbow lights the way.
~Authour Unknown


Gone Too Soon

This was a life that hardly begun
no time to find your place in the sun
no time to do all you could have done
but we loved you enough for a lifetime

No time to enjoy the world and its wealth
No time to take life down off the shelf
no time to sing the song of yourself
though you had enough love for a lifetime

Those who live long endure sadness and tears
but you'll never suffer the sorrowing years
no betrayel, no anger
no hatred, no fears
Just love, only love in your lifetime..
~Authour Unknown


They Say There is a Reason

They say there is a reason,
They say that time will heal,
But neither time nor reason,
Will change the way I feel,
For no-one knows the heartache,
That lies behind our smiles,
No-one knows how many times,
We have broken down and cried,
We want to tell you something,
So there won't be any doubt,
You're so wonderful to think of,
But so hard to be without.
~Author Unknown