After the nurses' initially assessed Matthew, they noticed that he was grunting, which can be a sign of respiratory issues. It was assumed that he had aspirated some amniotic fluid (and also some meconium, since he'd had a bowel movement in utero), and the quick delivery didn't help because he didn't spend enough time in the birth canal to get it all squeezed out of his lungs. The nurses tried to suction him out really well to help him breathe more easily.
They watched him for a minute or two, and then told me that they would like to put him on my chest for some skin-to-skin contact, to see if that would help him come around a little bit. So, I took him, even though I was still feeling very shaky and weak, and I wasn't sure how well I could hold him. I asked Nathan to stay close to me in case I lost my grip or something. Matthew was crying a bit, I could feel his rapid and shallow breathing, and I could hear him grunting.
I had about fifteen or twenty minutes with him before the nurses took him again and said they wanted to try and suction him again to see if it would help. So, he was out of my arms again. They had him under the warmer and were working with him a little bit, but the decision was finally made to take him to the nursery for closer monitoring. Everyone was acting like it wasn't a big deal, so I didn't think much about it or that he might be in danger. Nathan went with him, so I was left in the room all by myself.
A little while later, Nathan sent me a text message to tell me that Matthew was being moved to the NICU so they could watch him better. The rational part of me knew that if it was truly a big deal, there would have been a major scramble to get him there immediately after he was born. The irrational, postpartum, hormonal part of me was intensely freaking out. Of course, all the worst-case scenarios came quickly to my mind, and I was a bundle of nerves. There wasn't anything I could do, either, because I couldn't get up and around yet and no one was in the room with me. The only thought that kept crossing my mind was that if anything happened to Matthew, if he died, I barely got to hold him at all. I felt so racked with guilt for not paying closer attention to him when he was in my arms, it almost made me sick. How could I have taken those moments for granted? Was I being overdramatic? Maybe, but I couldn't think about anything else. I sat there and struggled to remember exactly how he felt when he was against me, how he smelled, and every little sound that he made.
Nathan came back when they were getting ready to move me to a room in the mother/baby area of the hospital, and told me that he had spoken with Matthew's doctor in the NICU. He seemed encouraging and very nice, and it put my mind at ease a little bit to hear that. There were more issues affecting our baby than we originally thought, but he was being closely monitored.
The NICU charge nurse came in to talk with us both before they moved me, just to give us some information about that area of the hospital, and to be sure that we knew to contact her if we had any questions or problems. Listening to her talking about the NICU made me worry a bit more, because it seemed like Matthew was in a much more serious situation than we originally thought.
Once I was in a room, had spoken with my nurse for the afternoon, and had been up and around a little bit, I was cleared to head down to the NICU to see my baby. Nathan warned me that it was scary. Matthew was hooked up to all kinds of monitors, they had put in a feeding tube, and there was constant noise from alarms. I was scared. I'd never been in a NICU before, and I think it would be upsetting enough to visit one even if your baby wasn't a patient there. As we walked through the hallways and got closer, I became a nervous wreck. I wasn't sure I liked the idea of going in there, but I desperately wanted to see my baby!
Before going in, you have to do a three-minute scrub at a huge, stainless steel sink - something like a surgeon's scrub before surgery. It was weird to have to sanitize myself before visiting my own child. I understood that it wasn't just for my baby, but for the health and safety of the other babies as well. Scrubbing around my IV/saline lock and the four thousand hospital bracelets was a little tough, though.
When we went inside, Matthew was the first baby in the unit to the left. I wasn't totally prepared for what I saw.
My poor little baby.
He looked so helpless and fragile.
Nathan and I stood there with him for a while, because his nurse was busy with another baby, and all we could do was just touch his back and the top of his head. I was watching him breath, and it was so rapid - it really scared me. His whole body was shaking with the effort to get any air. Hearing multiple alarms going off at any given moment, smelling all the different smells in the NICU, listening to the doctors and nurses chattering, trying to figure out what all the numbers on Matthew's screen meant, wondering if my baby was going to come home with us...I was completely overwhelmed. It was too much. And I couldn't pick him up. It was like I had to wait to ask permission to be close to my baby boy, and I wasn't sure what to do with myself. I just stood there in my hospital gown, a total emotional mess.
Finally, the nurse came over to sit down and talk with us about Matthew and all the things that were going on. The first thing she did was tell us that we really shouldn't be touching him. Yes, you read that correctly. We got reprimanded for touching our baby. Now, I know there was a good reason for that (and I'll get into that in a moment), but it really, really upset me a lot. We were allowed to put our hand on his head, but we couldn't rub him or stroke him at all, because it could wake him up, get him excited, and cause him to move around a lot, and they didn't want him to do that. They wanted him to be still and sleep so he could heal.
She told us about all the monitors and things, and what each was for. She explained the numbers as well, and told us the normal ranges for oxygen saturation, respiratory rate, and heart rate. She told us about the oxygen he was receiving through his nasal cannula, explained "flow" to us, and told us what "room air" was. It was nice to have some factual information, but it didn't really make me feel any better.
We got the basic rundown on his condition, which was the following:
1. Matthew had fluid in his lungs (aspirated anmiotic fluid/meconium). His lungs were "sticky" as a result of that, making it difficult to breathe.
2. He was retracting (he was struggling to
take a breath and get his lungs to reopen after he would exhale - you could see him
working to inhale because the skin would be pulled tight against his
lungs and on his throat).
3. He had a very high respiratory rate (he was having to
work really hard to get oxygen and couldn't get his lungs to open well,
so he sped up the number of breaths he was taking to compensate). Normal RR for newborns is about 30-60 (I think?), and Matthew's was initially in the 130's and higher.
4. He wasn't getting enough oxygen and had low saturation numbers (for the breaths he was taking,
he just wasn't taking in enough oxygen to allow his body to function as
it was supposed to, so his oxygen saturation numbers were dropping).
5. He had a pneumothorax (a hole or tear in one of his lungs from some unknown cause, leaking air into the chest cavity). This showed up on the chest x-rays they did in the NICU, but they weren't sure about the cause. It could have been from Matthew struggling to breathe, or it could have been caused by the meconium (which can cause a sort of chemical burn to the inside of an infant's lungs if inhaled).
6. His blood sugar was low (no big deal and easily resolved, but they still had to watch it).
6. His blood sugar was low (no big deal and easily resolved, but they still had to watch it).
7. He wasn't maintaining his own body temperature (it was too low, and he had to be under a warmer until it leveled off).
Matthew couldn't be held or touched very much, and they were really limiting his contact with people and trying to keep him quiet. They were afraid if he got excited or started to cry, the pneumothorax would get bigger and he'd have more problems. If too much air leaked into his chest cavity, they would have to insert a needle to allow it to escape.
The whole time the nurse was talking with us, I was crying. I'm sure she was used to seeing that, but I felt like a huge fool. Honestly, the struggles that Matthew was having were nothing in comparison to some that other families have to deal with, and I felt slightly selfish for being so upset when my child's prognosis was actually very good. However, I had just given birth to him, and I wanted to snuggle him and feed him. This was not how I expected things to be at all, and I was dealing with that, emotionally.
Matthew's doctor came over at that point to talk with us, and he was an angel, I swear. He was so, so sweet, and he really put my mind at ease very quickly. Basically, he said something like, "All these things are fixable. He's going to be just FINE, eventually. It's just a matter of how long it takes to get there. But don't worry - he's in good hands."
I told the nurses that I was totally fine with formula feeding, pacifiers, and anything else that they thought he might need to get better. I wanted to breastfeed, obviously, but they wanted his blood sugar to come up, which meant he had to eat something (and my milk wouldn't be in for a couple of days, most likely). I resolved to start pumping as soon as I could to try to get my milk to come in so that I would have a chance at nursing.
We went back to my room, where I finally ordered something to eat (I hadn't had any food all day long and it was already almost dinnertime). Nathan was really encouraging to me, and reinforced all the things the doctor told us to try and calm my worries. It was weird and depressing to be sitting in a mother/baby room, with no baby. I couldn't even care for my baby at that point, so I just had to sit there with nothing to do. We both agreed that the kids shouldn't come up and visit, even though I missed them like crazy and wanted to see them, because it would be hard to explain what was happening and why they couldn't see their brother. I didn't want them to be scared or upset. My parents were taking care of them at that point, and I knew they would do a great job of explaining the situation to them in a way they could understand.
I was feeling pretty good, physically. I was a little sore and cramping a bit, and I did end up tearing during delivery, so my stitches were a little tender. Other than that, I felt okay. Nathan was filling me in on all the things that happened during delivery, and it was good for a laugh or two. Apparently, I managed to spray the OB with all kinds of wonderful "birthing fluids," and she had to go home and change her clothes! Haha! Is it really awful that I didn't feel that badly about it, because she was a little, um, rude? :) Also, I apparently shot blood across the L&D room and hit the wall. Oops!
The rest of the night was filled with restless sleep, random trips to the NICU to check on Matthew, pumping, and lots of visits from nurses and other random hospital staff. As much as I tried to relax, I just couldn't. I wasn't sure what was going to happen next.
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