Saturday, March 5, 2011

Adeleine's NICU Story: Part 2

You must be 36cm tall to ride this rollercoaster.

Part 2: The first 24 hours

Immediately after Adeleine was born she was brought to the resuscitation room next door to the delivery room. She was wrapped in plastic to trap in body heat. She was a screamer (squeeker!), which meant her lungs were strong and for a minute they debated about even giving her the surfactant to help her breathe but in the end decided to and administered it through a breathing tube. Her APGAR scores were nine! Nine is good for a term baby and she was 13 weeks early! Again, she was so amazing. They weighed her and she was 970g or 2lbs 2oz, a perfectly average size for her gestation. Andrew and my Mom got to see her in the resuscitation room and reported back to me that she was doing great!

Then, she was transferred to her incubator in the back room in the NICU (there are several rooms, the back room being for the new or most seriously ill babies) where they wheeled me in and Andrew and I got to see our tiny tiny tiny little being together for the first time. She was bright red! She had the smallest hands and feet you could imagine. Her foot was the size of the end of your thumb. Her little fingers barely wrapped around mine. And she was adorable. She looked like a super tiny baby Liam with much darker hair. At the same time we were in awe of her tiny cuteness, we were also frightened by it - she looked like she wasn't done cooking. There was no mistaking it, she was not supposed to be out yet. But, here she was, all 2 lbs of her wiggling and squirming under her wires and tubes, ready to take on the big scary world. She was amazing.

It was hard to see her under all the equipment. She was covered in it from head to toe. She had a breathing tube in her nose and a feeding tube in her mouth. She had three monitors on her chest, for heart rate and respiration. She had a thermometer on her chest to monitor her temperature. She had an IV in her hand for nutrition and fluids. And finally, an oxygen monitor wrapped around her foot. She was covered in wires and tubes and tape.

The first 24-48 hours are critical for preemies and will pretty much dictate how well they do. Those were long long hours for us. Just before the birth the NICU doctors had given us the list of risks we needed to be aware of with a premature baby of this gestation:

1) Lungs are immature. She will likely be on a ventilator and oxygen for several weeks. This is not without risk as ventilators and oxygen can cause damage to the lungs. Lung damage is common in preemies and the NICU will try and minimize this.

2) Eyes will need to be monitored for Retinopathy of Prematurity (ROP), an abnormal growth of blood vessels in the retina as a result of being on oxygen. This can cause blindness, but will be monitored closely and laser treatment is used to prevent blindness before it occurs.

3) Heart problems such as a PDA (Patent Ductus Arteriosus), a structural design of the heart that optimizes blood flow in utero, which can become problematic in a premature baby, should it not resolve itself. If the PDA doesn't close on its own, heart surgery would be require to correct it.

4) Bleeding in the brain or damage to the brain can occur in the first few days. Intraventricular Hemorrhage (IVH) and Periventricular Leukomalacia (PVL) are two types of brain injuries premature and low birth weight babies are at risk for. IVH is bleeding into the ventricles of the brain, PVL is a white matter brain injury. Adeleine's brain will be scanned at 7 days and again at one month.

As I mentioned before, she was given a 60-40 survival without mortality/morbidity rate. Obviously this was a serious situation. She was not "just small".  So, as parents of this precious child, how do you take all that in? Well, what choice did we have? These are the risks. These are the facts: babies like Adeleine are at a greater likelihood to have these issues. So buckle up folks, the rollercoaster ride has begun.

*Please note that this blog is not medical advice. It is simply our story.*

Next Post
Part 3: Weeks 1-3

Previous Post
Part 1: Labour & Delivery

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