Saturday, January 29, 2011

Zack Attack: Day 4 of the ICU

How would you react if the nurse in your newborn son's ICU told you upon arrival that morning that your baby boy's heart rate had dropped to a point so low that it was abnormally slow two times during the night and that each time the event lasted about 3 seconds before self-correcting?
Right?
Now, what would you say if they followed that up with, "But for all we know that happens to a lot of newborns. We just aren't monitoring them the way we are little Zachary."
Soooooo....nothing to worry about?

Holy.

Fuck.

So, here we are. No more apnic episodes. No more tests. But he's still in the ICU. Still being watched because, well, those 4 events earlier in the week were pretty freaking frightening.

Today Beth was able to breast feed Zack and he took to it. He's been behaving like a normal baby for all intents and purposes. But we still won't have anything concrete til after the weekend. And no idea when he'll be coming home.

But in this case, no news is actually good news and our level of worry is starting to diminish.

But, please, Zack, breath, keep your freaking food down and stop with the heart slowing. Your making us nuts.

Zack Attack: Day 3 of the ICU

Here's an interesting theory that was posited by a nurse and then by me to a doctor who in turn denied the entire concept:
When I was holding Zack on the day of the episodes he proceeded to fart in my hand with the duration and gusto of an old jewish man in a retirement home after a dinner of Canters' Mish Mosh and a Fresser.
We laughed about this and were amazed at how long this went on for.
Later, in the icu, little Zachary pooped no less than 6 times. And these weren't your run of the mill, regular ol' craps. These were epic. Homer could have written books about these bowel movements. They were so powerful that they had to hose down his incubator.
The nurse put forth the idea that maybe Zack was pushing so hard that morning that he turned blue and stopped breathing.
Sounded good to me. In fact, I really liked the irony that a son of mine would nearly die from flatulence.
Then Mr. Johns Hopkins - neo-natologist - runs the nicu practically by himself - doctor said, "Nah.---But it would be great if it was that simple, huh?"
I love that guy.

Zach's third day in the icu was a turning point as far as we are concerned. He hasn't had a breathing episode since Wednesday morning and he has been off forced air for most of the day. It's beginning to look more and more like this was one of those things that just goes away. But the results of the tests are not in, so it could be anything.
He could have another episode and send us back to square one.
Or he could be fine.

In the meantime, taking the mask off, removing the IV, turning off the bright lights (his jaundice is gone as well) meant that Beth could hold him, skin to skin, and even feed him. This being her last day as a patient herself was the perfect, if bittersweet, outgoing present.

We both took turns holding, feeding, burping, all those things we should be doing at home. And then it was time to get Momma home. Her body, her spirit, her everything has been taking a beating since Monday morning. With issues compounding upon issues it's good that she be in her own home, with her dog, her daughter, her own bed.

In the morning she will drive to Cedars and feed him. When can we take him home? We still don't know, but most definitely not before Monday. Could be as late as next Friday.

Hopefully not.

Below are some pictures. The first is of how Zack looked when I posted the first report from the icu. The others are, well, they speak for themselves, I think.






Friday, January 28, 2011

Zack Attack: Day 3 of the ICU

Here's an interesting theory that was posited by a nurse and then by me to a doctor who in turn denied the entire concept:
When I was holding Zack on the day of the episodes he proceeded to fart in my hand with the duration and gusto of an old jewish man in a retirement home after a dinner of Canters' Mish Mosh and a Fresser.
We laughed about this and were amazed at how long this went on for.
Later, in the icu, little Zachary pooped no less than 6 times. And these weren't your run of the mill, regular ol' craps. These were epic. Homer could have written books about these bowel movements. They were so powerful that they had to hose down his incubator.
The nurse put forth the idea that maybe Zack was pushing so hard that morning that he turned blue and stopped breathing.
Sounded good to me. In fact, I really liked the irony that a son of mine would nearly die from flatulence.
Then Mr. Johns Hokins - neo-natologist - runs the nicu practically by himself - doctor said, "Nah.---But it would be great if it was that simple, huh?"
I love that guy.

Zach's third day in the icu was a turning point as far as we are concerned. He hasn't had a breathing episode since Wednesday morning and he has been off forced air for most of the day. It's beginning to look more and more like this was one of those things that just goes away. But the results of the tests are not in, so it could be anything.
He could have another episode and send us back to square one.
Or he could be fine.

In the meantime, taking the mask off, removing the IV, turning off the bright lights (his jaundice is gone as well) meant that Beth could hold him, skin to skin, and even feed him. This being her last day as a patient herself was the perfect, if bittersweet, outgoing present.

We both took turns holding, feeding, burping, all those things we should be doing at home. And then it was time to get Momma home. Her body, her spirit, her everything has been taking a beating since Monday morning. With issues compounding upon issues it's good that she be in her own home, with her dog, her daughter, her own bed.

In the morning she will drive to Cedars and feed him. When can we take him home? We still don't know, but most definitely not before Monday. Could be as late as next Friday.

Hopefully not.

Below are some pictures. The first is of how Zack looked when I posted the first report from the icu. The others are, well, they speak for themselves, I think.






Thursday, January 27, 2011

Zack Attack: Day 2 of the ICU

When I went to see Zack today he looked like a burn victim in an Iraq War Movie. His hands were covered and bandaged to protect him from pulling out the IV (s).
The doctors were very apprehensive about keeping him on IV fluids because he's not a preemie, he CAN eat. It's very important that he learn to eat food on his own and his mom has been pumping for that very reason.
So, they gave him about 45ccs of breast milk/formula. He did well...at first. Then he vomited most of it up. More cause for alarm. Does he have reflux? Is it a digestive situation? Oy.
The good news is he hadn't had a breathing "episode" in 24 hours. But he was still living in the incubator.
On top of that, he had become jaundiced.
Like I said, Oy.

I went to the ICU after dropping Zoe off at school and checking in on Beth. When I got there, around 9:30, I was informed that the docs had started their rounds and would be coming by soon. It took 90 minutes.
By the time they got to Zack they didn't tell me anything I didn't already know. They were continuing to run tests, evaluate the eeg, check for reflux, basically, runing the gamut.
Thank goodness I live in a country where we have great insurance!
I mean, thank the gods that I have been able to maintain my union insurance.
(I wonder if Zack's experience would count as a "pre-existing condition" in the Tea Party's Universe....)

I asked Dr. P when they planned on taking Zack off the CPAP to see how he would fare on his own. "I guess, now." He said. Which was great, because then Beth could get some quality "skin to skin" time with him.

I wheeled her up and she put Zack on her chest for the first time since Tuesday. It was magical. Beautiful. And wayyy too short.

I had to go pick Zoe up from school but I just now called and checked in with Beth and they were just starting some reflux probe. (I've been down this road before....)

The good news is Zack's been breathing on his own since about 1 and as I write this it's 6. So, five hours without incident.

Start the clock.

Zack Attack: Day 1 of the ICU

I debated with myself whether to write this and then I realized that I had documented Liz's death for the world, Zoe's gestation, the early parts of her life, and the entire in vitro process as podcast .
We also announced Zack's birth on facebook, so it would do him a disservice not to continue the reporting.

I don't believe in "God". I'm an atheist. I believe that when we die, we die and our contribution to the world and the universe and the multiverse is we become part of the soil and feed the planet. I think its too coincidental that just about every creatures' blood is the same color, even fish! There is too much in common with potato bugs and horses and pigeons to dispute that we are all interrelated.
It's for this reason that I was deeply offended when Lizzie was buried in a pink sarcophagus with little or no chance to decompose and become part of the earth. She's alone. In her pink tomb. It made me sad.
I was raised Jewish but I cotton more to the traditions and lifestyle guidance than I do to the dogma. It didn't rain for 40 days and nights and if it did it was just a pretty bad flood. But it didn't cover the Earth. It covered the small patch of land that was the neighborhood that the dwellers of the bible lived in and to them, that was the world. The stories are better suited as parable. They are Aesopian at best.
But, if I did believe in "God" I would seriously wonder just what he has in mind today. Because I'm sort of trapped in a cosmic joke.

At 11:30 AM yesterday, just under 28 hours of life, Zachary stopped breathing. He turned blue. I wasn't there to see it. Beth was and we were fortunate that she was awake to notice. She's on a lot of pain killers and little sleep, the C-Section and all.
To her credit she reacted quickly: She yelled for help. Then she called me and I raced through the streets of Los Angeles from West Adams to West Hollywood. Anyone who has had to deal with the San Vicente/Fairfax intersection knows what a feat it was that I made it, door to door, in 15 minutes.

When I arrived I made a beeline for the nursery. I could see Beth soon, but she was a few doors down and I really needed to check in on my son. There he was, in his lucite bassinet, sleeping behind three nurses who were going about their administrative business.
I breathed a sigh of relief and walked to Beth. She was so upset. I could see it in her eyes. Why shouldn't she be? But I assured her that her son was great. Come on, I implored, come, I'll show you.
I helped her to her feet and she, with great pain, ambled down the hallway to the nursery. As we walked in we approached the plastic crib. There was our son, all right. But he was turning blue. Again.
The nurses sprang in to action, especially the one nicknamed "Milkshake". That's what it says on her scrubs. "Milkshake". Wouldn't it be really great if that was her given name?
Alas, it wasn't.
I explained to her my previous experience with Liz (for Liz's story, please click here) and my understanding of O2 levels and the like. (Of course, in my panic, I misread the machine and thought her oxygen level was 120. And that was ridiculous.)
There's something about Cedars that has actually gotten even better over the past 4 years since Zoe was born there. The bedside manner has become even more helpful. It's now a case of "the customer/patient is ALWAYS right. Always where they need to be. Even if they are in the way." I came to learn that this was actually a dictum handed down from on high. Customer service and positive experience is the mantra of Cedars Sinai. Amazing. Liz would have loved this hospital.
The doctors determined that Zack needed to go up to the NICU (Neonatal Intensive Care Unit). I went with him. I've been down this road before. Liz had been in hospital something like 45 times and I think I only missed a handful of those visits.

I held Zack's hand as they stuck him to draw blood. I held him as they put in the IV stick.

No one could figure out what was happening, why this newborn had decided to stop breathing 3 times in 3 hours (it happened again while in the NICU), dropping his O2 to as low as 65 and turning blue.
Was it an infection? Was it neurological? What was the problem?

The doctor spoke with me for a bit and assured me that this is something they see in a great many newborns and 50% of the time it disappears without warning. 25% of the time it's infection. 25% of the time it's something else. He wasn't worried about it being fatal. Zack is healthy is every other way. He just...has some issues.

And that was yesterday. They put him on a CPAP mask which is blowing oxygen into his lungs about 20 times a minute. And they would monitor him all night. In the meantime I took a call from his pediatrician.

Zack and Zoe's ped is the best in town. We adore this guy. But in his effort to be thorough he did tell me that one of the tests they would run would determine the level of risk Zack would have for "crib death". Good that we can test for that, I guess. But, take a neurotic guy and tell him that and, well, that's all he's gonna hear.

See, while they see this type of thing a lot, my only experience that I can call on is being bedside by my daughter as she coded, turned blue and died. That's my "go-to". That's my frame of reference. Add SIDS to the affair and, let's just say, if there is a God, he's got one hell of a sense of humor.

Actually, that's ridiculous. Because it would paint him as just over the edge from Heath Ledger's Joker.

But, I can't help thinking that, actuarially speaking, this shouldn't be happening, right? I mean, once you bury one child, that's sort of it, short of sending them to war.

Right?

So we wait. He will be fine in the NICU. Hopefully they can figure out what this is. They were hoping to take him off the CPAP this morning and see how he fared, but before they could Zack did it again and went all blue. Just for 20 seconds but it was enough to put him on 48 hour watch before they take off the assistance.

So, that's where we stand. I'm home with my daughter, who is oblivious and just wants to know when her mother and brother are coming home. Beth is with her sister at the hospital. I'm thinking a LOT about Liz. I'm worried about my son. I'm drinking a nice glass of lowland scotch.

And, for some reason, I keep thinking about Job. Or is it Gob?

Monday, January 24, 2011

Zoe has a brother!

For anyone not on facebook or out of the loop today: