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May 9, 2001
Logan seemed fine to me. But that first night, his temperature was too low, so I went with him to the regular nursery to be placed in a warming bed for half an hour or so. He warmed up nicely and back to our room we went. Because we wanted him to stay warm, we bundled him up and turned up the room’s heat a bit. And he and I went back to sleep.
At the next temperature check, he had a fever of 100.4, and was breathing 88 respirations per minute, when normal is around 40 or so. So we all went back down to the nursery to test his oxygen saturation and to recheck his temperature. His oxygen levels were perfect and his temperature was still 100.4. We went back to my room, and went back to sleep, with slightly fewer blankets.
All this time, he’s nursing pretty well. He’s hard to get latched on, because he’s hard to wake up, and when he was awake, he had trouble sucking. But as soon as he got latched, he nursed like a pro. I, however, wasn’t drinking much. The water there tasted like Styrofoam, so I kept having the nurses bring me cranberry juice, but it wasn’t enough.
The next day, Logan’s temperature was just fine, and his respirations were still too fast. His pediatrician, Dr. B. was called and she came to see him that afternoon. Before she arrived, Logan had several blood tests done, including several sugar levels (all were normal), a CBC (showing an elevated white blood cell count, a bilirubin level of 11, and something else I can’t remember, but not all that alarming), and a blood culture. And his breathing and temperature had returned to normal. Dr. B. said that Logan looked really great, but that the temperature and rapid breathing bothered her. Those were signs of infection. I had not been tested for group B strep during the pregnancy, so it was assumed to be possible that Logan had it. The blood culture would show whether or not that was the case, but it takes 48 hours to complete. Which meant Logan was going to be there another two days. I was upset, but pretty okay, because they promised they wouldn’t discharge me without Logan. However, if Logan got another fever or started breathing too fast again, the next step would be a spinal tap to rule out meningitis. Also, if his bilirubin levels continued to rise, he would have to have phototherapy.
That night, when Logan was taken to the nursery for more blood work (a bilirubin level), he started breathing too fast again, and his temperature returned, 100.4. The nurse came in to talk to me. I broke down and sobbed when she was about halfway through. The plan was this: They were going to take him to the NICU and do a spinal tap. The preliminary results would come back fairly quickly, but the culture would take 72 hours to complete. The neonatologist would evaluate him and decide the next course of action. I was warned that they may put him under the phototherapy lights, and that if he continued to breathe so quickly, I wouldn’t be allowed to breastfeed him for fear he would aspirate the milk. Instead, I was to pump my milk and they would feed it to him through a tube run down his throat. The part that devastated me the most was the lights and the pumping, because once he goes under the lights, they don’t allow you to pick him up again, except for 30 minutes every 3 hours to feed, no matter how strong the need is to pick him up when he cries. And all I wanted to do was hold Logan and nurse him, and they were telling me I could do neither of those things.
And probably the worst thing was that I was to be discharged. As long as Logan was able to room in with me, I was allowed to stay, but as soon as he went to the NICU, we lost the room. They were going to let me stay the rest of the night there, but not another one. There was a possibility that I could be given a room in a place called the League House, which is for families of patients, or even one in the Ronald McDonald House. The thing was I lived over half an hour away from the hospital; so driving back and forth was difficult. I also had no one who could drive me, because someone had to stay home with Jacob. The idea of going home and leaving Logan there made me sick with grief.
Anyway, I’m told I can go upstairs, 6 floors up, to the NICU in about an hour, to give them time to do the tap and get everything hooked up. When I get up there, Logan is in a warming bed, with sensors stuck all over and one wrapped around his foot, and an IV run into the back of a hand. I couldn’t stop crying. The nurse taking care of him that shift told me the spinal tap went well and they had no difficulties, and that I could nurse him if I wanted to. When I told her I’d been told I wouldn’t be allowed to nurse, she scoffed and said he had been nursing just fine while he was in my room, and she felt very confident he wouldn’t aspirate my milk. And sure enough, while nursing him, his respirations would drop into a normal range.
He still had difficulties latching on, and it quickly became evident that he was a snacker. He would nurse hard for five minutes every hour or so, instead of every three hours like they wanted. No one really minded, even though it threw off the nurse’s feeding schedule. She knew that the more Logan nursed, the better, and it didn’t really matter if the schedule was ruined because I was doing the feedings. As long as I remembered the times, she would write them down.
And that was another thing. They wrote everything down. Who visited, what they did… They wrote down if I talked to my baby, nursed him, held him… There was even a space for Kangaroo Care on their form.
Logan’s blood work slowly started to come back. His blood looked normal with no sign of infection at all. I learned that when I was admitted, I had been tested for group B strep and was negative. So was Logan. But the bilirubin level had gone up to 12, and he was very dehydrated. The neonatologist decided that if the level gets to 13, that they would start phototherapy. So the IV was rehydrating him with sugar water, and they injected antibiotics into the line every four hours in case there was an infection they hadn’t found yet. It was explained to me that dehydration in a newborn can cause fever and rapid breathing, but that they hadn’t ruled out infection yet. I was repeatedly questioned about breastfeeding and how it was going. And they always started out by asking about my nursing Jacob. I know they were thinking that I was giving all my milk to the toddler and there hadn’t been enough left for Logan, because that line of questioning would stop as soon as I told them that Jake hadn’t nursed since I’d been admitted.
The nurses in the NICU were fabulous people. Positive and encouraging and polite. They felt so bad for me, having to leave in the morning, and being so incredibly exhausted. That first night, I went back to the room that wasn’t mine and slept a couple of hours. The maternity nurses snuck me a breakfast tray because I had no food or money, and was a starving breastfeeding mother. I cried at their generosity. I went back up to the NICU around 8 that morning, and nursed Logan whenever he was hungry, changed his diapers, and took his temperature. He never had another fever, but his breathing would still get high sometimes. They had increased his IV rate to 14 somethings from 3 because he was so dehydrated. And his bilirubin had remained the same.
Over the next couple of days, I drove home in the evening, narrowly avoiding falling asleep on the long drive home by biting the inside of my lower lip and singing to the radio, and drove back to the hospital in the morning to sit all day in a hard rocking chair so I could nurse my baby. I was eating poorly and drinking little. But Logan started getting better. They gradually reduced his IV from 14 to 7 to 3. And his bilirubin levels never went about 12. At their lowest they were 9.9, and slightly higher than that when I finally took him home.
None of the multiple blood cultures ever came back positive for anything. And the spinal fluid also never showed any infection at all, and was actually very healthy looking. The conclusion was finally made that he was merely really dehydrated. And I got to take Logan home on the 7th. He had been in the NICU for 4 days, for rehydration and testing.
He has a newborn check up on Wednesday and I’m rather afraid something will come up and I won’t be able to take him home. But having him home now is a joy and a relief.
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