Wednesday, August 8, 2012

Day 1: The first time ever I saw your face...

The trip in the car to the hotel seemed to take forever. I was so excited to see my children I totally forgot to pay the driver!!! Why didn't he follow me and ask for payment? I'll see if Dr. Hitesh can get payment to him tomorrow.

I rush to my room and unpack tons of stuff I won't need for quite a while. It helps me to feel organized. I pack a small bag with little hats, tiny NICU outfits, diapers, formula, and wipes. (All they take are one pack of wipes and will tell me to bring diapers later.) I force myself to shower so that I'm clean after all this traveling before I see my babies. I force myself to eat breakfast and pump one more time. I try to pace myself but I eat so fast I almost choke. The staff recognizes me from last year and smiles. The front desk clerk congratulates me and shakes my hand. I stop on the way to the NICU to visit my new friend Lakshmi, and find out her twins are also a boy and girl and doing well too. I ask her what to expect in the NICU, and she also warns me how small they are but reassures me that they are taking great care of them both and they are doing well. Our babies are all next door neighbors. They tell me the NICU is small, and some folks seem to think it isn't that clean. However, we discuss that often cleanliness is a perception based off of how shiny and new things look, instead of actual cleanliness. When I do arrive at the NICU it certainly seems clean to me, and a man wipes down the floors and every inch of the isolette while I'm there.

I take the short walk that seems to take forever to the NICU. I find it no problem based  on HammockGuy's You Tube video:
I realize it is a full fledged hospital and the waiting room is packed and very sick folks line the rooms along the long hall you walk down to the double doors of the NICU. You must walk through the ICU to get to the NICU it appears, so just don't touch anything.

Words fail here. I was shocked at how small they were at first. Everyone tells you that, but somehow the camera must have added a few pounds because until that moment they didn't seem so small. After the shock wears off I begin weeping with joy. A group of all 5 nurses gather around and I do not experience this moment alone after all. They all realize the importance of this moment and it is all smiles as they realize this is the first time I'm seeing them. They tell me I can hold them after I wash my hands, and I'm thrilled that hope has come true so soon.

As I scrub up to the elbow vigorously before putting on a green gown, I greet Suvarna by name. She is shocked that I know her name. I explain to her that she is famous among the small group of Dr. Patel's patients who are NICU vets. I tell her that everyone says she is an incredible nurse, speaks English, and takes excellent care of the babies. I thank her, and she seems very pleased.

I had stared at my 6 pictures of my children every day for probably an hour or more daily grand total for  a week and a half, yet I wasn't sure who was who at first. I was a little overwhelmed. I held my daughter first, I couldn't tell you how long. She was so tiny, but somehow seemed content. Her every tiny movement fascinated me. It's true that seeing the nurses handle your babies so deftly convinces you that they are not as fragile as they seem. I held my son for longer because the nurses were busy doing something else, and even lost feeling in my hand. When they finally put him back in the isolette, I have no feeling in my left hand and I see that it is swollen considerably. I hide it behind my back and flex back and forth to regain sensation. I realize my biggest issue with this NICU will be the incredibly uncomfortable white plastic lawn chairs. I think I will grow to hate them, and sitting in them for long periods of time as they systematically cut off circulation to my limbs and aggravate my herniated disk will be a supreme test of will power.

They ask me their names, and I realize my email with their names to Dr. Kothiala never made it to the nurses. I write the names on their chart and they all seem to approve, but are as confused that I chose Indian names that are not family names as they are about why a white girl likes to wear sarees. They seem to expect me to speak Hindi, and I really wish I did! I tell them my husband speaks some. They seem confused again that my saree is folded Gujarati style when my husband's family is Punjabi, but when in Rome....

I offer them my specially selected bag of goodies, but all they take are a pack of wipes and they'll tell me when diapers are needed. I do give them my black and white zentangles from my ladies group at church, and after some explanation they realize what it is for and seem pleased and place them in the isolettes. I ask if I can take pictures but tell them I know to use no flash, and they agree. I take a test photo in the corner to make certain the flash is off.


Tara checking out Mommy's zentangle

Tara's gavage tube gives her an Elvis lip curl thing going on

Sleepy little boy

Vivek checking out my friend Nancy's zentangle

Vivek smiling for Daddy!

Brown eyed boy
 They tell me I can go talk to Dr. Kothiala, because I'd only met one of the other doctors that I'd forgotten the name of. I greet the doctor, and am pleased to see that she has grey hair. I find that level of experience comforting in this situation.  We discuss many things of which I'll try to recall as well as I can in my sleep weariness.

1. They are indeed doing very well, especially breathing well on room air with no assistance. Not even a blow by oxygen or nasal cannula, though Vivek has a little scab on his nose from when he last had the cannula last week. She tells me they don't let them get to the point they get apneic or bradycardic, which I find comforting but confusing because my understanding was that these are normal and will happen routinely. Vivek did desat once while I was doing kangaroo care later, but the nurse adjusted his head and he went right back up to normal at just under 100% O2 sats and heart rate from 120-140.

2. Tara was born at 920 grams, and as of today she hit 935 grams. It took her a week and a half to gain back her birth weight and then some. Every little gram counts.  Vivek had one rough day where his little tummy rejected some breast milk supplmentation, so for that one day he had issues and that is what set him a little behind. He is at 1 Kg right now.

3. She is a doctor who prefers minimal invasiveness, which is a philosophy I can get behind. However she assures me that she does what is necessary, but if a natural course (like breast milk or avoiding IV's) is possible she will do it.

4. She speaks with pride about how she was one of the first to do a particular style of surfactant therapy to coat the immature lungs, using a tube to administer directly to the lungs then remove as soon as possible. She explains that this way only 1 out of 10 babies in her experience even wind up needing a ventilator.

5. NEC (Necrolyzing Colitis) is something she says every neonatologist fears, which is why she approaches everything gently, and won't give anything but breast milk until at least 32 weeks gestation. Two surrogates including my own are at the hospital and are pumping for them, and they did get the colustrum to boost their underdeveloped immune systems. Breast milk is free the first 15 days, and later Dr. Hitesh tells me they have cut the cost to 750 rupees per day (thank goodness).

6. I tell her about my induced lactation, and she seems pleased. She says whenever I produce enough we can start using it but I explain right now 10 drops from a week and a half of pumping is all I produce. She tells me that kangaroo care will help and sucking, even if it is non-nutrative at first and for comfort only. I can't wait!!! Something about her reassuring me that this thing I have provoked my body to do to help my babies will be embraced here is so comforting. I expected it, but yet somehow I am still so relieved!

7. She says I can do kangaroo care as soon as I am ready, and my heart soars at the thought. There is only one problem. Of all the things I brought to India, it turns out American clothes instead of sarees would have been the best thing. I need shirts that button down the front for kangaroo care. Crap. Crappity crap crap crap. I have NOTHING that fits that description in my 2 week supply of clothing. I buy a man's shirt later in the day for $10 for this purpose, but it looks ridiculous and is not made for a short person with hips.

8. She agrees it is good that my husband is coming at the end, which is when he will be needed. This helps me to know that I did the smart thing.  Dr. Hitesh later echoes that sentiment.  I explain that my two mothers will be here also at the end, and this pleases her immensely because she says four to five people are necessary to care for these two babies upon discharge. I assure her there will be four, and am infinitely grateful that I have the two most wonderful mothers ever. I tell her my mother is amazing with babies.

I go see Dr. Hitesh and the birth certificates are already in the works and should arrive within the week! Our contract must be redone once my husband arrives because we did not know to initial every page, and the surrogate is single (which is suprising because I thought they had to be married) and her father's name is in the section for her husband's name. I realize our payment to her will be life changing even more than I thought.  He assures me the last minute contract signing won't raise eyebrows at the Mumbai consulate and they have done it plenty of times without a hitch. He says with egg donation a DNA test will be a given and will slow things down by about two weeks if I have my husband tested in the US beforehand, but that if we can convince them it is an emergency then the exit VISA process can go quite quickly. I meet another woman waiting in his office who is from Turkey and is on her 2nd try, and I share our good news and tell her it happened on our 2nd try with only 5 good eggs. She asks about induced lactation and I tell her all about the Newman Goldfarb protocol.

Later on I do kangaroo care and it is the most wonderful experience. Read more about it here:    Tara is sleepy and peaceful, which seems to be her usual state and it is pure bliss. I do it with Vivek first and longer actually, and partly because I sense he is having a little rougher time of it. He has been quite squirmy all day, which is great for photo and video ops, but I would prefer to see him more restful. He settles down once he is on my chest save the one de-sat. His tiny hands brushing against my skin make me feel more like his mother with every touch. Feeling like a mother and bonding is not instantaneous as I've been told, and now that I've been there I agree. They don't feel quite like mine yet but every interaction changes that more and more.

Suvarna tells me we will do kangaroo care every morning and evening, and I am thrilled!  Tomorrow after kangaroo care in the morning I will solve this clothing problem and make a trip to Big Bazaar to buy supplies for the long haul. I am hungry and have nothing to eat. Room service is 24 hrs but no one is answering the phone. I sneak into the kitchen and steal some cookies so I can get back to sleep.

So for the grand conclusion of the weak description of the best day of my life, here are videos....which are so much more powerful than words could ever be.

1 comment:

  1. Emily! They are gorgeous! They look so healthy and you look so happy. Enjoy your will pass quickly. Best wishes and prayers coming your way. Pam