Friday, August 17, 2012

Day 10: No free rides

Today was one heck of a day. I'm not sure if it is good or bad that my high point of today was changing my little girl's diaper for the very first time. It's impressive how much of something that gross can come out of a baby just over 2lbs. I was given a 2 min time limit and I'd like to think I made my time.

Dr. Hitesh wasn't in until Monday so no taking care of business there, but there was drama across the way at the NICU. It did start off well, and I had an awesome time this morning at bath time taking pics and tons of video. We'll start with finding Mr. Vivek all discombobulated at the bottom ofhis crib with his hat, as usual, cast off to the side.

First up for bathtime was Princess Tara. She splays herself out and waves her limbs around frenetically, but doesn't seem to cry or distress like Vivek does. I think she likes a good portion of bathtime actually. I took two excellent action shots of our princess.

Here is a video of Tara's spongebath adventures:

Vivek on the other hand during bathtime makes adorable squeaks of protest:

Post bath time Miss Tara is quite alert, but Vivek wanted to go back to bed after a quick snack.

But soon after bathtime problems arose. I could tell my little chipmunks were hungry because they were pushing their little tongues out and restless, making sucking and smacking noises.

But the problem was by 9:15, 15 min after feeding time there was no breastmilk.the nurse had told me. I offer to go to Manju's room to see what the hold up is. Several things become apparent:

1. Manju has no pump of her own because the hand pump is shared between her and the other surrogate. I learned later they alternate every two hours who pumps and it is sterilized in between. This gives them four hour gaps and more rest and enables the two of them to produce enough milk...usually. I quickly decide to bring my hand pump at the hotel that I had bought for plane travel and give it to Manju so this won't hold them up anymore.

2. Manju keeps talking in Gujarati expecting me to understand her, and I never want her on my team at charades. She does point to her chest and say something that makes me think she doesn't have enough. I ask about the 2nd surrogate and she points upstairs. I am ticked because I wonder what Nita has to do that is more important than pumping milk for my babies.

I explain the problem to the nurses and Suvarna, the most amazing nurse in the world who is getting a huge tip when we leave, happens to have a 6 mos old baby and assures me that she will provide milk herself if needed to add to whatever Nita brings. I go to the hotel and sterilize my hand pump.

When I return at the next feeding it is apparent some more discussion has occurred, but I'm not sure what. Suvarna tries to tell me something about it when I hand her the pump, but due to the thick accent I have some trouble understanding it. Suddenly both surrogates show up, and I realized Suvarna was trying to tell me she was about to play hardball and take matters into her own hands...literally. She had made my low production surrogate come down so that she could assist her and pump her herself to make sure it was done correctly. She got almost enough milk for both babies but was a few mL shy. Manju did not seem all that happy about being manhandled, but I would like to have seen her more concerned about the welfare of my tiny hungry babies than her modesty.

The other surrogate had a long discussion in front of me with another nurse Anju who speaks some English but not much, and I could tell it was a lively one. The other surrogate Nita had struck me as a little pushy and I had been wary of her. I become increasingly nervous about the content of that conversation as I held my son for the next hour. When Dr. Kothiala comes in later as I'm concluding kangaroo care with Vivek, she compliments my singing and asks me about it. Turns out her CD broke but she had been playing classical music in the NICU based on her music therapy research.

I not so gracefully segueway the conversation into the drama that had been going on with the surrogates and twice delayed feedings due to poor supply. A pow-wow occurs where Suvarna and Anju fill Dr. Kothiala on what had gone on and I finally find out the truth.

Nita is my hero. The reason she had been upstairs was that she was going to all the other surrogates trying to get enough milk for my babies! I am almost certain that this was not the first time she has done this to cover for Manju. She also explained that Manju had been "losing interest" in producing milk for my babies. Don't get me started on how angry that makes me. Either work hard to produce or go home to Ahmedabad, but there are no free rides here. You'll get no sympathy from me because I pump every 3 hrs day and night for the one mL I produce, and she gets a liesurely four hours with meals delivered and no babies to see.  I am not a rich woman and this is not a surrority house. (Punny right!?)

Nita also had a surrogate in mind who would be interested in taking over for Manju so she can go home to her family. I make sure Suvarna and Dr. Kothiala know that I am not paying for someone who is not dedicated and productive in providing for my babies. Dr. Kothiala says I should go to see Dr. Patel's assistant and insist that Manju be cut off and sent home, and today or tomorrow morning they will resolve getting another surrogate to pump for me. Her assitant was very professional and confident and spoke superior English, and I felt instantly at ease. Dr. Kothiala assured me she would also contact Dr. Patel about the matter post haste.

In talking to Dr Kothiala during the whole wet nurse drama, I learn some other good info. In about two weeks we will start using my preemie formula (Similac Neosure) that I brought. She uses breastmilk only until gestational week 32, which should be the end of this month. She does that to avoid NEC (necrolyzing colitis I spoke about in a previous post) but the breastmilk is not as calorie dense and they don't put on weight and grow as fast as they do when you add formula to the mix. She is using some fortifier but explained she has maxed out on that for now. She will also try bottles and breastfeeding at the switchover point because the sucking burns so many calories, she would rather have them on a calorie dense regimen to ensure continual weight gain. I also learn that preemies at this stage in her experience take 3 weeks to gain back birthweight, so all my concerns about Vivek dissipate as he is getting close.

After all the drama I decided I needed to get away for a while and go for a jaunt about town for lunch. I dropped by to see my new friends from NY, and told them I was headed to Subway and they joined me. It was a hilarious ride in a Tuk-tuk. Seeing a guy the size of a middle linebacker cram into one is comical, and when you add two women and the driver...  It's not all that impressive to locals though cause I have seen about 7 folks crammed into one, and even more children on their way to or from school. The sandwiches and cookie were yummy and the second best meal I've had here so far. The place is as tightly in line with the Subway standard operating procedures and appearance as humanly possible in India, and the only main difference aside from localized menu selections were one side is vegetarian and the other isn't. It is a little further away, but worth the trip.

Tomorrow we do Alpha for lunch and will bring some back for my friend with her twins at the hotel, so I'm excited that I'll eat well tomorrow too and help them out again. But mostly, I'm excited for bathtime. And maybe now with having earned trust changing diapers I can look forward to another one tomorrow. How soon will it be before I no longer look forward to changing a dirty diaper, I don't know...

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