Today was uneventful, but after yesterday that is absolutely fine with me. Vivek has some swollen eyes, but he is already opening them sooner than I expected. Dr. Amin checked on him and said all is well. They've been moved to the far end of the NICU and Petra's baby and 2nd baby just born by her 2nd surrogate have been moved to the other room. I'm SO grateful because it was getting crowded with Mommies and Grandmothers because we often visited at the same time. Now I have so much more room to cuddle my chipmunks.
Vivek was a little cranky today overall, but who can blame the little guy. I was pretty cranky too had an upset stomach all day so only got in one visit, but Dadima took good care of them for me and made sure Vivek got some of the breast milk I had pumped. Mom was a trooper putting up with all the crankiness and then like a saint she waited in the lobby while I napped so as not to disturb me. I felt so bad she went to those lengths. We had lunch at Decent Restaurant and at night finally felt up to doing more laundry. She talked to the manager about the construction upstairs and insisted the banging stop by 8pm, and he agreed. Way to go! I'm learning that Mom is quite insistent on good hotel service and food being prepared to her specifications, and she will see to it.
Poor Vivek looks like he just left a boxing ring
Dadima reassuring Tara her brother is fine
It is getting so incredibly hard to leave them at the NICU with each passing day, to the point I am almost angry and feeling pent up every time I walk out the doors. I'm sure this is normal, but I would give anything for a punching bag or a treadmill and running shoes to work out my frustrations. Only 5 days left!
I am over the moon today! I feel like I'm walking 10 feet above the ground. It was a spectacular day. I though maybe next week bottle feeding would start, but they started today. Vivek decided to start off the morning showing up his sister since he was upset about yesterday.
I've decided to nickname my son Hoover for the week! He bottle fed like a pro with no desats at all and stayed at almost 100% the entire time when I witnessed the nurse feeding him! Pretty amazing. He was sucking and breathing and swallowing like the little multitasker he was born to be. I was stunned and so happy I was trying not to cry. I thought it would take weeks, and I've read how there can be considerable difficultly overcoming this particular hurdle. I got to feed him myself for the first time later that night, and he did desat at the end but that probably had more to do with my ineptitude than anything else. It won't go perfectly of course, but it is a surprisingly strong start.
Words cannot describe the joy I got from feeding my tiny boy and watching him suck away, or the overwhelming sense of triumph when I got my first burp out of him. I was pleased that earlier in the day I hadn't realized his feeding had come late and my instincts that he was hungry and frustrated were right, because I'd been operating on the assumption he had just been fed but he was acting more than just hungry. It's easy to worry so much that you won't be able to sense what's going on with your babies, but every day I trust myself more.
But the kicker was earlier in the afternoon the nurse said she though Tara would need more time and wasn't quite ready to bottlefeed. She thought she would take longer. Tara must have heard that because that evening not only did she bottle feed perfectly while I fed Vivek, but I heard the nurse yell out "first prize!" and hold up her empty bottle while Vivek still had half left! The best part was after she finished the bottle and they took it out of her mouth, she was still sucking away like it was still there. It was so incredibly cute I almost overdosed on adorable, but unfortunately my camera was in the other room.
Tara exhausted from the "bottle races"
When I hold them now I'm so much more relaxed and the alarm of any desat surprises me rather that being something I expect. They typically do a very slight de-sat now and pull themselves right out, and if any stimulation occurs it is early in the game and mild on my part and maybe not even necessary. My only worry right now is that Vivek is so alert and moving that I worry he is not sleeping enough like his sister.
I went out to lunch to celebrate at Decent Restaurant for some more bartha. It was a yummy meal, but ended on a humorous note. I ordered a mango milkshake as a little dessert treat to celebrate the morning events, and ordered it while I had them box up my leftover bartha. I waited. Then I waited some more. How long does it take to make a milkshake? Finally I called over the waiter, and it turns out they had put my milkshake in a baggie with the leftovers. Language barrier 1, Emily 0.
On the way back I did witness something disturbing. One of the stray street dogs was trapped in between the security grates of one of the businesses, and I got the sense that it was done on purpose because it was acting aggressive. Then a man came out and began beating it with a bamboo stick. It was upsetting, but I didn't stick around to see how far it went.
Tonight the family members arrived for the baby that had been on the ventilator next to my son, but is now graduated to a CPAP though he is having some seizures. The mother speaks perfect English and sounds American though she appears to be and speak Japanese. She was full of questions for me because she could tell I was the veteran around the place, so I answered as much as I could. Unfortunately her baby is full term and a lot of my recent knowledge base relates to prematurity specifically. I invited her out to lunch tomorrow after the 11am visitation, and hopefully I can help in some way. She is staying at Madhuban, so I may follow them back to their hotel so I can try the food there because it is probably the best in town.
I got my hubby's paperwork printed out for FMLA, and I'll have Dr. Kothiala sign it tomorrow since she is easier to hunt down than Dr. Patel by far! I did speak with Dr. Kothiala today for the first time about general time frame for discharge. She asked me "how soon do you want to be caregiver?" I was confused by the question, but maybe some folks are more timid than I am and want their babies to be bigger and a little more developed or feeding more than 2 hrs apart before they take them home from the NICU. I told her that while we would have apnea monitors being brought on the 7th with my mother in law, that I wanted to take them home when she felt it was safe and the risk of apnea and bradycardias have reasonably passed. However, the sooner that happens the happier I am. She said two weeks at the earliest, so around the 13-14th of September. That means about two weeks and my husband and mother will be here!!! My husband has a fire lit under him and he is rushing around getting everything done on his to do list. Between getting the car seats installed, getting extra apnea alarm batteries, adjusting the stroller to the car seats, contacting the DNA lab, buying formula, getting proof of residency documents, and packing....he has his work cut out for him!
Tonight's weigh in was shocking! Miss Tara finally succeeded in besting her brother, and not only weighs 5 grams more but broke the 3lb mark first by a hair. Vivek was clearly perturbed by this news, because tonight he was so active and restless, throwing his limbs around, making faces, tossing his head back and forth, and even crying on occasion. I was in the other room at one point and realized it was actually my baby crying, because now he has the strength to cry loudly enough to where I can hear when I'm not right next to him, and he sounds more like a baby crying than an angry squirrel like before. I took many, many photos of my mighty man declaring his discontent tonight and of his general expressiveness. If he closed his eyes and rested more and burned less calories maybe he would catch back up to his sister. Sorry pics are blurry, but he wouldn't stay still tonite!
Pensive Vik
Drowsy Vik
Exasperated Vik
Surreptitious Vik
Contented Vik
Curious Vik
Annoyed Vik
Miss Tara on the other hand was as peaceful as ever. I have to say tonight holding them both I felt a sense of bonding take over, but partly it is because they seem more alert and I am more confident and less concerned about the monitors desatting so I can just focus on loving my babies. The thrilling news is that so far today I noticed no discernable difference from them being removed from caffeine! So far so good....
Smiling at winning the weight bout finally
Saving her energy for growing bigger
I'm definitely becoming a more confident mother. Miss Tara grunted while I was holding her and I thought I smelled something, and sure enough my detective skills correctly identified a full diaper for the second time. The first one was a loud bomb, so I can't take credit for my discernment on that occasion. I didn't wait for anyone to help and I transferred her back to the isollette and changed it myself. This may sound like no big deal, but at only 3lbs she is still delicate, there are wires hanging off her and she is tangled up in a blanket, and I have to get her off of my bare chest where my clothes are discombobulated and gently transition from sitting to standing with grace and ease. I've developed a method for transitioning to cradle hold first using the blanket for stability, then it is easier and safer to stand up without risking any jostling or bumping. I was afraid to do much before this point because the nurses watch you like a hawk and don't initially trust you to do things like they would. I was partly waiting to handle my babies more independently until I watched how they did it and they were more comfortable with my handling.
Tara working something out
I've figured out a new method to get me emotional to help me produce more milk, and so far it seems to be working. When you pump 15 min at a time for 8 times per day you can only stare at pics of your kiddos for so long trying to stir up emotion. So instead I started watching videos on YouTube of babies and then that transitioned into vids of soldiers coming home and greetings by family, children, and dogs. It does the trick! I'm happier with my production level, and if I can put out just a little more I know that the 2-3 teaspoons I can produce per pumping right now will add up to something that helps my babies. I'm not trying to store and serve it to my babies right now because I lose so much in drops that stick to the sides of the plastic on the way to the bottle, and so focusing on when they attempt to breastfeed in a week or two may be more fruitful. It will also be easier than trying to collect all day for a tiny bit per baby that the nurses will find odd for me to push getting added to their feed of formula and be awkward with the language barrier.
Today Hitesh wasn't in, so still working on FMLA paperwork. It was a bad luck day with tuk-tuks and I must have chatted up 3 drivers for every 1 driver that knew where I wanted to go. This town is not that big, and I typically mention 3-4 nearby businesses to help them be sure the general area I want to go. Frustrating. I also follow two more generally smart rules:
1. Always name your price first before you get in. Prevents surprises and rip-off's later.
2. If you don't have 40-70 rupees (cost of most rides) then check to make sure they have change if you have 100 bills. They pull this "no change" stuff on you sometimes, which is a load of horse hockey. If they know how to say "no change" they have change, which is typically in their front pocket or hidden in a locked compartment on the console of the tuk-tuk. Maybe if the tuk-tuk is real beat up and the driver looks like they haven't bathed in a few weeks they may have no change, but usually I think they are scamming you.
I went to Dawat again, but despite me seeing eggplant all over town they said no Baingan bartha available. That was the 1 reason I went there, so for the rest of my stay I'm abandoning Dawat and sticking with Decent Restaurant where they have it with corn in it at least. I ordered spaghetti instead to try "Continental Fare." DO NOT FALL FOR THE SPAGHETTI!!! I've seen it all over menus around town, but it is spaghetti noodles with a super cheesy creamy sauce that is sweetened by pineapple juice. It is like a cheesy dessert thing trying to be savory. It was awful, but they love it around here. I took one bite and very politely told them I wasn't going to eat it, and to my suprise they didn't charge me for it. I felt bad. Then I walked over to Subway and got a veggie patty sandwich to go, where they gave and charged me for chips I didn't ask for, so I guess it evened out.
I met a guy from London and his twins tonight at the NICU, and I'm pretty sure his partner and mother in law. I'm pleased because I thought that Dr. Patel only helped heterosexual couples...but if my guess is correct then that isn't true. That was one serious criticism I had of Dr. Patel was that she wasn't open to homosexual couples or surrogates who were not married, but my surrogate is divorced and these two gentlemen appeared to be a couple.
But tonight ended with some special shots of me holding my son, because he was such a little bundle of energy and I realized I hadn't had many photos of me with the babies except for the first few days. I'll try to include more.
And my most favorite pic of all and my new Facebook profile pic:
I'm getting so excited because travel reservations have been made for my mother in law to arrive in Anand on Sept 7th!!!! I can't wait...just have to hold on until then.
Today started by my spectacular timing. I had a slow morning and slept in and arrived late, but fortunately it was right when the eye doctor was there examining my babies. He came in just to examine the both of them to establish their risk for ROP, or retinopathy of prematurity. It is an eye disease that affects almost exclusively preterm babies, though they eventually realized the risk ran higher in developed nations where more oxygen support was provided to preemies and changed protocols. In simple terms, full term babies are born with all the blood vessels they need in their eyes, but with preemies once they are born that growth can sometimes proceed abnormally. If you don't examine babies to see if the growth of vessels is abnormal, then it can affect vision and unchecked can cause blindness. Like a weed growing on a well groomed lawn, it must be stopped before it can take over. So the way to fix it is a procedure with a green laser that will cut off the blood flow to any abnormal vessel.
It has five stages, and my son almost perfect and only at stage 1. My daughter's right eye is stage 2, but her left is stage 1. She was at more risk because of her lower birthweight. He is going to return in 15 days to doublecheck their eyes, and if the growth hasn't arrested on his own we'll look into the laser procedure to make sure their vision will not be affected. I saw him take out tiny silver prongs that I knew were for keeping the eyelids open while he examined them, so as soon as he pulled out that with dilation drops and a bright light I decided to wait in the other room of the NICU. That way I wouldn't make a blubbering fool out of myself when they struggled and cried while the two other nurses held them still.
Another sign of progress today: they were taken off caffeine! This is standard for all preemies to decrease apnea, and now that it is removed I'm bracing myself to witness them desatting or having more apnea alarms. There is a chance they may not react, but we'll just have to see. If it has a strong affect, then they can continue it into week 34. But taking that step is a sign of progress, so it's exciting.
I decided to keep myself focused on the light at the end of the tunnel by buying the two baby carriers and the two baby beds I will need for them at Seven Eleven. I placed them by the door to remind me everytime I come and go that they will be filled with babies soon. The beds have mosquito nets that you can use if you want to or put underneath, along with little head pads. The carriers are rather cheap and simple but too deep for preemies according to Dr. Kothiala, so use the little head pads from the cribs and possibly other padding to raise the depth of the carriers to help make sure the babies heads don't roll foward. They have detachable plastic backs that keep them from rocking back and forth when you set them down. The carriers are just over 1100 rupees, and the baby beds are more reasonable at 395 rupees.
I couldn't bring myself to eat my leftovers from Flavours Restaurant yesterday, so I feel guilty for being wasteful but it just wasn't what I hoped it would be when I ordered it. Tonight I tried "Decent Restaurant" and promised myself I would figure out how to order soemething I really liked. I actually found bartha, though for some reason they put corn in it too. It was pretty decent. (Sorry..it was obvious but I had to.) It has a nice view of the traffic from the picture windows on the second floor, and I saw a carriage being led by two white horses appear out of nowhere. Tomorrow I'll see if Dawat has baingan bartha (without corn) and see who makes the best in town.
Hitesh didn't seem to be in at Dr. Patel's, and so I didn't pursue getting printouts and signatures on my husband's FMLA paperwork today. However the hotel will print out the pages for me, so I may just have them do it for me and try to get them signed tomorrow. Scanning is another hurdle entirely to email back, but maybe Dr. Patel's office can help.
Here's hoping tomorrow is a more productive day and I don't sleep through bath time or have two short visits like I did today. I don't think either one of my babies got held for more than 45 minutes today, so tomorrow lots of cuddles are in store to make up for it. But they don't seem to be suffering for lack of cuddling, because today she is 1335 grams and he is 1345. That means they are both over 2lbs and 15 oz, so by tomorrow there is a chance they could both hit 3lbs!
Day 6 for me, day 19 for my babies. My fears about weight gain were unfounded because I missed a few pages of the chart somehow last time I looked. My little girl is now 990 grams, which is about 2 lbs and 3 oz. This is 2 oz or so over her birthweight. Vivek is 1060 grams!!! This is around 2 lbs 5ozs, still not quite up to his birthweight of 2 lbs 7 oz but gaining much more than I thought.
I spent an hour and a half doing kangaroo care with Vivek today, but only 30 min with Tara because she had to go back to the isolette due to some desats in the 50’s and she got a little cyanotic. I wasn’t able to tell as well as the nurses but now I know to look for the bottoms of the feet looking ashen instead of pink. The doctor was there and I saw how they stimulated her back up to the 90’s. They then suctioned her and she had a better time after that. They clearly attribute all her desats to her GERD, and they will subside over time. I know from what I’ve read that this is normal, and I could actually expect a lot worse than I’m actually seeing. But knowing that doesn’t make it much easier to experience as a parent. I remind myself that she is on room air and no oxygen support at 29 weeks gestation which is still spectacular. I asked the doctor at what point would they put her on oxygen support, and she assured me they had no plans to. I asked again and they said if she desatted below the 50th percentile like that all the time and did not pull herself out of it with stimulation then they would go to nasal cannula. I felt better seeing both doctors and nurses attending to her and doing the suction, and it assured me she is getting proper attention and care when I’m not there.
I got confirmation on another thing I expected to hear…my son’s testes are undescended. I'm sure he'll thank me later for sharing this on the internet. For other anxious preemie parents out there, this is normal when they are born before this has a chance to happen. They will likely descend on their own with time. However this can be associated with inguinal hernias, and can sometimes require surgery. I’ve actually had that exact kind of hernia and had surgery myself for it, though strangely only 1% of women get that type of hernia. If the months pass and it doesn’t resolve we’ll address it once we are back in the US, but it is not a big deal and was something I’d expected.
I got to watch two new babies, a set of twins, get brought in right after birth. They are giant full termers so their parents will be short timers in the NICU. Me...I”m serving more serious time. There was a lot of fussing getting them all cleaned up and prepped and hooked up to lines and monitors, and they cried an awful lot. I did hear that a baby did die yesterday, and that was probably what was happening in the other room that I wrote about yesterday. This baby was much bigger than ours but had breathing problems from birth and had been struggling. Very sad. I’m told it was a local parent and not one of Dr. Patel’s patients.
So my biggest concerns right now are finding the State Bank ATM that I can’t seem to locate, which is the one machine that may not reject my card. I gave up at the point yesterday where a walk anywhere meant being ankle deep in muddy water contaminated with God knows what else. ATM's give the best exchange rate I’m told.
I also need to resolve my account with Dr. Patel and make payment to the NICU but their never seems to a be a good time. Hopefully tomorrow I can take charge and get both done.
So today I decided to go for a little adventure since my allergies were fully gone for the day and I felt better than I had since I got here. In spite of the rainy season, I decided not to carry my umbrella around and a little rain wouldn’t hurt me. I'm sure you can see where this one is going. I let myself wander lost through the streets with the ultimate goal of eventually catching a Tuk Tuk to D-Mart to score some toilet paper and feed my Tang addiction.
The coolest thing I saw was a place I'd read about where they make statues of Gods and Goddesses for festivals that at the end are burned as effigies. There is hay in the center and mud and clay on the outside. I was taking a picture and the owner with his chest puffed up in pride invited me in for more pictures. I took a few and tried to leave but he kept saying “nightshade.” I recall nightshade as being a plant with some kind of psychotropic properties and became concerned about why he wanted me to go deeper inside, and then he flipped on the lights and I understood he wanted me to get a better picture and I felt like an idiot. I thanked him and all the sculpture artists and took the shots you see below.
I am glad on this trip I didn't wear a saree because in ankle deep water it is going to get wet or you have to hold it up constantly. I find D-Mart and it is the micro mini WalMart of Anand. I was hoping for more in the food section, but I did find what I needed and like it about as much as Big Bazaar. I was hoping to walk back to the Alpha Restaurant about a mile away because my friend had told me it was their favorite place, but I was distracted from my goal by pictures of mouth watering food on a sign closer by. The bag from D-Mart was heavy to carry, but when I saw a picture of a giant juicy hamburger and fries I was done for. I practically ran to the front of the Dawat restaurant, where a doorman opened it for me so gracefully I mistook it for an automatic door. My first disappointment was to realize that I'd come at off hours so there would be 8 waiters either over-helping me or staring at me. Then one look at their rather substantial menu told me that nothing on the sign...read JUICY HAMBURGER....is actually served in the restaurant. I should have known better...but the picture of the hamburger sent me into a feeding frenzy. I would have been happy with something that even resembled one. My pulse races when I see bartha, my favorite Indian eggplant dish. I order it with glee, and find out that it is out of season. Now doubly disappointed I order papadi chat as an appetizer and malai kofta with sweet lemon soda. The chat was enough for three people, and the malai kofta was nowhere near as good as my wonderful mother-in-law makes. But I ate it happily and was waited on hand and foot, and even given a dish of warm water to clean off my fingertips with at the end. All for the bargain price of $3.50. Trip Advisor rates it #3 out of 8 restraurants worth eating at in Anand. http://www.tripadvisor.in/Restaurants-g1155996-Anand_Gujarat.html I want to try "Decent Restaurant" just cause the name is so funny.
I missed the pouring rain while I was eating, but when I return outside I see that what was partially flooded is now entirely flooded. I see a lone Tuk Tuk driver and ask him for a ride back to my hotel. He seems to know it, but insists on $50 rupees. I am set on 40 and for some reason feel very stubborn about it despite the flood. Don't ask me why half the drivers here don't know Rama Residency or “Station Road by railway train station” when this town is so freaking small.
So in my sturbborness I keep walking, and attract many more stares than usual. I guess it contradicts your assumptions when you live in India on $1 a day and are riding around in a Tuk-Tuk to avoid the water even though you have an umbrella, then see what is supposed to be a rich foreigner walking instead looking like a drowned rat without one. I try another driver and he clearly doesn't know my destination. Then when walking through high water the snaps on my shoes come undone in the fast current, and I slip and fall to my knees. This was very embarassing, and fortunately I wasn't narrowly avoiding traffic at this juncture of the road like I usually was. Death by Tuk-Tuk...I would feel so bad for all my family at the funeral having to explain how I died.
I redo my shoe snaps while random guy tries not to stare or laugh at my misfortune. I finally find a driver who seems about 50% sure of my destination and agrees to my price. I try not to stare at his teeth and fail miserably because they were the worst teeth I'd ever seen. He gets close to my destination but admits he is not sure where to go from there. I try everything I can think of. I say Kaival Hospital. Apara Nursing Home. Mahatma Gandhi statue by rail/train station. But then I say Dr. Nayana Patel, and it is instant recognition. He drives me right to her office.
I walk across the street to my hotel, worse for the wear but somehow feeling like despite my misadventures, today was a lot more fun that yesterday. I think that I should venture into Anand daily even if I have no purpose. Just the exploration lifts my spirits and helps me to accept my surroundings rather than feel like I am avoiding them holed up in a hotel room.
Other random happenings today. A student of social work drops by my hotel room with a poorly written survey for patient's of Dr. Patel, with Dr. Patel's endorsement to do. I fill it out anyway despite horrible questions like “If Dr. Patel recommended an amniocentesis due to possible problems would you abort the baby, yes or no.” I write it depends on the results of the amnio and if an extremely severe defect was discovered. Sigh.
I did finally get my cell phone delivered thanks to my husband's cousin and his connections in Ahmedabad. It is a comfort now that I won't miss all the calls from family and can make any calls I need to .
I’ve learned a few random tips in the past few days from some other patients of Dr. Patel. At the Rama Residency you can get a bigger room where they put a mattress on the floor, which is used for the babies to sleep on. It has a king and a twin bed for the nanny, as well as the floor mattress for babies. Uday could get you a crib, but I guess this is the Rama alternative. I was happy to lend my mosquito net crib contraption to my friend who may be bringing her twins back to Rama from the NICU today depending on how it goes…so exciting! Other random tips:
1. Keep all food stuffs in containers…beware of the sugar ants!!! I have had some before so you have to be careful to avoid an infestation because those suckers move quick!
2. The Chocolate Room close to the Subway is as awesome as it sounds. Chocolate pancakes, chocolate waffles and chocolate/coffee drinks.
3. D-Mart is about as big or bigger than Big Bazaar and has more American foods and slightly better prices. I didn't do much price comparison, but D-Mart has more clothes for sure and Big Bazaar has more home goods and appliances.
4. Big Bazaar has a spa on the 3rd floor which is pretty good and charges comparable US prices of $45 for an hour.
5. Tell the front desk no visitors to your room so that no money seekers will head your way. This is why I didn’t tell our surrogate our room #.
6. Shipping to India is crazy expensive (which I already knew) and your shipment is likely to get picked through in customs and only part of it will arrive. Despicable, but that is why you should bring what you need and pay extra for baggage.
7. Madhuban Resort and Spa review: Tuk-tuk there (maybe 100 rupees at most) and then took the Madhuban-car back to the Rama (it was $7 for the return trip). Lunch there was pretty cheap. They had a "Chicken sandwich" which I got. The picture on the table showed a whole chicken breast but that's not what you get. You get chicken-flakes and they're pretty spicy. My husband got a spaghetti-bolognase meat-sauce thing and he didn't like it. He said it was real spicy. He got Chicken-Tikka the next time and said it was really good. They have a big lunch buffet set up daily that most people seemed to be getting, it was all Indian food.
8. Dr. Hitesh can write you a prescription for antibiotics if you get sick.
That is all I can think of for now. This is a long post because once I again I took a “nap” and missed my second trip to see my babies and woke up at 1:30am with plenty of time to chronicle my misadventures while watching a late night showing of Mars Attacks while eating leftover cold malai kofta that looks like something a cat would throw up. I seriously need to stay awake a full day and get into the rythym of life here, but I think my 3 mile hike wore me out today. Here is little Miss Tara with her eyes open for a grand finale.
