No sleep for the wicked

It's just past 10 AM and except for little 45 minute intervals here and there, she's been awake. She's been fussy all night. ALL night. We've stayed pretty true to the 3-4 hour feeding schedule (or she's kept us to it), and wet diapers aren't an issue, but she really hasn't slept more than an hour at a time. She's also been eating. A lot! Like about twice what she was formulated to eat last week. I hope this is good and that we just aren't indulging her and gorging her full of milk. Man, though, sleep would be nice.
A working washing machine would be also, if we are going to continue to provide her with clean blankets and onesies. Ours broke down on Monday and the repairman is supposed to come out between 1 and 4 PM. In the meantime, my jeans sit in a pool of soapy water waiting for rinsing and spinning. When I contacted GE via their 800 number for service, the nice fellow at the call center told me that a service representative could be out here on July 9th. "July 9th?!!? I have a newborn at home! I can't wait until then! I'll get somebody local," to which he replied, "but sir, if you do wait, you will receive a five year guarentee on the part or parts replaced and the service done," as if reading directly from a script and without even reacting or replying to what I had just said. At least the local place gave me a 2 day turnaround instead.
I guess being unable to do laundry isn't the end of the world. Laundry mats do still exist and they are a reality for lots of parents. Before my own parents bought a wash machine in the 1960s, they used to do theirs at a laundramat in Enumclaw after my brother was born, and that was the era of cloth everything.
Our neighbor, Amy, gave us some nice gifts yesterday. Amy had her third baby, a girl, about two weeks before Clare was born, and has been a wealth of support for us. She bought us a book called "The Baby Book" and essentially called the baby's "owner's manual". It is hugely informative, talking about the importance of holding the baby and sleeping with her as much as possible. It looks to be one of those things that we didn't know we needed, but looks to be indispensible.

Well, the appliance repairman is here, and Clare and her mom went in to Fife HS to work. If the washer gets done, I might get to sleep!

Sleep when the baby sleeps

TUESDAY, JULY 1, 2008

We are now a normal family with a newborn:  we exist on a 24-hour schedule.  Showering is optional.  We eat weird stuff at all hours.  The house is a disaster.  Laundry was a constant endeavor--until the washing machine broke down today.  All food can in some way look like baby poop.  Some times we panic, wondering how we are EVER going to function again, work again, think again.  We don't leave the house. We couldn't tell you what day of the week it is, or how many days we've had Clare home.  And of course, we sleep only when the baby sleeps--if then.  As Tim just said, "we look like we moved back in with our parents and never got jobs."

Clare is doing well.  She's eating like crazy.  I never had any idea babies made so much noise...and I don't mean the crying.  She chatters all the time, when she's awake, when she's half asleep, when she's asleep...it makes listening to the baby monitor downright funny.  (In fact, right now we're listening to her hiccuping.)  She appears to like it here at home.  She's also decided she likes us to pick her up and hold her.  Diaper changes make her crabby.  So far, though (and we know this won't always be the case), she isn't inconsolable.   

Clare went to her first pediatrician appointment yesterday morning.  We woke up less than an hour before it and didn't have time to shower, so we rolled in there looking like a couple of welfare cheats.  The baby looked good, though, and that's all that mattered.  I decided pediatricians' offices remind me too much of elementary schools, with their seasonal decorations and years-old copies of Highlights magazine laying around--you know, the ones where some other kid has already gone through and circled all the hidden pictures.  Can you find the frying pan?  Oh, Spoiler Kid already did--it's circled in the tree.  Can you find the spool of thread?  Yep, because Spoiler Kid got that one too, looking like a knot in the tree trunk.  The bicycle, the tea cup, and the pencil are all circled too.  Damn.  

Anyway, the pediatrician's appointment went just fine.  Clare is now five weeks old.  It seems so strange to think I'm still supposed to be pregnant for 3 1/2 more weeks.  When we think of it that way, it's hard to believe she's doing so well.  She was just a little over 2/3 of the way cooked.

On a more serious note, Tim and I are realizing how much we have to process from our five and a half weeks in the hospital.  We miss our nurses Peggy and Lisa.  We greatly appreciate Meg the nurse practitioner, who took such good care of us, and Sue, our last nurse who really took the time to explain things to us and reassure us.  But we are both pretty angry with a number of things:  the nurse practitioners whom we'd never even talked to, who walked up and made (what appeared to be) snap decisions about Clare--like when we were to room in with her.  We figured out early on that the staff was evaluating us all the time, and this was confirmed by check-off sheets and shift reports in Clare's file.  Afterward, it became clear to us that the evaluating was continuing during our rooming in period, and that none of us (Clare, Tim or I) passed muster on the first day of rooming in.  It made us feel like guinea pigs in somebody else's experiment and like we were being set up to fail.  Additionally, there were a couple other folks who were particularly discouraging or judgmental, and whose discouragement and judgment made things more difficult for us.  I won't say anything more than that, because in the end our daughter is healthy as a preemie can be, and we have her home, and all of us will recover.  But the whole experience smacked of a lack of control and sometimes even a lack of dignity.  Our powerlessness was profound. It's going to take us a while to process everything our little family has been through.  There was a lot that, at the time, we didn't have the energy or luxury to feel.  Now, we may not have the energy, but we have the time and luxury, so we find ourselves coming to terms with this incredibly big experience, fraught with fear and worry and helplessness and ignorance.  

I guess I need to cut myself some slack, too.  I tell myself that I don't have much right to feel overwhelmed by having Clare home, because it's not like I'm trying to recover from childbirth, and we brought home a baby whom we know well.  We've been trained by some incredible nurses.  We have some distinct advantages over the parents of term-babies who are booted out of the hospital within forty-eight hours of giving birth.  But then I consider the past six weeks and figure our fear and fatigue and concern are all warranted and justifiable.

But most of all, we are grateful that now our pretty, tiny little girl is asleep just ten steps from us and we can pick her up whenever she wants us to, and tell her we love her as often as we'd like, and dress her in her own little clothes.  Changing a diaper is not the worrisome task it was when we feared what we'd find--now we KNOW what we'll find by scent, and it isn't anything every other parent in the world is finding in their kid's diaper.  The funny thing is, Clare's been unaware of her predicament this whole time.  She has operated under the instinctive knowledge that everything is the way it's supposed to be and has had no fears for the future.  

Maybe she's the very smartest of us all.

We're home.

Well, we made it. All three of us in our little family are home now. Yesterday morning, our nurse Sue called us and told us that it was official, that she had received the discharge paperwork and would be down with her now-certified infant car seat when she was finished with a meeting. Man, what a breath of fresh air. Literally. Hospital air is so dry, I think anyone would be sick after an extended stay there, even if they weren't infirmed in the first place.

Speaking of sick, the extended stress and discomfort actually made Amanda ill--she's fighting some sort of virus and is feeling really bad. Of course we read up and asked about what happens if mama becomes sick and like most childcare science, answers vary from "wear a mask" to "stay away". One thing that has been proven is that mother's milk passes on antibodies to the baby, even newly-produced ones meant to fight a mother's actual illness. I've been trying to take over the bottle feeding so she can get rest and beat the virus.

My dad Curt and his friend Arlene did us a huge favor yesterday and got us some groceries so we don't have to leave the house. They even went so far as to go to Metropolitan Market to get us the blueberry juice we like, and even bought Amanda some ice cream. We can't say how much we deeply appreciate this!

Until this morning, Clare had been drinking less and more often. We think it was symptomatic of all of the chaos, the discharge, the car seat and the car ride, and the fact that she had never been to her own house before, with new smells, new (and far less) sounds, new bassinet and sleeping arrangements, the dog, kitties--a lot for a preemie mind to process. It's weird how basic her life is, and if she has to deal with new stimuli, she has to shift energy away from basic life stuff, like digestion, breathing, and eating. No offense, but she's more like a worm or a reptile than a human being. And our nurse Sue said that all of that would go away once she hit term. One time she was attending to a new mother in the mothers and newborns section of the hospital, the one where the term babies room in with their parents for a night then go home. Sue noticed that the woman was getting ready to nurse the baby and asked her if she neede any help, and the mother said no. Sue was a disbelieving and kind of hung around until she saw the baby sidle right up and start nursing. It dawned on her; the baby was a term baby, not a preemie. The kid didn't have to learn how to eat!

Amanda spent yesterday afternoon (even though she was sick) finishing readying the room for the baby. This meant writing down all of the gifts and all of the names of the people that gave them that have lived in the middle of the floor of the room since the end of May, sorting them between "now" for preemies and "later" for when she grows (which we still don't really believe will happen yet) and storing the later ones, plus all the sheets, diapers, and blankets that you all have given us. If you haven't received a thank you, don't feel put out; you will get one soon. The nursery is now a comforting place, with a rocking chair, the bassinet, the changing table/drawers, the armoire and the storage shelves, plus a cool think green rug in the middle, and a small, portable stereo CD player.

Being out of the hospital is strange now. We don't know her current vital signs, her temperature, and now have a more vague idea of how much she ate last and when she will need to feed again. She seems different too; less programmed to wake at 7:30 AM for doctor's rounds and every three hours afterwards, less interested in sleep, more interested in being cuddled and taking in her surroundings, sometimes staring at us or things for long periods of time.

We think she's becoming a real baby!

Knudson Household, population 3

We are home.  It's hard to believe, and we're both disoriented like any new parents arriving home with their firstborn, but she's here and we're here and all our pets are here and all our stuff and we don't have to go anywhere.  She will never be free of pet hair again.

Clare's introduction to Luke was especially sweet.  We set her on the living room floor in her carseat, then brought Luke in.  He didn't see her at first, so I pointed her out.  He went right over to her and licked her face.  That's what he does to little kids and babies, so this wasn't particularly surprising.  But when Moly the cat walked over to check Clare out, Luke put himself between her and the baby and shooed her away.  Those of you who know Luke know he doesn't demonstrate a lot of protective instincts.  Seeing him "protect" the baby from the cat was really sweet and we wouldn't want the dynamic any other way.

Otherwise, Luke isn't particularly interested in her.  Maybe he now has something to attach to the smell we've been bringing home the last month.  The cats are funny too.  Moly's nose is out of joint;  she won't go see Tim.  Frank, who we expected to be completely freaked out by Clare, isn't bothered at all and just acts happy as heck that we're home.  

In addition to a baby, I also brought a cold home from the hospital.  After all these weeks of anxiety, I guess a stressed, sleepless night in a cramped hospital room breathing dry, canned air was the last assault the old immune system could take.  I started feeling lousy yesterday afternoon.  Really I'm just grateful my health held out for this long--and Tim's too.  The nice thing is that though there is some risk of sharing the virus with the baby, she's also getting antibodies for this specific virus and white blood cells from me via breast milk.  

It's hard to imagine not going to the hospital tomorrow.  We're going to miss the nurses who took such good care of us and Clare.  That's about all we'll miss, though.  Tim and I put our wedding rings back on tonight, wearing them for the first time since Clare was born and taken to the NICU.  Our watches too.  Now we don't have to scrub down for three minutes every time we go to see her.  It's going to take a long time to get the ICN out of our heads.  Right now, I can hear the many different babies' monitors chiming in my head (and I could tell you what each individual tone means).  I can hear the neighbor baby's desperate cries.  I can hear the sound of the privacy curtains as they're pulled around a particular baby's station.  I can see the carpet. Most of all I can see Clare in her isolette or in her cradle, with her little gavage tube taped to her face and the wires from the monitor sensors snaking their way out between the snaps of her little sleeper.  I can see her bare right foot sticking out from her sleeper and her swaddling blankets, exposed so her PICC line can be seen at all times.  Most of all, I see barriers between us, her on one side and Tim and me on the other.  It's amazing to look at Clare now, wearing her own little clothes, completely free of wires and leads and tubes.  

Clare has spent a lot of today awake, her now-tracking eyes scanning her new environment. One of my favorite memories from today is when we laid her on the couch all swaddled in her blankets and both of us leaned over her and whispered to her.  She was completely still and quiet, her eyes traveling between us from one to the other and back again as if she was straining to listen to what we were whispering and trying her darnedest to understand.

Tim will no doubt blog tomorrow and share his perceptions with you.  He was going to tonight, but he got too tired.  He's now snoring in the bedroom.  I think I'll go join him.

Things are looking good

It's the middle of the night and I'm watching Tim sit in the rocker in our room at TG and feed Clare.  He's incredible with her, confident and motivated and unafraid.  He is so clearly crazy about her.  Now he's measuring out how much Clare consumed (over 50 mls!) so we can call our nurse and report it.  Her consumption has been so good that the nurse believes we'll be able to get out of here pretty quickly in the morning (how about now...?).  We will no doubt be renting a scale to keep track of her weight and how much she consumes via me.  We are indeed eager to get home and get settled in.

As we look to our move home, we have to keep a few things in mind.  Clare is still a preemie and won't be a term baby for four more weeks.  She is still easily overwhelmed and tired out. As much as we want to show her off and pass her around, we've been warned to keep her activities focused on building her relationship with us so that she feeds well, gains weight, and thrives.  We feel like we're well on our way:  Clare is opening her eyes to look at us more frequently than she did in the ICN, which indicates her readiness to interact with us. Nonetheless, she is going to do best if we shelter her for a few more weeks yet.  I want so much to say, "everyone who's wanted to meet her, hold her, and play with her, come on over!"--but we can't yet.  I just hope that you'll keep us in mind over the month of July and that, as we get closer to that due date of July 24, that you will still want to come meet her.  We will keep updating the blog to let you know when she will make her debut into society.  Until then, please know we appreciate you, your thoughts and prayers, and that we are very eager to share Clare with you just as soon as we can.

bubbles in the bathtub

Last night at 10 PM was Clare's first bath.  I guess this is a monumental event, because we were supposed to bring our camera and such.  My first bath picture has me buck-naked in full stride on the floor of my grandparents Jamieson's bathtub, my Grandpa's huge hairy carpenter arms holding me by the armpits.  We opted out of the camera experience, thinking that it might be more informative to pay attention, and it was.  We had to find out that we have to hold her by the neck with the non-dominant hand and wash her with the dominant one with shampoo, albeit not much and in tepid water.  

This is usually a difficult task, not well-loved by newborns, but Clare LOVED IT!  She had the best time, smiling and wiggling while the nurse did 90% of the work.  

Unfortunately, it got her all worked up.  She stayed awake for quite a while, and slept very restlessly, and because of that, we did too.  Additionally, we had feeding sessions that took a long time and usually ended with her not eating much.  On top of that were the phone call reports and visits from the nurse.  On the whole, I think that I slept about 3 1/2 hours total, and Amanda didn't sleep pretty much at all.  

We were frightened.  Not of the whole lack of sleep new parenting thing (c'mon, that's a given--you don't think we knew that was going to happen?), but of the low amounts of milk that Clare drank during the night.  She barely stayed above the minimum necessary for her to maintain her body weight, according to a formula that the nurse shared with me over the phone at 5:10 AM in a fifteen minute detailed conversation involving mathematical formulas that she expected me to explain to Amanda (good thing I wrote them down with a Sharpie pen on paper on a white countertop--oops!).  

In the morning we raised a little hell, with perhaps one of the best nurses we've had at this hospital.  We told her flat out, "what if she doesn't eat enough and she ends up back here with a feeding tube in her nose?!" and the nurse first replied that "if that happens, it happens" to which we freaked (of course).  I think I said "so I can look forward to sitting in the ER at 3 in the morning with a low temperature baby waiting to have a tube put in her nose when we already knew she wasn't eating enough?", to which our nurse replied that this wouldn't happen; if we go through this exercise and she isn't eating enough, she'll stay and get a tube, we'll go home and try in again in a couple of days.  Phew.  That felt better.

Our nurse went the extra mile though and explained how this was beneficial for us, plus that hospitals are becoming cesspools of difficult-to-treat infections, and the sooner we can get her out of here, the better.  The best part was not that she told us this; she could have given us a long and quick clinical explanation, and she didn't.  She sat and talked to us.  She asked us questions, and listened to our responses.  It is interesting that some of the skills that make the difference between a good teacher/administrator and one who really can reach out to students are the same skills that make a great nurse.  

Then, for some reason, Clare turned a corner on the feeding at 9:10 AM. She ate 38 mls then, rather quickly.  Then, two hours later, 48 mls.  Four hours later, 50 mls.  Three hours later, 52 mls.  Because of her above-average feedings and her stellar performance in the car seat (in which she slept for three hours and gave us some much-needed rest), she's pretty much sure to be released to go home tomorrow.

First Knudson Family Vacation, Day 2

We are staying an additional day at the hospital, rooming in with Clare and getting to know her and learning to master the little dominance games that even preemies play to get what they want. We've been working with a great nurse all morning who has taken the time to sit down with us and really explain what's going on with the demand feeding, including the philosophies and reasoning behind it.  Again we are reminded that the whole sucking, swallowing, breathing thing is a learned behavior for a preemie, whereas it is an instinct for a newborn.  A skill is a skill, and we find it interesting how much of the pedagogy we use every day with kids applies to Clare's acquisition of eating skills.  It makes us feel more comfortable with the whole process.  And I suppose we've come to terms now with the knowledge that we won't be bringing her home today after all.  It might be tomorrow, it might be this weekend...we don't know.  Potentially, we could be staying at the K Street Sheraton tomorrow and tomorrow night too.  It doesn't sound at all appealing...I want to be home with my pets and sleeping (or not sleeping) in my own bed.  But things could be worse.  We started this whole odyssey over five weeks ago by staying in the hospital, and we're ending it the same way.

We are exhausted and both look like we tumbled down several flights of stairs.  Tim got it perfectly when he said this feels like a bad air travel experience, like our flight was cancelled and we got stuck spending the night on the floor of the Omaha International Airport.