Sunday, February 26, 2012

Titus Jacob Runyan- Two Weeks Old





2/12/12
10:31pm
6 lbs 4 oz
19"
Mt. Timpanogos Regional (Orem, UT)

Saturday, February 18, 2012

The NICU and HOME!




At his second check they found his blood sugar levels low, so they gave him a bottle of formula without even asking me. He zonked out and didn’t want to nurse the rest of the night. Finally around 7am I got him to nurse a little bit. When the new nurse came in a little later and heard him moaning or “singing” with each breath she became a little concerned. She asked how long that had been going on. I told her he’d done it some during the night, but the previous nurse had taken him and found his O2 levels to be okay. She took his temperature and said that was a little low too. She asked if it’d be okay to take him and have him evaluated again.

Jake woke up, breakfast came, and the pediatrician came by too. We told him our baby was in the nursery, so he said he’d go and meet him and come back to talk with us. We waited and waited, and waited. When he came back he said that Titus was showing symptoms of many “Late Pre-term Babies”. He said that Titus’ blood sugars were low again, that he wasn’t maintaining proper body temperature, and that his breathing patterns and oxygen levels were not where “we want them to be”.

After a little discussion we decided to admit him to the NICU where he could have an IV of sugar water to keep his blood sugar up, but then I could still try to nurse him. I really didn’t think he’d be in there too long. When Josh was born, he’d also done some grunting and went to the NICU to be on oxygen, but was only there about 3 hours. When we went to the NICU to check on him they had him hooked up to all kinds of monitors! They explained that the heated bed would regulate his body temperature, that they had hooked up his IV, and that they were monitoring his breathing and O2 levels. He was “holding” his breath for seconds at a time a couple times a minute, but would return to normal breathing patterns, and so far had not had to be on oxygen. They said that his body was so tired after those first hours of life doing everything else, that he was not showing any desire or even readiness to attempt nursing again.

Monday was the hardest day. It was so hard to see him so still, hooked up to all the monitors, and feel like I was useless. I wanted to pick him up and hold him, and try nursing him. I was advised though that his body needed time to focus on other things, and I should wait till he showed signs of being ready. My mom had changed her flight to come in that day, and her friend Lynne picked her up and brought her by the hospital before taking her to Heber to relieve Becca from kid duty. They were the only guests besides Jake and I to go in and see Titus in the NICU. Access was strictly limited.

Though Monday was a really hard day, there were a couple of blessings to come our way. You would think that having gone from 6 cm to complete in one or two contractions I would have torn and been in a lot of pain, but I didn’t tear at all! My recovery was very easy. This was a huge blessing, because had I been dealing with a lot of pain and unease on top of having a baby in the NICU things would have been much worse. All the nurses were surprised to see me walking so quickly to and from the NICU. The other blessing was that even though I was able to “check out” of the hospital Monday night, because we live further than 30 minutes away we qualified for “boarder privileges”. Basically the hospital let us stay in the room (unless they got really busy and needed it, in which case we would have been kicked out) for free while Titus was in the NICU. I wouldn’t get assistance from the nurses or hospital staff- but I had a room right there. Jake still wanted to go to a nearby friends’ house that first night and sleep in a “real bed”. I convinced him to go home to our kids and get some real sleep and collect a lot of things we hadn’t had time to think about getting when we left.

After he left I had some quiet time to myself to sit and process everything. I was reading through some materials about breast-feeding and the power of skin-to-skin contact. I felt very thankful I’d at least had that first night to connect with Titus a little, but felt a huge need to hold my little baby boy. I said a prayer that I would be allowed to hold him and try nursing him again. I kid you not, it was less than an hour later that I got a call from the nurses in the NICU saying that Titus was awake and wanting Mom. I texted Jake the good news, said a prayer of thanks and practically ran to the NICU to hold my baby. It took a little bit of effort, but Titus was soon nursing and we had a sweet bonding time together. When he was done the nurse told me that Titus and I should get some rest so that we would be ready for the next feeding. About 3 and ½ hours later I got a call again, and happily woke up and headed down the hall. He again nursed well. At his next awakening he wasn’t as interested, but we were all happy to see that his oxygen and blood sugar levels were looking much better. They began decreasing his IV drip with each good nursing session and his blood sugar levels stayed up each time!

Jake came back and was trying to tell the nurses that we’d be taking him home that day. They all smiled, but the pediatrician that saw Titus that day said that once he was weaned completely from the IV, could maintain his body temperature without the bed warmer, and as long as weight and oxygen levels stayed good, then we could take him home. By that afternoon they had the first successful attempt of taking Titus of the bed warmer. He was maintaining heat levels by himself! We were so excited. Jake and I took advantage of our NICU babysitters and went out for Valentines Day, and to celebrate his Birthday. We went to Carrabas at 4:30 before the rush, and the to The Chocolate for dessert. Jake went home again that night to help with the kids at home.

Wednesday morning Titus was completely independent of all the NICU equipment. The nurse said he’d even pulled out his own IV that they’d left in just in case they had to hook him up again. Now they were concerned about his Billy Rubin levels though. When the pediatrician came into consult I told him we really wanted to take him home that night. He said we’d better get him under lights for the next 6 hours and run one more infection test, and if in the afternoon those things looked better, and his weight was good (he’d dropped a little more during the night than they’d hoped) that he would okay us to go. I was only allowed 30 minutes with him away from lights for feeding, so Jake fed him a bottle of expressed milk while he was under the lights to make sure we were doing everything we could. Jake and I could not wait for 3:30 to come. Sure enough, Titus, our fighter, did everything he needed! We were discharged and heading home!

It felt so good to be home, to have the kids meet Titus. To be away from all the NICU beeps, cords, and equipment. I was so happy, and though I’d been a bit nervous about bringing this fragile guy home, he has been thriving. We took him for his last Billy Rubin test and to the pediatrician on Thursday, and he was given a clean bill of health then too. I can’t believe tomorrow will be one week since TJ’s birth. In some ways it has felt SO much longer than that, but in other ways I can hardly believe how fast its all gone. I’m just happy he’s doing so well!

2/12/2012 The Day Titus was born



While we were at church (1-4pm) I had a few contractions that felt low and crampy, much more labor-like than the Braxton Hicks I was used to feeling. We got home and I started making dinner and Becca was trying to decide if she should leave right away while there was still light, or stay for dinner. I was feeling pretty painful contractions consistently at this point, but all I’d told Jake was “I’m really not feeling well”. I had to sit down a couple times though, and Jake noticed this and asked, “are you okay?” I told him that I was feeling serious contractions and looking to Trish said, “Becca, we might want you to stick around for a bit longer…” Jake ordered me to sit down and start timing the contractions. When we found them to be between 3 and 5 minutes apart, and getting stronger. He ordered me to call my midwives.

I’d been planning on delivering with midwives at a birthing center in Orem. Given our high deductible insurance, my ease of pregnancy and labor it had seemed like a good idea when I first found out I was expecting. When we moved to Heber we did get a little nervous and look at changing things. However, there were no midwives or OBs even here in Heber- only GPs who do deliveries. The new hospital in Park City had a great midwife, but everyone told us that if a storm hit, driving that direction was more dangerous, even though it would be closer than going down to Orem. I ended up sticking with midwives simply because nothing else seemed to really fit us.

Then here, at 36 weeks I knew I was too early to be able to go through with our “plan”. I called the midwife group and explained my contractions and asked if there was anything I could do to slow/stop the labor and what I should do. They confirmed that unless I was to my 37 week mark, they would not be allowed to deliver me, and given my history of going fast and early (though never THIS early) that I should go to a hospital close by to at least be evaluated.

Jake and I were in shock. We started throwing things in a bag, but kept timing contractions hoping they would slow or stop. Finally we said goodbye to Trish and the kids and headed out the door, saying, “we’re just going to the Heber hospital to check things out”. We left our house a little before 6pm.

When we arrived at the hospital and told them I was 36 weeks and having consistent contractions they looked a little doubtful but said, “Okay, well lets get you hooked up to the monitors”. Once the nurse had me hooked up and saw that my contractions were consistent at about three and a half minute she called in the GP. He checked my cervix and said I was at close to a four and asked me a lot about my history regarding my other pregnancies and deliveries. He said he wanted to put me on an I.V. and see if just getting my hydrated might slow things down. He said that at 36 weeks it might not be worth doing more than that to try and stop labor. (Looking back I wonder why we didn’t talk more about what more they might have done). He also explained that when delivering early they usually want you at a hospital with a NICU in case the baby has complications- but with my history of going fast, they might prefer to keep me there. He said he was going to make a couple of calls, and left the room.

While he was gone they hooked me up to an IV and when he came back he said that they did want me at a hospital with a NICU and that they were calling an ambulance to take me to UVRMC, but Jake told them that was out of our network and asked if we could go to Mt. Timpanogos Regional instead. He left to make more calls, and came back saying that that would work and they’d already called them and told them I was coming. Right then I felt a gush of fluid with one of my contractions, and told them I thought my water had just broken. “No doubt now then, we have to get you down that canyon” was the doctor’s response.

Jake was extremely nervous and scared at this point. He didn’t like the fact that he would have to follow behind the ambulance down the canyon. When the ambulance team seemed to be taking their time getting me into the ambulance he said he wanted to scream, “get her down there- she usually goes FAST!” I was feeling really calm though, and told him everything was going to be okay. I even made him take a picture of me getting into the ambulance since it was my first time! We left the Heber hospital around 7pm and made our quick ride down the canyon.

In the ambulance my contractions got closer together and stronger, but we made it to the hospital just fine, and Jake was only a few minutes behind us. When they admitted me to the hospital they assigned me to the OB on staff, Dr. Gourley. After the nurse had me connected to the monitors he checked me and found me to still be at four centimeters, which was a bit of surprise. There was also some question on if my water had really broke back in Heber. Dr. Gourly had to break a bag of water- and when I asked if it was just a for-bag he said that he’d “learned not to argue with a woman who thought her water had broken,” that it could have been a just a for-bag, or that since they hadn’t done a pH test in Heber, maybe my water hadn’t really broken like they’d assumed. Again, now looking back, I wonder if maybe more could have been done to keep me from delivering so early.

I stayed at 4 cm for what seemed like forever. With midnight (and Jake's Birthday) no longer seeming too far off, we thought they just might share their Birthdays! I’d been on my back for a long time. I asked for an exercise ball, but whenever I thought about getting out of bed I’d have a contraction and lose the nerve. Jake finally convinced me to at least stand up for a bit, then quickly rolled the ball over in case I wanted to try that too. I sat down on the ball and found it more comfortable than I thought. The contraction would come and Jake would steady me and massage my shoulders.

The doctor had not been in the room since he first evaluated me, having gone to a sleeping room just down the hall. The nurse was in about every hour. I’d told them I was planning on delivering unmedicated, and so they pretty much left us to it. It was strange going back to this sort of set up, compared to my delivery with the midwives when I had Naomi. That time I’d had two midwives and a friend for a nurse buzzing around me the whole time I was there. This time it was pretty much just Jake and me. It was actually a very sweet experience. I think with so many women in the room when I delivered Naomi, he felt a little pushed aside or of no use. This time Jake was right there; coaching and comforting me. We put to use all the things we’d learn with Naomi. I’d been in labor from four to eight or nine pm and sat at 4 cm the whole time. But once Jake convinced me to get out of the bed and onto the medicine ball I could tell things were changing. My contractions were getting really intense now. The nurse came in a little after 10pm and I got back into the bed. She found me to be at 6 cm and could see my contractions were much stronger. She said she thought things were going to start moving really quickly. She said she’d get the doctor soon so they could be ready. As she was leaving I had a huge contraction with a desire to push. I screamed out for the first time. She came running back in and checked me, “Still at a 6” (“How can that be?!?!?!” I thought) but she told Jake to push the call button and commanded into the intercom, “get in here NOW”. As the next contraction came she told me to try to NOT push. I tried so hard, but let’s be honest, that’s like telling someone who’s nauseous not to throw up. You only have a little control; your body just kinda takes over. And with that, out came Titus’ head, into the nurse’s one gloved hand. “Push the call button again!” Jake pushed it, “We’ve got a head out!” Another contraction came just then, I tried not to push with everything I had, but out came baby- onto the bed. In walks the doctor, “We have a baby? How did that happen?!” Time on the clock 10:31 pm.

Titus started screaming. Jake, still worried about his preemie baby was counting all fingers and toes, looking him over good. “He’s perfect!” he declared. Titus was 6 lbs 4 oz, 19” long and got a 9 on his APGAR score. I was able to nurse him right away and he was doing great. They transferred us to a room, and told me that because Titus was early they would have to monitor him closely, checking on him every 2 hours, but he was able to be in our room with us all that night.

The night before...


This year Jake and I decided to celebrate Valentine’s Day a little early with a nice date to the Tree Room. We had a certificate that couldn’t be used on the holiday, and we figured it’d be easier to get a sitter on a different night anyway. We called “Aunt Trish” to see if she wanted to come watch the kiddos for us, and she agreed. Since it’s a bit of a trek to our house from her place in Lehi, she planned on staying the night that night, and was going to head home the next morning. Early Sunday morning Heber was hit with a huge snow storm though, and Trish was worried about going down the canyon with so much snow falling, so she decided she’d stay and go to church with us and wait for the storm to pass.