Archive | June, 2018

Welcome, Amos Elliott // Our NICU Story

First photo as a family of SIX!

All right, the story continues! When I left off, Elliott, our new baby, and I had just moved to the postpartum unit around 7pm, and our baby was doing pretty well. Elliott had gotten my dinner order and left to pick up a celebratory meal of sushi and sparkling wine.

The night nurse took over, and around 8:30 while Elliott was gone she came in to check on our baby. She spent a while watching his oxygen saturation and his respirations, which unfortunately had picked back up to 90 breaths/minute. To my dismay, she then called the NICU team to come observe him again.

The NICU team came in, and the NICU fellow saw our baby for the first time then. Crushingly, she made the call that he should be transferred to the NICU. She felt like he needed extra breathing treatment and antibiotics, as well as closer observation by the medical team. The tentative diagnosis at this point was TTN — transient tachypnea of the newborn — and she wanted to address his slightly labored, rapid breathing and find its underlying cause.

I texted Elliott to give him the update, knowing there was nothing I could really do (with a clean conscience, anyway), but panicking slightly because I knew things were slipping out of the range of “normal” and we were headed for a whole new world with our baby.

I took this photo as I followed our baby to the NICU with the two NICU nurses. He was calm on the way over and as they hooked him up. Elliott found me there, both of us feeling bewildered and like we had lost a lot of control as parents. The nurses said they would be putting in an IV now and starting CPAP (continuous positive airway pressure, a form of breathing treatment to open up his lungs), and did we want to take a little break to eat our dinner? I couldn’t nurse him or do anything to help, and our baby seemed calm and at peace. We left, feeling helpless.

Amos in the NICU

When we returned after our “celebratory” meal, we found our baby screaming in his NICU bed with 4 holes in his arms and feet from failed IV sticks and also two little plastic tubes stuck into his nostrils blasting air into his lungs. I started crying just looking at him–I’m about to cry again just thinking about it. I cannot imagine how parents go through agressive medical treatment with their children on a regular basis!

Elliott was upset because he wasn’t convinced that any of the treatment was necessary, and, even days later, I am still not sure if it was. The medical team decided to stop the CPAP early because our baby was just not tolerating it, and holding him in my arms and nursing him and seeing his peace and comfort after that was one of the sweetest reliefs I’ve ever known. The medical team also started antibiotics at that point, which they hoped would clear out any infection in his lungs due to the fluid they had seen on a chest x-ray.

Father’s Day in the NICU… not anyone’s first choice!

Elliott and I stayed for another couple of hours, with me nursing as much as I could. Our fear was that being away from our baby (me on the postpartum unit on the 8th floor, him in the NICU on the 7th floor) would mean my milk would not come in like it should. The nurses talked about pumping to increase production, but I wanted to just try to nurse as much as I could and go from there. I had no idea what I would do if our baby had to stay longer in the hospital than I did… but I would cross that bridge when I came to it.

Eventually, around midnight, our nurse encouraged/sent Elliott and me up to our postpartum room to sleep for a few hours. Our baby was calm and fed. The nurse agreed to text me from her hospital phone as soon as our baby woke up hungry.

Sure enough, at 4am she texted, and I slipped on shoes and hurried through the hospital in the middle of the night in my gown and robe to nurse my little one. I was able to lay him down after that, slipped upstairs to sleep again, and then returned again at 6am.

And thus began our hazy, harried two days of postpartum and NICU life. I spent almost all my time at our baby’s bedside, and Elliott was with me almost every minute, too. We took turns holding him, and I nursed him whenever he seemed hungry. Every few hours I would slip back upstairs to clean up — since I was still bleeding a great deal after having delivered a baby only hours before — and shovel food into my mouth from whatever meal tray was waiting for me in my big, sunny, gorgeous, very empty postpartum hospital room. Elliott would hold our baby while I was gone, and almost always I was away only for 15-20 minutes before he was texting me to come back and nurse.

Whenever I was on the postpartum unit to eat, the nurses and techs would hurry after me into my room to offer me pain medication (thankfully I really wasn’t in any pain), take my blood pressure and temperature, and make sure I was feeling ok. Then I would be gone again for hours.

Elliott in our postpartum room, where we slept for two nights.

Our hours at our baby’s bedside were slow and uncertain. I never knew you could spend so much time staring at a tiny baby, gazing deeply into his face, both of you locked in on him, praying endlessly for and about so many things, wondering what was going on inside him, what tomorrow would hold, how we had gotten here… and what we would name him! We felt unmoored, being away from our other children and so tied to this brand new, unknown, completely beloved little newborn son.

Lena, Gil, Forest, and my parents-in-law came to meet our baby after church on Sunday. He was almost 24 hours old then, and thankfully doing pretty well. The children were all able to hold him, and we were so grateful to see them all together, but also emotional with the unknowns and lack of sleep.

Lena and “Marmee,” Elliott’s mom, meeting Amos for the first time.

We also finally decided on a name that afternoon. We had gone around and around with a few final options. Naming children is so hard! At long last, we chose Amos Elliott for our little boy. “Amos” is for the Old Testament prophet who followed God’s call to prophesy in Israel despite his everyday vocation of shepherd and gardener, and who spoke a message of covenant faithfulness and justice. “Let justice roll down like waters, and righteousness like an ever-flowing stream.” (Amos 5:24) I have loved that name for a long time, and it grew on Elliott over the hospital stay as we discussed it, until we both sincerely loved it more than any other choice. We chose “Elliott” for his daddy and also for the heritage of the Elliott family (Amos’s grandmother’s family) and their faithfulness to God as pastors, fathers, and people of God throughout their whole lives.

And so: welcome to the world, Amos Elliott Garber!

How we spent the hours!

That second night of NICU life was similar to the night before, but then around midnight the medical team ordered another chest x-ray and blood draws. I was alone with Amos and growing increasingly exhausted, and Amos’s nurse could see it. She finally suggested I go sleep and she would text me as soon as he woke to feed.

When I came back around 3am, Amos had been moved to the “step down” side of the NICU for healthier babies who were getting ready to go home. Such good news! I fed him twice that night, and then Elliott and I stayed with him that whole day, waiting for an update from the medical team.

We were thrilled to hear that the plan was to send Amos home that evening if all went well — which would also the same time that I would be discharged. Amos had finished his course of antibiotics, and his breathing rate and oxygenation continued to stay within normal range now. Whenever anyone asked me how I thought he was doing, I could say with a clear conscience that he was behaving just like my other newborns. He was nursing well, I could feel my milk coming in, and he didn’t seem distressed at all with breathing, eating, or sleeping. I couldn’t wait to get him home!

One last burp before getting in his car seat. Amos’ monitor is empty behind him for the first time because he has been discharged!

Finally, around 6pm, we were ready to go! His nurse took his IV out of his tiny little hand, checked my ID and his arm bands before cutting them off, and gave us a folder of paperwork. Then we buckled our little Amos into his brand new car seat — and left for home!

As soon as we pulled up, all three of our older kids raced off the porch where they’d been waiting. My heart swelled with joy to see them all dashing down the steps — Forest pausing to turn around and carefully go down backwards — and standing by the gate until the car door opened and they could hop into the van beside him. Those first few minutes of bringing a new baby home are always so surreal and precious, especially after a more eventful hospital stay.

That night Elliott and I slept beside Amos somewhat nervously, unsure how his first night at home would go, but he did so well and slept just like a newborn — even deciding he was ready to get up for the day around 4am! Welcome to real life at home, right? Since then Amos has continued to behave like a normal newborn, complete with plenty of blown-out diapers, 5am wake-ups, and sour milk running down our arms and over our shoulders — and lots of darling newborn grunts, squeaks, and snuggles, too. His breathing also seems normal, both to his pediatrician and a home health nurse that came to visit us, and to all of us watching him at home, too.

While we’ll never know completely what was affecting Amos’ breathing — an infection in his lungs? his lungs taking a longer time to transition out of the womb than normal? extra fluid? all three? — we’re grateful now that he seems unaffected by his rougher start to life. Thanks be to God for health!

Amos after his first night in the NICU. So thankful he is home safe and sound!

22 :: in Amos, family, motherhood, Virginia

Welcome, Amos Elliott! // His Birth Story

I am sitting here in bed beside my sleeping newborn, sipping my second cup of coffee, listening to my mom play with Forest upstairs, unable to believe this is my life! I have absolutely nothing to do, nowhere to be, not a thing more important in this world than to sit right here and soak this in. What a glorious, unsurpassable, and fleeting privilege. The labor is finished. The joy is so sweet.

Before these days fly by too quickly, I wanted to capture them in the way I have before — with the story of our new baby’s birth and first days at home.

(Gil’s birth story is here. Forest’s birth story is here. And Lena was born before this blog began!)

39 weeks!

Those who follow me on Instagram will know that our fourth baby’s due date came and went without event. My mom went home that morning after waiting with us for two days, I took the kids to their last day of VBS at Portico Church, and then Forest and I walked for the 3 hours of VBS… trying to get things started!

I felt frequent, painless contractions, but I’d been feeling them for weeks. My membranes had been stripped for the second time the day before and my midwife had exclaimed that I was “four centimeters but I can stretch you to six!” so it seemed like something could happen any minute.

But it didn’t.

The afternoon passed. I cooked what I referred to as “my last supper” (aka the last meal I wanted to cook for a long time, if I had a choice) and invited my in-laws and brother-in-law over for BBQ chicken and cornbread. We ate out on the porch, me feeling hot and exhausted, uncertain how much longer I would be in this limbo.

Later that evening, around 9pm, I felt like maybe my water had broken, but it was such a small amount of clear fluid that it seemed unlikely. I’ve always had my water broken at the hospital right before each delivery, so I didn’t really know what the experience would be like. Birth is such a unique experience each time, even your fourth time around.

Eventually I called the midwife on call and told her I thought my water had broken, and after talking to me for a while, she surmised I probably had a “high leak,” meaning the bag had broken but would just trickle for hours, and also she wasn’t entirely sure it had broken at all. Elliott and I watched the last episode of C.B. Strike while we waited, and when the leaking didn’t seem to continue, we called the midwife and decided to come in the next morning after a night of rest. More than anything I hoped that labor would start naturally in the night and I wouldn’t need to be induced.

I didn’t rest well that night, of course, and the leaking continued. Also… no contractions. At all.

The next morning I checked in with the midwife on call and made a plan to come in around 9am. We ate a huge, delicious breakfast of blueberry pancakes with my in-laws and then left our three children in their capable hands. Around 9am, Elliott and I finished packing our bags (just in case) and drove to the hospital holding hands… probably to have a baby.

Driving to the hospital to have a baby!

All was quiet on the L&D unit; we seemed to be almost the only patients there. We settled into a triage room, and our midwife did a couple of tests to see if my water really had broken. Yes, it had! So now I needed to get some antibiotics (due to being GBS positive), and after 4 hours she planned to start some pitocin to help the baby move down, then break my water, and then have the baby.

Settling into the labor and delivery room… always a surreal experience.

It was now around 10:30am. I got an IV, moved into a regular L&D room (the nicest on the unit, and with a tub–that I would never use!), and met my nurse, a peaceful, kind woman. She started my antibiotics, and my midwife started some aromatherapy as well, which was a relaxing touch.  

A little light reading while in labor. This book is HILARIOUS, highly recommend!

Meanwhile, two things started happening. The first was that I was having contractions now that were 3-5 minutes apart, and were growing slightly painful. Around 12pm, the contractions picked up, and I was now having to breathe through them. My nurse changed the position of the bed so that it was like a giant chair, and we talked between the contractions, which were about 3 minutes apart now.

The second issue was that the baby’s heart rate had gone up, and was now consistently 190 beats/minute (when it should be 140s-150s). My midwife was getting concerned, so she gave me a bolus of fluid and also brought the attending MD on call in to meet me just in case things got more serious. She also finished breaking my water (there was a pocket of water around the baby’s head), which would certainly speed up labor.

I got up to use the bathroom and saw what I thought was meconium (baby poop) in the toilet. This shows the baby is probably in distress and needs to be born quickly to prevent infection and aspiration of the meconium. I reported this to my midwife, who thought it was unlikely, but checked.

I was right, unfortunately.

(I learned later that this was a pretty tenuous time, and I was beginning to be in danger of a c-section because of the baby’s distress.)

Meanwhile, after using the bathroom and having my water broken, the contractions had really picked up. I have never had an epidural, but after my midwife checked me right then and said I was still only 8cm, I started to think about asking for one. I thought I still had a ways to go, and it also always takes me a while to push because I don’t have that classic “urge to push” that so many women do. I thought I had at least an hour of misery still ahead of me. I’ve done this same thing three times already, and I knew so well that harrowing tunnel of pain that I had to get through in order to have a baby. For a few moments, it seemed more than I could bear again. I said the words in my head, trying them out, imagining me saying them out loud. “Can I have an epidural?”

However, when the next contraction hit, I decided to push just to do something through the pain, and I could feel the baby begin to move. I tried again as my midwife hastily pulled on her sterile gloves and gown. Then I pushed again, and my midwife told me firmly that I needed to do that once more right now. Elliott told me later this was because the baby’s head had already been born, and I had no idea. I buckled down and did what she said, pushing with all my might, and our baby was born in a glorious, familiar rush into the world.

Elliott soothing our baby while the NICU team worked on him. He was so responsive to Elliott’s voice–became so calm when Elliott talked and said “shh”!

They immediately put him up on my chest and everyone started rubbing and patting him because, terrifyingly, he looked pretty gray. He also wasn’t crying out or opening his eyes like all my babies have done right away. I could hear the charge nurse saying, “Come on, baby. Hmm, I don’t like this.”

Knowing he needed to be skin to skin, I opened my floral robe, only to remember I’d kept on a cute nursing nightgown… everything had happened too quickly to change into a hospital gown! Word to the wise: forgo cute and be prepared.

Elliott and I were thankful, in awe, and slightly worried all at once. He was here! He was definitely a boy! He had all 10 fingers and all 10 toes, and a mop of dark brown hair, and he looked so much like his siblings right away. Our baby, on my chest, in our arms! It is miraculous and insane and glorious that we have been given this unbelievable gift–a child, a baby, our own flesh and blood–not once, not twice, but four times now. Thanks be to God!

But even as we gasped and marveled and touched him for the first time, the medical team was getting increasingly concerned. After a few minutes of rubbing him on my chest, they whisked him away onto the baby warmer right as the Pediatric team from the NICU finally strolled in, shocked to find the baby had already been born. They went to work suctioning his throat and nose and watching him, and eventually he pinked up, but he was still breathing very very quickly (about 90-110 breaths/minute when the acceptable average is 40-60). His oxygen saturation was now consistently in the low 90s, but would often drop to 85-89%. (Although the acceptable average for babies is 85-95%, the ideal in all humans is 98-100%.) When they did give him back to me, I tried to get him to nurse, but unlike all my other babies, he didn’t seem to have any interest. He was just too exhausted from breathing.

After nursing him for the first time — so thankful he’s doing better!

An hour went by of observation, snuggling skin to skin, and monitoring. Finally, after about two hours, his breathing rate had slowed down a little, and he seemed more relaxed, less strained. Our baby was able to nurse, and I was so relieved and thankful to see him respond and latch on. I’ve always nursed my babies within minutes of birth and been so thankful to see their reflexes kick in to nurture themselves. The relief was all the sweeter this time after waiting a couple of hours.

Around 4:30 the nurses felt comfortable enough with his breathing to put him through the distress of his first shots and weighing and measuring him. We were all astonished to learn that he was a hefty 8lbs 13.6oz! Almost 9lbs! Lena was 8lbs 4oz (two days late), Gil was 8lbs 3oz (5 days early), and Forest was a little peanut at 7lbs 7oz on his due date. Where did this huge baby come from?! Everyone was assuming he’d be smaller since he was so active in utero and even turned sideways two weeks before his due date. Athletic little guy, beefing up in there!

Elliott’s Father’s Day gift… a day early

Elliott went out to get me a snack and came back with a huge mocha from the coffee stand where I used to get mochas between nursing school classes in college. I hadn’t had one in years but so many memories came rushing back! He was also bearing two slices of pizza and a giant M&M brownie. Food never tasted so good. Our nurse nodded in pleased approval as Elliott fed me the pizza and I nursed our precious newborn. All as it should be!

Around 6pm the medical team gave the OK for us to move from the L&D unit to the postpartum unit, which also meant that our little boy didn’t have to go to the NICU. Sweet relief! I was feeling great at this point, so I walked over to the unit instead of riding in a wheelchair. Little did I know I had a lot of walking and time on my feet ahead of me.

We basked in the spacious beauty of the postpartum room, something we’d been looking forward to for months. The huge windows looked out over UVA, and we had a stunning view of the Rotunda, St. Paul’s steeple, and even glimpses of the Corner. Elliott left for about an hour to pick up a huge celebratory sushi dinner and a bottle of Flying Fox sparkling wine that we’d been chilling in the fridge since our babymoon.

Beautiful postpartum room at UVA.

And now, dear readers, I’m going to take a break here. I’ll be back soon with the rest of our hospital story, as things took a turn for the worse right after this and there is much more to tell! To be continued later this week…

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