Part 7 - Blue Baby

We will never forget the smell of the NICU - the smell of antiseptic wash and the humid, oxygen filled air from the isolettes. As soon as the elevator doors opened the smell would hit us and our steps would quicken with the anticipation of seeing our son again. We would come home from the hospital and breathe the smell of our hands and our clothes, aching to see our son again.

Lucas' journey through the Neonatal Intensive Care Unit was relatively uneventful. Immediately after entering the world, he was intubated, a ventilator doing all the breathing for him. He was born weighing 1140 grams (approx. 2 lbs, 8 oz.) and 37.7 cm long. It takes a lot of people and equipment to care for a baby so small - someone told us that (for the first days) Lucas' care cost about 25,000 dollars...a day. We are immensely grateful for Canada's medical system - I'm sure there are a lot of problems with it, but, especially for Canada's tiniest patients, the system works. The care he received was truly amazing.

After only two days of being ventilated, the medical staff decided to try him on C-PAP, which stands for Continuous Positive Airway Pressure. A premature baby's lungs are not developed fully, and don't have the lubrication required of them to stay open while another breath is being drawn. A preemie will usually be given a dose of lubricant (usually from a pig or a cow!), called surfactant, to encourage breathing, but it usually takes a while for the little body to start creating it's own surfactant, and then for the brain to make the connection to keep breathing. C-PAP is a device that keeps continuous pressure on the lungs, but requires a baby to do all the breathing on his own. It is a huge, ugly box-like contraption that is strapped over the nose using a hat. A lot of babies will tolerate C-PAP for a while and then get tired, and will have to be ventilated again. Lucas tolerated it like a pro, and after only a week he was taken off of C-PAP and given oxygen prongs to assist his breathing.

He also tolerated his feeds very well - he had a tube that first went down his throat through his mouth, and then after he was done with C-PAP, it went through his nose to his stomach. They started with 1 cc of milk (the same as 1 mL) and gradually increased to full feeds 10 days after he was born, which meant they could remove the IV. Full feeds meant 14 cc's. Less than 1/2 an ounce. I was still bruised from my IV, so I was very relieved that my little son did not need an IV anymore. The last IV needle they put in had to go in his scalp - they had used all the veins in his little arms and legs. I watched as they shaved his hair, held him down and stuck a needle into his head - a head the size of a baseball. His tiny cries sounded like a mewing kitten and broke my aching heart.

Before a premature baby is discharged from the hospital (in Canada), he needs to be breathing and eating unassisted - no oxygen, monitors, feeding tubes. He also cannot have any A and B spells for at least 5 days. A and B's, as they're called in the medical community, stand for Apnea and Bradycardia. Apnea is the cessation of breathing (a baby 'forgets' to breathe) and bradycardia is a drastic drop of heart rate. They often come together, and we learned how to tickle Lucas' tummy or pinch the bottoms of his feet (sometimes quite hard!) to 'remind' him to breathe. A and B's happen very frequently in the NICU, and are often no cause for concern for the nurses - just part of the job. Remind the baby to breathe, check. Holler, "It's okay" if the monitor continues it's alarm for longer than a few seconds, check. Look for blueness around the mouth, check. I learned how to appear calm and respond well. But my poor mommy heart was often near my toes...how many times can a mom see her baby turn blue? How many times would I, in the middle of a snuggle, have to start pinching the bottom of Lucas' tiny feet? How could I keep my eyes off the monitor, checking every beat of the recorded heart rate, checking his oxygen saturation level, his breathing rate? They told me to "enjoy the cuddle. Don't watch the monitor." HOW is that possible?

Eight days after Lucas was born I was permitted to change his little diaper, and then to actually hold him. Eight days. Both his nurse and a respiratory tech were required to be there. I sat in the glider chair and took my son in my arms, trying not to tremble. Trying to stay relaxed. Trying not to cry. A little warm doll in a gigantic blanket. His nurse told me not to watch the monitor. I tried not to. He opened his eyes, wrinkling his forehead with the effort, and squinted at us. Colin shielded his eyes from the dimmed light and sang Mozart. I swallowed huge lumps in my throat and sang "You are my Sunshine." Then the nurse positioned him back into his isolette.

With aching hearts full to the brim, we said good bye again.