Holding Steady

Just before bathtime last night, Mish MoneyPenny had gained some 20 grams. Not a colossal gain, but not a loss, either: I'll take it.

The thing is, she seemed to do a great breastfeeding job on Lefty, but when she was done she still acted hungry -- starving, even -- yet wouldn't take Righty. Buh? So Mary the nurse said "what the heck, let's see if she'll take a bottle," and she sucked that thing down like a starving Armenian. Double buh? I have no idea what's going on. But later that night she took another bottle, the whole darn thing. So I guess right now bottles are easier than breasts, and neither is the dreaded tube, so I'm sticking with it. Because eating sans tube is a ticket home.

I can't talk her into enjoying her bath, strangely. Who doesn't love a bath? Well, right now the answer to that would be: Penelope. She squalls, then stops to check: am I still in the bath? Then she resumes squalling. Fortunately her squalling is both cute and hilarious, but I feel bad for subjecting her to such annoyances.

But these problems are so much more fun than the ones I was having a few weeks ago!

Blarg

So I guess we've hit a bit of a plateau, and I had a frustrating night last night. First of all, Penelope has lost weight for the third day in a row -- just a little, but still a loss, and she's certainly not gaining. I found out she has still been getting the OG tube -- and here's how I found out: I walked in and she was getting one. You know, this hospital is super responsive to the parents and has a very open-door policy, but sometimes I swear they are either weirdly passive-aggressive or they just don't really mean it when they say they want the parents involved. I understand that sometimes she gets tired and has to have the tube, and after the nurse explained that she was tired all day I was ok with her getting the tube, but what the hell? Can we talk about it? How about let me in on the conversation?

As with any other health-care situation, you have to advocate for yourself -- i learned that early on, when she was taken off feeds and they fogot about the milk that was in the fridge, so it went bad and had to be tossed. I try to read her chart when I get to the hospital, but there's so much going on with just the overwhelming emotion of seeing her again and getting her to breast that first time of the day that I sometimes forget. Whatever -- I'm there every damn day! It's not like I'm hard to find.

I also found out they've been giving her formula for the past two days because they ran out of the milk I'd frozen while she was sick. Now, I know intellecutally that formula is no big shit, but again, nobody could mention this? I'm redoubling my pumping efforts, and/but ...

... the milk I had with me yesterday? I idiotically forgot to put it in the fridge when I got there. I actually thought of it and then said "oh no, that's right, I left it home because I thought we were going to stop in again before going to the hospital." In fact, it was with me, but by the time I realized that it had been in the cooler for 12 hours and the nurses thought it was too iffy. I know this was entirely my fault, but I still wanted to punch the nurse when she told me it made her too nervous.

To make matters worse, Penelope was, in fact, super-tired yesterday, and every time I put her to breast she fell asleep before she was really done (maybe getting a full feed every other time). At around 9:30 or 10pm she woke up hungry, and latched on but wouldn't suck. She was rooting like an insane monster baby but just wouldn't seal the deal no matter what I did, and I got increasingly frantic and worried, which of course doesn't help. And I guess the nurses that were on last night just weren't the best match for us, because they just stood around and had no advice or encouragement for me...

big difference from two nights ago, when I had the awesome Chu and wanted to get an isolette of my own and just stay there. Jeez! Not only that, but when I finally decided to pump so she could eat fresh, I don't know what happened, but one of my pump bottles just disappeared... vanished! You know that thing where you just keep looking where something is supposed to be, because it's not possible for it to have just walked off? I just couldn't fathom that it had vanished, so in this tired, frazzled, frantic state I was poking around the bassinette for like a half hour at midnight.

I don't know. I'm used to having Randy there with me at night and he kind of drags me out of there by like 11, so I probably need a wingman to keep me focused after a certain number of hours.

All of this sort of gets made worse because the more I look at Penelope, the more I realize -- even as I see her developing to a closer-to-term baby -- that she is really supposed to be inside me right now -- always in contact, always in communion with me. It's maddening to have to put her down, let alone leave her for the night, when I realize that.

Blarg. So the plateau is this: she doesn't have the energy or skills to take enough food by mouth to keep gaining weight. so she still has to take every other feed via tube, AND she has to get formula some of the time because my production is good, but still not quite enough. (Ferinstance, I'm pumping as I type this, and I just finished -- totally under target. I should have had a snack before I started.)

But I'm still thankful: see this spread? One of the cleanup ladies, Angela, has taken a shine to another one of the moms and myself. She made all this food, plus soup, and set it out for us on the day after Thanksgiving -- the noodles were a special un-spicy version for nursing mothers. (She wouldn't let us try the one she made for the pot-luck the day before, because "too spicy for the baby! I don't wanna take the chance!") When I walked into the parents' kitchen and saw this, I melted into tears -- which indicates that I am still quite hormonal. And that people are really wonderful even when you're feeling homicidally stressed and apoplectic.

So, you know. The problems are small and will be overcome in a matter of days or a week or two. It's just a moment.

Thanksgiving

Oh goodness. It's Official Arlo Guthrie Gets Played on NPR Day, and I haven't checked in for three days. Whoops!

Penn continues to get bigger and better, except for the bigger part. We've switched to a feeding-on-demand schedule, and it's a few steps forward and a few steps back all the time. I'm learning how to figure out if she's really swallowing or not and trying to gauge how much she takes in, anxiously timing her breastfeeding, measuring post-breastfeed pumps, and making sure her diapers are wet when they're supposed to be. She's learning that for eight hours each day, the only food she's going to get is from me, and she'd better get to work. It's a bit of a learning curve for both of us, and she's actually dropped a little weight in the last two days (she's just a hair below 5 pounds now). But the nurses say that's to be expected, we're pushing her to eat and taking away the easy put-on-the-pounds tube, which can plump up kids quick but leaves them with no eating skills. All right.

So I can deal with a day or two of dropped weight (especially since she gained a freakish amount, 100 grams in one day, on Monday) as long as I see she's peeing and pooping. What I don't like is how fussy she was yesterday. Babies are fussy, I get that, but she just never settled down, and I kept putting her to breast, thinking she must be hungry. But even when I gave up and gave her a bottle, she was restless and seemed uncomfortable, and that just worries me. If it turns out she's a restless baby, fine; but so far, she's been very predictable, letting me know when needs something and settling down when she gets it. So this is unusual and I am looking forward to seeing her today to see if she settled down after we left. Randy did get her to sleep by the time we left -- at like 11pm. It's really hard to leave when she's fussing.

The nursery we're in is much more crowded -- fewer nurses to more babies, in less space. But it's the step-up nursery, where the kids don't have any real problems other than being small and dumb, and everyone is friendlier and more engaged with one another (especially the mom of the twins who's been in the same room with me from the beginning, except during Penn's infection). There are fewer beeping machines and less of a sense of pervasive dread. So that's a plus.

Anyway, here we are on Thanksgiving. I am thankful, of course, that she's doing so well. I'm a bit aware that I'd originally hoped to have her home today. I'm worried, now that I've met with her pediatrician, about keeping her safe from the flu and, of all things, whooping cough, which is apparently pandemic right now. But mostly thankful, yes, for Penelope and for the team that's been caring for her. Okay.

Movin' on up!

Let me tell you something, this little girl of mine is amazing. Today I went in to see her, and she'd been moved again. No biggie, I checked the other bays -- but she wasn't in any of the usual places. Turns out she and her roommates have checked into the "high observation" nursery -- down the hall, right off the "well baby" nursery. She's moving on up!

She's also up to 5 lbs 1 oz, maintaining her body weight, and as alert and aware as any full-term newborn. I have to keep reminding myself that she's still a pipsqueak, and as strong as she seems, she's still fragile and sensitive to noise, light and germs. To me, she's huge; to anyone else, she's still terrifyingly small.

But she's so vocal! She lets me know when something's amiss, and when I fix it, she stops fussing. That's magic!

The other big news from today is that we're switching to "ad lib feeding." That means she eats ___(noun)___ whenever she ____(verb)____. No wait! that's "mad lib feeding." Ad lib feeding means she eats on demand, unless she doesn't demand anything for four hours (not likely). And it means she eats directly from me whenever possible, so whenever I arrive I can just whip off my shirt and let her go to town, and I don't have to make her stop for fear of exhausting her, nor do I have to wait for feedin' time. Let me tell you, this child likes to breastfeed, and she's not shy about it. Which helps my cows come home, so it's win-win.

This might be TMI, but they have these little thingers that go over my nipples to make them smaller. Apparently, the fact that she CAN open up her head like Ms. Pac-Man and get it all in there is all fine and dandy, but it's also exhausting. Making them smaller lets her get more without working so hard, and bonus: it hurts less. So she was able to feed a lot more efficiently. The downside to that is that she was concentrating so hard on the suck-swallow-breathe trifecta that she forgot how to keep her heart beating a couple times (totally normal, that's called a Brady, remember?), so with so many steps forward she took a little step back. Remember, she's supposed to still be in utero, so her "dumb preemie brain" still has to figure some stuff out, and we're giving her time to do that. It's no problem. We'll continue to let her breastfeed, and give her stimulation if necessary -- a jiggle or two does the trick.

If she were doing that while lying in her bassinette, it would be terrible. But we know why it's happening so we're just continuing to let her figure it all out, and in a day or so she'll have it down.

She's very close to being released, but it won't be this week. Okay. That's fine! I can see where we're going and what needs to happen. She's not getting the stupid tube down her throat anymore, or much less, so I'm OK. (She'll only eat by breast when I'm there, and we'll track her weight carefully to make sure she continues to gain. If not, we change the plan.)

All in all, she's doing fabulously well. Sorry for the lack of pictures -- i was literally falling asleep at the hospital and barely made it home with my eyes open, but had to check in with you people. Photos of last night's bath should be posted tomorrow.

Quick Check-In

Okay, I'm less angry but have a million things to do, so I'm just going to say this:

All IVs are OUT
Which means no more sponge baths -- I gave her a REAL bath last night, I guess the first one since she was born!
She liked it -- at least, she liked it after she pooped in it and we had to change the water and start all over again. Randy said she was like a frightened squid.

More later!

A Rant

I think I've hit a wall with this whole experience. I have to say. I'm glad the hospital is there and I am grateful for the care, but I am so frustrated and tired of it at this point, and I want her out. I know that sounds crazy to everyone who isn't me, because Penelope sounds so small and fragile, but she's so much stronger than she was, and we're at an awkward point in her treatment.

I think all preemies go through a time where they are strong enough to object to treatment -- IV pokes, long hours of sitting alone instead of being carried and cuddled, and especially the blasted gauvage tube (the one they feed down her throat every mealtime) -- while not yet quite being able to leave the environment of the hospital. So I get that this is a bit of a transition. But it is not happening fast enough for me. The tube to her stomach is what really gets me steamed. She's surely ready for a bottle when I can't be there with my (really nearly useless) breasts, but they keep gagging her with that fucking tube, and I want to punch the nurse every time. She did not mind when she was tiny and weak. Now she's big enough to know it feels uncomfortable and wrong, and she hates it. I don't know what the hell is going on over there; I keep asking for her to be given bottles, and they keep NOT doing it without explaining why.

If it's an issue of her not being strong enough to maintain her body temperature and suck on a bottle, then put her back in the frigging isolette. I mean, how does that logic not make sense? Let her do one thing at a time, and let the first thing be what'll fatten her up so she can do the second thing. Explain where I'm going wrong with this.

Here's the thing: Who goes to hospitals? Sick people. My daughter's not sick. She's small. And fragile. And being around a germy hospital is not going to help. There's another mom in there with me, her daughter came at 32 weeks, 2 weeks after Penelope, and now she has a staph infection from her IV site. Are they kidding me? That's enough. I want her home and away from IVs and away from a million sick people and their germs.

Okay.

Today I do battle over the bottle. I want her eating like a normal person. Last night she spit up with the tube down her throat and I don't even know how that happens. And I just had to put her little bundled-up self back down in the isolette and walk out? I never saw my daughter spit up before. I'm tired of not being the one to take care of all this. She's my kid, hand her over.

(over to you, sally field.)

brilliant child

That killjoy Randy, joined by the killjoy medical profession, wants to tell me that no, in fact, my four-week-old preemie is not actually holding the binky in her mouth. she just likes to mash her hands into her face and is not cognizant of the fact that (a) she has anything to do with her hands getting mashed into her face and (2) that this is what's keeping her binky in place. I say nuts to that.

In other news, we are turning the heat down in her isolette again, getting her ready for another try at the bassinette. Since she's now up to one ounce per feed, fortified with extra fat for fatness, and gained another 70 grams so she's up to 2170 grams (4.78 pounds), I say she's going to do it, by george!

She's also a breasfeeding champ. I, unfortunately, am not. I am redoubling my efforts in that area, because the irony would just be too great.

I think she gets her IV out today (Thursday). I am heading over there now to see if that's the case. (I am still home because I had a doctor's appointment -- my blood pressure is holding steady! Hooray for my blood pressure! -- and have to get prescriptions filled, check the local used-stuff store for a co-sleeper, etc.) (defensive much?) (yes, I feel guilty whenever I am not at the hospital. Yes, my husband is desperate to see a movie and I'm too worried she'll miss me. Yes, this is all ridiculous. Now you know.)

That was a lot of parentheses. I'm exhausted.