All In Knots

The Lord bless you and protect you; The Lord make his face to shine upon you, and be gracious to you; The Lord lift up his countenance upon you and give you peace. Number 6:24-26

Day of Life: 20

On my way to the hospital this morning, I talked to my friend, Alicia, who is due to have her second baby in the next couple of weeks. I told her that I feel like I am taking the same picture of Tera over and over again each day. Tera must have heard me say this because today was full of photo ops. So, before I get into all the serious stuff, I'd like to take a moment to laugh at the expense of my frail and tiny child. The following is a pictorial montage of Tera Awakened. I hope you find it as funny as I do.

1. Strike a pose.

2. Show me "Surprised!"

3. Now, hit the high note.

4. Go deep in thought.

5. Let me see "Relaxed."

No, not creepy drunk eyes. You'll never make it as a model. (And her daddy breathes a sigh of relief).

Now onto business. I think I told you that last night Tera had gained 33 grams, bringing her total weight to 1020 grams, about 2 lbs 4 ounces. I can't tell you how happy I am about that tiny weight gain.

This morning I arrived earlier than usual because I planned to be in and out throughout the day, so I wanted to start the process early. When I arrived, I was so sad to see that Tera had spit up, and it was covering her little mouth and chin. I know it's silly to be worried about something this simple, but I think you've heard me mention that this new floor she is on is "different." Let me see if I can explain it better before I launch further into my day.

My worries can be summed up in two short examples. First, Poppa stayed with Tera all Saturday afternoon while Barry and I took Canon out for his birthday celebration. While there, he reported that at times, two hours would pass before a nurse would come to check on her. Two hours! So, when I walked in this morning and saw spit up all over the bottom half of her face, I didn't know if she had spit up five minutes ago or an hour and a half ago. It's just depressing to think that she could have been laying around in it for so long. The second illustration of my worrying comes from the fact that on this, the eighth day in the CCN, Tera has had seven different nurses during the day shift. Eight nurses if you count the fact that her nurse today went home sick, and a different nurse came in to take her place for the afternoon. We have created what's called a Care Team, a list of nurses that we want to be assigned to Tera whenever they are on duty. Someone else actually started the list for us (I'm hoping it's our favorite nurse from the NICU, but I honestly don't know for sure) but I have added a couple of names to the list throughout the week. But still, after a week, we've only had one nurse that has been with Tera more than one day. The inconsistency of it is disturbing.

Now, onto my day. I immediately told the nurse about the spit up, and we cleaned it up. Whenever I come in to Tera's room each day, I wash my hands for three minutes, then open her isolette so that I can rub her head and hold her hand. When I did it this morning, I noticed that her fingers felt colder than usual. In fact, her bed felt a little less smoldering hot than I remembered. I asked the nurse about it, and she told me to take her temperature to check, 97.4. It was a little low, so we covered her up with a blanket. The isolette is supposed to use Tera's body temperature to regulate the temperature of her isolette. But the little tab that regulates her temperature seems to be very sensitive. If it slides under her diaper, it won't work correctly, and there are some other scenarios that would cause it not to show an accurate temperature. Gee, I wonder why I'm staying so worried these days. Nonetheless, I felt proud to have identified a minor problem, but still worried that I had to be the one to do it.

Later that day, after returning to the hospital after lunch, Tera de-satted down into the 50s. Her oxygen saturation (which is supposed to stay between 85 and 95) fell into the 50s. The red lights on her monitor went off, as they do anytime this number falls below 80 for too many seconds. Only this time when the beeps started and continued for several seconds, no one came in to check on her. I've learned that it takes these nurses longer to respond to monitor beeps and dings than it does the nurses upstairs, but this time, no one showed up at all. I should mention here that the nurses have all of the babies' monitors pulled up on their computers, so they can see at their desk exactly what I can see in her room. They could see (or were supposed to see) that she was slowly but surely pulling her own oxygen up, but they could also see that I was in the room listening to those loud noises and probably wondering why the heck no one had come in there yet. But they didn't worry about it like I did.

Shortly after, Nonna and Canon came into town. They picked me up from the hospital so that we could take Canon to his first movie at the theater. I almost backed out at the last minute, but instead decided that I had to put my trust in the nurses (ok really, in God) and try to believe that no harm would befall my daughter.

We had a great time at the movies. We went to see Tangled at the dollar theater. I paid $3 to get Nonna, Canon, and myself into the movie and $9 for water and popcorn. Theivery! Canon absolutely loved it. He started off in Nonna's lap, then asked to move to mine. He just sat there, wide-eyed and wide-mouthed as the movie played. Occasionally, he would haphazardly reach for the popcorn bag or his juice cup.

When the movie was over, we had to stay until the very last credit had rolled. Canon moved up and down the aisle dancing, jumping, and running.

I know these pictures are a little dark, but hopefully you can see the fun he had even after the movie was over. While I had tons of fun with Canon and was able to put my hospital worries aside for moments at a time, I was still in knots about everything when the movie ended. We went to Lydia's house afterward for a few minutes, and I took the opportunity to call the Charge Nurse on our floor. I didn't want to complain, I just wanted to know what I was supposed to expect on this new floor. I told him my worries of having so many nurses in one week and of knowing how often nurses were supposed to check in on the babies. He explained that it was unusual to have so many nurses, but sometimes nurses either call in to be replaced or have to move to another unit (like the NICU) if they are understaffed. In those cases, the nurse that had us yesterday would not have us today. He also said that nurses should check on the babies every one to two hours. They get their vitals and make sure the family is taken care of. I should have told him about the spit-up incident and the de-sat earlier in the day, but I'm a coward and I didn't. I think I was too scared that I would burst into tears on the phone and would just sound like a blubbering idiot instead of an educated, concerned parent. Still, I hung up feeling a little better about everything. At least the nurses are acting in accordance with the floor policies, though those policies are a little loose for my taste.

div>Nonna and Canon went back to the hospital with me for awhile. Canon was absolutely wonderful. He let Nonna hold him so that he could look at Tera.

The front desk nurse gave Canon a sticker that said "I feel great today." He decided to put it on Tera's bed instead.

He spent most of the time playing with either my or Lydia's phone, watching Thomas the Train on Netflix or watching The Bee Movie Trailers on youtube.com. This kid is a real couch potato if you let him be.

After they left to return to Winfield, I decided to stay at the hospital to make up for time I had not been there that afternoon. I even asked our new nurse (the one that took our earlier nurse's place when she went home sick - the 8th nurse of the week if you're keeping count at home) if I could hold Tera. Because it was getting late, and the night shift was about to start, I decided just to hold her wrapped in a blanket instead of skin-to-skin like I usually do. I won't make that mistake again. At one point her heart rate flat-lined, which scared me until I realized that the sticky things on her chest that measure her heart rate had gotten stuck to the blanket and fallen off. She de-satted several times, and I had some difficulty getting her back up to 85, even with the oxygen mask right next to her face. At one point, her heart rate fell (legitimately this time, not just the stickers coming off) at the same time that her respiratory rate fell. That really made me nervous. The night nurse (who had just started her shift), came in immediately, and I told her I was ready to put her back. I felt like the whole experience was stressing her out, and the beeping and blinking was stressing me out. She's just too tiny to hold in a blanket I think. While I did enjoy getting to look at her while I held her, from now on I think I'll stick to skin-to-skin.

Because Tera was already out of her bed, the nurse decided to go ahead and take all of her usual measurements. She gained .4 ounces (I'll find out how many grams this is tomorrow, but I am excited to be able to use the word gained) and she is now 16 inches long, which is 1/2 inch longer than the day she was born. After a diaper change, this tiny little girl was ready for some comfort. The nurse found her pacifier, and Tera clung to it like it would save her life.

I really don't think I've ever seen her this ready to be back in her bed. Once the nurse rolled her over on her belly and got her meal started through her feeding tube, I decided I needed to get the same relaxation she was getting. Though it was hard to leave her, I knew that staying would only make me more uncomfortable. And I love this nurse and feel completely comfortable leaving Tera in her care.

I typically try not to share my stress with Barry too often. There's not a lot he can do from Dothan except worry, and I really hate for him to do that. Tonight, however, I just couldn't let it go. I told him all about everything from the spit up to the revolving-door nurses to the de-sat. He almost got in his car to drive up here, but I convinced him instead to call and talk to the Charge Nurse. He explained our concerns in his usual I'm-a-nice-guy-but-this-is-unacceptable voice, and they soon had it worked out. I called in to the Charge Nurse next, and we started our Care Team list over, adding only the names that I felt comfortable with. She gave me two additional suggestions that she thought would fit well with the people I had already mentioned. She will assign them to Tera at some point so that I can see how I feel about them.

And now I am sitting here, way too late into the night, writing about things that may seem insignificant to a lot of people but that scare me to pieces. I am a tough-love kind of person when it comes to children, but Tera is going to be a completely different experience. If I get this upset about her having spit up on her face, I can't imagine what it's going to be like the first time I send her to Time Out.

I did read to her this morning, "Praying for Your Child to Love God's Word." This chapter is about the importance of knowing the scriptures, even as children. One example tells of a man who tried frequently to commit crimes, but everytime he tried, the bible verses he learned as a child would spring to his mind to keep him honest. This is my prayer for my children tonight:

"Do not let Canon and Tera merely listen to the word, and so deceive themselves. Let them do what it says." James 1:22.