Ophthalmology Scares Me!

Day of Life: 44 Happy Birthday, Nonna!

The following comment is not meant to neglect the efforts of parents who deal with cholic-y babies, formula allergies, or breast feeding dilemmas. It's just meant to be a general philosophy on parenting: When asked my advice about being a parent, I have often told friends that baby development is as much for the parents as it is for the baby. In the first couple of weeks, the baby basically just needs to eat and sleep. Most anyone can do that with little to no stress. Then, just as you get completely comfortable with your role as Nutrition and Sleep Provider, the baby demands something else, like more attention when she is awake or more rocking to get him to sleep. Because the parent has mastered sleeping and eating, they now have their wits about them to manage these new demands. As those skills are mastered, new demands come into the picture. In short, the parent grows and develops with the baby. I should have known that premature babies offer the same for their parents.

Over the last six weeks, Tera has offered me many opportunities to grow and develop with her. Some opportunities brought more growth and development than others, and these opportunities have not always come in the simplistic order that I mentioned above. Nonetheless, we have grown together these last few weeks. We had recently entered into a stalemate, Tera and I, doing little but waiting on weight to increase and oxygen needs to decrease. However, today it was evident that we would now be entering our next round of growing and developing. Let me begin with today's installment of Room Feature. Today, I will be featuring the dry erase board in Tera's room. On it, we record some of Tera's important information such as emergency numbers, doctors' and nurses' names, and special notes for the various people that come in her room. A few days ago, one of Tera's nurses began writing Tera's weight in the top right corner. Today's written weight was a very exciting number - 4 pounds!! When I called in to the nurse last night, she told me that Tera weighed 1820 grams. She has gained 4 ounces in the last 24 hours, bringing her weight officially to 4 pounds!

Don't worry Tera. I don't think the extra weight went to your face.

One of the "special notes" written on the board says "*Mom wants to give first bottle." That promise was fulfilled today, much sooner than I expected when gave Tera her very first bottle (or at least part of it). Soon after my arrival this morning, the Neonatologist and the Nurse Practitioner came in quickly just to check Tera out. The NP told me that she would be back soon to update me. "Soon" usually means "sometime today," but the NP apparently follows my definition of "soon." Less than ten minutes later, she was back in the room and proposing the idea of a bottle feeding. Because Tera's weight is so impressive, she had suggested this to the Neonatologist during rounds, and he agreed.

The NP assured me that there were no expectations here. We would just try it, and let Tera decide how it would go. I recently attended a short informational meeting about how to bottle feed preemies, so I had a basic foundational knowledge of what to do. The NP will work on getting a Speech Therapist in to help me with more specifics in the next few days, but for today, our nurse and I are going to try it on our own.

Step one, get T bundled up.

Step two, give her to me. There are plenty of rules that go along with bottle feeding a preemie, and positioning is an important one. The best way to hold her is at an angle (not laying flat) and, if possible, turned slightly on her side. Because Tera is still on oxygen, I needed to keep the blow-by close to her airways so that oxygen deprivation didn't prevent the suck-swallow-breathe sequence that is essential to the successful execution of this project. I also have to hold both Tera and a bottle.

You do the math - 2 hands, 3 objects. I ended up holding Tera's head in one hand with the blow-by, and the bottle in the other. At my request, the nurse held the camera.

Step three, try to get the bottle in Tera's mouth. This proved easier than I thought. The nurse instructed me to let some milk drip onto her lips to help coax them open. The first taste of food opened her mouth immediately. I had to wait patiently for her to allow the nipple of the bottle past her gums, but she eventually complied.

A couple of minutes and a few milky dribbles down the chin later, we exchanged the regular nipple on the bottle for a slow-flow to prevent too much milk from flowing into her mouth. Step four, wait. The key to this is to let Tera take the lead. I can't force her to drink from this bottle anymore than I can force her lungs to get strong enough to breathe room air. I just held the bottle there and waited to see if Tera would figure out how to get milk to come out of it. In no time at all, she had it figured out. She sucked (or is it suckled?) a few times on the nipple.

Step five, wait. Will she swallow it or let it dribble down her chin? Will she hold it in her mouth and stop breathing? Will she swallow it and choke? Though a few drops made it down the side of her chin, the rest seemed to go down her throat. There were a couple of times when I couldn't tell if she was choking, swallowing, or just staring at me. When her monitors stayed quiet and she didn't turn blue, I assumed she had swallowed it all and was ready for more.

When the nurse (and I) was sure I could handle this new parenting skill, she left me to continue feeding. I bottle-fed for close to fifteen minutes. During that time, Tera sucked/suckled more than a few times. It wasn't constant, and there didn't seem to be any consistency in her method, making it difficult for me to plan a strategy for future feedings. We just did the best we could.

When the nurse returned, Tera was plum tuckered out. The nursee took the bottle and discovered that Tera had taken 7 of the 30cc in the bottle. She put the rest in a syringe to feed her via her feeding tube. I don't know how impressive this is in medical terms, but in Mommy terms, it is phenomenal. We made it through another first with no bumps, bruises, or drama. I celebrated by staring at Tera, asleep in my arms. Tera celebrated by falling deep into sleep, dropping her heartrate and her oxygen saturation. At one point, every monitor in her room went off at the same time. Six weeks ago, this would have sent me into a crying babbling spell. Today, however, I looked at the monitors, then looked at the still-pink and snoozing baby laying against me, and ignored the bells. I'm not going to have these monitors at home. I need to start depending on Tera to tell me how she's doing. I think she was more content than ever at that moment.

To further commemorate the occasion, the nurse decorated Tera's first bottle, which brings us to our second installment of Room Feature today - Tera's first doll. MyGoo brought this Madame Alexander doll to Tera during her visit last week. I thought she would be the perfect caretaker of the first bottle until it finds a permanent place at home.

After watching Tera have so much fun eating, I decided I needed some lunch as well. I walked down to the corner to grab something at Moe's. By the way, if you're ever in the UAB area, and you're wondering where your doctor is, he (or she) is at Moe's.

When I returned, the nurse informed me that Tera would be having her first eye exam today. She put drops in her eyes to dilate them, then there was more waiting, this time for the Eye Doctor. While I waited, (Big) Tera's mom, Pat, dropped by for a visit. She marveled at how big (Baby) Tera has gotten. Lydia and Nonna also came by, so I had plenty of company to keep my nerves in check while I waited on the Eye Doctor.

In the preemie book, "Half Baked," that I have been reading since we arrived here, the author describes her daughter's eye exam as being quite a horrendous experience. It was just as devastating as she described it. I took this picture . . .

. . . then placed myself strategically behind the doctor and his nurse so that I could not see the horrible things they were doing to my daughter, though her heart-wrenching screams were very telling. If you have a strong zoom on your computer, you can tell that these monsters have basically taken tweezers with two-pronged forks in place of the sharp pointy ends, and pried Tera's eyes open. He then shone a bright light in her eye and placed some other tiny tool dangerously close to (if not actually touching) her eyeball. They did this to both eyes.

Good, it's over.

Nope. They picked her up, turned her in the opposite direction (with her head now where her feet were) and repeated the whole process. The doctor explained that the first time, he looked at one half of each eye, and he turned her so that he could see the other half. Did I mention Tera was screaming through this whole experience? My insides were churning.

When it was finally over, the good doctor explained that everything looked great (not from where I'm standing). Her blood vessels are still premature, so he'll do another exam in two weeks (I think I'll be at Moe's), but there seem to be no pending sight issues in her future.

The doctor eventually left, and I held back tears as I looked at Tera. Apparently, she wasn't able to do the same. Her eyelids were red and seemed swollen, and there was a tear just under her left eye. She tried to open her eyes a couple of times, but it looked like it might have been too painful, so she gave in and fell back asleep.

I seriously never want to see this again. I left soon after to sit in traffic until I could make my way to OLS and Canon. Our friend, Anna, whose children also go to OLS, has invited us for pizza and play time at her house. It was a perfect evening for it. Canon has graciously allowed me to drag/drive him all over Birmingham this week with little to no time outside. When we made it outside after pizza, it was obvious that Canon needed the release. He ran around like a wild child, throwing balls in all directions, then chasing them down to do it again. He also played basketball with Jackson and swept the driveway with Addie.

The slide, as always, was a big hit.

All good things must come to an end, and we were leaving Anna's house just as the sun went down, promising to make this a more regular get together. Back at Lydia's, we immediately got started on our Night Time routine. Canon even put on a quick show for me in the bathtub, singing the ABCs a few times. I took a video, but I accidentally caught more of him on the screen than I intended, so I won't post it on the internet. At bedtime, Canon insisted on reading his books to me, which he did with surprising accuracy. We tend to read the same books over and over, so it's no wonder he has them memorized.