February 09, 2011

The Learning Curve

It's weird to think keeping perpetual watch over a preemie child can become routine, but it does, in a sort of non-routine way. I suppose that doesn't make sense unless you experience it all firsthand.

My wife usually wakes up at 4:30 a.m. to pump and save milk, and I get up at that time to transition to the couch, so she can go back to bed after pumping and not be woken up by me at 6:45 a.m. when I get up with our son. It's an odd early-morning tango that seems to work, at least for the time being.

As I said, I get up with our son, and I spend the next few hours playing with him and preparing his breakfast. Once he's in his high chair, chomping away and watching the NickJr channel, I call the NICU to get a Zoey update. The act of me calling is actually sort of a relief in its own way, because if the NICU calls me. . . well, those just aren't good calls. Thankfully, I haven't had an incoming NICU call for some time. Still, a call to the NICU can be comforting or concerning, depending on a lot of factors I wasn't even remotely familiar with before Christmas.

For example: oxygen levels. I've known for some time earth's normal oxygen level is about 20 percent, but I've never obsessed over that tidbit of information. In the NICU, however, the oxygen percentage is a number I watch like a stock trader.

For a preemie, too much oxygen can actually be quite harmful, but it's also necessary for the blood to maintain a healthy oxygen level, so there's this delicate balancing act constantly going on that can make me nauseous at times. If I come into the room and see an oxygen level at over 60 percent, my mind starts to race, when such a level normally just means Zoey had an apnea spell and needs more oxygen to bring her back up.

"Bring her back up" is a term used to refer to her heart rate, which can dive during an apnea spell like a WWII bomber taking flak. Apnea spells are totally common and expected for preemies on CPAP ventilation, and the nurses treat most spells like they forgot to add a bit of extra sugar to their muffin recipe. When I'm in the room during an apnea spell and see the heart rate plummet, however, I look for a public address microphone to call in a crash cart--not for my daughter, but for me.

There are other terms, like PEEP, which refers to how much pressure is being forced into her CPAP vent which, like golf, is better the lower the number. And, like golf, when I hear a low number, I want to cheer and clap quietly. And, like golf, when I hear a high number, I blame Tiger Woods and his infidelity.

There are other inquiries during the "routine" morning NICU call, like how the morning chest X-ray looked (the term usually used is "cloudy," like we're talking about the weather), or if any blood transfusions are anticipated, and it's all absorbed like I'm calling about a car in the shop.

There's so much more I've learned. Did you know they give preemies caffeine to keep them alert enough to breathe? Take THAT people who said my Diet Pepsi addiction was harming me; I'm BREATHING aren't I?

Also, I've learned, actually relearned, I can love someone so entirely, a part of me will go if they go.

So, Zoey's sticking around, or I'll kick her ass.

Posted by Ryan at February 9, 2011 09:25 PM | TrackBack

The oxygen level used to keep me up at night, and was always the first thing I checked every time I walked into the NICU. My little Marty was on caffeine, too. His morning cup o' Joe as I liked to call it.

Do you ever wonder how the nurses survive working there with the constant bells and whistles? After a few days I was hearing them at night. In my house. 20 minutes away from the NICU.

Posted by: Kristin at February 10, 2011 12:22 PM
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