Baby Fiala’s scary 2nd day
On Thursday morning, 10/23, I had just gotten off the phone with my hubby. I was feeling great, and looking forward to going home. I was nursing my peaceful baby, when in walked the pediatrician. Hm. The pediatrician in my room? Coming to see me? The baby? Hunting me down? Her? Didn’t seem like a good sign to me. “Finish nursing your baby, then bring her back down to the nursery. She needs to be put under UV lights because her bilirubin levels are very high.”
This particular doctor was from my pediatrician’s office, but not my kids’ doctor. Before the previous day, I had never met her. She was young… late 20s or early 30s, and seemed to me like she had a chip on her shoulder, like the motivation to prove she was a Real Doctor. I had also already observed her “bedside manner” in action with another family… she left a lot to be desired on the comfort side of things.
Earlier the day before, I had witnessed something transpire between that doctor, three nurses, a baby, and the baby’s family. The baby was breathing hard and heavy, but her pulse ox was low — around 90%. She was also very pale and other than her quickly rising and falling chest, quite limp. The doctor wanted to find out why she wasn’t receiving adequate oxygen, so ordered some blood tests, then a chest x-ray and an … oh, gosh, I can’t remember the name of the test, but it was to check out her heart. I’m not a doctor, but it seemed obvious that the pediatrician wanted to see if the problem was in the baby’s blood, heart, or lungs. The doctor left the room, and the nurses started talking. I was the only mother in the room. The nurses kept their voices down a bit, but it was clear to me that they thought the doctor was being overly cautious, and ordering too many tests for what seemed to them to be an extremely minor problem. As they continued their critical assessment of the doctor’s orders, their backs to the back door, of course, in walked the doctor. It took the nurses several seconds to realize that they were being listened to by the very person whom they were critiquing. They zipped up and received a cold glare from the doc.
I think the doctor had just returned from the mother’s room, because shortly afterwards, a contingent of family came to the nursery door, begging for more information, saying that the mother was absolutely distraught and inconsolably worried. The doctor matter-of-factly turned them away, saying that the tests couldn’t be interrupted and that she would let them know the results as soon as possible.
This episode, all of about 20 minutes total, stayed with me. Later that day, when the baby was no longer in the nursery, I tried to find out what had happened to her. I figured it was either really good — that the baby turned out all right and had been returned to her mother. Or, really bad — that the baby had been transferred to a hospital with level 3 infant care. I asked a nurse, with the understanding that she probably couldn’t tell me — doctor/patient privilege and all — and sure enough, she couldn’t.
Anyways, all of this — the possibly over-reacting doctor and her cold bedside manner — was in my head as she herself visited my room.
I grilled her for more info. She said, speaking at a fast, no-nonsense clip, “We’ll keep her under lights for 12 hours, then test her blood for the levels. If they’re still in the high-intermediate zone, we’ll keep her overnight. You’re breastfeeding, which contributes to her being dehydrated, and since she’ll be under the lights, they’ll have to supplement feed her to keep her fluids up.”
I was totally taken aback. I told her I could understand about the lights, but that I did NOT want her supplement-fed by formula, at all, for any reason. The doctor conceded, “The only other option is to put an IV in her to keep her fluids up.”
“OK, then. Put in the IV.”
“You can come in as often as you want to sit with her. You can stay in the nursery the whole time, if you’d like. If she’s distressed, you can nurse her every two hours. If she’s doing OK, you can nurse her every three hours.”
The doctor left the room. I knew then, and I know now, that my daughter was not in mortal danger. But, here she was, barely 24 hours old, and the doctor was telling me that she would have to stay in the level 2 nursery, and I couldn’t have her for a minimum of 12 hours, and likely more. That was really hard to swallow. Really hard.
I called my husband, who was not pleased. He told me to call our pediatrician for a second opinion. Theoretically, I had no problem with that. But I knew the way my ped’s office works: You call in, leave a message for the triage nurse, who either answers the question herself, or asks a doctor, IF she deems it necessary, and she probably wouldn’t ask our own ped, but whichever doctor was the one answering triage questions for the day.
Sure enough, that’s what happened. The triage nurse ended up calling my husband at home, repeating the same info that the doctor had told me, and that I’d already told him. It did put him more at peace, but later, it made things a little tense between the doctor and myself, because she came to me saying, “If you wanted a second opinion, you should have asked me to contact your doctor directly, instead of going around behind my back.” Ugh. I knew the triage message would get back to her, and I knew it would appear that we were “going behind [her] back” but that wasn’t my real intention; it’s just that we trust our ped, but didn’t know her from beans.
By 11:00 a.m., they had wee baby Fiala hooked up — right wrist immobilized and taped up with an IV needle, WeeSpecs on, under a warmer and two banks of UV phototherapy lights.
Even that little heart-shaped thingie was hard to look at for me. It simply monitored Fiala’s skin temp and automatically adjusted the temp of the baby-warmer. Still. I just don’t like seeing cords hooked up, taped on, whatever, on my baby. It didn’t seem right.
I do know now that the doctor was probably right to be cautious. The thing that was of particular concern with Fiala is that her levels peaked so high within the first 24 hours of her life. She was never in extreme danger, but because her levels were in the “high intermediate” zone, if no action was taken, it was likely that her bilirubin count would increase to a dangerous, health-threatening level.
All my kids had jaundice; I’m not sure why, but I guess that’s an associated risk factor for jaundice that requires phototherapy. We didn’t have any of the other risk factors in play… And, I didn’t see any evidence of “our” doctor or any other doctor over-treating jaundice: Out of the 30 or so babies in the hospital at the time, Fiala was the only one receiving treatment. (The hospital where I was at usually only has 5-7 births a day, but there was a birth explosion for some reason; 22 babies were born the day before Fiala was born! For that reason, my recovery room was in a corridor Martin and I had jokingly called The Dead Zone while I was making my pacing/walking rounds awaiting Fiala’s birth. It was down a twisty path and hadn’t seen any updating/remodeling in probably 20+ years. And, wouldn’t you know it? That’s where they placed me. In fact, they opened The Dead Zone just for me. 🙂 I was the first patient in that hall, and for about six hours, until more recovering mommies were brought in, the nurse who tended me said I was her only patient. Hehehe.)
This was taken later, but here’s a close-up (taken by my 7yo, Wesley) of Fiala’s hand w/ the IV in it. Makes me sad:
I did spend a lot of time in the nursery with Fiala. And, I did nurse her every three hours. The only thing that enabled me to not lose it entirely was the fact that she weathered this storm really spectacularly. She didn’t seem all that bothered at all! I’d leave the nursery and go back to my room and cry and pray, always remembering to thank God that Fiala didn’t seem to be traumatized by the whole thing.
At 9:00, they tested her again, and I got word at 10:00 that they would, indeed, be keeping her overnight. I wept. Talking with my dear husband, he said, “Well, at least since they’re taking care of her, you can get some good sleep.” Theoretically, yes. In practice, no. I was SO tense and sad and missing my baby that I would lay down and NOT be able to sleep. Then, I’d turn the TV on and watch SportsCenter. Then, I’d try to sleep. No go. Then, I’d get up and go to the freezer down the hall for my pint of Ben & Jerry’s Karamel Sutra that a kind friend had brought for me. Then try to sleep. Nope. Then, go down to the nursery and feed Fiala… This went on all night. Those first 48 hours, I got a grand total of about two hours of sleep.
They tested her again at about 9:00 a.m., and with the results that came a couple of hours later, they released Fiala to my room at 11:00 a.m. I wheeled her back, sat on my bed, and wept again, tears of joy and relief. My husband called just at that point, and of course, I couldn’t not answer, but of course, he was highly concerned to have his sobbing wife answer the phone. I told him they were tears of joy. 🙂
They left the IV in, because they had to test her one more time just to make sure her levels were holding. That test was at 4:00 p.m., and I got word at 6 p.m. that we could go home, that she was OK and down into the low risk category. ~huge sigh~
So, Martin and the kids ate dinner at home while I finished packing up everything in the hospital, and getting the two of us ready to go… (Fiala’s take-me-home outfit was given to us by my dear friend Shellie. She made the bow.)
Martin had stayed with me the first night, while I was in labor, of course, and through the midafternoon of the next day. Our four kids had visited three times, but this time, when Mom & Fiala actually got to go home, was by far the best. 😀
All told, I was in the hospital for about 45 minutes shy of 72 hours, which was the longest stay ever. Paid by insurance, bless God.
Since Fiala really wasn’t in mega-serious danger, I still feel a little chagrined that it was SO hard on me to see her go through her hard 24 hours; so many mothers and so many babies have weathered much more serious conditions for much longer than I did. But, golly, it was just hard, and I’m so glad it’s over.