Sunday, August 7, 2011

Big Belly

Yesterday was just one of those days.

Nothing was going right.

When I entered Tessa's room, all of her alarms were going off because her CPAP had fallen off. She had become unswaddled and had somehow scooted down in her isolette, causing her airway to become restricted.

I immediately contacted the nurse to put her CPAP on, and her saturation levels came back up in no time.

The nurse said, "Oh, I am not sure why her alarms did not come to my phone. We have been having problems with them."

I thought, "Well, then check in on her every once in a while, for crying out loud!"

Previously, I mentioned that part of the difficulty with the NICU is that you are trusting others to care for your baby.

There is a certain consistency that I have come to rely on. For example, Tessa is fed 28 ml every three hours. Her belly is checked, her diaper is changed, and the contents of her stomach are pulled back to see if there is anything residual left over in there.

In the last week, there have been a few minor mishaps....which is part of the reason I have become more uneasy being away from her.

For example:
-the CPAP being off for goodness knows how long
-her residuals weren't checked
-temperature probe dinging that she is too hot, and no one even noticing
-feeding at the wrong time
-her bottle being left out for over an hour, wondering if the milk was spoiled
- trying to feed her 60ml (twice her normal amount)

While these are all considered minor, you can see how my mind starts racing. If this is happening when I am there, what in the world is happening when I am not there?

Anyway, back to yesterday.

After the CPAP issue, I noticed Tessa had been paired with a baby in isolation.

I am already sort of a germ freak, so for her to be paired with someone that obviously has an illness requiring isolation put me on edge.

I then had a nurse come in and tell me that another baby died (same room as Reed). I asked if he was sickly, and she said "No, he was born healthy and then died suddenly."

At her eight pm care time, they took a measurement of her belly, and it was up 2cm...one of the first signs of NEC.

I have mentioned NEC before, but wanted to give a brief explanation of why I am so terrified of it.

No one knows what causes it.
It can happen to any baby, but is far more likely in a preemie.
In the most severe case, the baby can be completely fine, have their bowel perforate, and pass away within hours.

The doctor was called to do an examination, and concluded that she looked fine, but they would watch her.

During the night, her belly went up 5 cm. They took an X Ray and so far she is not showing any other signs of NEC.

They think it is because she has air in her belly from the CPAP.

Please pray hard for her to stay healthy. Please pray that this belly business is nothing serious.

I swear I am going to end up in Pine Rest before this is over:-)

9 comments:

Anonymous said...

While most of the nurses are very good, it is the one's that are not that cause so much stress. No excuse for some of the behavior like not checking when alarms are going off.

Judy said...

Jamie, as I'm reading your post I'm thinking I would feel as frustrated and anxious as you. It is my nature to want to fix things and protect my loved ones. I will pray for God's hand of protection over Tessa. Also for you to feel peace knowing that Tessa is never out from under our loving God's watchful eye.It's so wonderful that she keeps growing and progressing! Praise God!

Anonymous said...

I am praying for little Tessa's tummy that it goes down and she doesn't have any more problems with it. She is such a wonderful blessing to our family and we pray that God will protect her. Praying for you to have peace with others having to care for her when you are not there.

Love ya, Mom

Anonymous said...

*sigh* I know. I totally know. Nick spends most of his time with Angel while he is inpatient because, as a nurse himself, he cannot handle NOT being on top of everything. Nurses are human and therefore will make mistakes. But somehow when you are there you feel like at least YOU have a hand in helping make sure they don't. I am sure you know this... but if it were me and I had to be away I would call at that 3 hour mark and ask if each thing had been done. Annoying Mom? Maybe. But the good nurses would just consider you a good mother. The maybe not-so-good ones would be the annoyed ones. ;) Praying for that little belly and those intestines. We sure know "intestinal" prayers well! (Sarah P.)

Kristi said...

Jamie, I feel your anxiety. I remember when my Kyle was in NICU and we would have a bad day. My doctor told me do not feel like a bad mom when you do what you need to for your child. YOU need to be the advocate for her. You are a GREAT mom and are not going crazy. Most of the nurses are on top of things but once in a while they do make mistakes. You have every right to check up on them whenever you want. She is your baby and you know her better than anyone else.
We will continue to pray for her to stay healthy and to continue to grow. We will also pray for peace for you as you go through each day and the anxiety that it brings. We will also pray for Josh and the boys as this is such a busy and trying time for all of you.

Kristi Handlogten

Angie said...

Jamie - I'm a natural worrier, even though I know God tells us not to be. I would be right with you in all of this. I can't imagine what you are going through! I will continue to pray for Tessa and you as well!!

Anonymous said...

Dear Jamie;
I have been away and catching up on your last couple of blogs, I can't help but feel your anxiety. I will be praying for little Tessa to continue to be healthy and thrive. That you will be able to rest and have peace, that Tessa's caregivers will be dilegent and there will be no more mistakes. Praying for you as a family too , that you will know that you are being lifted in prayer continuiously. Blessings and peace to you.
Dillene Van Beek

Laurie said...

It's hard to trust other people to care for our little people when we as moms are so used to being the one in charge. Then add on medical issues, it is completely understandable that you worry. We are praying for Miss Tessa and we will pray for peace for you. Peace that she won't get any infections, that her CPAP can be reduced, and that she will take to a bottle quickly.

Blessing to you Jamie! Hang in there. Oh, and I hear Pine Rest is nice this time of year. ;)

Anonymous said...

Jamie,
When I worked in NICU we did a lot of things that required extra safety precautions because our patients were so very tiny. We always double checked with another RN to see that we had the right babies milk and the right amount. If the babies measurements increased by 5 cm we would do tests before continuing the feedings. It is possible that it is air but that would very easily show up on an x-ray. As far as the milk being out for an hour it is ok if it is only breastmilk with no additives. There are many studies out that demonstrate that no bacteria grow in breastmilk for quite a few hours because of the antibacterial factors naturally found in your breastmilk. Formula on the other hand must not be used after one hour due to bacterial growth.Also for a RN in the NICU to say her "radio" is not working and she doesn't hear her babies alarms is completely negligent. The RN needs to sit by Tessa's bed until the radio is fixed. Additionally, the pulse oximeter keeps a record of the saturation and you can have the doctor backtrack to the time that the incident occurred and you can see exactly how long the saturation was down for. As you know keeping the appropriate temperature for a 3 pound baby is critical. If Tessa is cold she burns up extra calories and doesn't gain weight. If she is hot she breathes too fast, uses up extra oxygen and it is exhausting to her. The number of issues you had in one day are significant and I would ask to speak to the director of NICU or even the Nursing Director of the hospital. You are Tessa's mom and you are her number one advocate. If you don't speak up then no-one else will. When my son was really sick with encephalitis it was really hard to be a mom and a RN. You don't want to rat out people but you have to get the best care for your child:) We have been praying for you and your family. Love from East Highland, CA.