November is Prematurity Awareness Month. As part of that cause, I am
participating in the Bloggers Unite Fight for Preemies event to raise
awareness and hopefully support for our dear friends a the March of Dimes.
She may not have been facing down an unforgivable curse from He Who Must Not Be Named, but my daughter is a survivor in the truest sense of the word. She is either very lucky, or unlucky. I guess it depends how you look at it. Almost five years into this journey of parenthood we are still trying to figure out on which side of Karma we seem to have landed. I suppose our daughter could be seen as a one-trick-pony, but hey, what a trick!
Amanda was born at 24 weeks + 3 days gestation. We were surprised by the premature labor. The staff at the hospital was also surprised by the premature labor! I was hooked up to the monitors which were unable to register any contractions. We suspected a urinary tract infection, which can be quite common during pregnancy though I had never had one before. My water broke, they called the NICU and put them on alert. I was given a steroid shot to mature the baby's lungs before delivery and I was whisked off to a labor and delivery room. Things settled down for about 5 minutes. Long enough for all of us to take a deep breath and start thinking of a game plan when BOOM, here she came. They never had a chance to check to see if I was dilated. It was most definitely a "natural birth" and yet the most surreal experience of my life. It took around 20 minutes or so from start to end. (Not enough time for that steroid shot to be effective.)
Amanda was 1-pound 15-ounces and 12-3/4-inches long at birth. This is a large size for a 24-weeker! Her skin was translucent, she was covered in bruises and her eyes were sealed shut. She could not breathe on her own. I saw a quick flash of a red face before she was taken to the NICU and Tim and I were left in the delivery room alone wondering what in the world had just happened. We were traumatized and shaken and feeling very vulnerable and lonely. It didn't seem real at all. I said, "We have a daughter." I thought that if I said it out loud that would make it seem more real, but it didn't. We held hands and wiped tears from our eyes and just waited for someone to come explain everything. No one came.
The next several hours I spent alone in my hospital room on the maternity ward. I have never felt so alone. My room number was 911. I did not find this humorous at all. A Karmic joke perhaps? Tim went home to take the dog out , pack a bag for me and make some phone calls. I called my office to let them know I would not be back in that afternoon as planned, and I would need to take the next week off. "Oh yeah, by the way, I had the baby." Funny thing this having a baby when you weren't planning on it, it tends to change your plans. The nurse brought me a couple of Polaroid pictures of Amanda. The Neonatologist came to visit me and told me the baby was alive, if she continued to live through the first 24 hours that would be a major milestone. I waited for Tim to get back before I went down to see her. I couldn't walk yet on my own anyway.
That first trip down to the NICU was really scary. We learned how to scrub in, learned the rules and protocol and then had to be directed to her bed. I was looking at a room full of isolettes and I didn't know which one was mine. They said this baby, in this bed was mine, but how did I know that for sure? I just went with it. I should love this one because they said it was mine. The bonding was a long time in the making. I wanted to love her and I just kept working at it until it really happened.
We had planned on my taking a maternity leave and then returning to my full time job once the baby was born. Since we knew Amanda would be in the hospital for a good 3 months (if we were lucky enough that she survived that long) we would need to make some plans. We couldn't afford for me to just stop working and spend all day every day at the hospital. Working for a small company (too small to qualify for FMLA), that wouldn't work for them either. So, after taking a week off I went back to work on a reduced schedule and started a new routine. Visit the hospital in the morning, go to work, home for dinner with Tim then the two of us went back to the hospital before bed. Get up the next morning and do it all over again. I was getting up close and personal with the breast pump, freezing the milk, looking forward to the day when they would actually start feeding her instead of providing her nutrition through an IV. The entire three and a half months Amanda spent in the NICU I listened to "Harry Potter and the Chamber of Secrets" in my car. I had it on repeat and listened over and over and over without really absorbing what was being said. I felt comforted by Hogwarts and the wonderful rich voice of Jim Dale. It was my only escape.
I slept at night because I was exhausted, yet every time I closed my eyes I was right back in the delivery room feeling every ounce of anxiety and terror that I did in the moment of birth. I went to bed hoping the phone wouldn't ring in the middle of the night. It was a horrible existence. I learned what Post Traumatic Stress felt like. I learned that life as a working mother of a baby in the NICU meant that whether I was at the hospital, home or work I felt like I should have been somewhere else. I felt like I was constantly letting someone down. I felt like a failure in every aspect of my life.
Routine was what saved us. We found a rhythm and stride and just kept it up as best we could. Amanda's health would improve and then backslide. There were times we laughed and joked with the nurses and there were times when she was labeled "low stim" which meant we were to whisper and keep the lights low. We could look but not touch. We learned how to change diapers around cords and tubes and wires. Some to help her breathe, some to provide nutrition and some to let us know whether her heart was still pumping or not. We watched the numbers on the monitor more than we looked at her. The numbers told us she was still alive.
We saw other babies come and go, some went home with their families, others did not. I walked in one morning and headed to the back corner, "our corner" which turned out to be where they kept the sickest babies though no one told us this, only to find an empty bed. My heart stopped. Where was my baby? They had moved her to the "feeder and grower" area by the nurse's station. Later that night she was moved back to our corner with a bowel obstruction. The nurse had to bag her to keep her breathing. I felt as if I had been punched in the gut. That is what they call the "roller coaster" of the NICU. On the same day you get great news you can free fall at 100mph and wind up at your lowest point. You never know what will happen next. Milestones and setbacks happen at the same time leaving you reeling and not knowing whether to be happy or sad.
I left her in the hospital to attend my baby shower on April Fool's Day. (Another Karmic joke or just a convenient day?) I arrived late at the hospital one Saturday after walking in the March-of-Dimes WalkAmerica (now March for Babies). (We raised over $2400 that first time out. Oddly, since I no longer have a baby in the NICU the fundraising has become more difficult.) I spent the whole day at the hospital on Mother's Day just to be close to the one person in the world who made me qualify as a mother after so many infertile years of feeling pain and loss on that day.
Amanda spent 105 days in the NICU. She came home three days before her due date. She should have been born on 6/6/06. I think that date plays a part in our Karma flip-flops too. How could it not?
But she lived.
Just when we thought it was safe to consider ourselves parents of a normal healthy toddler, Amanda was diagnosed with Hepatoblastoma. She had stage IV liver cancer which had already metastasized in her lungs. It is quite possible that the cancer was connected to her prematurity, either due to immature liver tissue, her low birth-weight or even one or more of the treatments she received in the NICU. Karma (good or bad) found us once again as she pushed on through chemotherapy and a tumor/liver resection surgery. We found a routine again as a family with two working parents and a child in the hospital. I firmly believe that our experience from the NICU gave us an advantage over the other families in the pediatric oncology ward. We knew how to listen to the doctors and then ask the nurses for more detailed user-friendly explanations. We knew how to advocate for our daughter. We had fought for her life before, the other families were all new at it. While we felt it was highly unfair to be facing her mortality again, in a twisted way, it gave us an edge to have been-there-done that.
She suffered, we suffered, but again, she lived.
The research that has been done by the March of Dimes has made it possible for "lucky" preemies like Amanda to survive. They can save more and more babies these days. So, what to focus on now? Preventing the premature births in the first place. I wish I had recognized the signs of premature labor. If I had gotten to the hospital sooner, maybe they could have stalled my labor, at least long enough for those steroids to help her lungs. Maybe she could have cooked a little longer. Maybe we would have had a slower, less traumatic birth experience. Maybe she wouldn't have had to suffer as much as she did.
I believe that every preemie in the NICU must be Buddhist on some level for "all of life is suffering". They must suffer in order to live. Not knowing the full reason(s) behind the premature birth and not getting a reliable answer about how any future pregnancies might turn out and not intending to put another child through the torment of the NICU we decided that Amanda will be our only biological child. We heard of families who revisited the NICU with subsequent babies and gave wonderful glowing updates to the staff of how the older former-preemie siblings were doing. To me, this is child abuse at its most basic level. We felt we did not have a choice about whether Amanda had to suffer through that or not. If we gambled with another pregnancy and wound up back in the NICU we would have inflicted that pain on that child intentionally for our own selfish purposes. No. NO! It is just wrong. I had surgery on September 11, 2009 (there is that 911 number again) to have my tubes tied and an endometrial ablation to treat symptoms of my endometriosis. We have not completely ruled out adoption but as time goes by it is looking more and more like Amanda will be an only child. This is another huge blow, as we had always intended on having two children. The impact of this one premature birth is shocking as its effects are revealed in all aspects of our lives.
I will continue to support the March of Dimes in hopes that other babies, other families, will not have to suffer the way that we did. I will write for BloggersUnite as long as I can do it without hurting myself more in the process. (It's not easy.) This many years later, the trauma is still very real. The effects will follow us the rest of our lives both in her developmental levels which are SO CLOSE yet not quite up to age level and our own social/emotional ties. But we are the lucky ones. We brought our baby home. She can see. She can hear. Her heart defect healed itself. Her congenital eye disorder (Duane's Retraction Syndrome) is not so bad that it requires surgery and her vision is good. We are all so very lucky. We ended up on the good side of Karma in the end. (Please, please, please let this be the end!)
Amanda is beautiful and charming and smart and funny. I wish she could be known most for those things which make her special. Instead, I fear, she will always be known as The Girl Who Lived.