Hello Charlee, My Name is Dad – Part II, The SCN

Our day was the literal rollercoaster of emotions – from being anxiety riddled while waiting on Becca’s major surgery, through to happiness and elation over the birth of our daughter, and then down to concern and panic over Charlee in her current state.

Seeing a loved one in an intensive care unit is heartbreaking. Seeing infants in such a situation is all the more painful and traumatic.

The specialty care nursery is what’s known as a Level II neonatal intensive care unit (NICU). They provide care to infants born at more than 32 weeks’ gestation and weighing more than 1500 g who have physiologic immaturity such as apnea of prematurity, inability to maintain body temperature, or inability to take oral feedings.

This was Charlee in a nutshell… or rather, in an incubator.

With Charlee moved to the SCN, I was asked to come by and speak with the nurses there while registering for a card to access the room. Becca waited back in our room, as she was still on Percocet and other pain medication, having literally just had major surgery no more than 12 hours ago.

The nurses advised that we were going to be on a strict feeding schedule to try and bring Charlee’s blood sugar levels up while they were being supplemented via IV. This would involve us arriving bedside for Charlee around the clock, every 3 hours for feedings, however in our reality, this meant the following:

Having been upgraded to the deluxe suite (in which we would no longer be sharing family bonding times with our infant), we found ourselves at one of the furthest points from the specialty care nursery. Becca was having difficulty sitting up in bed, let alone the fact that she was unable to walk or even use the bathroom at this point (TMI, but she was still on a catheter, which was to be removed just before our first initial visit).

Fortunately for the first of our feedings slated for midnight, Becca was given the use of a wheelchair. After struggling for about 10 minutes to comfortably get Becca into the chair, I slowly wheeled her into the SCN for feeding.

This attempt unveiled a few issues.

Firstly, the IV that Charlee had in her left hand, limited the number of comfortable positions for breastfeeding – an issue that had not been present in the recovery room when she was latching so well.

Second, Becca’s recovery from surgery also lent itself to make even the most basic positioning for Charlee incredibly painful.

And last, Becca’s milk had not come in yet, so even the limited amount of colostrum was tough to get to Charlee and once in her, it would need to make a fairly large impact to her blood sugar levels.

Be that as it may, we pushed through, and Becca and I were determined.

After an hour of feeding – some attempts resulting in just soothing more so than feeding, but other times quite successful), I wheeled Becca back to the room for a rest before starting at it again.

It was 1:30 in the morning when we returned to the room and 2 AM by the time I got Becca back in bed. Forty five minutes later the alarm went off and it was time to start at it again.

This time however, Becca needed to pee. We managed, but it took time and was incredibly uncomfortable and by the time we were done, I couldn’t find the wheelchair.

Great.

I hailed the nurse down in the hallway, and she advised that there was only one wheelchair for the floor and we couldn’t keep it for ourselves. Becca was going to need to walk it.

For an able bodied person, we’re talking a 2 minute walk – literally.

For someone who has just had major abdominal surgery within the last 24 hours, much longer.

We arrived at the nursery around 3:30 and were greeted by the nurse ripping into us about how important it was to stay on schedule and that the baby depended on us for this so she could get nourishment.

Not the guilt trip we were looking for.

I held in my frustration, and Becca went about feeding Charlee again.

This time the walk back after feeding, got us to the room closer to 5 AM. This time I set the alarm for 5:30, and after an impossibly short sleep, we were up and at it again.

Becca gradually healed more and more, but her progress depended heavily on pain medication that needed be administered by the main nursing team in the maternity ward. The same nursing team that were late to every checkup for vitals, impossible to reach, left us in recovery for 7 hours, couldn’t adjust the temperature in our room, served Becca solid food twice when she was not allowed it, neglected to place an order for a liquid dinner until after the kitchen closed, and also insisted on hoarding the one and only wheelchair.

We continued back and forth like this to the SCN approximately 48 times over the next 3 days.

We were exhausted, physically and emotionally.

"I am slightly perturbed"
“I am slightly perturbed”

Meanwhile, in the SCN, Charlee was doing ok, but for a span of 18 hours, I could not hunt down an on-call paediatrician to find out what the plan was with my daughter! As far as I knew, she was tapped into an IV until her blood sugars levelled, but how could we tell, and what were next steps?!

Finally I found a paediatrician who advised that the plan was to continue feeding Charlee breastmilk and supplemented breastmilk from pumping, while at once weaning her off the IV watching carefully to ensure that her body temperature and blood sugar levels stayed constant (above 36.6 degrees for her body, and above 2.6 (or ideally 3) for her blood sugars).

As the feedings continued we began to see a light at the end of the tunnel! Low and behold, Charlee’s body temp and blood sugars were staying strong and we watched the IV level drop from 11.5 millilitres per hour, to 10.5, 9.5, and all the way down to 2.5.

But then suddenly, a dip.

Her body temp dropped and her blood sugars fell to 2.5 – not what we wanted.

The nurses discussed with the paediatrician and it was decided to bring her back up to 3.5 ml/hr.

Another feeding session. Another measurement. Another dip.

She was brought back up to 4.5 ml/hr and the incubator temperature was cranked to 33.5 degrees.

We were at a loss – why wasn’t this working? What were we doing wrong? Charlee’s other vital signs were immaculate and she was otherwise a perfect little baby, albeit a tad jaundiced. What was going on??

Doing the math at that point, we realized that the expectation was for Charlee to wean off the IV down to zero, and then have 3 successful feedings off IV, out of the incubator, and still generate the appropriate body temperature and blood sugar levels. If we were at 4.5 ml/hr and they were reducing by 1 ml each time…. with the feedings 3 hours apart, we were talking 8 feedings, or a full 24 hour cycle.

Saturday night was probably the worst feeling. Becca’s pain levels were high, and the nurses in the main ward versus those in the SCN were continuing to be very inattentive and uninformed. Becca needed her pain medication in the short window before attempting to walk down the hall for feedings otherwise she would be in excruciating pain. That night, the nurses opted to double Becca’s dosage at midnight to “help alleviate” the pain.

While Becca may have seemed fine for the actual feeding, when that medication wore off it was like dealing with a heroin addict being forced through rehab. She was vomiting, and in pain, with nothing I could do but hold her hair back, find her a plastic bag, feed her some water, and help coach her through the discomfort.

It was the best of times, it was the worst of times.

We kept muscling through the walks, the feedings, the heartache of not being able to stay with our baby, and the frustration of not being able to get proper, timely information.

When we look back, we kind of realize the irony of having the healthiest baby in the NICU. The healthier you are, the less priority you have there, and hence our predicament.

And then something oddly miraculous happened Sunday night.

First off, during one of our routine feedings, Becca noticed that her breasts were much fuller, and she was definitely getting more food out into Charlee. We even did a test and weighed Charlee before and after the feeding, and she gained an incredible 45 grams in one sitting!

As Becca and I finished a feeding in the late afternoon, we said our goodbye’s to Charlee and headed back to the room. While we were gone, just as Charlee was settling in at her usual levels of 4.5 ml/hr of glucose being pumped into her veins, the IV started to malfunction.

Normally this would be a sign of worry, but our nurse kept a keen eye and ran some impromptu tests on our little energizer bunny.

When we returned 3 hours later, she advised that IV’s in tiny bloodline’s like Charlee’s, can have a tendency of failing and needing to be replaced. However for the window of time that Charlee was without the IV, she miraculously kept her body temperature at 36.6 degrees, and her blood sugars at 3.5… all on her own!

The nurse then went on to say that we no longer needed to wean and we could jump straight to the three IV-free feedings needed to satisfy the paediatric staff and send our little Charlee home!

We were elated!

But wait… it got better!

Our obstetrician came by for a check up on Becca and advised that she was all clear for being discharged. We could finally leave our deluxe suite of horror. Our angelic nurse then advised that she had secured a room for us inside the actual SCN, where they usually house out of town parents who need a place to sleep and monitor their child.

Faster than you could say “cheque please!” we were bagged and shlepped down the hall, into the SCN, and into our new room.

If things couldn’t get any better, would you believe they even took our baby out of the incubator, and brought her into our room for the very last feeding? Everything was turning up Charlee!

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One sleep later, and 6.5 hours of paperwork (not even kidding), we were finally discharged from the NICU, and I wrapped up our little Charlee in her brand new car seat to take her to her real home.

The last four days were some of the most trying on our souls. The combination of lack of sleep and the emotional turmoil of dealing with a baby in the NICU is overwhelming.

I am very much aware that in spite of all this, we got off easy. As I casually mentioned, Charlee was the healthiest baby in the NICU, and several times our nurse rotation mentioned how they rarely get to see babies that big in the SCN. Charlee’s neighbouring incubators had premies weighing as little as 3 pounds, and several times there were emergency situations that had our nursing staff running in all directions.

I have many takeaways from this experience.

First and foremost, it’s ok to ask questions, push buttons, and hound people down for information. This was my child, and my priority, and I had to put at least one nurse and paediatrician in their place to remind them of that.

Secondly, if you’ve ever needed to have a situation that tests your relationship, this is one, and not to toot our horn, but I think we passed with flying colours.

I cup fed my baby, while Becca slept. She fought pain and frustration, with emotional anguish, yet kept it together and never lost her beautiful nature. One morningI woke up late, around 3:30 – 30 minutes past our scheduled feeding time and flustered as I thought I had slept in and not woken Becca.

I found this bedside:

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That, ladies and gentlemen, is love.

And it’s with that love that I now will be raising my beautiful daughter and beginning a phase in my life that I’ve been anticipating for years.

And I couldn’t be happier.


 

Stay tuned for the third and final part,  Hello Charlee, My Name Is Dad – My first week with baby

 

 

 

Hello Charlee, My Name is Dad – Part I

On September 17, 2015, Becca and I welcomed to this world Charlee Sophia Goldberg. Weighing in at a whopping 7 pounds 14 ounces, she is nearly 20 inches long. Later, I was advised that she is LGA, or large for gestational age, as she technically was delivered at 38 weeks, 6 days. We’re thinking if she went full term, Charlee would have easily topped out around 9 pounds or so – pretty huge for a couple of five and half foot tall parents!

As I type this, Becca and Charlee are both fast asleep.

My ladies.

My everything.

I am beyond grateful to have them both in my life, and Charlee’s recent arrival has truly been a gift. I have felt emotions that I’ve never knew existed, and she has fundamentally changed who I am.

The following is the story of Charlee’s birth, written for me, for Becca, for Charlee herself, and for all the dad’s out there waiting on their own child’s birth story.

My underlying message is that things change. Accept the change. Embrace the change. Don’t get frustrated beyond control. Don’t lose your cool. Remember that it’s like John Lennon said, “everything will be okay in the end. if it’s not okay, it’s not the end.”

I encourage you to share your stories here and with the world, cause as a new dad, I would have loved to know other’s stories and how they handled all aspects of it.

So to all the new dads, old dads, and dads to be – Enjoy!


Labour’s Eve was Wednesday the 16th, and Becca and I thought we would tie up all loose ends. We dropped the dog off at doggy daycare, grabbed some last minute groceries, and quadruple checked our packing for the hospital.

It was all very surreal and yet strangely appropriate.

Becca and I are very organized people – how proper was it that our baby would not leave things to chance, but rather cause a situation where we would need to schedule a C-section.

That night we chatted extensively about what to expect. It was all just a combination of what we’d heard from others, and probably what we’d seen on TV.

I barely slept.

I watched the clock tick towards five and stopped my alarm clock before it could begin.

We showered, changed, and packed everything into the car.

The hospital is a short drive from the house, so we arrive in a matter of minutes, found parking, and went to the Maternity Ward triage.

Another couple was there, in the early stages of labour. The wife was having some serious pain, and the triage nurse was getting frustrated with the woman’s refusal to listen to her. I don’t know what the issue was specifically, but the husband was trying to ease the wife’s concerns as well, while the grandmother (to be) was also assisting. At a certain point the nurse stated that the woman needed to open her legs so she could see how dilated she was, yet the woman refused. Bit of an odd choice if you ask me, but I never knew what else the issue was with her or the baby. We bumped into the couple in the Special Care Nursery later, but more on that in a bit.

Through all the commotion, we were there in a very cool, calm, and mostly controlled state. Becca was not going into labour, and for all intense and purposes, with the exception of our nerves being on edge, we were otherwise doing just fine.

Becca was given a hospital gown and laid down in a bed while they checked her and baby’s vitals. We had around 30 minutes to kill before the scheduled section, so we waited up front and finally met with the midwives as they arrived.

Becca and I were brought down a long corridor and before I knew it, she was being directed through the operating doors, while my midwife escorted me to the recovery room where we could leave our belongings and I could get suited up to be in the operating room.

She brought me back to just outside the OR and asked that I sit on one of the benches until they call me.

I eyed that door for what seemed like a lifetime, with the midwives popping out every so often, and then our obstetrician doing the same. I was told that it wouldn’t be much longer, and that they were just waiting on the anesthesiologist to finish with Becca.

Finally, our midwife waved me in.

I donned my mesh hair cover and surgical mask and walked through the double doors of the OR and into one of the two operating rooms.

Never in my life have I been in an OR (thank God), but I must say it was all very hollywood. Nurses running around doing a million things, the doctor standing over Becca lying slightly tilted back with her arms out and the curtain right at her chin. A chair was pulled up for me to sit right by Becca’s face.

My boss told me on my last day of work, “whatever you do, don’t look over the curtain. What you see, cannot be unseen”. Of course, there was also the fact that I too was a C-section, and my father passed out at my birth… but that wouldn’t happen to me… right?

As the doctor began, I stroked Becca’s hair and had her try and keep eye contact with me.

The doctor was quite rough, much more physical than either of us had expected, and Becca bounced a little, side to side, as the doctor proceeded.

She was not in pain, but the sensations were overwhelming and she started to tear up.

I wiped away Becca’s tears, reassuring her that she was doing a fantastic job, and we were almost there.

Another doctor close to us was watching the procedure while checking Becca’s vitals. She suddenly announced, “hey, there’s a foot! Daddy, did you want to see?”

Don’t look over the curtain.

“No, I’m ok”, I replied with a jovial, somewhat facetious tone.

She said, “oh, it’s not that bad. Come on, you need to see what you’re having.”

I thought to myself, you know what? This isn’t something I want to regret NOT doing, so I stood up and looked.

The scene was astounding.

The Dr. was just then pulling our baby out from Becca’s abdomen. Yes I saw some things that I would rather have avoided, but the image of my child rising up above it all was incredible.

The Dr. said, “see what you’ve got?” Unfortunately, I could not, because his arm was in the way, so I asked, “is it a boy?” to which he responded “try again!”

I started to cry.

Becca started to cry.

Our daughter was here and we were overjoyed.

The Dr. cut the umbilical chord (sadly I wasn’t offered) and passed the baby over to the midwives, who called me over to watch and help, while the doctor and nurses closed up Becca.

I moved back and forth between the baby and Becca constantly checking both to see how they were doing. Finally Becca was stitched up and stable and we were given the all clear to move into the recovery room.

It was about 9:30 at that point and we were having a wonderful opportunity to bond with our newborn. Becca tried out breastfeeding and Charlee latched immediately. We were able to have tons of skin to skin time, with only the odd interruption from the nurses or the midwives checking on Becca and Charlee’s well being.

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We opted to wait for a private room as I didn’t want to share this experience with strangers and their families. Oddly enough there was an influx of births from the night before, and we were queued up. Considering there are close to 40 spots available for families, that is a busy maternity ward indeed!

My understanding was that we couldn’t see guests in the recovery room, so unfortunately when my mum and dad showed up, I had to visit with them in the waiting room for a few minutes before heading back to be with Becca and Charlee. I sent them home but told them that a room booking wasn’t far away, so stay tuned.

Little did I know that throughout the course of the next 7 hours, Becca, Charlee and I would wait, sometimes impatiently, for a room – private or even semi-private – we weren’t picky at this point.

Finally they moved us to the deluxe suite, which they said was a real treat as the price was the same but the square footage was nearly a third more than those other private rooms.

Sweet! Maybe it was actually worth the wait.

When we got there, the nurses told us to lay Charlee in the baby warmer until they came back to do vitals and bathe the baby. At this point, she was nearing 8 hours old which is the window they wanted to use. The problem was that they did not turn on the baby warmer, or in fact heat for the room whatsoever, and it was sitting at approximately 21 degrees (or just shy of 70 fahrenheit).

It wasn’t until 90 minutes later they finally came in.

There excuse was that it was time for a nursing shift change (one of many we were going to be privy to) and they needed to report in to the on-call paediatrician. The new nurses came and started taking Charlee’s vitals. They were immediately concerned about her temperature which was quite far from the 36.6 degrees that they were looking for.

They advised immediately to do more skin to skin and brought us blankets to cover Charlee with at the same time.

An hour later they came back and tested again, this time with two of the on-call resident paediatricians who again flagged Charlee’s temperature. They proposed that we have her blood sugar levels tested too. This involves pricking our baby’s heal and then measuring through the blood before putting a bandaid on to stop the bleeding. These heal pricks would increase in frequency as our hospital stay continued.

I came to learn that the cold in the room caused Charlee’s little body to exert more energy to try and bring her core temperature up. This means burning up her blood sugars, and therefore registering a low number (this information was all in hindsight).

The concern heightened, and the nurses were requested to provide supplemental feedings in lieu of Becca’s breast milk fully coming in. They cup fed Charlee 10 cc’s of formula to help boost her blood sugar and give it a valiant effort before advising the inevitable.

After another hours wait, her blood sugars were taken again, and sadly again, they were low.

The on-call paediatrician was signalled to come in and she discussed with us that at this point we had only one option. She said they had prolonged the unavoidable through attempting the formula supplement, but Charlee was going to need to go to the Specialty Care Nursery.

Becca knew what that was.

I didn’t.

It ends up that it is a Level 2 neonatal intensive care unit and it’s scary as hell.

They carried Charlee over there and advised that we could come visit in an hour and get signed up for an access pass and discuss the next steps with a nurse.

This was how we found Charlee

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We were told that Charlee had an IV providing her with the much needed levels of glucose to help support her body.

Over the next 3 days, Becca, Charlee and I went through some of the toughest times I’ve ever experienced. Times that Charlee will never remember, but Becca and I will never forget.


 

Stay tuned for Part II – The SCN