Month: September 2014

Pre-Fatherhood Thoughts on Fatherhood

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Written in 2013. September 19th.

Passing thoughts on Fatherhood.

Being an expecting parent has made me dwell on my own mortality like never before. A little morbid sounding that is, but, I suspect, not uncommon. Looking at the sonogram pictures, so clearly seeing life anew, I dwelled on my own end, but the dominant feeling while looking at the sonogram image was the inescapable sense of adventure, an adventure I expect to enjoy for many more decades.

I have also had a heightened protective instinct, also quite common among expecting fathers. That instinct takes many forms, among them worrying a little more about Kate’s well-being and health or looking not twice, but three times before we cross the street. I find myself being more careful when I am out for a run, driving, hiking, etc. I have always wanted to live for Kate, for us, but now I am living for another human being. This gives simple phrases, like drive safely, uttered in habit to someone walking out the door, a whole new weight as if they’ve never been spoken with meaning before.

Life becomes more exciting, serious, and scary when one is expecting a baby. Not all of those emotions I feel to the same degree, but all are felt with more intensity.

Until today I didn’t know I could love something so small. Kate and I saw our baby for the first time. It’s .75 cm long and about 7.5 weeks along. We saw its heart beating. How miraculous.

One last thing…

I am not a person who typically uses the phrases, “I saw God in…” or “God made himself known to me,” to list just two examples, but as Kate and I turned to the sonogram screen for the first time and saw our unborn child, I felt God’s presence in our lives, in all three of our lives. There, on that monitor, a blob of white, not even a centimeter long, was our child, something we are responsible for. It’s not the clearest image and the doctor has to tell us where to look and what we are looking at exactly, but I saw God smiling back and a new dimension of love, one that rocked me to my core, began to surface.

Busy, Writing, and Travel

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Taken the weekend of our first overnight trip with London.

It’s been a busy week around here and I’ve not found the time to sit down and write a new post, for which I have some guilt and disappointment. This is the toughest thing about keeping a blog like this. There is so much material to delve into, but not enough time to do the delving. On certain days, not getting the opportunity to do that really stings.

We are going to the mountains tomorrow for a couple of nights. My parents are meeting us there. We hope to catch some fall color and to just be away from Denver for a little bit of time. Writing that reminded me of the shock I had in May when I realized that I had not been out of Denver for more than a few hours since London was born. There was one short trip to Fort Collins for a baby shower. That was it. If I had mapped my location during the three and a half months London was in the NICU, you could see a very heavy line from home to hospital and then tiny little branches breaking off from that. Each brach representing a trip to a restaurant, grocery store, or a coffee run. I kid you not, there was no more variety to my destinations for 109 days. Hospital, home, restaurant, grocery store, and coffee shop.

Now that London is home we get a little further out from the house and with greater frequency, but it is still a challenge to compare our range now as a family versus what it was a year ago. Luckily, as London ages and strengthens our travel radius from home will lengthen out to something closely resembling the old, have freedom, will travel, spirit of the pre-London era.

NICU Bragging

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I don’t know what else to call it, but NICU bragging. It’s an odd thing, something Kate and I became aware of while London was in the NICU, but something that really reared its ugly head once we were out and could take London to public places.

As emails went out to notify friends and family of London’s emergency birth and her condition, we started to hear back from all sorts of people. Those who had had preemies themselves did share some of the most useful information, but every once in a while there would be a line dropped in an email or spoken in conversation that, while perhaps not ill intentioned, would sound a little like bragging. Typically, these lines would be in response to us sharing London’s gestational age at birth (26 weeks, 4 days, but rounded down in the NICU to 26 weeks) or her birth weight (2 lbs, 6 oz).

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My girls.

In response to the gestational age, people were eager to share if their son or daughter (or relative) was born earlier. In response to the weight, people were eager to share if their son or daughter (or relative) was born weighing less than London. Initially, it was a little bit comforting to know that there are preemies born quite a bit earlier and lighter than London who can turn out fine, but not too long after London was born I had a hard time interpreting these comments as anything but diminishing our particular situation. In some cases, I knew people were trying to comfort us, but with others I said little in response to them about our preemie and NICU experience, hoping they would sort of get the hint and walk away.

I found that the comments in response to London’s birth weight were the most bothersome and they nearly always contained a detested title, micro preemie. If you’re wondering, a micro preemie’s birth weight is less than 800 grams (1 lb, 12 oz) or with a gestational age of less than 26 weeks. More often than not, I felt like micro preemie was shared in conversation with us as if it was the highest commendation a preemie could receive and it was delivered with a tone that implied one thing, our preemie has had it harder than your preemie. Nothing irked me more than someone referring to their preemie as a micro preemie merely because it was born weighing less than London but its gestational age older, like 28 or 29 weeks, or even later. From what I was told in the NICU, from nearly everything I have read, gestational age is more important than weight. Of course, being bigger than average at 26 weeks, like London was, is a huge benefit, but staying in the womb even for just one more week would have been vastly more beneficial for London. So, if someone told me they had a micro preemie, but it was born at 29 weeks, the only thing I cared about was ending our conversation.

Before London left the NICU, we had to attend a discharge class with other parents whose baby or babies were going to get out soon. Naturally, we all sit there and talk a little bit about our circumstances before the nurse shows up to teach the class. Most of the conversation centers around birth weight, gestational age, and length of NICU stay, i.e., the premature baby’s big three. By the time Kate and I sat in on this class, London was the veteran of the NICU, with over 100 days under her belt, and we were very much aware of NICU bragging. Thus, we were sensitive to parents, for example, who spoke about their three-week NICU stay stretching out to what seemed like three months. In our NICU class we did not share one of the big three stats because we did not want to give the impression to anyone that we were diminishing their own private and frightening experience.

Parents of preemies always find one another in public. It’s rather easy for us, we see a baby out and about with oxygen or an NG tube, and we know part of the story even before we talk to the parents. We have been approached by parents of preemies nearly every time we take London out to the mall. The parents approaching us to ask about London are eager to hear a little bit about her story, but mostly they are very eager to share their own. Some of these folks just unload a life history on us even though we met them thirty seconds ago inside a Nordstrom. For Kate and I, with our somewhat introverted personalities, this can be uncomfortable, to say the least.

As you can imagine, such encounters are even harder to avoid when going to a special care clinic at a children’s hospital. Last week, I overheard a conversation that must have started when one parent spotted another baby on oxygen.

“Oh, was he a preemie?”

“Oh yeah, 28 weeks.”

“What’s that, 3 months early?”

“Two and a half.”

“Ours was 3 months early.”

End of conversation. I felt like the parent whose baby was born three months early was just looking for the quickest route through the conversation so he could say, “Ours was 3 months early,” and then walk away. That’s precisely what happened. I’ve seen this a lot. It’s NICU bragging.

It is important for parents of preemies to talk with one another, to share their unique stories, but to share the big three stats and walk away, well, that does no one any good. As Kate and I have grown into being parents of a preemie, we have become increasingly conscious of this truth when talking with other parents of preemies. We would love to share with you London’s gestational age, weight, and number of days in the NICU, but only if you ask. We know there are preemies who were born earlier or later than London, born heavier or lighter than London, and stayed in the NICU longer or shorter than London, but that does not necessarily mean their time in the NICU was automatically easier or harder than London’s. A preemie’s care and progress can be influenced by many factors and is vastly complicated. This truth is never fully borne out by sharing the big three stats. We will do our best to never start a conversation with them.

Baby Kale

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Two weeks after London was born I was foraging through the refrigerator for anything edible. We hadn’t been able to go grocery shopping since Kate was pregnant. I was not hopeful about what I would find, but why not try? If I found something, then maybe I would cook a meal at home. At this point we were living off meals delivered to our door while we were at the NICU.

As I moved condiments aside to see to the back of the fridge, I spotted something. It looked like lettuce before I saved it from the depths of the Kenmore, but it didn’t need saving, the package of baby kale spoiled at least a week prior. However, this was much more than a package of spoiled lettuce. I bought it before London’s birth so it was a relic of my former life. Standing there, holding the baby kale, I could picture the day I bought it. It seemed like ages ago. It was just a trip to the grocery store and the now yellowing leaves of baby kale made me yearn to be in that place again, where I was simply gIMG_3979rocery shopping without, in hindsight, a care in the world.

The baby kale linked me back to this person who I no longer was, a person I didn’t have the time to say goodbye to. Not only a person, but a lifestyle too, that in the weeks following London’s birth I mourned. In a way, as expecting parents, you have nearly ten months to transition from one lifestyle, the one with no kids, to another lifestyle, that of parenthood. One of the toughest things about having a preemie is that those remaining three months (in our case) were lopped off with no warning and in six hours you are thrust into an experience so beyond what you could have imagined. An experience with terrifying responsibilities and with horrific consequences.

There are of course things around our house that Kate and I bought long before London arrived, but the baby kale brought me back to the pre-London era like nothing else could. As I dropped the kale into the trash, I was not simply letting go of spoiled food, I was letting go of a past, one I could no longer identify with and letting go of a self I could barely remember being.

Stroller Love

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Remember when BOB strollers were cool? Yeah, well, in this household the BOB fell short, quite literally, right from the start because I am 6’9″. There’s no point in asking if you’ve tried pushing a BOB stroller when you’re 81 inches tall because you haven’t. I’ll just tell you. It is freaking miserable, like walking around bent at the waist, stretching your hamstrings wherever you go.

BOB strollers have a great reputation, so when I first tried pushing one in a store I was so discouraged because I mistakingly thought BOBs were the pinnacle of strollerdom and if this stroller wasn’t going to do (and it clearly wasn’t) then what’s left?

Let me tell you what’s left…the just-as-short Graco strollers, the Eddie Bauer BOB look-a-like strollers (EB, really? I thought you learned to not branch out after the Ford Explorer Eddie Bauer Edition, but after a quick Google, it appears the EB edition is still a thing…how?), Britax (practical, a little taller, but Jony Ive needs to redesign them because they’ve been hit with the ugly stick so many times their wheels have two spokes…what were they thinking?), and Chicco (which just seems like a mashup of Graco and Britax). I could go on, but you get the point, right? All of these strollers, despite their own unique flaws, are all too short.

All hope was lost until we walked into the Right Start, sort of a posh baby store, and an actual employee listened to what we were looking for and walked us over to this beautiful stroller she was calling the Uppababy something, I didn’t catch the name right away because she said it right at the moment I looked at the price tag. While laughing in my head at the absurdity of paying that much for a stroller, I obliged the employee and took it for a little spin, but right before I strolled off, the employee reached to the center of the handle, gripped, and pulled. The handle raised a few inches higher off the ground. It was love at first step. My hands didn’t have to go down to my knees to push this thing. My feet didn’t hit the rear axle of the stroller because it’s not there, leaving plenty of room for my full-stride with size 15 shoes. The Uppababy Vista moved like butter around the store. Each and every step was a little more painful because I was falling more and more in love with the stroller but knew we weren’t going to IMG_3720drop that kind of cash on such a ride.

After that initial trip to the Right Start, we kept looking for strollers. We pushed around cheaper models at Target and Babies R Us. We pushed around much more expensive models (didn’t know that was possible, but makes sense, the celebrity parent needs something to push around) at a boutique stroller store. But always, the Uppababy Vista was there, lurking, pulling us back to its many wonderful features. However, it was always the height that appealed to me. Other bonuses, like the included bassinet, seemed unnecessary. The brand name, Uppababy, even bothered me. It was too pretentious sounding and it looks like it was missing an umlaut.

We kept resisting, but the stroller search was leading us nowhere. Before we formally spoke about it, I think we both knew the Uppababy Vista was going to be ours. It was inevitable.

We eventually were ready to buy and then we received an incredibly generous gift certificate to the Right Start from friends we met in Milwaukee. This made the purchase easier to stomach. And so it was, a week after I made a few fast clicks on the Right Start’s website, the Uppababy arrived at our doorstep and I immediately assembled it. Since it was April 14th, the stroller sat in the living room for a month like a piece of precious furniture that no one could sit in.

Months later, I can’t imagine having a different stroller. The cost of the stroller, even without the gift certificate, would have been worth it. Never once have we regretted the purchase. That unnecessary bassinet became indispensable. The car seat attachment beautiful. The height always right. However, I still think Uppababy is missing an umlaut.

Born in the USA, Raised in the NICU

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London is a remarkably happy baby. She tolerates so much and cries very little. We hear this from nearly everyone London meets. I tell them I have a theory. For the first 3.5 months of London’s life she had medical professionals treating her around the clock. In addition to the diaper change, temperature check, and respiratory check every four hours, she was also interrupted with head ultrasounds, echocardiograms, at times shots, the placing of a new IV line, and physical therapy. This is the NICU norm. For the baby, they assume this is what life is like, this is how all babies live out their early days. So, what is crying going to do?

That is the attitude London embraced. To make London cry now, you almost have to give her an ROP exam. Her frightening start and all the procedures that it necessitated made her one tough babe. I like to think that most long-term NICU babies also graduate as super tough and tolerant little things, but I have a few reasons to believe that that is not the case because all too often nurses would tell us how amazing London is with a shot, for example, when she would barely cry for one second in response to the needle, but the boy next-door would wail for a couple minutes.

In a way, the NICU schedule of around the clock treatments or feedings continues when some preemies come home. Usually with full-term babies it’s the baby waking the parents up, but with preemies, it is quite often the parents waking the baby up. Whether it is a feeding time, a cannula check, a breathing check, or just a general are-you-alive-over-there check, London’s day and night were interrupted by her parents for quite some time.

Below are some pictures and a video that only give you a sliver of the stuff London and other preemies endure at the NICU.

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One of the less intrusive procedures, an echocardiogram when London was not even a week old. This one revealed a PDA, which was resolved over the two weeks following this echo.

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As London’s lungs strengthened, she was placed on CPAP. Of course, I loved the progress, but I had a strong dislike of CPAP because it covered up most of her face. It was nearly impossible to see both of her eyes from the same angle when she was wearing her snorkel-like attachment. It drove me crazy, but London, always so chill, tolerated it like a champ.

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An every four-hour checkup on London, one of her “cares.” This particular picture was taken during London’s three-chin phase of life.

It was May by the time of this echo. As you can see, it’s no big deal to her. She’s about ready to fall asleep mid-echo while nurse Eileen chats away in the background about how busy the NICU is that morning. We thought London was done with echocardiograms by this stage, but the doctor ordered another battery of tests to see why she was so tired and not eating. On this particular day, day 95 in the NICU, it was London’s peaceful state of mind that helped calm us down.

The Eyes Have It

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London’s first ROP (retinopathy of prematurity) exam was around 8 weeks after she was born. From the first time someone mentioned the ROP exam, they made it sound like something that we, as parents, would not want to stick around for. Kate always heeded that advice. I did not.

After London’s eye exams revealed Stage 2 ROP, I knew avoiding them was going to be impossible. They were happening once a week and, as with every other procedure, I decided that I wanted to be with London through it all. I did not want to shield myself from what she was enduring. If I did not watch the exam, I would feel out of touch with her care and progress.

When it was time for London’s next exam, I had just put her back into her isolette. I informed the doctor that I was going to stay. “Okay, stay seated, because I’ve had a dad pass out on me before,” she said.

I stayed in the chair even though I was confident I could stand up and get a better view without passing out and hitting my head on the floor.

The nurse that day gave London some sugar water or “sweeties”, designed to distract London from the imminent eye invasion. When the nurse had an arm on each side of London and her hands holding London’s head firmly in place, the doctor placed the miniature eye speculum. London squirmed right away, but she didn’t start wailing until the doc was looking in her eyes. I had never heard London cry like that.

Now, having watched so many eye exams, the noise London makes when her eyes are being examined is the hardest part of being there. The speculum and the probing with other tools looks quite unpleasant, but I promise you it is the noise that is the worst. It is a traumatic enough burst of screaming that an adult might only make it if they were being slowly stabbed again and again.

It is nearly enough torture for the parent to hear as it is for the baby to endure. Once I heard her scream like that I knew the sound would be with me forever. But, as I sat there and watched eye exam after eye exam, I tried to absorb as much of London’s pain and fright as possible. The eye exams became a unique way for London and I to bond.

As soon as the eye exams were over, the nurse would hand London back to me. She would immediately stop crying, look up at me, and immediately rest her head against my chest.

Last week we endured one last ROP exam together. If London had to have another exam I am not sure how the doc and her assistant would be able to contain London’s thrashing and kicking. One last time I attempted to share in the pain with London by being by her side and one last time I had the privilege of comforting her as soon as the speculum was pulled away.

Real Time Update

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I haven’t given an update about London’s health and growth in a while. Since we just saw the doctor today, now’s a good time. 

London is just over 7 months old now. Her corrected age is just over 4 months. 

She weighs 17 lbs. That a girl. 

She is just shy of 27 inches in length. 

Last week, she had her final ROP eye exam because her eyes have fully vascularized. I am so glad I don’t have to watch another one of these exams.

As of today, we can have her off of oxygen whenever she is awake. She will need oxygen when sleeping at night or napping during the day for quite a while still, but this is huge progress. 

When we were sitting in the doctor’s office today, the pediatric dietitian looked at London and said, “Are you sure she is a 26 weeker?”

A few of you have been asking about the enterovirus scare going around Colorado and much of the Midwest. We aren’t taking any extra special measures for now. An employee at Children’s did tell us that they aren’t allowing inpatient visitors at Children’s right now and that many people have postponed their child’s outpatient appointment. London is not supposed to have contact with babies or kids. This is the way it has been since we brought her home so no changes there. As always, we have plenty of hand sanitizer around the house. I think we’ll be just fine. 

London will get a standard flu shot, but she will also receive Synagis for RSV (Respiratory Syncytial Virus). She’ll be getting all of these within the next month, staggered of course. 

One last thing, if you’re planning on holding London and visiting with her at any point this flu season, you just have to get a flu shot. No flu shot, no London time. Flu shot, London time. Pretty easy decision if you ask me. 

Happy to share this update on London’s progress!

More Baby Time

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DOL 2: Eyes still fused shut.

How long is a baby considered a baby? Yeah, I just googled that because it feels like London has already been a baby for so long. The Google consensus is that a baby is a baby from one-month old to less than two years. Prior to a month, a baby is a newborn, although I never referred to London as a newborn when she was less than a month. She was a baby. Still is. And, I guess, she will be for quite some time still.

I suppose it feels like she has been a baby for so long because we watched her last three months of in-utero development outside of the uterus. By three-months, most babies are doing something new each week, maybe even rolling over. London was still doing something new each week, but at three-months she was still struggling with eating. Watching that development outside of the uterus is special. Not many parents get to watch their baby struggle as they open their eyes for the first time (which usually happens in the seventh month of pregnancy). But Kate and I were standing right there as the seal broke and London’s eyes flickered to life right in front of us. It is those moments that make London’s seven months of life stretch out to a year in my mind.

I know, among parents of preemies, I cannot be alone in marveling at the changes that can happen in 7 months. But I am also pretty sure most parents of full-term babies are also astonished at the changes 7 months can bring. Naturally, that feeling is more intense when the starting point is three months earlier and seven pounds lighter than you were expecting it to be.

The Header Image

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Just a quick story about the header image. It is a panoramic shot of London’s second room in the NICU. This is really the penthouse of the NICU. When we moved from our original pod to this one it felt like going from the ground floor to the fiftieth floor. It’s 1.5 times the size of our first room and it is the only room in the NICU with a whole wall of windows. Our first room had no windows.

I was hesitant when the room opened up and it was first mentioned to us that we could possibly move in there. This was the room that was opposite our first room. I wrote about it in this post. So, you understand my hesitancy.

One of our primary nurses had one stipulation about our move into this room. She said that everyone else that gets that room always ends up pulling the shades and blocking the only flood of natural light the NICU gets. If we were to move in there, we would have to promise her that we would only have the shades down in the morning when the sun is unpleasantly shining straight into the NICU’s eyes. We promised. I got over my initial hesitancy and we made the move, knowing that we had well over a month left in the NICU so why not upgrade for free?

The move was one of the smartest things we did while London was in the NICU. We were there for quite a bit longer than we thought we were going to be. We fell in love with that room, as much as one can fall in love with a hospital room.

Toward the end of London’s NICU stay, there was a leak in the ceiling in London’s room and we had to give it up for just one night while it was fixed. The next morning I came back to the NICU and London was in her temporary room, which was much further back in the NICU. No natural light made it there. Everyone was pale and had a depressed look on their face. At least, that’s the way it seemed after living in the penthouse for so long. I only had to sit with London in that room for 40 minutes, but that was more than enough. I pushed her back to her pod with a nurse and it was like stepping out of a tunnel into a glorious sunny day.

We are so thankful for that upgrade.

Blinded By The Light

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Last night, Kate and I watched some old videos of London in the NICU as we were falling asleep. We did this every night while she was in the NICU. Now, not so much, because we can get out of bed and walk twenty feet to her crib and there she is, sleeping so peacefully. As we scrolled through old photos and videos on our camera roll, we happened upon this one…

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Kate said, “You should write about this picture and the bili lights.”

“Okay,” I said. But it took me a few more minutes to figure out where I could go with a post about this picture. First, I should just tell you about the picture, it is of a very small stuffed animal (beany baby size) wearing the goggles that London wore while she was under the bili lights. We have a couple of these BluBlockers because the nurses thought London was done with the bili lights and then she went back on them after we had taken the first goggles home.

These goggles were addicting to me once they were home because I could, whenever I would pass them in the living room, pick them up and smell them. Their smell transported me back to London’s room. So when these goggles came home, it felt, for the first time, like we had brought a little bit of London home with us. Before bed I would inhale deeply from the goggles. When I got downstairs in the morning I would take another hit from the goggles. It’s starting to sound like I’m talking about a bong, but that’s entirely appropriate because the smell of these goggles made me relax, they transported me to another place, and I was at peace.

Sadly, the goggles eventually lost their scent of newborn London. Unfortunately, one can’t take that smell and store it away in a NICU keepsakes box where the goggles now rest.

Every one of the fifteen weeks London was in the NICU, I took a load of her laundry home. And every time I was about to put her clothes in the washer I smelled them, although with clothes I had to carefully select where I was going to plunge my nose. Then I threw them into the washer. By the way, do you know how many preemie outfits you can fit in a modern washer? I’ll save you the calculation: a lot.

Smell was and still is an essential way to connect to your baby, especially if they are in an isolette. Even before we were discharged from Kate’s room at the hospital the nurses had us wearing receiving blankets in our shirts as we slept. Whenever we were next at London’s side, the nurses took the blankets from us and placed them near her head or wrapped her up in them. The blankets were supposed to familiarize London with her parents’ smell.

I liked to think of her taking a deep inhale from the receiving blanket before she fell asleep in her hot and humid isolette. And again, in the morning, taking a deep breath and catching a hint of mom or dad in the air so a part of us was always with her.

Mind the Hierarchy

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Here’s a pro tip for doctors from someone with no formal medical training:

When you are a resident, regardless of what year you are, introduce yourself as such when you are greeting parents of a 26-week preemie (or any other person in the hospital). Do not say, “Hi, I’m the neonatologist,” as if you are the attending when I can clearly read the giant block letters on your name tag that spell out, “R E S I D E N T.”

Important reasons for identifying yourself as a resident, in no particular order, are:

1. If you’re not a great doctor and you introduce yourself as the neonatologist we are going to assume, at the very least, that you are a fellow or maybe even an attending. And then we will be frightened because if you’re the fellow, then who the hell is the resident and are they next to my baby and, if so, can they please step away from her right now.

2. It’s nice of patients or parents of patients to know your resident status. We will actually give you a little slack (some of us will) because we know you are in an intense three-year period pursuing specialization in your desired field of study.

3. If you say something we disagree with or want to challenge (for example, ordering up another chest X-ray), it’s important for us to know you are the resident so we can communicate to you that we want the fellow’s opinion as well or that we want the attending in on this decision.

4. In rounds, don’t forget that you are the resident. You may be high on your horse, but remember, there are nurses in this circle that have been taking care of preemies since before you were born. There’s also a hierarchy. If a fellow is challenging your idea and nurses are backing up that fellow and the attending is sitting nearby not saying anything, that should really clue you in to the fact that the attending approves of what is happening.

5. You earn your title. Attending. Fellow. Resident. Intern. Clerk. Sub-I. So let us know exactly where in this hierarchy you reside. It’ll be best for all of us.

Daddy Kangaroo Care

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The best thing a dad can do for his baby in the NICU is kangaroo care. Mom’s got the breast milk covered, so dad needs to, again, man up, take his shirt off (or unbutton the shirt until it’s open), grab his baby, and sit in a chair for a few hours. When kangaroo care was explained to me, it was emphasized that the most beneficial kangaroo care is skin-t0-skin and that some dads are a little hesitant about taking their shirt off to do this. This was not the only time I heard of machismo getting in the way of taking care of a baby. (That is a whole other topic that I would like to address in later posts.)

After two weeks of London’s life, we were allowed to do kangaroo care with her. Of course, mom got the honors, but I worked my kangaroo care in when Kate had to hook up to the breast pump.

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For the next couple of weeks London was small enough to tuck into Kate’s shirt. I thought that was the cutest. The two of them were so happy together during kangaroo care. I could not stop smiling whenever I would look at them. It was such a peaceful scene that I too could fall asleep even though I had been drinking iced coffee since I got up.

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The most challenging part about kangaroo care is the management of the tubes and wires when you are moving from isolette to recliner. Once the transfer is complete, you get to enjoy the easiest part about kangaroo care, falling asleep.

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Not the sharpest picture, but look at Kate, my sweet Kate. Whatever was happening that day with London, as soon as she got on mom’s chest she was doing better and every single time Kate looked like she was having the time of her life. Beaming. So proud.

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I did not always take my shirt off when I held London, especially toward the end because we would be switching so often between reading and sleeping on my chest. This was the day of London’s discharge from the NICU. Getting ready that morning at home, I grabbed this purple t-shirt, knowing I had worn it the night London was born, and now the day London came home. I still think of that every time I reach for this shirt in my closet.

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A lot of aspiring writers ask professional writers how they do the work they do? What do you start with? And a common response is, “Butt in chair.” The time to write was not while London was in the NICU, but it was the time to do the most important job I will ever have, which still required my “butt in chair.” This was my view for 109 days, I could not leave it the day of her discharge from the NICU without taking a point-of-view picture. Looking at it now takes me right back to that pod, from where we left the hospital together for the first time.