Emergencies

PTSD from the NICU

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Another day down, but one last peek at London before we leave for the night.

When someone first suggested that I am suffering from Post-Traumatic Stress Disorder (PTSD) I stifled my disagreement and listened, doubtfully, to their explanation. A few minutes later, when they were done speaking, I was nearly in agreement with them.

Prior to this conversation, having PTSD was not something I thought I could get. Naively, I associated PTSD with war veterans and not many other people. But this is so wrong. The National Institute of Mental Health (NIMH) defines PTSD this way:

When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.

PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers.

Kate and I were afraid for months while London was in the NICU. We did not always realize it, but we were preparing ourselves for the worst outcomes in the NICU in an attempt to defend against them. Now that London is out, far removed from those most terrifying days, we still occasionally feel frightened and on edge. I first noticed a change when I was performing simple tasks, like preparing some milk for London. On a few occasions I spilled some of that milk and instantly my temper flared. And if anyone was around, I was mean to them. When I am like this I do not want to be near anyone. I was not crying over spilled milk. I was inconsolable over spilled milk. I was not sad. I was irate that something did not go my way. Everything sucked. I consider myself to be a patient person, so this new feeling of anger over something so unimportant was troubling. In fact, that realization made everything worse, bringing a snowball effect to my PTSD.

In addition to losing my temper, I can be anywhere doing anything and if I slip up and think about the scariest moments in the NICU or in the OR the night of London’s birth I am fighting back tears. These are not voluntary recalls. I do not want to think about the scary moments, but the trauma of London’s start is prolonged and fresh in my mind. To think back is to invite some of those moments into the present and once you do that it is hard to stop the flow.

The NIMH definition of PTSD continues:

PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes.

Or as someone recently put it, “You were not just in a single life-threatening accident with London. You were in one week after week after week and the person most precious to you in this world was the one always at the greatest risk.”

Truer words have not been shared with me. Having a baby at 26 weeks is exactly like that. Every time we drove to the hospital we braced ourselves for the accident. For a while, we got bad news every day. Sometimes it was just a trickle. And on the worst days it was a flood.

Even when the bad news did not come, we still braced for it. Do that day after day for 109 days and PTSD becomes a near certainty. For almost four months Kate and I did not just daydream about worst-case scenarios. On top of the worries every parent has concerning their newborn baby, we had to have real, hard discussions about our variety of worries stemming solely from London’s delicate start to life. At the end of most of these discussions one or both of us were crying and holding onto each other.

Until your child comes home from the NICU you live at a heightened state of anxiety. It becomes your new normal and when you plateau for that long coming down can do some really weird things to you. We are still adjusting.

The Fastest Year of My Life

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Taking in the sunrise from our room in Mexico.

Last year, Kate and I were in Playa del Carmen for a wedding during the first weekend in November. I was thinking of this trip just last week and I momentarily refused to believe it had almost been a year since Kate and I strolled along on the beach during a midday thunderstorm. That walk and the rest of that trip are so vivid and crisp in my mind, we could have been there last month. How could those memories be a year old?

Less than two weeks after we returned from Mexico we went under contract on our first home. The next 12 days I was busy with the purchase of the home and making sure we could move out of our apartment before the lease ended. Then we were off to Wyoming for Thanksgiving. Then we drove back. A few days later we flew to Orlando for a week. Then it was a week of last minute Christmas gatherings and preparations before we traveled to New Mexico. There for nearly a week, we drove back and closed on our house that Monday, December 30th. I started painting throughout the house that afternoon. We moved furniture on January 7th. The house was a mess and there was still more painting left to do. We then had a relatively calm three weeks (as calm and restful as settling into your first house can be).

Then the night of January 29th arrived and Kate had painful contractions at 26 weeks. The next significant date in my head is May 19th, the day London came home. And then a summer spent on edge as London slowly strengthened and we traveled to weddings. And then fall arrived. And now we’re almost back where we started.

From January 29th to May 19th, it did not matter what day of the week it was. It did not matter the month, the holiday, the weather, the time. It only mattered that London was doing okay and getting better. These days are curiously recalled in my mind. There is so much held within the borders of them that it will take years to process just how much we changed during that time and how it affected us. Yet, at times, those days seem like one really long fast day. And then it was summer and our girl was home. I recall pausing during my walk out of the hospital one day in April to take in the weather. “My God, it’s spring,” I mumbled to myself. Where had winter gone? I was actually dumbfounded. I can easily remember the cold night we arrived. That was the last day I cared about the weather.

Living on edge makes life go by very quickly. That is one thing I have learned in the last year.

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May 23, 2014. 4th day home.

London is home now. She is strong and happy beyond our wildest hopes and expectations. I do not call her a miracle baby because I never want “miracle” to be a term I casually use. But it is true. She is a miracle. And she is not the only miracle of the last year. It is a miracle all three of us made it through. At times it did not seem possible. It did not seem possible that time would slow. But it did. And I care about the weather once more.

If You’re Just Now Getting Here

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I probably should have done this sooner, but if you’re just now finding this blog via a tweet, Facebook share, or web search, then you should know that it all started with a series of posts detailing London’s birth. These posts are the foundation of this blog and, for their author, the hardest to write and the hardest to reread.

Feel free to scroll down through the archives, but if you’re looking for square one, and for getting a better feeling of how this family got its start, follow the links below. A quick word about the original posts, there are thirteen of them, but they aren’t very long posts so reading all parts is not a big ask.

London’s Birth Part I. 

Part II.

Part III.

Part IV.

Part V.

Part VI.

Part VII.

Part VIII. 

Part IX.

Part X.

Part XI.

Part XII.

Part XIII.

The NICU Is A Fortress

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One of my favorites. Her 2-month birthday. “To infinity and beyond.”

As badly as I wanted London to leave the NICU I was also terrified of some of the things she would lose when we walked out of that hospital. 24/7 caretakers. A team of RNs, NPs, and MDs just feet away. The opportunity to talk to one of them whenever we wanted to and to ask the dumbest questions of.

As a parent, you do grow accustomed to having your baby in the hospital 24/7. It is comforting to know that your child has the best babysitters in the world.

While London was still in the hospital I wrote:

Right now I feel like taking her home will be bittersweet. I’ll be beside myself, in a good way, when we walk into our house holding London, but it’ll also be frightening to leave our NICU family.

Back then, the approaching discharge date meant exposing an already fragile baby to the terrors of this world like driving home with her! Or contact with the public, those creepy baby oglers who think they have the right to walk up and touch your child just because she is the cutest thing they have ever seen. Can’t stand these people! We would be responsible for a baby, yes, but also all the leashes that come with her: NG tube connected to a feeding pump, an oxygen cord, and a pulse ox connected to her foot. Monitoring all that could be overwhelming on top of normal baby duties.

But a baby has to leave the NICU eventually. We had our gambles and triumphs there in that pod, but the good stuff was to be found in life beyond those hospital walls. It is hard to think of leaving the NICU as anything but a tradeoff. An adventure was before us, filled with successes and failures, loss and gain, losses and victories. But behind us was London’s NICU pod, which, for her parents, became the safest place in the world.

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.

We’re Ready

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About two weeks before London was born, I was talking with a mom of two kids and telling her about the baby girl that we planned on welcoming into the world on May 4th (or sometime around then). When I finished up sharing my exciting news, she had a question for me, “Are you ready?”

“Yeah, I’m ready,” I said.

“No. No, you’re not,” she replied.

For some reason this exchange, between the parent who is in the thick of it and the expectant parent, is commonplace. And, I would be willing to bet that expectant fathers get this response more than expectant mothers do, but I am not bothered by that. I am bothered by the response, “No. No, you’re not.”

Obviously, I recognize that this response is, in part, a weak attempt at humor. What appreciation I have for that humor though is wiped away by the response’s other message, one that seems to imply that my wife and I, one, did not know what we were doing when we decided to make a baby and, two, that prior to that decision, we did not think about what we were getting into or taking on.

Of course, no one knows for sure what they are getting into when they decide to start a family. We certainly did not know that five months to the day that we found out we were expectant parents our little girl would arrive. We did not know that London’s prematurity meant that I had to stay at home with her. We did not know of how deeply we would love our child. We could not have imagined our lives changing so much in the span of six hours on the night of January 29th.

But we did know something before London was even a whisper. We knew that if we moved forward with our desire to start a family we were embracing the unknown in a way we never had before. Within that unknown, there sure was the possibility of having a preemie. There was the possibility of a miscarriage. Really, the possibilities are endless and that is a frightening thought, especially when you become a parent.

For the chance to love someone more than ourselves; for the opportunity to have our hearts leave us and become a little human being, these are joys that trump the unknown.

For that mom who said, “No. No, you’re not,” who knows what surprises and challenges came her way in parenthood, but, she must know, and so must other parents who tell expectant parents that they are not ready, that, indeed, some of us are.

Forget About Stress Eating, We Forgot to Eat

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A few words about food. If you have found yourself in a situation similar to ours, you will know that really simple things, like grocery shopping, cooking, eating…heck, even bathing, become so overwhelming that they don’t get done. Of course, that is if you even think about them. There were quite a few mornings that I did not think about them at all as I sat in the NICU holding London. Then, around noon, when I would start to think about lunch, I’d realize I hadn’t had breakfast. I hadn’t thought about it at all. Trust me when I say this, I have to be extremely stressed out and busy to completely forget about eating.

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Coq au vin, prepared by my mom. With Odell beer and Highland Park 18 Yr Scotch.

Things were like this for a while. Kate and I did not have the time or energy to sit down and plan meals for a week and then figure out the necessary items to pick up at the grocery store. It was never going to happen.

We had so many people asking us how they could help. I don’t know about you, but it feels weird to say things like, “Well, we could really use a dinner tonight,” or “Do you want to go vacuum our house?” “Do our laundry?” “Bring us lunch at the hospital.”

Luckily, we have some amazing friends who know from their own experience or the experience of others that stepping up and providing a meal is the best thing you can do for parents who have a baby in the NICU.

We had meals in the freezer for weeks. Friends even came into our house while we were still at the hospital and made dinner, so when we got home there was soup in the crockpot, bread on the counter, and salad in the fridge. There were meals on our doorstep, driven in from Boulder. There were strangers at the door, well, someone who knew someone who knew Kate, dropping dinner off and telling me, “You look tired. Be sure to get some rest.” There were people showing up at the NICU to meet London, but also handing us a meal. There was a Trader Joe’s gift card in the mail. There were parents who cooked amazing meals for us at the end of a long day in the NICU.

I did not do a big grocery shopping for four weeks. I occasionally had to get a few items like milk (of course), eggs, and bread, but other than that, we survived on peoples’ kindness and generosity for weeks, even months. I want to write that we could not have made it through the NICU days without them, but that is silly exaggeration. We would have made it, we just would have survived off countless Chipotle burritos, Einstein bagels, and Panera sandwiches. For bringing a home-cooked meal into our home, we thank you. For keeping us far away from regular fast food stops, our tastebuds, waistlines, and digestive tracts thank you.

Why Was London Early?

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*In which I try to fill in some medical details I left out of the posts regarding London’s birth.

The doctors never exactly figured out why London was born early. London’s premature birth may or may not have been related to a very small blood clot seen in one ultrasound quite a few weeks before London was born, but the doctors never seemed overly concerned with what they saw.

We don’t know why Kate started to have contractions, but we were very thankful we went to the hospital when they started. As noted in an older post, once Kate’s water broke we knew things were very serious, but we learned shortly after her water broke that doctors can successfully put fluid back into the uterus so the baby is once again protected. They tried this for Kate and, obviously, it didn’t work.

The next option the doctors had was to simply stabilize London and Kate so they could theoretically rest for a week, hopefully, until London was delivered. This would have given London a huge boost. She could have received all the benefits of betamethasone, which would have drastically strengthened her for the outside world and would have better protected her from the stresses of delivery.

London’s heart rate kept dropping due to her funic presentation, this is “where the umbilical cord points toward the internal cervical os or lower uterine segment.” In the most serious cases, this can lead to an umbilical cord prolapse. This is when the umbilical cord “protrudes into the cervical canal,” and why London’s heart rate would occasionally drop due to Kate’s contracting cervix. A medical website describes the situation as “an obstetric emergency that in a viable fetus necessitates an expeditious delivery.” The same medical website, radiopaedia.org, reports that umbilical cord prolapse occurs in 0.2 to 0.5% of all pregnancies.

So we will never know what set this all in motion, but we do have a clear reason why London needed to come out as quickly as possible. On January 30th, had we not been near a hospital that could perform an “expeditious delivery,” I would not be here today writing about raising London. Kate and London’s treatment in the hospital was miraculous, a true marvel, but it was just as miraculous to us that we were a ten-minute drive from a top-of-the-line NICU.

London’s Birth: Part XI, Changing a diaper on a two-pound baby

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

While in the waiting room a doctor came in to talk with us about London’s condition. She sounded positive, being clear to us about what our expectations should be. We had to stay there for a while until Kate’s room was ready. When it was time, I helped push her bed over to the new room with nurse Amy, from earlier in the evening. We were on the fourth floor, facing south over the main entrance to the hospital. Kate was a little disappointed we didn’t have a mountain view. If you looked off to the right you could see the mountains bending southward, but it wasn’t very majestic like it would have been with an unobstructed view west.

I was able to go be with London once more before Kate was ready to head over there. That’s when I met nurse Megan and the new employee she was training, Laura. They were immediately helpful and gave me so much information I couldn’t keep track of it all. They pointed to line after line telling me what it was and using acronyms that I quickly forgot. “This is where she is getting her TPN.” “This is the PICC line.”

London was in her isolette, which was ridiculously hot and humid inside. Megan started to tell me about these things called “cares.” They are at certain times of the day, every four hours to be exact, and that is when we would take London’s temperature, change her diaper, listen to her, poke and prod and make sure she is doing well. Megan and Laura were just about to start and asked me if I wanted to jump in and take her temperature and change her diaper. Megan emphasized that if I was not ready, she could do it this time. This surprised me, but I did not take her up on that offer, I said, “I can do it. Just coach me through it.”

They showed me the one button on the isolette I was allowed to touch. It activated a heat shield so when I opened the little openings for my arms to go into the isolette it did not cool off in there. They gave me a thermometer and told me that I will take her temp in her armpit. They showed me how by placing the thermometer and holding her arm against the side of her chest. I put my hands in the isolette and immediately noticed the jungle like feel to the air in there. I had not touched London yet. I was so afraid. I felt like a simple touch of her arm would snap it. Because I felt that way I was much too gentle with her and failed to get a good temp reading. I didn’t have the thermometer truly in her armpit. The nurses corrected me and told me I could be a little firmer with her. They were right. London was so small and looked extremely fragile, but I could apply enough pressure to get the job done correctly without causing her any harm.

I had changed diapers before, but never on a two-pound baby in an isolette with really low arm openings for someone who is 6’9” and with intimidating wires and tubes everywhere. At this stage, London’s skin was so delicate that I could only touch and release with my hand or finger. I could not rub her skin because of the risk of it breaking and sloughing off. Yeah, that was easy to remember. Do not rub your daughter’s skin off. Check.

My hands are not monstrously big, but they fit my frame, so one of them could completely cover London’s body. During the diaper change I was using giant tools for a micro job, but because of the nurse’s help I changed London’s diaper. The nurse said, “Once you learn to change a diaper on a preemie like this, every diaper will seem easy.” I knew she had a point. This was harder and slower going than any diaper change I had ever done or thought I would ever have to do. Megan wrapped up the rest of London’s cares. I walked back to Kate’s room, thankful that when I returned to London’s side I would be with her mom and we would all be together for the first time.

London’s Birth: Part X, Into the NICU

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

Right outside the double doors the charge nurse introduced herself. She guided me through a winding path of at least sterile-looking hospital hallways. Now was as good a time as any, “Can I get a new mask?”

“Of course,” she said, stopping at a counter and getting me one and several tissues. I pulled my mask away and took a peek at the inside, not a pretty sight.

I followed the charge nurse to a pod. Each baby in the NICU we were walking into stays in a pod, not a room necessarily, but more like a cubicle with walls nearly to the ceiling. We walked the length of the NICU, took a left and there was London, skinny, vented, cleaned, and holding on. The doctors kept telling me she was receiving surfactant, which is a mixture of fat and proteins made in the lungs, but preemies are often born before their lungs can produce enough surfactant. The mixture coats the alveoli, or air sacs in the lungs, and this prevents the alveoli from sticking together when the baby exhales. A nurse said London’s lungs were like a hardened sponge right now, not ready for life outside the womb.

I stood there for five to ten minutes, all the while an occasional nurse and doctor would tell me about what they are doing or what they plan on doing. I did not retain that much. I was just locked to my daughter and I was in sort of an emotionless state, unable to fully register the last six hours. I was thinking enough to take my phone out and snap a picture of her. I was hesitant to get close. I had the same feeling I had earlier in the OR, stepping up to the bedside and taking a picture of London meant I was getting closer to her. I was letting my guard down. I was starting to realize that five and a half months ago we embraced the idea of creating a life we ultimately had no control over. The unknown and deeply frightening future belonging to my daughter was coming into sharp focus. I took two quick pictures. London with a full head of hair turned to her left, eyes fused shut, gaping mouth with the endotracheal tube snaking out of it, monitors on her chest, blood pressure cuff and pulse ox on right arm, umbilical chord clamped shut, plastic covering her lower body to keep it humid, and a nurse’s blue-gloved hand holding her legs down. I said a quick prayer when I took the picture, please God, do not let this be the only picture I get to take of her.

Sometime later, the team was prepping London to place a peripherally inserted central catheter or PICC line and an umbilical catheter. They told me it was a good time to go check on Kate because they would be working for a while. I thought that sounded great. I took a picture of London’s pod number, “Pod 3, 423,” not knowing if I would be able to find my way back or if I would need that information later on. I started stepping away from the pod and realized I had no clue where Kate was now. Someone took me to a room, which looked like it was used to just house patients in limbo who might be fresh out of surgery and do not have a room to go to. There were four hospital beds and four curtains, but none of them were drawn. Kate was the only patient there. She looked great to me because she was still here, conscious, and strong, but she looked amazingly tired, which is to be expected. I know I looked like hell. We chatted about London and where she was placed in the NICU, what they were doing to her, her weight and height. 2 lbs, 6oz and 14.75 inches long.

London’s Birth: Part IX, What’s her name?

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

Throughout the operation there were tears slowly dripping from my eyes and my nose was a leaky faucet. I was aware that my snot had flowed through my mask and even in that moment I was mildly annoyed with the thought of having to ask for another mask. I would ask later, when the time seemed right. Until then, I tried to minimize the flow of tears and snot.

It may sound like my eyes were wandering once my daughter was out of Kate, but they weren’t. I glanced for split seconds here and there, but my eyes were essentially locked on the little human being in front of me. Vented now, the doctors seemed a little more relaxed with her and ready to move. They told me where we were going. It went in one ear and out the other. I would follow them anywhere. They started to roll my daughter a bit, making for the double doors I had come through to enter the OR. They halted for a second, one NP turning to me and asking, “What’s her name?”

I had not yet imagined when I would announce to those present in any room the name of my daughter, but if I had, it would never have crossed my mind that this would be how I would introduce her to the world. “Her name is London,” I announced. It sounded weird giving a name to her at this stage because when your child is born this small and fragile, they almost seem like a science experiment. I had started to become aware of a disturbing, but natural protection mechanism that sets in when you see your preemie like this. I wanted to protect myself from her in a way. I didn’t want to become so attached to her just in case I lost her in the next hour, but giving a name to her instantly made it harder to keep my distance.

London and the team working on her started moving out, rolling right by Kate’s face and slowing down a bit so she might possibly get a glimpse of London’s face. I saw Kate strain her head to try to see her baby before we went through the doors. I stopped and gave Kate a huge kiss, an exchange of tears cheek to cheek, and a word about how London is vented. I also checked that I should keep on walking with London and the team. Kate nodded yes and I was off through the double doors with an “I love you” and one last glance at the amazing team sewing up my wife.

London’s Birth: Part VIII, 18 People

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

I confirmed with Kate that I was to go be with the baby now. We kissed. I told her she was doing great and walked to the foot of Kate’s bed where the doctors had placed my daughter’s very small bed.

In front of me was an impossibly small baby girl. To call her a baby is not quite accurate. She looked more like a very, very small, skinny human being. There was no fat on her and she had none of the cuddly attributes that full-term babies have. There were seven doctors and residents attending to her, looking for signs of breathing, mostly. They seemed to poke and prod here and there with their hands and a few tools.

Immediately to my left, Kate was on the operating table, with her incision still wide open. I didn’t stare long, but I felt comfortable looking at the incision and the tissue and organs that were being rearranged so they could settle back into place. I turned my head ninety degrees right and continued to watch the doctors revive my daughter. I saw them prepping a blade to start the intubation when another doctor informed me that was exactly what they were being forced to do. She said this was very common. She was tall, had blond hair, and I remember a minute after my baby girl arrived on her miniature bed, she referred to her as a him. I clarified, “It’s a girl, right?” She looked again, “Oh, I’m so sorry.”

My daughter was successfully intubated a moment later. Her head and neck seemed impossibly flexible for the doctors to place the blade and insert the endotracheal tube. I looked left to Kate again. A nurse walked right in front of me carrying a metal dish with a big red blob in it that had what looked like puncture wounds. It was the deflated, tragic looking placenta that had prematurely detached from the uterine wall, aka placental abruption.

The OR was highly organized chaos to my uninitiated eyes. I took a moment, counting all the people in the room saving my wife and daughter. Eighteen. It was the beginning of a deep, new appreciation for the professionals around me. I was learning in the quickest and most explicit way possible that the quickest way to my heart was to save the two people dearest to me. It was early to have this revelation because I didn’t know if everything was going to turn out fine, but I still felt like I would love and cherish these people for the rest of my life because of their effort here.

London’s Birth: Part VII, 27 Minutes Later

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These posts are in reverse chronological order. Read earlier posts first. They can be found by scrolling all the way down or clicking the links provided here: Part I, Part II, Part III, Part IV, Part V, and Part VI.

The only time I have ever seen a C-section setup in an OR was on ER. Well, in that respect, the set of ER got it right. Kate’s neck and head were peeking out from a curtain draped across the top of her shoulders. There was a nurse standing to the right of Kate’s head. There was a chair positioned to the left of Kate for me to sit in. I walked over and sat in it. I gave her a kiss. We exchanged “I love yous” and I sat down.

At this point, we didn’t have to discuss whether or not I would watch the baby come out or whether I would go be with the baby once she was out. Just a few days ago at home over dinner we had talked about what we would do in the case of a C-section. I said I would sit by Kate and would want to be present for everything. We agreed that I would go be with the baby once she was out of Kate, if Kate was clearly doing okay. I also expressed interest in seeing the baby being pulled out. In hindsight, it is incredible that we had this discussion already.

When seated next to Kate, I couldn’t even see the doctors working on her lower body. Kate said all she felt was pressure. I could see Kate’s head and shoulders shifting up and down and left to right on the bed as the doctors peeled away the layers, pushed things to the side, and cleared a path to the uterus.

The urgency of the C-section and the speed at which it all happened was astounding. I was not next to Kate long before the nurse next to her spoke up, “They are about to pull her out. Do you want to look?”

“Yes,” I said. The nurse would tell me when to stand up and look. “Okay.”

“Alright, stand now if you want to see,” she said.

I hesitated just for a second or two, perhaps not quite ready to see what I was about to see, scared to see what I was about to see, or just trying to register the moment. I’m sitting by my wife behind a curtain and on the other side is the rest of my wife’s body with a significant opening in it from which they are pulling out this human being we made, our daughter, who will be in my thoughts for the rest of my life no matter what happens in the next few minutes, hours, or days.

I rose from my chair and saw two doctors lifting my daughter up out of Kate. My daughter’s foot, the last part of her touching Kate, was just slipping the protective casing that had collapsed around her. Nothing could have prepared me for that view. It was beyond beautiful and it literally took my breath away. My legs gave out a bit and I had to sit down quickly. I was crying and Kate was looking at me expectantly. “She is the most beautiful thing I’ve ever seen,” I reported. We smiled through our tears. It was 4:02am, twenty-seven minutes since I had texted my dad, saying we were going to the OR.

London’s Birth: Part VI, At the Doors of the OR

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Parts ONE, TWO, THREE, FOUR, and FIVE of this series should be read first.

The walk to the operating room was extraordinarily difficult. Dwelling on a worst-case scenario was unavoidable at times. Kate occasionally cried while she was being pushed toward the OR. The doctor told us that they would do their best to use local anesthesia so Kate could stay awake and so that they wouldn’t have to intubate her. I was told that I couldn’t come into the OR until the team had determined what type of anesthesia Kate would need.

At the huge double doors to the OR I had to say goodbye to Kate. No other goodbye I’ve had in my life had been that hard. How long was I saying goodbye for? I didn’t know for sure. Five minutes? I hope so. Five hours? I hope not. Five days because they had to intubate her and then there were complications? I don’t know how I would have gotten through it. But there was also the question in the back of my mind, for forever? The team pushed her through the doors and I was alone in this barren anteroom with two chairs and a couple of carts with masks, gloves, and other sterile clothing.

I did not expect to be alone at this point. I thought someone might stay with me. I sat down on one of the two chairs. At this point I continued praying, which I had not stopped doing for a while. It felt more like begging at this point or, more accurately, making demands of God. I sat with my head in my hands.

In a few minutes the doctors were attempting to place the epidural. Kate was screaming like she was being cut open. The trauma of having an emergency C-Section at 26 weeks coupled with the pain of the needle is enough to make any woman scream. I didn’t know what sounds to expect from the OR at this point, but that was as much as I could handle. Still seated, I think I may have been rocking back and forth at this point, still with my head in my hands.

The doors to the OR were to my right. A few doctors went through them once they got gowned up. Some of them wore clear shields that covered their whole face. One knows exactly what these are for. They’ll protect the doctors’ faces from splatters from cutting my wife open, moving aside some organs, and pulling a little human being out.

A doctor came through a different set of doors to my left. As she gowned up and scrubbed in she spoke with a healthy dose of authority, giving me a one-minute crash course on 26-weekers. “They have an 85% survival rate,” she said. That is higher than I thought it would be, I thought. “A common complication is with the eyes. It’s called ROP. It can be fixed with laser surgery,” she continued. And with that she walked through the doors. She was just very matter of fact and did not give me a parting “goodbye” or “see you in there.” But I completely understood. She was going into the OR to save the two most precious people in my life. If I could have sped her up somehow I would have. Godspeed, Lady.

A few more minutes passed and a different doctor came out of the OR with good news. “Kate is on a local anesthetic and doing great. You can come in now.”

London’s Birth: Part V, “We gotta get that baby out.”

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This is a post in a series about my daughter’s birth. Read parts one, two, three, and four first.

Around 3:20am our doctor came into the room and made the call. The baby needed to come out now. Her heart rate was dropping too much and too frequently to safely leave her in Kate any longer. We were terrified, but I kept telling Kate silly things like, “It’s gonna be okay,” or, “We’re gonna get through this.” Kate was crying a lot, but also trying to compose herself. I remember her really losing it when a nurse and I were had to work Kate’s bra off in order to prep for the OR.

My scrubs were delivered to our room. They looked like a flight suit. I put them on backwards at first. A nurse pointed it out, but she said it didn’t matter. It mattered to me, so I turned the one-piece around, but didn’t quite zip it up yet.

You can easily argue that nothing in the future is certain. That is why so many of us worry. Especially during traumatic moments, we start to consider all the wildest and scariest scenarios. Kate and I had arrived at that point. “You know what to do if anything happens,” Kate said. “You know about my life insurance. You would have to contact my employer.”

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“Yes, I know,” I said. “But I’m not going to have to deal with that.” In response, Kate probably said, I know, but I can’t remember. I was at her side and just crying with her and telling her over and over, it’s going to be okay, she’s going to be okay.

Before I tucked myself into my scrubs and isolated my phone in my jeans pocket, I sent out text messages to both sets of parents and then we were off to the OR. It was 3:35am.

London’s Birth: Part IV, 2:30am Phone call

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Just arriving? Read parts ONE, TWO, & THREE in this series before moving on.

The nurses placed monitors on Kate’s belly to watch the baby, but every time Kate had a contraction the baby’s heart rate dropped dramatically or the monitor was no longer picking the heartbeat up. Every time this happened the nurse had to come in and adjust the monitor to find the baby’s heartbeat. This happened so frequently it was pointless for a nurse to leave the room.

Absolutely ignorant of how the rest of the evening was going to unravel, Kate and I attempted to rest. I laid down on a couch, almost two feet shorter than me, but comfortable, and closed my eyes, but it was fruitless. The baby’s heart monitor would beep every couple of minutes; there were nurses in and out, and a few doctors here and there. After I while, I sat up. The doctor was in and out more often talking about the baby’s heartbeat. I don’t remember at all what time it was, but at some point in the evening, before we attempted to rest, we called Kate’s mom. We put her on speakerphone with the phone resting on Kate’s chest. Kate was getting IVs put in at the moment, one in each arm. The nurses were giving fluid, obviously, in hopes that there could be some fluid retention in Kate’s uterus, to build up a buffer for the baby. And in another arm she was starting to get some other drugs that I would learn a lot more about later on.

My mother-in-law went into a mom/nurse practitioner hybrid mode, which I can’t blame her for. She wanted to know all the technicalities. I just wanted Kate to tell her the basics and get off the phone because Kate should be resting. Eventually they hung up and I texted for a while with my mother-in-law. I tried to imply that Kate was really tired and shouldn’t be staying up and talking on the phone at the moment. The message was well received.

I had moved to the side of Kate’s bed as things continued to get a little more serious. I knew I had to call my parents. I hated knowing a call was necessary. By dialing them I was losing the last bit of me that thought everything was going to calm down soon. It meant I was giving into the seriousness of the situation because I was willing to introduce into my parents’ lives a horrible and scary scenario that would make them cry and worry like they haven’t done in years. My mom is old school. She doesn’t even sleep with her cell phone on usually. If it’s on, it’s in another room of the house. I went with my dad’s cell and after a few rings he picked up. I tried to imply right away that we were all still okay. Without saying it, I meant that we were all alive. I also tried to give him a few seconds to wake up and tune in his ears due to the difficulty of receiving a call at 2:30 in the morning. I just cut right to the chase and said, “Kate might be going into labor. Her water broke. We don’t know exactly what is going to happen, but this is what happened so far…”

I remember hearing my mom wake up in the background. She realized my dad was on the phone and not just talking to himself. My dad took a moment and recapped for my mom what I had told him. I heard it in my mom’s voice right away, shock, worry, and sadness. I disliked that I brought that upon them, but I had arrived at the point that not telling them was out of the question. We weren’t on the phone long, but I said I would keep them posted via text message about any changes on our end. We said our tearful goodbyes and hung up.