World Prematurity Day (or Peter’s Story, for those who haven’t already read it)

In July 2010, when I was 27 weeks pregnant, I found some blood in my panties. The on-call obstetrician told me to go to the maternity unit at UMass. The thought never crossed my mind to bring anything with me like a change of clothes or a book or a camera. I was just going to be reassured that everything was fine and sent home.

In triage, however, it became obvious that I was having contractions every 4 minutes. A bag of IV fluids did nothing to mitigate my contractions, and after a couple hours in triage, my cervix started dilating. Nifedipine brought my labor to a halt, thankfully, and for 20 hours, my cervix held steady at 1-2 cm dilated.

At 3:00 a.m., almost 24 hours after my initial steroid injection for fetal lung maturation, I had to admit to myself that my contractions were becoming painful. I called for my nurse. She didn’t seem worried, but I was becoming increasingly concerned as the contractions intensified. At 3:35 a.m., a resident arrived to do another internal exam, pain and pressure mounted, and I struggled to lay still. He pulled his hand out and told the nurse quietly, “I feel nothing but membranes.” I stopped resisting the pressure, and my water broke in a huge gush. My baby’s feet slipped out my vagina.

The next 15 minutes passed in a whirlwind. Someone called Code White, the obstetric medical emergency code, and I was quickly surrounded by medical professionals. On the way to the operating room, a doctor exclaimed, “This is not the way it’s supposed to happen!” Those words still ring in my ears every time I think of my son’s birth.

A dozen screams and one long push – that’s all it took to deliver my 2 ½-pound baby. At 3:51 a.m., a wave of relief swept over me as the pain vanished. Then a wave of shame consumed me. I was mortified that after giving birth to a tiny, silent baby, my primary response was to feel relieved that the pain was gone. Finally, a wave of uncontrollable shivering overtook me, and my heart went numb.

About an hour after the birth, a neonatologist came to update me and my husband. Dr. Picarillo congratulated us and asked whether our son had a name. I panicked, not ready to commit. Thankfully, my husband had a sufficiently level head to christen our son.

“Peter. His name is Peter.”

Dr. Picarillo told us that Peter was alright. He promised us that we could see our baby in a couple hours after Peter’s umbilical catheters had been placed. After he left, I finally broke down and cried.

For most parents, their baby’s NICU stay is filled with both highs and lows; it is often described as a roller coaster ride. Unfortunately, we inherently recall negative events more easily and in greater detail than positive ones. Looking back on Peter’s early weeks, I remember all too well the green aspirations that a nurse pulled from his stomach when he was 4 days old, the x-ray that showed just how inflamed his lungs and intestines were, the neonatologist’s decision to treat Peter’s patent ductus arteriosus with NeoProfen, and the numb feeling that overwhelmed me during this first setback. I remember how tears blurred my vision and guilt knotted my stomach when I was told that Peter’s second cranial ultrasound revealed an intraventricular hemorrhage. I remember how horrified I was to learn that Peter’s 1- and 5-minute Apgar scores were 1 and 4, to realize that he was in hypovolemic shock after delivery, and to be told that Peter “gave us a run for our money” in the delivery room. I remember how hopelessly impatient and frustrated I felt when, after making it 4 days without a recordable bradycardia spell, Peter had several spells on the night shift that set back his discharge yet another 5 days. The list of Peter’s diagnoses still rolls off my tongue: respiratory distress syndrome, hyperbilirubinemia, apnea of prematurity, anemia of prematurity, bilateral stage 2 retinopathy of prematurity, hydronephrosis…

Thankfully, the emotions associated with those negative events faded from memory more quickly than the emotions associated with the happy events. Nostalgia for Peter’s early milestones gradually supplanted the feelings of sadness, guilt, and fear which at the time made the NICU stay a torturous marathon. I have many cherished memories of our time at UMass: the first time I held Peter, the first day he was allowed to wear clothes, the day his nasal cannula was discarded, the day he moved to an open bassinet, and the day that he was finally unhooked from the vital signs monitors. I miss the way Peter used to open his eyes one at a time, wrinkling his entire forehead as if it took a tremendous effort just to lift an eyelid. I miss reclining after Peter’s feedings with him asleep on my chest. And I especially miss watching Peter’s miraculous transformation from a wrinkly old elf into a chubby-cheeked cherub.

Peter was discharged weighing 5 lbs, 6 oz after 73 days in the NICU. It was the happiest day of my life, a day worth waiting for. We still had some hurdles to overcome after discharge: follow-up appointments with specialists, developmental screenings and therapy, and six months of quarantine during cold and flu season. My attempts to get Peter to exclusively breastfeed and to sleep through the night before his first birthday were ultimately unsuccessful. The memories of Peter’s abrupt delivery came back to haunt me, and I struggled with PTSD for a few months after he was discharged. But at the end of the day, I knew that we were lucky. Peter didn’t have any severe complications of prematurity, and his prognosis was good. One by one, he was discharged from specialists and therapists, and his neonatal diagnoses were archived, leaving him with a clean bill of health.

Peter is now an amazing little kindergartener. Ironically, if he had been born near his October due date, Peter would have had to wait an extra year to start school. The day he was born, I honestly expected that we would be facing learning disabilities when he reached school age. Instead, Peter turned the tables and taught himself to read around the time he turned 3 years old. He is a spatial thinker and loves geography. He memorized all 50 states and capitals around his fourth birthday… just for fun! Now his fine motor skills are catching up, and Peter has started to write and spell. Peter’s first months of life were not easy, but his early struggles made me all the more grateful for and amazed at each milestone he has achieved. I’ll certainly never take a single breath – or opportunity to hug my son – for granted.

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