Dear Jacoby [1 week]

Dear Jacoby,

It's been one week since you were readily and excitedly welcomed into this world by so many people who love you!

It was one week that I never want to repeat again.

Shortly after your birth, a nurse informed me that you were breathing a little fast and that your blood sugar was a little low. She asked if I was ready to nurse you--I was--because commonly lower blood sugar can cause the rapid breathing. After you nursed like a champ for a bit, she retested your blood sugar--it had increased from 47 to 61. A move in the right direction. Later she tested it again and it had balanced out quite well so that was no longer a concern. Yet your respirations were still heightened a bit.

The nurse did the normal routine in the labor and delivery room, then we were all moved to the recovery room. All the while, the nurses continued to monitor your respirations. You met your Grandpa & Grandmomma-cita Clum, Uncle Zac, Aunt KK, Aunt Jess, Grandma & Grandpa Massie, and of course your big sis Ainsley that evening. Then the nurses informed me that your respirations had continued to speed up [up to 88/min.; 60/min is the top normal limit] and you were going to have to spend the evening in the special care nursery.

This.was.so.hard.

We followed you down to the nursery where they informed us that you were going to be hooked up to monitors to keep a close eye on your pulse, heartbeat, and of course respirations. Additionally you were going to be receiving an iv with antibiotics because heighten respirations could be caused by an infection. You were also in an incubator that only had the two openings on each side to reach in and touch you.

Many tears were shed as a result of seeing you like this.

Basically, there were multiple small red flags that meant you could have an infection--Group B positive but didn't receive antibiotic the full 4 hours prior to delivery, heightened respirations, heightened  C-Reactive Protein Levels which indicates an inflammation in the body which could mean that there is an infection--all of these warranted getting an iv antibiotic and just like for adults, it's best to take let the antibiotics run its full course versus stopping once the symptoms have ceased.

On that first night, I went down to nurse you for your 2am feeding. I think I spent the majority of that feeding time with tears streaming down my face. What was going on? What could I do? I would do anything to help you and not have you hooked up to everything, but there was absolutely nothing I could do. I composed myself to put you back in the incubator before making my way back to my room. Part way back I lost it again. I was quite worked up as I entered my room, waking your papa as I entered. You see Papa had had bronchitis and so after a not-so-thoughtful comment from a nurse, we assumed he wasn't able to see you in the nursery. Add this fact to seeing you how you were, I couldn't handle it.

A very thoughtful nurse came in a few minutes later and asked if there was anything she could do for us. Through the tears, I explained how hard it was to see you how you were without knowing what was going on and that to make it even worse, your own Papa couldn't even go back to visit. She assured us that you were receiving good care and said that even Papa was welcomed to go back to you. Had we not have told her he was sick, she wouldn't have even known.

This set my heart a bit at ease.

The next morning [Friday], you had some tests run and two things came back abnormal--your bilirubin count was a little high [jaundice] and your CRP [C-Reactive Protein in the blood which indicates inflammation] was at 4.3. The normal level from CRP is less than 1.0 and it should be less than 0.4. The doctor said you could come off the oxygen--it was at 30% over night and then 21% which is what normal air is that day--and they would retest your bilirubin levels that evening. The doctor's report reiterated what we were already told--individually things didn't look too bad, but there were too many small red flags to ignore. 

Your bilirubin levels continued to increase so you had to be put under the bililights to help break down the bilirubin in your blood. Your papa and his parents were the first to see you under the lights that evening. It was very difficult for them. Hopefully you'll never have to experience it with your own children one day, but the feeling of helplessness as you laid in the incubator was one that I wish no one to have to experience.

Friday evening was extremely hard. We were so overwhelmed yet had no answers. You looked so helpless hooked up to so many monitors. We felt so helpless not being able to do anything for you. 

Saturday morning your CRP levels had dropped to 2.4; the oxygen was finally taken off your nose--even though the doc said that could be done the previous day; you were placed into an open crib versus the incubator. This was two-fold. You could be closer to the bililights and it wouldn't be as warm since your temp was slightly elevated. This was a sigh of relief. Off oxygen and into an open crib meant everything appeared more normal. 

Quick snuggles while you weren't
under the lights.

Despite the improvements, Saturday's doc report was one of the hardest to hear. Up until this point we had been under the impression that you would be in the special care nursery through Monday. The doc informed us you would have to have a full 7 days of iv antibiotics. We weren't going anywhere until Thursday. Ugh. 

The positive news at this point was that you were permitted to come to my room every 3 hours for 30 minutes for feedings. This allowed for others to burp you and hold you as we stretched the 30 minutes into 45 minutes each time. It was so hard not to!

Everyone soaked up the moments
you were able to be in our room.
Notice IV in head.

Saturday night was another rough evening. I was technically discharged and your Papa went home with your big sis so she could have some normalcy. Being alone in the hospital, worried about you, worried about your Papa, worried about your sis. The feeling of helplessness continued--different answers from different people; not knowing the next steps or even options.

On Sunday, your iv [which was now in your head] was leaking during feeding so they took out and going to replace. I stayed for the de-taping and it wasn't as bad as I thought it may be with all that tape in all that hair. You definitely didn't enjoy it though! That afternoon an IV was restarted in your hand. [At this time, you had a continuous drip of D-10--sugar water--and then twice a day was actually receiving your medications of ampicillin and gentamicin.] Perhaps starting Monday we were given the hope that you can be done with the continuous drip and depending on the bilirubin count, you may be able to be in our room, except for overnight. On the flip side, if your bilirubin levels come back higher tomorrow [today was 13something], we may have to stop the nursing altogether so you can be under the lights the maximum time possible and formula "clings" to the bilirubin and helps it pass through your system. To help with your time under the lights, on Sunday we only did every other feeding in my room--better than nothing.

Three Generations of Massie Men.

Monday morning at your 5am feeding you only ate for a quick 15 minutes but then thanks to chit-chatting with a nurse, we had and hour of glorious snuggle time! I was just hoping and praying that I wasn't given this extra time because you were going to be restrained to the bililights and formula for the next 24 hours.

Your bilirubin count was lower this morning!! [11 something] Wahoo!!

Under the bililights, clinging to Papa's finger.

Today's doc report pretty much said what I was expecting. Bilirubin is moving in the right direction so I can continue to nurse. We'll continue with the bililights today and hopefully tomorrow an adjustment to the amount of time you have to be under them can be adjusted. He said that he's waiting on the results from my placenta to see if there was any indication of infection there. I didn't realize that was something they were even looking at, but IF there happens to be a sign of infection, your antibiotics will likely be extended to 10 days instead of 7.

This was mildly frustrating as it was another "Surprise! We're monitoring this too!" As your Grandma Great expressed upon receiving this update, "What are they going to say next?!"

So that's exactly what I asked the nurse practitioner during your next feeding. She informed me that they were supposed to be getting results from the placenta yet it was never sent for whatever reason and is still sitting in the fridge so they aren't going to worry about it at this point. So the iv extension can't be made based on that. After your 2pm feeding, they capped off your iv so you're no longer on the sugar water drip and will only be hooked up to the iv machine twice a day (noon and midnight) when you are getting your antibiotics for about an half hour each time. Throughout the night, we're going to keep him under the lights and another bilirubin count will be done in the morning. The CNP said we could take you off the lights today but would rather "blast" the jaundice as much as possible first. So starting tomorrow [Tuesday], you should be in room with me with the iv capped off except for 2x/day meds. 

Down to just an iv in his foot.

Starting Tuesday, that's exactly what happened. Except for your noon meds and overnight, you were in my room. Finally time to hold and snuggle you without the tension of keeping you out from under he lights or like I was "supposed" to hold you! And others got to too!! When it came to life with, this is what I was expecting since day one and although it took 5 days to get to this point, I was so, so glad we had made it to this point.

Grandma & Grandpa Massie, Papa & Jacoby

At this point, I began counting down the hours until we'd be released!

Grandpa & Grandmomma Clum, Momma, Ainsley, & Jacoby

5 IVs [one in each hand, one in your foot and two in your head], oxygen in your nose, breathing/heart monitors, bililights with foam glasses. Overall, they never found anything wrong with you--I could've told them that since you're our perfect lil' man--and they treated you for a suspected infection. The other little red flags of Group B positive, quick respirations, and CRP levels made it so that they couldn't ignore all the factors put together. The CNP commented that everything could have been caused by you having a little mucus caught in the back of your throat and you didn't know how to clear it, but better safe than sorry! [While I agree that I'd rather be safe than sorry when it comes to you or your sister, this is a phrase I was so.sick.of hearing by the end of the week! And I'll have to remind myself of that when I get the hospital bill!]  

Off all the monitors and just has a capped IV.

We were able to bring you home Thursday afternoon. It never felt so good to be home in all my life. You, Ainsley, Papa and me. All together. All home. Just as it was supposed to be!

Love
Momma!

P.S. I know this is long and not likely what you will care to read about when you get older, but it was what consumed the first week of your life and so I had to note it all as it was such a long week for all of us.