This is a long one...

This is long, honest, and hard to write, but also important because sometimes the tough stuff needs to be said too.  It's therapeutic for me to write this so bear with me, but remember we do have a very happy ending!

Sean and I were pretty excited that I went into labor when I did, it was the weekend so he was home, four days before Christmas so we knew we would be home in time and Sean would only need to take two days off work.  It seriously couldn't have worked out better!  We both also kept laughing about how easy and wonderful my labor was, nothing like the first time.  With Griffin we both walked around for about a week following his birth with PTSD type symptoms because it was so long and somewhat traumatic.  I was so happy that we would get the next couple hours alone with our new son and that Griffin would get to meet his little brother that very day.

We started to pack up our things from the labor and delivery room to be moved to a recovery room.  I was in the wheelchair holding Graham when I noticed he was looking pale and grunting every time he would breathe.  I asked our nurse if she thought he was ok, she noticed he was also flaring his nose, which in a newborn is also a sign of respiratory distress.  She left the room to get a pulse oxyimetry unit to check his oxygen levels.  While she was gone I notice his respiration rate increase and his color wasn't looking great.  When she got back they attempted a couple times to get his oxygen levels but the unit wasn't working that well.  Graham seemed to be doing worse so I asked them nicely to stop messing with the oxyimeter and call their NICU team.  He was turning blue despite trying very hard to breathe and I knew he wasn't oxygenating.  Our nurse agreed and the team arrived about a minute later.  The nurse practitioner looked at him and said he needed more advanced care and took him to the NICU.

I took this picture before I noticed he was having issues breathing, but you can already start to see his color changing.

This is where I broke down, I completely lost it.  We were just so elated, snuggling our newborn and now not five minutes later, he's turning blue and we didn't know why.  Having a medical background, understanding respiratory distress all too well (thanks ECMO), and knowing the outcomes and consequences of poor oxygenation in newborns had me so sick I thought I was going to vomit.  Sean was trying to be strong for me, but we both just kinda lost it.  

They wheeled me to our recovery room, it was the furthest room from the NICU, so we had the pleasure of going by all kinds of visitors and families while balling our eyes out.  We finally got to our room and a new nurse came in, she got me a breast pump and told me I needed to start pumping to help my milk come in.  I was so upset I couldn't even comprehend what she was telling me, I just felt so numb.  I wanted to know how Graham was doing and all my nurse was telling me was that I needed to eat and pump.  I told her I didn't feel well so she asked me if I wanted to see him, ummm yeah.  That was all I could think about and I didn't even know that was an option.  She wheeled Sean and I to the NICU.  When we got there they were hurriedly working on Graham and told us it was not a good time, the neonatologist came out and told us they were not sure what was going on but gave us three possibilities:

1.) Congenital pneumonia ( super rare) and that they were going to give IV antibiotics as a precaution.  They drew blood cultures as well to see if he was septic.

2) Amniotic fluid and blood aspiration.  They thought he might have aspirated a fair amount of blood, apparently this can happen easily with retained placentas.  They think he might have swallowed it then threw up and aspirated when he received his vitamin k shot.

3) Pnuemothorax.  Sometimes when newborns cry VERY hard they can pop their lung.  They would take a chest X-ray to rule it out.

The last thing he told us was that Graham would either get much better in the next eight hours or he would get much worse.  We just had to wait.

They took us back to our room and told us that they would call when we could see him.  We got back to the room, Sean ordered us some food even though neither of us were hungry.  Then we just sat on my bed, held each other and cried.  I have never been so scared in my entire life.  

Our food came, I drank a bunch of water, forced down a quesadilla and tried to pump.  I was upset for all the above, but also really devastated that I might not be able to breastfeed Graham.  What if he couldn't nurse and need to be tube fed? Would he ever learn to latch?  What then? And then I had to even think, what if he gets worse and doesn't make it?  Pumping was the physical representation to me that I didn't have my son in my arms, it was everything that I didn't want at that moment.  But, I did it anyway, every two hours for the next 48 hours because it was what my body needed to stimulate milk production.

They finally called and said we could see him, my epidural was still lingering enough that I couldn't walk, so Sean wheeled us back to the NICU.  When we got there I looked at him and he was hooked up to an EKG, pulse ox, IV and high flow oxygen.  His heart rate was almost 180 beats per minute, his oxygen saturation was 89-90% and his blood pressure was only 55/20.  I asked to see his blood gas, his pH was 7.2 and his oxygen was only in the 30s and CO2 was 65.  That was WITH all of the support.  I almost vomited on the spot, my little Graham was sick.  Really sick.  I broke down again and was actually thankful to be sitting in that wheel chair.  I was cursing every bit of experience I had in this area because I think I would have preferred to be blissfully unaware of exactly how bad he was doing.  

I just wanted to hold him, comfort him, so he could feel just how much we loved him.  Surely that would help him get better, right?  We couldn't really even touch him though, it would agitate him and make his breathing worse.  His tummy was pushing up so big at every breath, you could see that he was working incredibly hard.  So we just sat there, taking turns holding his hand and talking to him, telling him that mommy and daddy were here, that we loved him so much.

We sat for a couple hours, I had to leave to go pump again.  We found out his chest X-ray was full of infiltrates, meaning he had gunk all in his lungs.  They were not sure if it was pneumonia or aspirates but had ruled out a pnuemothorax.  We would have to wait for his blood culture to come back, however they did a complete blood count and his white cells were elevated to the point that he was fighting something.  

So we waited, cried a lot and just held his hand.  Around 11 pm that night his oxygen levels increase to 94% and he wasn't as agitated.  The nurse felt like we could try to hold him, I was pumping at the time, so when I came back to the NICU I saw Graham in Sean's arms.  That was the first moment since that morning that I felt like it might actually be OK. I held him next, it felt so good to have him in my arms.  The neat thing was that when Sean and I would hold him he would oxygenate better, sometimes at 99%.  That made us feel pretty good.  It's tricky trying to hold a baby with all of the tubes and monitors hooked up, so we held him for a couple hours, then kissed him goodnight.  I needed to pump again and get a little rest because it was 24 hours since I was admitted for delivery and we both needed it.  

Finally got to hold him

I set my alarm for every two hours to make sure I remembered to pump and we spent almost the next whole day a this bedside.  His oxygen levels slowly started to go up, 94%..95% to the point where they started to decrease his oxygen support.  The doctor came and spoke with us that morning, he was very optimistic about Graham's recovery.  We found out that his blood culture did come back positive but they hadn't identified the bacteria yet.  He was already halfway through his antibiotics so they were not going to do anything different.  His repeated chest X-ray looked much better so they said it would just take time for his lungs to clear.  I was hoping to be able to nurse him soon, he just had to be able to tolerate decreasing his oxygen flow.  He was on 5 liters of oxygen flow, which blows air into his tummy too, so he would not be able to latch until he was down to around 1.5-2 liters of flow.

Graham's nurse in the afternoon was awesome, she knew how much I wanted to nurse him so she was super proactive about helping him wean enough that he could latch.  By dinner time he was down to 2 liters of oxygen and we could try nursing.  I was nervous he wouldn't be able to but she helped us with all his tubes and got him on my chest.  He latched like he'd been doing this all his life and I just cried tears of joy.  

It may not look like it, but I was really really happy here!

Nursing him was more then just nourishment, it was giving him everything we couldn't give him for the past 48 hrs...security, warmth, love, and knowing his mommy and daddy were there.  It literally broke my heart to sit next to him and not be able to breastfeed him.  We were approaching three days without him feeding, they would have tube fed him the next day if he couldn't nurse, so I was incredibly happy when he finally unlatched and was in a milk coma!

milk drunk

I was still a patient at the hospital so that night I had the nursing staff call my room when he was up to feed.  I would head down and feed him, then go back to sleep.  Sean went home to take care of big brother.  My mom and Sean's parents had been babysitting up to this point.  Griffin needed at least one of his parents at home.  He was also getting sick, between the total disruption of having his mom and dad away, he was having a really hard time.  A couple times while we were gone he found my Mom's shoulder and unloaded some pretty heavy feelings of sadness and missing his parents.  I'm so thankful he was able to feel safe and loved enough that he could release those feelings with his Grandma.  He  continues to have a rough time with the  adjustment, we are doing our best to offer lots of love and acknowledgement of his feelings. Each day gets a little better.

Graham was still on oxygen and IV fluid support for the next 24 hours.  I nursed him as much as I could, every nursing session they weaned his IV fluids.  They weaned his oxygen down to 21%, which is room air concentration and continued to wean the flow until they turned it off completely.  He had to be able to be OK for 24 hours after the stop of all support. Unfortunately, he had started to become jaundiced.  His levels jumped high enough to have to stay in the NICU.  I was feeding him every 2 hrs and when he wasn't being fed he got light therapy to reduce his billirubin.  I was hopeful we might get discharged on Christmas!

It didn't feel like Christmas at all, we were not together as a family, Sean at home with Griff and me staying in the NICU.  Christmas Eve my Dad came and was able to meet Graham, it was really nice to see family.  While he was there, Santa came and gave gifts to all the babies.  It was so awesome, I almost cried:). I had completely forgotten it was Christmas Eve.  Graham got his first Christmas gift ever, delivered by Santa none the less.  It was a little red stocking with a small brown stuffed bear.  I put it on his little bed. I think I'll cherish that little gift forever.  

Graham's first Christmas gift!

I stayed there that night and wished Santa would bring us discharge papers for Christmas the next morning and he did! I called Sean the next morning with the good news.  We had to follow up with our pediatrician the next day but they felt it would be OK to go home.  Sean and I tried to figure out a way to have him come to the hospital for discharge but it was going to be difficult with Griffin because he wasn't allowed to be in the NICU.  We just decided to have me bring Graham home by myself so we wouldn't mess with Griff's nap. I quickly packed up out things and got Graham's car seat.  I think I would have sprinted from the hospital if I could have run, I was SO INCREDIBLY THANKFUL for the doctors, nurses and staff at TMC but I wanted nothing more then to be home with my husband and Griffin.  I did have a little sadness with leaving by myself, it was different then leaving with Griffin.  Sean wasn't there to drive 10 mph below the speed limit, I wasn't in the back with Graham watching him like a hawk and no feelings of "ok, what do we do now?".  Instead, I was alone but knew that we would be OK.  I was going home to the most wonderful husband and life partner and a sweet little boy who needed nothing more then to have his family back together. Above all, we were going home with our baby, something we weren't sure would even happen.  It's funny how life always brings you back down and reminds you of what's important.  I can't say enough good things about the staff at TMC, from the moment I walked through the door in labor to the nurse helping me carry Graham to car, we had excellent care.  I'm thankful we chose to deliver there, I remember hoping that we wouldn't need a NICU the second time around but figured if we did, TMC was where I wanted to be.  Apparently our babies need a little extra help after delivery!  

So what actually happened? We still don't know, the doctor still doesn't know, we don't have a definitive answer.  The best guess was that Graham swallowed a decent amount of amniotic fluid and blood during delivery and when he received his vitamin K shot, he threw up his stomach contents and aspirated them into his lungs.  They suctioned a huge amount of blood from his airways when he got to the NICU and that in itself could have caused a lot of issues.  His positive blood culture could have just been a contaminate from the draw, we still don't know.   I wont dwell on the "why" and "how" because we probably will never know and our son his home and healthy.

Graham turned two weeks old yesterday and he's doing great.  His jaundice is almost gone, he sleeps and eats great and is such a chill little guy.  Griff loves to pet his head and kiss his face but is otherwise not totally interested! We are slowly adjusting to life as a family of four and Sean and I are slowly feeling a little more normal. We'll get there, we have been through a lot as a family and I can't expect anything else.  I'm incredibly thankful for our wonderful family and friends and all the home cooked meals and random acts of house cleaning that you have done for us!  We couldn't have done it without you, and we love you all so much.