Thursday, January 29, 2015

That One Time We Bought a Dental Practice

{Kate in daddy's soon-to-be office}


Jay is closing on his dental practice tomorrow. We are two days away from being Business Owners. Though, technically, on paper, I'm not a part of this thing at all. It's weird how this huge endeavor, according to the government and anyone else that matters, is all solely in Jay's name even though it's affecting both of our lives astronomically.

Sometimes I think we're getting into the wrong racket. I mean, if you're going to buy a business, why not go for something that makes people happy, like a Krispy Kreme franchise? But then I think about how all I would do is eat donuts. There's a time in my life I would have wanted nothing more, but now that I'm getting older, my body likes to treat me like I'm a five year old by punishing me anytime I do something fun but slightly irresponsible. I get a headache when I eat too much sugar now. I can't even blame it on something else (my kids) because it's a specific kind of headache that coils like a spring right behind my forehead. And I seriously hear my body talk to me in a patronizing tone (she likes to blather on about choices and consequences) while my five year old self sits sullen with folded arms and says, "well, it was worth it!" even when it wasn't.

So I guess, all that considered, it's a good thing we're buying a dental practice. (When you think about it, a dental practice is kind of the anti-Krispy Kreme.) 

Jay has made so many spreadsheets for the business that I can't even keep track of them anymore. It's all he can talk about. He's excited and anxious and passionate about the potential of this fledgling practice. For all the time and attention it requires, I'm pretty sure it counts as our third child. Or triplets. 

The whole experience has been rather overwhelming and all-consuming. I'm not nearly as much help as I would like to be because it turns out that it's difficult to get anything done when I only have sporadic time chunks when my two year old isn't trying to lie on top of her baby sister. I used to be super strict about Kate's TV consumption (meaning she only watched three specific movies and only at times when there was no other option), but that has gone out the window this last week. And I mostly don't feel guilty about it because I'm sure I've heard a saying that goes, to every thing there is a season: a time to weep, and a time to laugh; a time to be a great parent, and a time to be a really sucky one.

Mostly I am just tired. I have told Jay that I want to be sedated for the next year because it's going to be a doozy, but he seems to think the girls need a caregiver who is not a medicated zombie. 

I'm going a little bit crazy, but we're excited and hopeful and grateful for this new chapter in our lives.

Saturday, January 24, 2015

Friday, January 16, 2015

Hospital Diaries: Part III

The story of Jayne's hospital stay last September. Part I here. Part II here.


We were released on Friday with a handful of prescriptions and care instructions. The next week was long and incredibly taxing. I was overwhelmed with both a feeling of gratitude that my baby was going to be fine and with an uneasy terror that if we'd lived in a different time or a different place or if we hadn't taken her to the hospital, she would have died. I love living in a time with so many medical advances, but in a weird way it feels like playing God.


Jayne still wasn't sleeping well; the antibiotics ravaged her GI tract, and she just couldn't get comfortable. She pooped constantly, and her little bottom was raw and ulcerated. We went through 20 diapers a day. My head buzzed atop tightrope-tense shoulders and my eyes ached from constant sleeplessness. I broke down multiple times, at one point crying tears that had nothing to do with emotion for nearly 24 hours straight--it was like my body was telling me I was sinking by springing a leak. I was so spent that I couldn't fall asleep--a cruel, spiraling irony. I found that gratitude for a living baby and bone crushing exhaustion are not mutually exclusive. I wasn't a good mother to Kate, and I couldn't take care of myself, let alone two tiny girls. I gratefully accepted dinners and playdates for Kate from wonderful friends, Jay did what he could while he was home, and even though it all helped, none of it was enough.

I know this is personal, but draping reality with doilies and daisies isn't my style, and I don't want to paint over the situation with high-gloss varnish. It has been hard. It is getting better. 


Since being released from the hospital, Jayne has had more tests and doctor appointments. She will take prophylactic antibiotics and be reevaluated after a year. There is a chance she will need to have surgery in the future. She had finally adjusted to her original antibiotic when we had to switch to a different one, so we went through another bout of diarrhea and sleeplessness, though it's much better than it was the first time. 

Living in the hospital for several days taught me how to be an advocate for my child, especially toward the end of our stay. I think I drove the doctors and nurses crazy with all the questions I asked, but I didn't care. I stayed on top of Jayne's meds and called as soon as she was due for more. If she was sleeping, I asked the nurses to wait on taking her vitals until she woke up. Sometimes I would make them wait for a few hours if she was taking a long nap--since she was in stable condition, her rest was my priority. If a nurse or tech came in to run tests on her, I always asked how long they'd been working with kids and if they had frequently done that procedure on tiny babies. When a nurse came in with a student, I allowed the student to stay and watch but insisted the nurse do the procedure. I called the nurses whenever I needed anything and requested to speak to the doctor when I hadn't seen her in awhile. I wrote things down and called competent friends and family for second opinions.

I lost all sense of "modesty" and nursed Jayne when she was hungry regardless of who was in the room. I slept during the day when I could (which wasn't often) and barely held on to my sanity most days until Jay came home at night. I took showers and choked down hospital food and didn't leave Jayne's side. I couldn't. 

Our journey isn't over, but the hospital stay is. I am so grateful things played out the way they did. My heart is full, but there is a shadow there now from the knowledge that there are millions of mothers throughout the span of history who lived my experience but had different outcomes. If any of the variables had been different, Jayne could have, would have, died. 

But I lived in America in 2014; I noticed Jayne had a fever; I knew to take her to the hospital; she responded to antibiotics; everything worked out. And now she's a completely normal almost five month old with a huge open-mouth grin. You would never know that she once tiptoed around death's long shadow. 

And I have the luxury of productive exhaustion, of complaining about diaper blow outs, of watching my baby's eyes grow heavy over the video monitor. I have the uneasy peace of knowing I could have lost her but didn't. 


Tonight as I walked Jayne to her room, she snuggled into my shoulder in slumber, curled like a comma against my chest. I stood by her bed, my heart aching with a love that filled the room, my lips pursed in a silent prayer of gratitude for all the nights like this, for all the nights she's mine.

Thursday, January 15, 2015

Hospital Diaries: Part II

The story of Jayne's hospital stay last September. Part I here. Part III here

That first night in our room in the pediatric unit felt endless. Jayne was restless and in pain. Her fever wasn't coming down with Tylenol, so the nurse brought in wet washcloths to wrap around her neck and back to cool her down. Jayne would cry out at the cold of the cloths, and they were warmed through within minutes. Her fever temporarily lowered after these applications but would ultimately spike again. It felt awkward to hold her. She had wires and tubes coming off her arm and foot, and her little forearm was taped to a tiny board to keep her wrist from bending and dislodging the IV line. Adrenaline coursed through me from fear the Tylenol wasn't working like it should, and I spent the night nursing, rocking, and holding my very miserable baby. I would attempt every hour to lay her down and would get to lie down myself for two minutes or so before she began to fuss again. I think I got about 30 minutes of sleep total that night.


{Jayne, eyes still fever-red, after she started to get better.}

Our nurse, Tina, was amazing. She anticipated our needs, didn't make me feel stupid or bothersome, and went above and beyond in caring for Jayne. "Normally I wouldn't come in so often," she said, "but I'm going to check on Jayne every 30 minutes to monitor her temperature and make sure you don't need anything." I was so grateful for her companionship and attention on one of the longest nights of my life. 

Jay and I both stayed with Jayne in the hospital each night. During the few hours she slept, we curled up together on the narrow couch, our exhaustion overtaking our discomfort. I only left the hospital once during our five day stay; I couldn't imagine leaving our baby in that place alone. The nurses told us that the screaming baby next door wanted to be held, but his parents weren't there and the nurses couldn't be with him all the time. I was so grateful my parents lived close by and were able to take Kate so we could focus on caring for Jayne.


{The pull-out couch where Jay and I slept.}

We met Jayne's pediatrician the next day. She informed us that Jayne's blood culture showed signs of bacteria growth, indicating a blood infection. Our baby was septic. I didn't know much about sepsis except that it's bad, potentially very bad, and I spent the rest of the day in a hazy panic. It was then I was grateful for the lumbar puncture, as traumatic as it was, since sepsis increased the odds that Jayne could have meningitis. Obtaining the CSF sample at the beginning ensured that if there was infection, we would know as soon as possible.  

We learned from a renal ultrasound that Jayne's left kidney had hydronephrosis (swelling from excess fluid). Though her urine culture wouldn't show any bacteria growth until Thursday, it was becoming clearer that the sepsis was very likely secondary to a UTI. 

Jayne's temperature had lowered and, for the most part after that, the fever was controlled with revolving doses of Tylenol and occasional ibuprofen. Tuesday night was much better: she slept for 2-3 hour stretches and was more calm.

Wednesday morning, Jay went back to work. Before he left, he noticed Jayne's skin was white. It was eerie. Like the rest of us, she has never had much pigment in her skin, but she normally had the pale, rosy complexion of a redhead. Those healthy pink undertones were gone; Jayne was a pallid porcelain. Her ginger hair and pink lips offered the only contrast on her sweet face.

When I expressed this concern to the doctor, she explained that because Jayne's body was seriously ill, it had pulled blood from less important areas like her skin to help fight the infection. It reminded me of times I'd looked in a mirror when I was sick with gut-churning nausea to see my face bloodless and ashen.


{Jay filled out Jayne's "about me" section}


Jayne's little system was addled by the strong doses of IV antibiotics. She had horrible diarrhea and a worsening diaper rash, and Wednesday night, if she wasn't nursing, she was screaming. We bounced her, rocked her, shushed her, patted her, held her. She still screamed. Jay and I were both exhausted, and we felt helpless and desperate. I finally lay down with her on the couch and she calmed as she fed. Just then, our new night nurse came in and offered to take Jayne to the nurses' station for a little while so we could get some rest. Since Jayne was finally dozing, we declined but told her we might take her up on it later.

About an hour later, I was awoken from my doze by Jayne's renewed screams. I began to have what I can only assume was an anxiety attack. I quickly passed the baby to Jay as the strength drained from my body and my arms and legs shook uncontrollably. I ran to the bathroom, dry heaving, and asked Jay to call the nurse to take Jayne. 

After she whisked Jayne away, Jay gave me a blessing that my body would calm and I would be able to rest. I lay down and instantly felt better--my shaking stopped, the nausea vanished. It was a miracle.

Feeling somewhat guilty but intensely relieved, we crammed onto the couch and fell asleep. We slept for five hours. When I woke up, I almost started crying from intense gratitude. I told the nurse those hours of sleep were the greatest gift anyone could have given me in that moment. Jayne had spent the night sleeping in a swing at the nurses' station after taking a bottle and fussing a bit.


{Jayne in the little hospital swing}

After that night, things were on the upswing. We learned Jayne's infection was from a strain of E. coli that was, thankfully, responsive to all antibiotics. She had a blood draw that, while still showing inflammation markers, was clean. She was much more herself on Thursday, content to lie in her bed and look around and make sweet noises. Her fever spiked briefly one more time in a last little cough of effort, but then it left for good. 

Wednesday, January 14, 2015

Hospital Diaries: Part I

Part II here. Part III here.

On a Sunday evening in late September, at the close of a whirlwind weekend of family, fun, and travel, I noticed Baby Jayne felt toasty in my arms. I rested my cheek against her hot little head and chalked up her heater status to being sleepy and swaddled. Monday morning we left my parents' house and drove home. We dropped Jay off at work, and after a brief milky meal at home, Jayne slipped into sleep. It was a long, albeit fitful, nap, and I took advantage of the respite by grinding wheat, making bread, doing laundry, and taking care of Kate. Once Kate was down for a nap, I cozied up with Jayne on the couch. She was fussy, and her cries were guttural. Heat radiated from her little body.


{At the Boulder cabin on Sunday afternoon. I didn't know it yet, but Jayne was a very ill little baby.}

I got our temporal thermometer from Kate's bathroom and, with trepidation, swiped it across Jayne's tiny forehead. 

100.4. 

I took her temperature again and again as I nursed her.

100.6. 100.1. 100.5. 100.4.

I grabbed our axillary thermometer and, for the first time in my life, took a rectal temperature.

100.5.

Jayne's pediatrician and the nurses at the hospital after her birth had drilled into us that any temperature 100.4 or higher in an infant is serious and should be evaluated immediately in the emergency room. Her doctor had also told us that when an infant is seen in the ER, they require a full workup of tests, including a lumbar puncture.

I called a nurse friend, my mom, and my pediatrician's office, but the twisting feeling in my gut told me I already knew what we had to do. My fraying emotions completely unraveled, not just because of the possibility that Jayne was seriously ill, but because I didn't want to put her through painful, potentially unnecessary tests.

At my somewhat hysterical request, Jay canceled the rest of his day and came home early. We dropped Kate off at a wonderful friend's house, my mom began the two hour drive to Las Vegas, and we drove Jayne to the children's ER 20 minutes away. 

Minutes before leaving, I checked Jayne's temp again: 99.5. I desperately hoped we were overreacting and that when we arrived at the hospital they would laugh at the neurotic mother and send us home with a patronizing pat on the head.

The emergency room at the Summerlin hospital was hopping that day: people in gowns dotted the waiting room, their postures slumped and faces taut from pain or malaise, as harried nurses rushed others through triage. We stood at the reception desk for a good 15 minutes before a worn nurse broke away from her patient to help us. We had barely given her our names, reason for visiting, and a $100 copay when a man came out and called our name. I was surprised at how fast we were taken back when so many others waited outside.

Jayne fussed a little as she was weighed and measured. The CNA took a rectal temp, and my hopes of leaving were dashed and fears were validated when the thermometer read 101.4. 

For the next five hours, we sat in our own room in the pediatric ER wing as doctors and nurses came in and out. Jay and I took turns snuggling our feverish baby. They wouldn't allow me to nurse her until after she had the lumbar puncture, so I waited, my breasts full and aching as my body craved to comfort my child in desperate, primal instinct. Jayne took her pacifier but did not root for food as she dozed restlessly in our arms.


{Jayne in her hospital room. We didn't put clothes on her for the first couple days to keep her fever down.}

Those hours in that room are a blur now, but writing about it brings back flashes of the emotion and panic I felt as I subjected my tiny baby to a horrific array of painful experiences. I remember helping hold her down, dipping her pacifier in sugar water again and again to help ease her discomfort as the pediatric nurses poked her over and over to start an IV (God bless the NICU nurse they finally called down. She was warm and funny and reminded me of my friend and got it placed on her second try.). I didn't harbor any ill will toward the nurses--they were competent and doing their best--but I remember the words "Surely this must be Hell" scrolled through my mind on repeat like a looping marquee. I was quiet about it, but tears dripped from my nose to the papery sheets on the hospital bed as Jayne writhed and the nurses poked.

We had to watch her back arch and her fingers clench and her legs jerk through multiple attempts of the litany of tests: blood draw, catheter, nose swabs, IV. When the pediatrician finally came in to do the lumbar puncture, we had been there for over four hours. She told us  Jayne's urine had markers of infection in it and that it appeared she had a UTI. "I recommend you step outside," she said before starting the LP. "You don't want to be in here for this. But it won't take long--just 5-10 minutes."

Jay and I walked to the end of the hall and stood with our arms around each other. The corridor was a noisy place, but Jayne's screams cut through the ambient sound. They were wrenching, and I paced in nauseous nervousness. A PA from pediatrics came down and asked us myriad questions. Behind her, I saw nurses going in and out of Jayne's room as the minutes ticked by. I heard one ask another nurse for yet another LP kit. We'd been in the hall for half an hour. Jayne was still screaming. 

It finally ended, as all horrible moments eventually do. I nursed Jayne--at last--as the PA continued her questions and explanations, and even had a moment of mad hilarity when the sweet PA, after hearing that Jayne often slept for 6-8 hour stretches at night, expressed solemn concern and said that babies who sleep so long and don't eat often enough are at risk for failure to thrive. "Excuse me, but have you looked at this baby?" I asked in a shocked half-laugh as I felt the rolls on Jayne's thighs through her blankets. 

When Jay peeled the band aid off Jayne's back the next day, there were six small puncture scabs dotted in a small line. The back of my knees cringed at the suffering she had gone through, but later I was very grateful the doctor had persisted.