Eventful night for Emilia

This morning when I arrived at her bedside, the first thing I noticed was that her breathing machine had changed. I lifted up the incubator cover and found her with a CPAP mask/prongs instead of the ventilator tube in her nose. First I was so excited that she was off the ventilator but, two seconds later I asked myself "why is she off the ventilator??". I had left the hospital around 10:30pm the night before and she couldn't have miraculously grown out of the ventilator overnight. Definitely something "bad" must have happened to make the respiratory therapists perform emergency extuabation. So, the nurse reported to me that Emilia apparently "self-extubated".

I don't know what she was doing exactly but somehow the tube accidentally came out (I know from my observation that the tape was quite loose all day long and she kept pulling that tube out too). According to the report written by the night nurse, Emilia extubated herself, her O2 was desaturated to the level of 29, Nurse called for help, RT had to use a puffer to manually breathe her, and her heart rate dropped to 59 bpm or something as low as that. Yes, it is quite upsetting and unsettling. Accidental extubation is one thing but I don't know how long she was "off" the vent and how long she was desatted. Was her brain or other major organ deprived of oxygen during this accident? Was the nurse not nearby to help her when she was obviously desatting below 60? Or did this happen in a matter of seconds? Or did Emilia desat to 29 all the while the nurse was trying to help? .....Could she have died???

Any how, by accident, Emilia is back on the Biphasic mode again. Last time she was on Bipahsic, they had to put her back on the ventilator only after 2 days. I hope this time she does not get tired too soon. I want her to prove to everyone that she can do better now. During the morning medical round, the doctor said we have been everywhere with Emilia in terms of respiratory support and she does not see any benefit of going back to the ventilator. She wants to "steer clear of intubating her again". I really appreciate her direction, as the other doctor (who is not on duty this week) kept saying she was not in a hurry to wean her from the ventilator.

All I can hope right now is Emilia keeps pushing and breathing. I know it is very difficult for a tiny baby to breathe like us grown-ups, but I want her to do well and surprise everyone. I know... my expectation is too high and unrealistic. Right now the only medical complication she has is her respiratory system and I feel that is the only reason she is in Level III NICU.

Skin-to-skin experience with my preemie

It's called Kangaroo Care - holding your baby skin-to-skin even though your baby is a preemie. I had the opportunity to hold her in the first week, when she had a CPAP mask on.

At first I was intimated by the idea of holding her - she has so many wires and lines all over her body. What if something gets knocked off or what if I am holding her in a wrong way and hurt her....? Despite all these worries, when I first held her, I felt I was her mother and she was my daughter. Surprisingly just holding her took away all the fears I had and gave me pure joy only. Even all the sadness and pessimistic thoughts on our future disppeared. I suddenly felt a surge of strength and determination that I had to stand strong FOR HER, I had to protect her and console her, and I had to stop crying at her bedside.

Sadly, I haven't been able to hold her on my bare chest since about 10 days ago because she is now on a ventilator that has stiff tubes. The respiratory team is trying to wean her from the ventilator so hopefully she can have a CPAP mask again soon and I can hold her on my body again. I want to hum our favourite songs again. I want her to listen to my heartbeat and fall asleep just like she did in the womb.

Week 2

Week 2 was quite exciting for Emilia's mom and dad, maybe not so much for Emilia.
First I started changing her diapers and taking the temperature. I also help nurses weigh Emilia and chage her bed sheets in the incubator. I also got to clean her eyes and mouth with wet sterile gauze. I guess the NICU staff want to involve parents in the baby's basic care as much as possible.

The best thing that happened in the 2nd week was that Emilia started her feeds. She is now getting my breast milk. Started off with 1cc every 4 hours, now she get 6cc every 2hours. Woohoo. My hard work of pumping breast milk is finally being paid off. It really gives me motivation to continue pumping around the clock.

Emilia gained some weight in the 2nd week. She was born 870g, and dropped to 700's and then moved up slowly to 800's and the upper end of 800's. We are so happy that she is growing now. She doesn't look anything like a full term chubby baby yet but she's getting there.

First 7 days of Emilia's life

One week old.... or 26 weeks and 5 days in gestational age.
She was quite stable for the first 5 days or so. All the doctors and nurses said she was so feisty and active. She was very active when she was in my tummy too. She used to kick so hard at the fetal heartbeat monitor.

But to our dismay, after one weekend of so many attempts of IVs and PICC lines all over her body, the doctors said she seemed to have gotten some kind of infection.
She seemed to have lost the willingness to fight. She became so lethargic and limp. We were so furious. Just how many needles does this baby need to endure? And now because of that, they think she has sepsis...? Suspected sepsis - now this brings on more poking: blood test, spinal tap, etc.

Whether related or unrealted to sepsis or PDA, her deteriorating condition made her step down from CPAP to HFO nasal prongs on her 6th day and then finally to a ventilator on the 7th day. When they told us it would be better to intubate her, I broke down. The doctor and respiratory therapist thought I was crying because I considered this a step backward from CPAP. No. I was devastated because of the pain that my baby would need to go through with the tube going into her nasal cavity down to her throat and chest. Her cries would now be silenced.

Infinite guilt clouds my heart. If only I were able to carry her to term, she wouldn't need to go through all this. She was supposed to be sleeping and playing around in my tummy, not poked, intubated, taped, and monitored in a noisy bright NICU.

My pregnancy, my baby

Just as I was about to celebrate the beginning of the third trimester of my pregnancy, I was admitted to hospital on May 25 due to threatened preterm labour. All the doctors told me it was very likely that I was going to deliver in the next few days. Only I didn't think that was going to happen because I was not experiencing any labour symptoms - no cramping, no painful contractions, no bleeding, and no fluid leakage. All I had was what I thought were Braxton Hicks, which is just tightening or balling up sesation that is normal around this time of pregnancy. A neonatologist came to my hospital room to tell me a million bad things that my baby would face if she was born that day. I was also going to be transferred to a hospital with Level III NICU - any hospital in Ontario that had a bed available. Luckily Mount Sinai in downtown Toronto had a bed freed up the following day and I was transferred by an ambulance.

I was on hospital bed rest for 5 days without any issues. Then on May 30, I started feeling very mild cramps. Just in case, I let the nurse know and she started monitoring the contractions. During the monitoring period, I got again what I thought were the normal Braxton Hick tightenings, about 3-4 times an hour. I thought the nurse would look at the graph and then take the monitor off my tummy so that I could eat my dinner and carry on with my day. Contrary to what I thought, she wheeled me to Labour and Delivery and asked L&D to observe me until they could confirm I was not going into labour. I began to feel nervous but still believed the cramps were due to the round ligament stretching and the contractions were just Braxton Hicks. After a vaginal exam, I was declared 6cm dilated. I was in shock. How could this happen - I was on bed rest for the last 5 days! Then the cramps got much worse than before and I started to bleed - perhaps from the exam. I was still hoping it was a false alarm. They would probably wheel me back to my room. Then, around 11pm I was moved to another delivery room, which was right next door to the NICU team. NICU visited me again to discuss what they would do to my baby. Anesthesia visited me to discuss different options for pain control. In between these talks with different doctors, the intensity and frequency of the pain was increasing. Finally the reality sank in and I knew I was in labour. By 5am, the pain became severe and it came every 10 minutes. By 7am, the pain was just unbearable and it came every 5 mintues. I was beginning to sob uncontrollably.

What was more agonizing than the pain was that I had to deliver this baby. I could not undo this situation. I could not halt it or delay for a few more days. I felt so lame that I could not even meet my first goal of reaching 28 weeks. I felt so guilty that my cervix was not strong enough to hold my baby longer. At 8:37am, my baby girl finally arrived. She was crying, she was breathing. I rejoiced and cried too.

I was only 25 weeks and 5 days pregnant that day. I didn't even get to finish my second trimester. I didn't even get to wear all the maternity clothes that I had bought 2 weekends ago. I had taken photos of my baby bump only once, on the day I reached 24 weeks. I hadn't even read the final sections of "What to Expect" book. I hadn't even had a baby shower yet. Eun and I hadn't even picked out a name yet. My pregnancy ended so abruptly and, sadly so did my baby's peaceful time in my womb. We now have a long journey ahead of us... an incredible one it will be when we look back at the end of it. So here it is, a blog I am going to keep for my baby girl, born without a name.