Also that week I started trying to put Cecilia on the breast. By now she was 36 weeks so she should be ready to try. Usually they try to put premature babies on the breast by 34 or 35 weeks.
Cecilia did seem interested but she just could not get the hang of it and she would get very frustrated.
The first week went by and Cecilia was still not attaching. That’s when Kate Taubert (she usually works in Ward 41 North but she was on her three month rotation) and other nurses (which I would love to mention their names but I haven’t asked them for their permission) suggested that I speak to Samantha Gordon. Samantha works as a nurse in NBS usually in Bay 1 and 2, but one of the many great skills that Samantha has, is that she is also a Breastfeeding Counsellor.
Meeting Sam was a breath of fresh air. She was always smiling, had heaps of knowledge and best of all she was of great support.
She introduced me to the ‘Breast Shields’ these are great!!! As you may know, not all nipples are the same and not all are easy for babies to suck on.
Cecilia did suck her dummy so she enjoyed sucking on the shield but unfortunately Ceci did not have the strength or the skill to suck hard enough to actually be able to feed by her self. We also started to notice that she would get very upset. Sometimes she could be trying for 45 minutes but my breast was still full. Something else was going on.
The Family Resource nurse (also a great person but I haven’t got her permission to mention her name) suggested we make an appointment with the Speech Pathologist.
A Speech Pathologist? Yes this is what I asked myself. Why do we need a Speech Pathologist if Cecilia is too little to be speaking!! Instead of asking straight away what a Speech Pathologist was, I just waited for her to turn up, which is very wrong. If you don’t know something you must always ask. They say that ‘there is no such thing as a silly question ‘which I truly believe when you are someone’s advocate.
When the Speech Pathologist arrived I learned that not only do they assist with speech issues but also with feeding/swallowing.
Finally Cecilia had reached 1.8kgs so she was able to come of the isolate as long as her temperature didn’t drop under 36.5 º.
It was really exciting being able to see her all the time without a glass between us, being able to pick her up as many times as I wanted. Even though she still had all her leads attached she looked free.
I had forgotten to mention before but since Cecilia was taken to NBS they put on her three leads (three colours: green, black and white). These were to measure her respiratory rate and also she would have a SATS probe which would measure her oxygen saturation and heart rate. These had to be on all the time. Only when she would have a bath we could remove them as long as she had been stable that day.
Back to the Speech Pathologist; as she tried to feed Cecilia she noticed that Ceci was not sealing the nipple, that her tongue was not under the nipple like it should and that she had difficulty swallowing.
She suggested that apart from trying with the breast that we should start trying with a very low flow bottle. This also meant that I had to be very patient and pray to all the Gods that eventually Cecilia was going to be able to feed by herself.
While all of this was happening Cecilia had her first Hearing Screen. This is one of the routine health checks that they do at NBS. The Victorian Infant Hearing Screening Program (VIHSP) is a program that they wish to eventually incorporate in all hospitals across Victoria.
I had given my consent way back when Cecilia was born but I wasn’t present when they did the first screening, and I say the first screening because Cecilia had to have a second one as she did not pass the first one.
I didn’t think too much about it because she could have been unsettled during the screen or had fluid (or other temporary blockage) in the ears. I wasn’t going to worry if I didn’t have too.
Sunday, February 7, 2010
Wednesday, January 27, 2010
The Biggining of our Life in Hospital, continued
Cecilia had already been one week in Bay one when her SATS started to drop below her low limit of 88 (SATS can only be as high as 100) but because they would pick up immediately they were not too concerned. The nurses said that it was quite normal for premature babies, so they would keep an eye on her
On the morning of the 11th August 2008, when I walked in the Bay Cecilia was not there. The first thing that I said was “Where is my baby?” As I started to panic and cry the nurse that was looking after Cecilia that morning walks in to tell me that Cecilia had to be moved back to Bay 8 (NICU) because her SATS were below 88 and she had a high temperature (for babies the range is 36.5º - 37.2º). She told me that it would be better for me to wait for all the blood tests and Lumber Puncture (also called spinal tap) were done before I could came in (usually there is eight isolates in NICU so the space is very limited and tight). Those were one of the longest 20 minutes I had ever had to wait. Also I had no idea of what a Lumber Puncture was so in those 20 minutes I asked my mother what it was and I started to cry again.
For those that do not know and hopefully do not have to experience this procedure, a needle is inserted in to the lower spine to collect a sample of Cerebrospinal fluid. This sample is obtained to detect or rule out suspected diseases or conditions. CSF testing looks for signs of possible infection by analysing the white blood cell count, glucose levels, protein, and bacteria or abnormal cells that can help identify specific diseases in the central nervous system. Most lumbar punctures are done to test for meningitis, but they also can determine if there is bleeding in the brain, detect certain conditions affecting the nervous system.
The patient will be positioned with the back curved out so the spaces between the vertebrae are as wide as possible. This allows the doctor to easily find the spaces between the lower lumbar bones (where the needle will be inserted). Older children may be asked to either sit on an exam table while leaning over with their head on a pillow or lie on their side. Infants and younger children are usually positioned on their sides with their knees under their chin. Cecilia was positioned on her side.
When I was finally able to enter the doctors explained to me that in a couple of hours they would be able to know if there was any indication of infection. If there were they would start with the antibiotics while they waited for the complete bacterial culture which takes 48 hours. They also told me not to worry that this was just part of their procedure to check for all possible diseases or infections, which is quite common for premature babies to catch a few infections while being in hospital.
Two hours later it was confirmed that Cecilia had an infection but they didn’t know where so they started with the antibiotics which should last for five days.
I felt devastated, so guilty. I just felt that this was my entire fault. She has only been experiencing pain since I gave birth to her. Why did this have to happen?
Cecilia was also back on CPAP, the drip and feeds had been stopped again.
I know had to call Manuel and I just didn’t know where to start. Also I didn’t want him to get upset at work but he had the right to know what was going on with her daughter.
I did call him and of course he was upset, especially because we could not be together to support each other.
Around lunch time I went back home to rest and come back during the afternoon with Manuel.
When we went in later that afternoon, Cecilia had been stable and her breathing had improved.
Two days later everything came clear for meningitis and for any brain infections. Infections levels were still high but they could not find out where the infection was. I wasn’t happy with this answer, I wanted to know where the infection was but once again they told me that this was very common.
After five days of antibiotics Cecilia was clear of infections. Now she just needed to get of the CPAP and recover some of the weight she had lost. Two days later Ceci’s SATS started to drop again. Another infection. Tests and antibiotics all over again for another five days.
On the 3rd of September 2008 Cecilia was finally moved out of Bay 8 to Bay 5.
On the 11th of September I was able to give Cecilia a proper bath. It was very exciting and emotional. On the 13th Manuel was able to bath her for the first time and also weighed her. Cecilia was now weighing 1.656kg so hopefully in a week she would be weighing 1.8kgs and they can try to bring her out of the isolate in to an open cot.
On the morning of the 11th August 2008, when I walked in the Bay Cecilia was not there. The first thing that I said was “Where is my baby?” As I started to panic and cry the nurse that was looking after Cecilia that morning walks in to tell me that Cecilia had to be moved back to Bay 8 (NICU) because her SATS were below 88 and she had a high temperature (for babies the range is 36.5º - 37.2º). She told me that it would be better for me to wait for all the blood tests and Lumber Puncture (also called spinal tap) were done before I could came in (usually there is eight isolates in NICU so the space is very limited and tight). Those were one of the longest 20 minutes I had ever had to wait. Also I had no idea of what a Lumber Puncture was so in those 20 minutes I asked my mother what it was and I started to cry again.
For those that do not know and hopefully do not have to experience this procedure, a needle is inserted in to the lower spine to collect a sample of Cerebrospinal fluid. This sample is obtained to detect or rule out suspected diseases or conditions. CSF testing looks for signs of possible infection by analysing the white blood cell count, glucose levels, protein, and bacteria or abnormal cells that can help identify specific diseases in the central nervous system. Most lumbar punctures are done to test for meningitis, but they also can determine if there is bleeding in the brain, detect certain conditions affecting the nervous system.
The patient will be positioned with the back curved out so the spaces between the vertebrae are as wide as possible. This allows the doctor to easily find the spaces between the lower lumbar bones (where the needle will be inserted). Older children may be asked to either sit on an exam table while leaning over with their head on a pillow or lie on their side. Infants and younger children are usually positioned on their sides with their knees under their chin. Cecilia was positioned on her side.
When I was finally able to enter the doctors explained to me that in a couple of hours they would be able to know if there was any indication of infection. If there were they would start with the antibiotics while they waited for the complete bacterial culture which takes 48 hours. They also told me not to worry that this was just part of their procedure to check for all possible diseases or infections, which is quite common for premature babies to catch a few infections while being in hospital.
Two hours later it was confirmed that Cecilia had an infection but they didn’t know where so they started with the antibiotics which should last for five days.
I felt devastated, so guilty. I just felt that this was my entire fault. She has only been experiencing pain since I gave birth to her. Why did this have to happen?
Cecilia was also back on CPAP, the drip and feeds had been stopped again.
I know had to call Manuel and I just didn’t know where to start. Also I didn’t want him to get upset at work but he had the right to know what was going on with her daughter.
I did call him and of course he was upset, especially because we could not be together to support each other.
Around lunch time I went back home to rest and come back during the afternoon with Manuel.
When we went in later that afternoon, Cecilia had been stable and her breathing had improved.
Two days later everything came clear for meningitis and for any brain infections. Infections levels were still high but they could not find out where the infection was. I wasn’t happy with this answer, I wanted to know where the infection was but once again they told me that this was very common.
After five days of antibiotics Cecilia was clear of infections. Now she just needed to get of the CPAP and recover some of the weight she had lost. Two days later Ceci’s SATS started to drop again. Another infection. Tests and antibiotics all over again for another five days.
On the 3rd of September 2008 Cecilia was finally moved out of Bay 8 to Bay 5.
On the 11th of September I was able to give Cecilia a proper bath. It was very exciting and emotional. On the 13th Manuel was able to bath her for the first time and also weighed her. Cecilia was now weighing 1.656kg so hopefully in a week she would be weighing 1.8kgs and they can try to bring her out of the isolate in to an open cot.
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