Being Jacob’s Dad, Part 6: Day One in the NICU
When I left off my story (Becoming Jacob’s Dad, Part 4: The big day), I had just become his dad, mentally survived his first medical procedure, saw Andrea and him to bed at the hospital, and gone home. So my story has to change now, it isn’t about becoming Jacob’s Dad, it is about being Jacob’s dad.
But before I continue with today’s story, I need to digress for a small second. You read the previous blog. You may have read all four of the previous blogs plus the photo digression. There’s something missing from the story. Did you spot it? Did you notice I didn’t talk about something in particular? An obvious experience that I didn’t relate?
The story of Andrea seeing and holding Jacob for the first time. That wasn’t an oversight in my writing. It’s absent because it didn’t happen.
Here was the simple logistics puzzle:
- When Jacob was born, we didn’t get to hold him, he had to go directly to the NICU. Safety first, okay, we get that. Once there, they don’t let him leave. They hook him up to everything, put him in the incubator, and protect him. It’s an ICU for babies. If your baby is in there, he’s in there for a reason. You don’t take him out for a leisurely stroll.
- Andrea was in recovery and more or less had to stay there. The bed she was in was too large to take into the NICU, even if they were willing, which they were not given the potential for extra germs, etc. So she couldn’t be wheeled over in the bed. But she also couldn’t sit in a wheelchair — the C-section was rough, MAJOR surgery by anyone’s calculation, and the equivalent of a car crash by mine. A wheelchair was out of the question.
Andrea couldn’t go to the NICU, Jacob couldn’t leave the NICU. Ergo, Andrea didn’t get to hold Jacob that day, or even really see him except across the room in delivery and on videos/pictures I brought back and forth.
I have very few regrets in my life, as I don’t really believe in them. You do the best you can with the info you have, and you might be disappointed with a result, but regret seems too much like Monday morning quarterbacking to me. But I regret that outcome with every fibre of my being. I feel like I failed my wife. I didn’t even realize it was happening, not really. I was so focused on safety, security, health — I was so relieved they were receiving care, my brain didn’t go beyond that.
Which of course is probably the worst example of a male dealing with delivery issues. Don’t get me wrong, nobody else said anything either. Not the doula. Not her parents. Not even Andrea, perhaps demanding to see her child, which I hope would have registered with me, “Oh, wait, of course that should happen.” Andrea was out of it too though, that’s not a slam against her. She wanted to see Jacob but couldn’t see how it would happen, and the pain of getting in a wheelchair wasn’t an option. And she wasn’t going to endanger his health to force them to bring him to her.
Yet, I’ve told our story to a NICU doctor in the U.S., and her response was swift and immediate, “Why didn’t the doctors do it automatically?”. Good question. I’ve been told by two different women who had similar experiences at the same hospital that demanding to see the child would have made little difference in outcome — they just don’t take the baby out of NICU for any reason and Mom can’t go in unless she suffers the trip in a wheelchair, which most can’t do. No discussion. A ridiculous setup. And a lifelong regret.
The next morning
I woke up that first morning feeling the same as I had the day before. It had been a roller-coaster of a day, but I think I expected that I was going to feel “like a dad”. Feel different somehow.
I didn’t. I felt like we’d been through an event, but I didn’t feel different inside. Part of it was the unreal expectation, part of it was that I was still in some shock with a healthy dose of denial too. I grabbed some breakfast, decided I needed a shower to survive the day, grabbed a couple of bagels at Tim Horton’s and headed off to the hospital. I wasn’t racing, I was deliberately setting a measured pace for what was likely to be another very long day. I wasn’t really thinking, anticipating, I was just trying to keep on an even keel for as long as I could for the day.
I arrived at the hospital just before 9:00, wondering where Andrea was going to be. I didn’t know if they would have taken her over to the NICU already, or maybe Jacob would be with her feeding, I really didn’t know.
Nope. Andrea was in her room, toe tapping, waiting for me to take her to see Jacob. Nineteen hours after the birth and she hadn’t held him yet. I’d like to say I regretted it immediately, but honestly, I didn’t even realize the magnitude of it until Andrea and I talked about it later. A friend had waited 50 minutes to hold their son a few weeks earlier, and I found THAT story traumatic. Andrea waited 19 hours and I hadn’t even registered. We had made it through the delivery day, Andrea was safe, Jacob was safe, it’s as far as my brain had gone. But it was time to go to the NICU.
When you get to the NICU, you enter through a small triple-doored foyer. Through the first two doors into a small ante-room, with a place to leave coats and stuff, wash your hands twice, check in with the reception and be buzzed / let into the NICU. Andrea and I had bracelets on our wrists that matched one around Jacob’s foot to identify us as his parents. It was his patient number, written on charts, and notes, and everywhere. Andrea and I could go in together, but if we had a guest, we had to take them in one at a time. Two people per baby, max. The first day they apparently relax that a bit for grandparents, but not for long. Andrea’s parents were there later in the morning, but couldn’t hold him, just really see him through the incubator. They limited holding Jacob to parents only for the first few days.
I had been in the NICU the night before, but I don’t know that I fully registered that my son was in an ICU, and there for good reason. It wasn’t simply precautionary. He had had the pneumothorax procedure the day before, still had issues with breathing, but he was looking pretty good. I think if you asked me, I would have said that I still expected him to go home in a day or two. I was nuts, in retrospect, or just in denial. NICUs are rarely merely weekend retreats.
I don’t remember when we found out, or even who told us exactly, but we learned that day that there was an informal expectation in NICUs — babies often go home around their original due dates i.e. the equivalent of week 39/40. That’s not a hard and fast rule, but it’s a good initial planning date. For us, that meant another 2-4 weeks. A sea change in perspective from thinking it would be a day or two at most.
NICUs are also hard to describe. People who have never seen a NICU — or even know they exist — think they are like the nurseries they see on TV. Bright, cheerful, happy places. They are not. They are bright, at times, sure, but they are clinical. Serious. Sombre in some ways. Professional. They can be happy places, but rarely light-hearted. Not quiet, either, with lots of machines beeping constantly.
Jacob had moved from where he was the night before and was now in a room with five other babies, with 1-2 nurses. The more serious babies require almost a single full-time nurse to monitor them; most are in the 2-3 babies per nurse range for the first little while. He was also in a fully-enclosed incubator, the type you access through the arm holes in the side. He had a feeding tube through his nose, prongs for oxygen, monitors beeping all around him, and an IV inserted into veins in his head (the ones in his arms are prone to being ripped out through movement). With all the wires, they tend to leave them in a diaper and wrapped in blankets, no need for snugglies yet. It’s scary to see your child in such an enclosure.
After checking in, I wheeled Andrea over to Jacob’s area. We basically nudged the nurse with the news that Andrea hadn’t had a chance to hold him yet, and I may have imagined it, but she looked a little taken aback, almost guilty. Not enough to rush to get him to her, but to focus on that as an immediate short-term goal. They took out the feeding tube (they had to put a new one in anyway), left the oxygen prongs but disconnected the IV from his head so he was a little less “wired”, and settled him in her arms. One of the most beautiful sights I have ever seen in my life.
I got to hold him too, and to do my first diaper change. It was the first time I got to hold him in a relaxed fashion, rather than a quick hold and cuddle from the night before.
Andrea even got to feed him for the first time. Today was her first day pumping, an unexpected outcome as we thought she would simply breastfeed. Jacob wasn’t quite up to breastfeeding, particularly with the asymmetry issues in his face and jaw, but Andrea got to put a little bit in the nipple of a bottle for him to try feeding. He had a feeding tube and an IV, but we would need to get him latching soon.
I mentioned Andrea’s parents being there, and it was great to have the support. When they were in with Andrea and Jacob though, I hung back, partly to give them privacy and partly to honor the “2 person” maximum for visiting in the room. I know very little about their NICU conversations, or the pride Andrea likely felt showing Jacob off and the love coming from them. Her parents also have experience dealing with health issues in babies, having dealt with it themselves when Andrea was little, one of the few resources we knew.
For my mom, I was worried. She was turning 80 the year that Jacob was born, and my sister wanted to drive her up to Ottawa to see Jacob in the NICU. At first, I wasn’t sure that was a good idea. She would have to see him in the incubator, she wouldn’t be able to hold him, I didn’t know if she would be able to handle it. NICUs are kind of scary. In the end, I decided it wasn’t my call. If my mom wanted to come, she could, but I made Marie promise to explain to her that it might be a difficult sight to see. It would not be the carefree viewing of her previous dozen grandchildren and great-grandchildren.
They arrived in the afternoon. I think my sister went in first, which is odd for order, but I think we did it so that I could talk to my mom a bit first, and so Andrea could come out and I could take my mom in (the 2 person rule). Then I think I took my mom in. You know what’s weird? I don’t remember any of the visit with Jacob. I don’t remember my mom standing at the incubator, I don’t remember anything in that room. Maybe Andrea took her in. I just remember my Mom coming out, and sitting in a chair to rest for a minute. While she sat there, my sister asked her something along the lines of, “So what do you think, how did he look?”.
I steeled myself for the response. Mentally, physically, emotionally, I was expecting a hit of some sort. My mother was rarely, if ever, politically correct. As she aged, she became blunt. Not intentionally harsh, unless she was mad, but sometimes the words would hit harder than she intended. She looked at my sister, screwed her face into her trademark disgusted look, and said, “Hideous. Absolutely hideous.”
I laughed. My mother was mocking us. She knew we were worried about her, worried about seeing the baby, worried about what she might say. So she turned it back on us with sarcasm. Like she would see anything but love when she saw her latest grandchild. Like she couldn’t handle it. The worry was so unnecessary that she could laugh at us, mock us with a little twinkle in her eye. That laugh of mine was the first time I had really felt any tension leave my body in ten weeks.
I also felt a little guilty that I had underestimated my mother. I should have known better. My mother was born just before the Great Depression, left school in Grade 9 to look after her brothers and sisters, buried her grandparents and parents, lost a brother in the war and buried other siblings through natural causes, had two miscarriages, raised six kids. And then buried her husband thirteen years before. I don’t think I ever loved her more than when she mocked my fear.
While most of the day was spent just holding Jacob, there were lots of medical things to discuss with the hospital. They were still worried about his “oxygen saturation” levels, aka his “SATs”, and so he had oxygen prongs still. We learned he had a herniated umbilical cord, which apparently isn’t painful and likely would be “nothing to worry about”. I ignored that advice and worried about everything anyway. There was still some swelling on his left cheek and neck, some asymmetry in his mouth and jaw that could cause challenges for breastfeeding. We asked about his eyes and they were surprised…why were we asking, was there an issue? Up until the day before, it was all we were expecting. Likely cataracts. They agreed to do a consult with the Eye Institute that is attached to the hospital, where family members had gone for their own eye surgeries. A top notch facility.
Generally, today started our NICU routine. We didn’t know it yet, but we had a two-week slog ahead of us. Go in the morning. Stay for rounds. Hang out, help with baby care. Hold our son. Feed our son. Change our son. Rest. Eat. Repeat. Tuck him in for the night.
And then leave the NICU. Without our son. Repeatedly.
An odd thought hit me as I left that night. I dropped Andrea back at her room, and then headed back down the hall. In the maternity ward, there is a little kiosk, common to many hospitals. They’re little tiny automated photo huts, except instead of having a stool you sit in, they have a camera mounted above a little bassinet area. You can put your child in the bassinet, snap a photo, and email it to yourself after adding funny borders, a stuffie, cute little saying, etc. When Andrea was in the hospital at 26 weeks, I saw the kiosk and thought it was a bit cheesy.
As I left that night, I saw a father and mother using it, trying to figure out how to place their child in it at an optimal angle. And I was extremely jealous. This family was worrying about the angle of a photo, while I was worrying about a child who had to be in an ICU. I wanted the simplicity of just walking down the hall and holding our son. No wires. No tubes. No worry other than lighting in a photo.
I felt guilty for being envious; I felt guilty for wanting more when there were babies in the ICU in far more serious situations than Jacob. I wanted to take my wife and son home with me. I wanted to feel the indescribable joy that goes with THAT experience, not the indescribable knot in my stomach that had softened a little in the ten weeks leading up to the delivery but was back with a vengeance now that we were experiencing the NICU in full.
I went home feeling like I had survived another round with a pro boxer. If Round 1 was the PPROM and Round 2 was the delivery, where the opponent had gone for the early knock-out, then Round 3 had been the stage where they start working on the long-game, landing body blows to soften you up overall. I went home, I slept, and then it was time to go back on Sunday for Day 2.
