7.20.2005

Banal chores in a surreal world

Our nurse in the NICU yesterday was Jill, a confident and bubbly gal, probably a couple of years younger than Anna. Each NICU nurse rotates between two babies, and but for lunch, dinner, and the occasional restroom break or supply run, they stand (or sit) between them for the entirety of their shift. Anna and I haven't seen the parents of Frankie's nearest neighbor, the other baby under Jill's care at the moment. That leaves the three of us more or less alone for long stretches of time that lend themselves to conversation. Given the intimate nature of the situation into which we've been thrown together, our talk begins at a very personal level. After an hour or so of increasingly self-revelatory banter, she offers as a clarification appended to her standard issue sympathetic condolence w/r/t our situation, "I mean, I don't have any babies of my own, but I can just imagine...I mean, I know I can't really imagine...I mean, it's just so..." Her voice trails off because she, like 95% of the doctors, nurses and technicians we've dealt with, is incredibly sensitive to our feelings, which should apparently be more fragile than mine seem right now. Perhaps it's denial or some related, subconscious defense mechanism, but I feel confident that Frankie is going to be okay, even if we've got a ways to go before he gets there. I realize this is a totally irrational optimism to which I subscribe, but it seems to be working. And so, when Jill stumbles awkwardly onto sensitive ground, I redirect the conversation with a question that's been on my mind since we arrived here Thursday. "Does being a NICU nurse make you think twice about having babies?"

As I've mentioned at least a dozen times, we were totally unprepared for this little adventure. We survived as well as we did because of sheer luck and the support of family and friends. Everything from flexible bosses and sympathetic employers to above-average insurance coverage have made this whole thing manageable. But for our good fortune, this could have been a soul-crushing experience. What few advance preparations had been made before all of this began were primarily a result of Anna's innate proclivities. We certainly didn't plan for this, largely because nobody suggested it as a possibility. And it's not like we weren't actively seeking information. I've complained before about the woeful inadequacy of our birth and baby care class, and I can honestly say that I can't recall a single mention of the possibility of preterm birth, other than a blithe dismissal of one expectant mother's concerns about the subject. "That won't happen to you," or some such misguided reply. And the pregnancy books aren't much better. In
Planning Your Pregnancy and Birth by The American College of Obstetricians and Gynecologists, discussion of preterm birth and premature babies is limited to four pages at the end of the book, in the chapter on "Complications of Pregnancy." It's here, on page 366 (of 422), that we are finally informed that "about 1 of every 10 babies born in the United States is born preterm." See, to me, 10% is kind of a large number. Every tenth baby born in the United States arrives before the end of the 37th week. Now, admittedly, those born after 36 weeks suffer very few of the complications generally associated with preterm birth, but still, that's a lot of babies. What little information PYP&B offers on the issue of preterm birth and preterm babies is limited to identifying the symptoms of preterm labor and describing the process for preventing its progression. Less than half a page is dedicated to the discussion of preterm babies. The remaining references to preterm birth, premature rupturing of the membranes, and preterm babies are scattered throughout the latter pages of the book, always in association with a discussion of some risk factor, such as drug use, alcohol consumption, smoking, sexually transmitted diseases and other medical conditions or physical abnormalities, none of which applied to Anna. Nothing in this book indicates that we should have been even slightly concerned about preterm birth. The Mayo Clinic Guide to a Healthy Pregnancy is slightly better, boasting both a 4-page section on preterm birth in the last part of the book, "Complications of Pregnancy and Childbirth," and also an 8-page section on premature newborns in the chapter "Your Newborn." Still, there's nothing in the book to indicate that we should be concerned. If these books are to be believed, the ten percent of birth parents who go through preterm birth must be two-pack-a-day, diseased drug addicts, not tobacco/alcohol/drug-free women who go to the gym four times a week and subsist on a diet comprised entirely of organic foods. So naturally, we weren't prepared.

But what were the books and birth instructors supposed to tell us? That every woman is at risk of preterm birth, regardless of their medical history or the precautions they've taken throughout pregnancy? That nobody really knows why membranes spontaneously rupture months ahead of schedule? In short, yes. Everyone should be aware of the risks going in. Even if there's nothing you can do to prevent pre-term birth (although I'm not convinced that's necessarily the case), preparing yourself financially and emotionally ahead of time can certainly soften the blow. I guess I just wish I could've seen it coming. Like I said, we got lucky. How many among the unfortunate ten percent don't?

I suppose I really don't know that it's possible to prepare emotionally or psychologically for preterm birth. The question about whether or not being a NICU nurse made Jill more reluctant to have babies stemmed from my own uncertainty about whether or not knowing about this in advance would've really helped. Would knowing this was a possibility have changed anything, or would it have just added another element of anxiety to an already overburdened mind? Like Jill said, sometimes knowledge is counterproductive. Still, I think I'd like to have known.

There are certain things that can only be written in hindsight. Some moments over these past few weeks have been unspeakable until now. For instance, from the time we checked into the hospital at the end of June, right up until the time Frankie arrived, I had a frequently recurring nightmare. I can't remember any of the dream but the very last moments, and it was always the same. I'm holding Frankie in the palm of my hand. His head rests near the tips of my fingers, his bottom against the ball of my thumb, his tiny legs dangling on either side of my wrist. His chest is heaving, his breath keeping pace with his racing heartbeat. His eyes are closed, and he reminds me of a featherless baby bird, fallen from the nest. When I was very young, probably six or seven, my cousin, my sister and I found such a bird on the concrete breezeway outside of the reception hall where my great-grandmother and great-grandfather celebrated their fiftieth wedding anniversary. In the dream, the sight of Frankie in the palm of my hand conjures vivid memories of that event. As I'm staring at Frankie, thinking of that dying baby bird, I remember that I couldn't save it, and I become panicked by the thought of just how fragile my son is. I don't know how long I am transfixed by this terrifying image, but each time the nightmare ends with Frankie's tiny head lolling to one side, his tiny chest collapsing, then motionless. And then I'd wake up, lying on a cot next to Anna's bed, my heart pounding as I strained to hear the reassuring
thuka thuka thuka of Frankie's heartbeat on the monitor across the room. My sister took a picture of my dad and I shortly after Frankie arrived, before the doctor told us about the complications. The ecstatic expression on my face is at least partially attributable to the huge sense of relief I felt when I saw how big Frankie actually was. And of course, the nightmares stopped immediately thereafter.

You don't have to be familiar with Freud or Jung to parse that particular dream, but I find it interesting that it is the only one I can recall in any detail. Throughout our pregnancy, I remember few dreams about Frankie. I definitely had a couple, but they were infrequent, and for the most part unremarkable. I don't think I ever thought about one for any longer than it took to finish a first cup of coffee. But this nightmare stuck with me. Not only did it occur on multiple nights, but the image haunted me at various moments throughout the day, when my mind would wander into the forbidden territory of
Things That Could Go Wrong. I employed the usual tactics of distraction and misdirection to exorcise my imagination, with limited success.

If this post seems disjointed, it's because I'm grappling with a series of events that make little sense to me, but which have utterly consumed my life. I wasn't lying when I said that I am optimistic about the eventual outcome, but the moments between are strung together with doubt and frustration. As fortunate as we've been, and as positive as Frankie's prognosis is, this has been the most emotionally taxing episode in my life. Somehow, telling y'all about it seems to help. Now, I'm going to buy groceries.

9 Comments:

Anonymous Judy B said...

My "dark thoughts" came while I was wide awake two weeks before the planned baby shower in Oklahoma and I couldn't shake them so when Anna called to say her water had broken, I went straight to "panic mode" and stayed there until I learned what was wrong with Frankie. This was a case where I wished I didn't know what I thought was ahead for all of us. The book you write about this experience will be more important than the novel your dad has always wanted you to write, David. Painful as this has been, it's a story that needs to be told to help others know what is possible. It will be a story with a happy ending, as Frankie is going to be just great, but the words need to be written. I love you, Mom

8:00 PM  
Blogger Silver Zephyr said...

that one made me cry, grandma...we miss you very much here... -a

9:42 PM  
Blogger MommaS said...

All I know is that I was afraid my entire pregnancy. Every time I saw a doctor, my "advanced maternal age" caused concern for my baby. Downs, defects, disappointment. Chris & I just started calling it the 3D effect. I don't think I actually had "dark thoughts", I just couldn't shake the feeling that after trying so long, everything would be ok. My dream/nightmare was the old familiar "I can't find my baby." I would wake in a panic, feeling for my belly, prodding it until he moved. That's probably why he doesn't really sleep well now! Tell everyone, Dave, from a father's point of view. It will make a difference. Just like this special little man we're all anxious to meet. Give him a poke for me!

Love
S

4:00 AM  
Anonymous spencer said...

It's true that this story doesn't get enough press - a Google on the terms: "'baby blog' preterm bedrest" gives a whopping 8 hits (taking the quotes off baby blog gives you a few hundred - not all of which look helpful. This is all compared to 46 million hits on "pregnancy").

The story you're telling has already touched alot of lives and I wouldn't be surprised if it went on to reach more.

And after you're done with this part of the tale, you can go back to the get-rich-quick scheme of PopCulture magazine ...

6:48 AM  
Anonymous Jennifer (CMS) said...

Your descrption of little Frankie brings back vivid memories. I have often tried to explain to others how it feels to hold your son in the true palm of your hand, you describe it perfectly. Your optimism is your saving grace! With the outcome for Frankie a positive one, optimism is easier to warrant. Should for any reason the doctors reports give you the impression that is discouraging, NEVER loose the optimism. You will all survive this experience because of your positive outlook. It seeps into every person whom you come in contact with, it seeps into Frankie every day. I am very blessed to read your blog. To remember the past and cherish even more my (now taller than me) "palm held" son. LOVE, OPTIMISM, PRAYER, FAMILY, FRIENDS will create an environment for Franke to thrive. You and Anna are truly blessed!

8:51 AM  
Anonymous joy said...

Frankie is one of the luckiest people I've read about. He has the most caring, capable, educated parents that a kid could have. He has the best Medical care available. He will be a superhero.
You don't really know me, but I heard about him through a friend. My heart goes out to you during this time, but I find that your strength and support of one another is a consolation to all of your readers/family/friends that you will be fine. You and Anna have tremendous talent in written communication. Have you thought of publishing your writing...magazines, books, pamphlets? You say that you don't know if knowing about Frankie's possible complications would have changed anything. Maybe it would have been helpful to know just to keep yourselves from being blind-sighted. What can I do to help?

6:52 AM  
Anonymous Anonymous said...

"Nicu nurse" heh heh. sounds kinda naughty.

Franklin is the newest named storm! maybe he'll be a hurricane.

12:44 PM  
Anonymous Anonymous said...

I just wanted to let you guys know that I'm thinking of you, as are the Dieters and my friend Evie. If there is anything they can do, like take care of your cats, bring you some food, etc. I will send them to help - since I'm too far away.

Also wanted to tell you that my next door neighbor's son was born with the same esophogus problem that Frankie has, and he is now a burly, strapping 15 year old asshole. So I'm sure Frankie will grow up just fine. But he won't be an asshole :)

Anyhow, hang in there. I know it's going to be tough for awhile, but you've got a beautiful little boy and family and friends to help you as best we can.

Much love,
LINDSAY

12:51 PM  
Blogger Silver Zephyr said...

aren't *all* 15 year olds kind of assholes?

but yes, frankie will be perfect, we know. at least to us anyway!

thanks for you sweet thoughts lindsay, shelee, spencer, jennifer, joy and anons. having everyone's support makes all the difference and whenever i read comments on the blog like this i tear up and think about how lucky we are. wish you all were here. xoxo, anna

9:12 PM  

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