Showing posts with label NICU. Show all posts
Showing posts with label NICU. Show all posts

October 27, 2017

Life Tips for a One-Month-Old


“If there’s a NICU rocker in the house, can you come to Bay 3?” I heard on the hospital intercom. The baby girl I was rocking was asleep in my arms, so I returned her to her bed and answered the call.

When I walked into Bay 3, I saw the familiar, relieved smile of a tired nurse who desperately needed help with a fussy boy so that she could finish charting before her shift ended.

She was about to go home.

And when I saw a car seat sitting on the floor near his bed, I knew Fussy Boy would be going home soon, too.

“He’s doing really well,” the nurse said. “REALLY well. We’re so happy he turned a corner.”

I settled into my rocker with a pillow to cradle my elbow. When she handed him to me, Fussy Boy was warm. Baby warm. I don’t know what the exact temperature is of Baby Warm, but if you hold enough babies, you quickly discover that they have a special warmth: A physical feeling, but more notably a spiritual warmth that melts your heart.

Soon the nurse was off to her computer station, typing away to update her patients’ charts for the next shift. And Fussy Boy, although wonderfully warm, was uncomfortable. Irritable. Fidgety.

So we worked on the first thing that usually calms restless souls: body position. Rocker protocol is to always start with a flat cradle, making sure the baby’s chin is tilted upward enough for good airflow through the throat. So I cradled him flat. He fussed. I moved the pillow to raise his upper body. He whimpered. And then I hit the sweet spot (every baby seems to have one): I held him upright against my chest, patted him gently on his bum, and began humming a slow “Love Will Keep Us Together.”

He couldn’t hear my hums for his crying, but I kept humming anyway. My experience is that at some point, the baby takes a breath, and can hear other things going on besides his own cries. He hears a soothing hum, a vibration from my chest to his, and then his cries slowly lessen.

So I kept humming, patting, and rocking. After that song was over, I moved on to “Muskrat Love.” And when that song was over, he had become quiet. I could tell by the pace of his breathing (and the monitor) that he was falling to sleep.

I was quiet for a long while, enjoying listening to him breathe. I noticed that he had a big 1 on the side of his bed. He was one month old already!

Since I knew he’d be going home soon, I suddenly felt compelled to give him some advice. So I just started talking.

“A lot of what I’m about to tell you is from a book I wrote, which you may never read, so I’m going to give you the CliffsNotes version.

“1. Always respect your parents. At first, you’re going to love your parents. They’ll do everything for you: feed you, clean you, play with you. Then when you get older, they’ll teach you things, take you to the park, and tell you what to do. You may not want to do what they tell you to do. In fact, you’ll probably get really mad at them at times. It’s O.K. to be angry at someone you love. But be respectful. They’ll be mad at you some day, too, but that doesn’t mean they don’t love you. No matter how mad you get, even if you’re right about something even though they say you’re wrong, show respect. I’m saying a prayer for you right now that you have a good, strong, loving relationship with your parents. I didn’t have that. It was hard for me. And I don’t want that for you.

“2. Always say hello to your mom and dad when they come home from a long day at work. Until you’re old enough to take care of yourself—pay for your own food, shelter, transportation—they’re going to work hard to provide for you. They may have had the most absolutely horrible day, and you saying hello and being present might just be the love they need at that very moment.

“3. Never lie. Unless your life is in danger. Seriously, just don’t. It’ll get you in so much trouble and cause pain for you and those around you. It’s so hard to remember a lie, anyway, but you always know the truth, so just stick to that. Now, when you’re older, if you decide that you like to write stories, then it’s O.K. to write fantasy books (hint, hint). But, dude, just don’t lie. Life’s so much easier that way.”

Fussy Baby became fussy again, but he was well on his way to a good nap, so I switched to cradling him in my left arm.

“Do you have siblings?” I asked. “Well, No. 4 is a real challenge. Always try to have a good relationship with your siblings.”

He made a sour face.

“Oh, so you already know what I mean?” I chuckled.

“Yeah, this is a hard one. It’s hard for me, and, boy, I’ve made some mistakes. But your siblings are training-wheel relationships—practice for how to communicate, collaborate, and cooperate with others. You’ll build puzzles together and maybe have sword fights in the back yard. And you may tell them your fears and dreams. Then sometimes they’ll be annoying. So try to be patient.

“5. Eat your fruits and vegetables. When you get old enough to chew and digest real food, you’re going to LOVE to eat. And there’s some really tasty food out there. But don’t forget to eat stuff like broccoli, spinach, apples, bananas, oranges, cauliflower. This stuff is really good for your body, and will help you grow and stay healthy. Your parents may want you to try certain foods. Don’t be stubborn. Try it. You might like it!

“6. Speak up for yourself. Tell others when they’ve done or said something that hurts. If they love you, they’ll hear you, apologize, and not repeat the behavior. If they ignore your words, you might want to walk away. And make sure you apologize when you've done the same. Never be afraid to own up to your mistakes.

“7. Trust your instincts. And if adults tell you to keep a secret, just between you and them, that’s a sign that you DEFINITELY need to tell someone. Go to someone you trust and tell. You won’t get in trouble.

“8. Don’t do drugs. Just don’t. Trust me on this, nothing good comes from it. I did it. O.K.? Full disclosure here, I drank a lot and experimented with drugs, and it didn’t turn out well. Now I’m better, but I wasted a lot of Earth time with chemicals. I know that when you get older, your school friends are going to want you to try drugs and alcohol. So if you don’t mind, I’m going to plant a little seed here. You ready? ‘I don’t like drugs and alcohol. I don’t like drugs and alcohol. I don’t like drugs and alcohol.’ If you stay away from that stuff, you’ll bypass a lot of pain.”

Fussy Boy was no longer fussy; he was now snoozing a soft, nasally hum. The monitors indicated that he was in a deep sleep when the new shift’s nurse came over to check on us.

“I see a car seat on the floor over there,” I said. “I know what that means!”

“That’s right,” she smiled. “He’s about to go home!”

“Did you hear that?” I asked No-Longer-Fussy Boy, though he was fast asleep. “You’re about to go home, where there won’t be so many noises, lights, beeping monitors, and round-the-clock assessments. You’re going to love home. You’ll get so many more cuddles from your parents.”

No-Longer-Fussy Boy smiled. Or burped, depending on your interpretation. I slowly rose from my rocker, placed him gently into his bed, and tucked the baby blue polar bear blanket under his body.

“Have a great life,” I said as I left. “We’re so glad you’re here.”

June 2, 2017

Maybe

The other night during my baby rocking shift in the NICU, I saw that J. was awake, so I pulled on the standard purple latex gloves, leaned over the bedframe, and started talking to him.

J. has a mass on his head, and he’s most likely blind. Nurses aren’t sure whether he can hear. J. has been in the NICU for months now, and he needs stimulation. So I just decided to talk to him for a while, whether he could hear or not.

He's a sweet boy. Patient. Curious. Sometimes scared about things he obviously doesn't understand. I found that rubbing his belly while talking to him works to calm his spirit. (Maybe he feels the vibration of my voice. Maybe it's my imagination.)

I slowly and softly rubbed his belly while I told him my version of an old Zen story of the farmer and his horse.
 

“There once was a farmer who had a horse. One night there was a terrible storm, and the lightning scared the horse so much he busted out of the corral. The next day the farmer realized his horse was gone.

“His neighbor said, ‘Now you don’t have a horse to plow the fields. That’s terrible!’

“And the farmer said, ‘Maybe.’

“Two days later the horse came back with two mares. They all trotted right into the corral.

“And the farmer’s neighbor said, ‘That’s terrific!’

“And the farmer said, ‘Maybe.’

“The next day, the farmer’s only son put a saddle on one of the mares to tame her, but when he climbed on, she bucked wildly. She threw him down on the ground so hard that he broke his leg.

“And the farmer’s neighbor said, ‘That’s awful!’

“And the farmer said, ‘Maybe.’

“Days later, a war broke out, and the emperor sent a group to the area to draft young men for his army. Well, the farmer's son had a broken leg. He couldn’t serve, so they left.

“And the farmer’s neighbor said, ‘That’s terrific!’

“And the farmer said, ‘Maybe.’ ”

By now, J. was peacefully sucking on his binkie. His eyelids had started a now-familiar, slow, downward droop. He was falling asleep. And so I left him with my moral of the story.

“J., maybe you’re blind. Maybe you’re deaf. Whether these are bad things depends on perspective. There is likely a gift in you that none of us recognize. So you hang in there. You grow into the man you’re supposed to be, because your story hasn’t been written yet. And even if it had, maybe—just maybe—the ending will change into something completely different.”

J. fought sleep, but sleep was winning, so I pulled off the latex gloves and left his side.

The nursing staff know all the medical jargon and reasons why J. might be in for a challenging life. But I have to remember that medicine—the physical realm—is only part of the picture of this little boy’s life.

Is it a tragedy that he’ll be blind and possibly deaf?
 
As the farmer often said, “Maybe.”

September 15, 2016

The Impact of Others—and 'Muskrat Love'

It was another bittersweet night in the neonatal intensive care unit (NICU) at the hospital where I volunteer each week. The night started out with the usual finger-to-elbow soap scrub and antibiotic sanitization, the check-in at the nurse’s station, and then the search for the perfect baby to rock. The night ended with a profound need to acknowledge the impact others have had on my life and the lives of others.
 
In the first NICU bay, at the first bed, was a squirmy little one who needed cuddling. I didn’t hesitate.

I don’t know if all baby rockers have elaborate conversations with the infants they hold, but I do. This baby had obviously been on this journey before. His squirms were an impatient sign that he was ready to get this life stuff going. He had things to do! People to meet! Art to create!

Yes, while holding him, I intuitively knew that he would grow up to be an artist. And that he would have something inspiring and powerful to offer the world—art that would change lives. I felt honored to hold him, and soon his impatience waned and he fell asleep. I rocked him for about 90 minutes before his nurse took him for feeding. I told the nurse that I was headed next to see my Ninja Warrior, the baby who’d been struggling for months in another bay.

She shook her head “no,” and her lip curved downward.

“About an hour ago,” was all she said.

My heart sank.

I dragged my Sketchers through the long hallway, wondering if the baby and his parents were still in the bay. They weren’t. In fact, the corner of the bay where the Ninja Warrior had fought so hard for so long—once filled with cards and prayers of encouragement—was already cleaned out, sterilized, and ready for another infant. And yet, the little one’s spirit still seemed to be there.

Boy, what a fighter! I thought. You did good, buddy. You did good. Rest now.

I started to imagine the pain his parents must be feeling—and I started to feel a debilitating sadness myself—when out of a small isolation room erupted the most thunderous cry I’d ever heard.

“Oh, you want to rock her?” asked an overwhelmed nurse with big eyes. “She’s all yours.”

Determined to comfort this baby as best I could, I returned to Expert Baby Rocker mode. I reached into the bed and gently lifted the infant into my arms. She was wrapped as tight as a bean burrito, and she tooted like she’d just eaten one too! Maybe she had gas. Maybe that was the reason that she was so irritable. NICU nurses have a name for grumpy babies like this: “hangry”—hungry and angry. These are the babies who, because of certain circumstances, get a hard start in life, and they’re quite unhappy about it. But this little girl was different. She wasn't hungry. Her diaper was dry. And yet she was inconsolable, and she proclaimed her displeasure loud and long. Repeatedly. This little girl had a feisty spirit and some lungs!

When you rock in the NICU long enough, you quickly realize that all babies are different, and that what works to comfort one doesn’t come close to easing the anxiety of another. However, all babies have a sweet spot—a position, a song or a combination of things that allows them to relax and settle into rest. This little girl was testing that reality.

I held her horizontally, her head cradled in the bend of my elbow. She cried.

I switched to the other side. She cried.

I held her up closer to my chest, and for a minute, she was silent. And then she cried.

I held her up on my left shoulder so that she could see everyone and everything better, and for a minute she was silent again. Then she cried. I switched to the right shoulder. She cried.

I rocked her, bounced her, patted her on the back and then patted her on the rump. She still cried.

I played musical chairs with this little one, trying to find her sweet spot. Nothing was working. And that’s when I remembered my kung fu training:

Never expect. Never compare.

I began to relax when it occurred to me that I'd expected her to calm down and stop crying.

Taking several deep breaths, I began accepting that it was O.K. that she was crying—that maybe that’s just what she needed to do. My job wasn’t to keep her from crying. It was to hold her. So I started to pat her on the rump while singing Captain & Tennille songs. She began to settle a little with a slow version of “Love Will Keep Us Together,” but I guess in another life she knew that Daryl Dragon and Toni Tennille got divorced, so she began to cry again.

Next I softly sang “Muskrat Love.” Now I’m not the best singer (I only sound good in the shower), but there was something about the melody of this song that made her close her eyes for a long second. Then a longer second. Then a minute. And then minutes. I watched as her face relaxed and her breathing changed pace. The monitor’s long white vertical lines clumped together, indicating my suspicion: She had fallen asleep.

I kept humming “Muskrat Love” a while longer, and as I hummed, I wondered if Willis Alan Ramsey, the guy who wrote the song, and Toni Tennille, the singer who helped make the song a hit, ever thought that something they created would be used in such a kind, loving, and powerful way—that it would be a tool to comfort a little baby who came into the world with difficulties and who just needed a little help to heal. I wondered if any of us realize how who we are and what we create affects others.

Soon, the little girl’s mom came into the room, and I handed her over. She remained calm and comfortable.

As I left the bay, I passed the empty corner where the Ninja Warrior fought his last battle, and I said a prayer for all those who would come after him—that they’d have an easier time. That they’d have first birthdays, second birthdays, kindergarten, first dates, college, and babies of their own. And I promised to tell others when they’ve had a positive impact on me—that I’d take a moment out of my day to say to people like Sifu that even though I’m a scattered brain kung fu student who has been missing a lot of class lately, I’m never not on the kung fu floor mentally. I take the art and his lessons with me every day.

So to honor the life of the Ninja Warrior, I challenge you today to reach out to someone and tell them how they’ve impacted your life.

This journey is way too short to not realize how special each of us is to one another.

September 1, 2016

A Life in Three Minutes

What do you do when you hear a NICU nurse say that the baby you’re about to rock “is incompatible with life”? Just what do you do?

I volunteer once a week in the neonatal intensive care unit of a hospital in Austin. I started volunteering in December because of the things I was learning about myself via kung fu: I love babies. (You learn a lot about yourself when you stand still enough and perform purposeful movement of a form called Siu Nim Tao.)

But I knew going in that there are things that come with the territory of a NICU unit, and rocking babies who won’t survive is one of them.

So what do you do? What do you say? You give them a life in three minutes:

You say, “Happy birthday! Happy Thanksgiving! Merry Christmas and a Happy New Year!”

You recite the Pledge of Allegiance.

You sing. You sing the ABCs.

You tell them that they were born in a place called the United States of America, and though it's not perfect, it's home. And then you sing “America the Beautiful”:

O beautiful for spacious skies,
For amber waves of grain,
For purple mountain majesties
Above the fruited plain!
America! America! God shed His grace on thee,
And crown thy good with brotherhood
From sea to shining sea!

You hum the tune of every holiday song you can remember, even the ones you've always found annoying.

You say silly things like, “And the Oscar goes to…you!”

And then you sense a tear rolling down your cheek because you realize how hard it’s got to be to be that baby—and the parents. So full of hope and excitement. A life ending before it got a chance to start.

Too soon, the nurse says she needs to get a few stats, so you hand over the Little One for the first and last time, and whisper into the left ear, “Thanks for coming to visit us. Come back again when you can. And stay longer next time.”