95 days later

We celebrated a special family milestone this week: following 95 days in neonatal hospital care, our prematurely born daughter Talia passed her 95th day at home.

191 days before this milestone, I was a different person. Walking with blind faith through a seemingly ordinary first pregnancy, I knew nothing about prematurity, had never heard of CPAP or NEC or ROP, wouldn’t have known a bradycardia from the Brady Bunch, and had never experienced the indescribably gut-wrenching fear of losing a child almost before its life had properly begun.

Today I am the mother of a petite, smiling daughter who should only be three months old, not six. Looking back on the extra three months of daily hospital visits, I remember urging my little scrap of humanity to survive, anxiously checking for any gain in her weight, increase in her milk intake or improvement in her breathing, and I realise just how much further families of prem babies need to travel in order to arrive at the same place as families with healthy full term babies. It is an emotional journey on rough roads through strange territory, navigated via heart-rate and oxygen monitors, and not a few prayers. This neonatal landscape has changed us forever, left its shadow on our hearts, and opened our eyes to fears and wonders never before encountered.

After 95 long days, one journey finished and a new one began. We have been blessed twice over, both with the life of our child and with all we have experienced and learned about her incredible survival.


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Family Living Interstate

Soon after we moved from Sydney to Melbourne i fell pregnant with our first baby. Ronan arrived 13 weeks early at 27 weeks gestation weighing 1140 grams. Ronan spent 110 days in hospital due to Chronic Lung Disease, PDA & a Hernia which was operated on 1 week before discharge.

With all my family living in Sydney i found it very hard not having the support of my family around here in Victoria. I spoke to them frequently but it was still tough on days when Ronan had not so good days. I felt a strong desire for them to be part of Ronan’s premmie journey so i created a website dedicated to him, and updated his progress daily. The news and photographs were a great comfort to my family, and an outlet for me during this stressful time.

All of my husbands family live here in Victoria and whilst they were nothing short of fantastic it just wasn’t the same as having my own family here with me. My mum flew down the day i had Ronan and she cried the whole time she was here. It was heartbreaking to see my mother crying over what i felt to be a positive experience considering the circumstances.

I do find it hard now that Ronan is growing up as my family cannot see Ronan on a weekly basis. They cannot see him grow and thrive from the small premature baby he once was to the young toddler that he is today. I still update Ronan’s journal with photographs and entries regarding his progress. My mother looks at his website daily and blows kisses to the computer screen good morning which is beautiful. We are going to Sydney in October for a week and i cannot wait for my family to see how big Ronan has become.

http://www.totsites.com/tot/ronantoivonen

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National Premmie Foundation

L’il Aussie Prems is a sponsor of the National Premmie Foundation which is being launched in October at the Pregnancy, Babies & Children’s Expo here in Victoria. I am apart of the foundation as i am a committee member for Lifes Little Treasures who are just a beautiful group of women. I am creating the foundations website as we speak and having alot of fun doing so. A representative from each of the 6 founding groups were flown up to Sydney overnight back in August to attend a two day meeting on how we were going to progress with starting the foundation. We had a fantastic time and spoke to great lengths about the foundation, rules, aims, visions and we all walked away feeling very overloaded with information.

We have all been working together really well and i am so proud to say that through me L’il Aussie Prems is a sponsor of the foundation. I represent Lifes Little Treasures when it comes to foundation tasks.

The foundation is made up from 6 groups, Loddon Mallee Kids, Lifes Little Treasures, PIPA, NICCUPS, Little Wonders & NNPSNS which is a new group formed on the NSW Central Coast.

Our aims are;

To act as a parent body, guiding and assisting prem support groups by helping to:

  • – Raise the profile of all groups
  • – Attract members and volunteers
  • - Share ‘best practice’, information and resources
  • - Raise money for family support and information, hospital equipment, education, and awareness.
  • To be a central point of communication and publicity, proving information to families, hospitals, health professionals, relevant health authorities and the wider community.
  • Represent the interests of parents of prems in terms of hospital policy, Australia wide.
  • Raise the profile and awareness of the plight of NICU/SCU infants and their families, and issues surrounding their care and long term development.
  • Assist with research into causes of pre-term birth and the treatment of premature infants.

This is a fantastic new journey we are all excited to be on and i wish the NPF all the success in the world.

www.prembaby.org.au 

Signing with a premmie

Before Erin was born my husband and I decided that we’d like to teach her to sign. We’d read that children who were taught to sign often speak earlier and have a wider vocabulary than children who were not. Parents also report that children who sign have fewer tantrums then their non-signing siblings. Now that she’s here and because she was born premature it seems more important that we sign with her as, children who are born premature often experience speech delays.

Our daughter is not vocal. While she does coo to herself and others on occasion, at 3 months corrected (6 months real) she doesn’t do it with any frequency. In fact, in the past week I could count on one finger the number of times I’ve heard her vocalize in anything other than a cry. What worries me is not that she will have a disability, rather, that she’ll have something to say and not be able to express it.

So, with the hope of pre-empting any language delays Erin may have I went in search of a book that would help us introduce her to the world of sign language. After careful selection of the only two baby signing books available at our local Borders (apparently sign language isn’t that popular of a subject in Australia) I bought “Signing Smart with Babies and Toddlers: A Parents Strategy and Activity Guide” by Michelle Anthony. My reason for choosing this book was that it offer a variety of activities you can do with your child to introduce signing into their (and your) every day lives.

For the moment Erin is too young and lacks the fine motor skills to sign back but I’m hopeful that, by introducing sign language early, we will give her the best opportunity to communicate with us and to speak.

Wish us luck!

If you’re interested in teaching your child sign language you may find the following resources and articles interesting.

That’s Life Magazine

Myself and L’il Aussie Prems are going to be featured in issue 41 of That’s Life Magazine 2007. I am so excited as the story is a little about our journey but also about LAP in the hope that more parents and families with premature babies will join the forum for the support and also to talk about their little babies.

Once i have a copy of the article i will post a picture.

Jane Hansen – Every parent’s nightmare

AT 12.10pm, on December 13, 2003, I lay under an enormous operating light. Through tears welling in my eyes, I counted 12 people fussing. Nurses, anaesthetists, neonatal staff, obstetric team. Two teams: one for me, one for my baby.
When I looked at the intensive care cot being readied in the corner, I shook with fear. It just didn’t feel right. It’s too soon, the words kept going around in my head. It’s too soon. Dr Brieger took my hand and squeezed it.

“How many 26-weekers have you delivered?” I asked through tears.

“Heaps,” he said reassuringly.

“How many have survived?” I asked.

“All of them,” he said, and I knew he was lying, telling me what I wanted to hear.

Jackson Nelson Fisher was born in Sydney’s Royal Prince Alfred Hospital at 1.20pm. He weighed just 958g, two pounds on the old scale. They wheeled me to my room and Andrew bounded in like an excited labrador puppy. “Oh Jane, he’s beautiful,” he said, so terribly excited and as proud as any father could be. Andrew had always been a naturally optimistic person, a Tigger to my Eeyore.

All I could think was that Jackson only had an 80 per cent chance of survival. While 80 per cent may be good in any other setting, if your child has a one-in-five chance of dying, that’s just too bloody high odds.

I was pushed along in my bed to the neonatal unit. It was like a futuristic cloning lab, with eight humidicribs dotted around the brightly fluorescent-lit room. Inside each makeshift plastic womb were tiny, tiny babies clinging to life. The air carried the distinct smell of antibacterial handwash, the hiss and hum of the ventilators punctuated regularly with the pinging of various alarms. They pulled my bed alongside Jackson’s humidicrib. I strained to see through the plastic sides, which were opaque with condensation. Jackson’s skin, still transparent, just wasn’t ready for the outside world yet. They had painted him with medical-grade lanolin to keep his body heat in. The nurse wiped the inside of the plastic so I could see my son better. Through the pills of moisture I saw my baby boy – my tiny, tiny, tiny boy. His head and body together were the size of my hand with skinny little legs flayed out to the side, but he was just beautiful with long fingers and a head of dark hair. There were so many wires and tubes hooked up to him; I could barely see his face. I put my hand through the porthole to touch him. His tiny fingers grasped my index finger and hung on for dear life. I fell hopelessly in love.

December 15. Two days old. You have EEG pads attached to your head, monitoring for any brain bleeds. A ventilator tube down your nose, and tubes coming out of what’s left of your umbilical cord. You’re wiggling around like no-one’s business and you keep kicking away your tiny nappy. I have only held your hand but I wish I could cuddle you with all my heart. Your nurse says you’re quite a fighter and strong-willed. You keep pulling the electrodes off your head! By early evening you wouldn’t settle. The nurse suggested I put my hands in and lay them across your legs and your arms and chest, to hold you “in”. It seems to work; you visibly relax.

Most premature babies die in the first week of life. For the first time in my life, I felt real fear; knee-shaking, breath-quivering fear as I tried to comprehend the minefield that was laid out before this little baby, no bigger than a Coke can. First there was the risk of brain haemorrhage. Were there to be a bleed, he might end up with cerebral palsy, or it might kill him. His lungs were bad. Before 28 weeks, the millions of tiny sacs that make up lung tissue are not yet formed and collapse on each other, causing “respiratory distress syndrome”. And for every life-saving treatment or drug, there was a downside. The ventilator can damage the fragile, half-formed lung tissue; getting off it quickly is important. The extra oxygen used to compensate for bad lungs can cause eye damage, even blindness. It might be necessary to use steroids to help his lungs but they can affect brain development. There was a valve open in his heart that was supposed to be shut, and this was making his lungs worse. He would need drugs to close the valve and, if that didn’t work, surgery might be necessary. And hospitals are full of bugs, humidicribs a prime breeding ground. Almost all premature babies get an infection. They’re sitting ducks.

December 16. Three days old. I’m feeling very sad today that my body let you down and you found yourself out in the world far too soon . . . all I can do is hope you find the strength to battle, which is a very big ask for such a little boy. If you can get through this you can get through anything, my little one. I love you so much. It’s amazing how nothing else matters anymore. I haven’t even read a newspaper yet. Saddam was caught – on your birthday! Big deal! You’re the most important thing now. I watch your chest rise up and down and pray with each breath you get stronger and bigger. We have wonderful things planned for you.

Jackson’s lungs were the major issue. We agreed to start steroids on day eight to help him off the ventilator. His breathing improved, but then he became anaemic. He needed a blood transfusion; it felt like one step forward, two steps back. Finally he got off the ventilator and on to a contraption known as CPAP – continuous positive air pressure. He hated it – it must have been like hanging your head out of a car at 100km/h. If Jackson didn’t like something, the fight was quite extraordinary. Thrashing around, crying and pushing hands away. But as distressing as it was to watch, it was the fight in him that gave me the most hope.

On Christmas Eve, 11 days after his birth, I finally got to cuddle my baby. The nurses juggled all the wires and tubes and placed him in my arms. He was so light, so tiny and I couldn’t stop the tears, they dripped all over his little head and then he just went to sleep in my arms.

He grew gram by gram. Day after day, week after week I sat with him, willing him to grow bigger, reading him chapters of Winnie the Pooh so he would get to know my voice. After six weeks, on his last day in intensive care, my parents came down from Queensland. When Mum saw him, still a tiny 1700g, tears sprang from her eyes. She had never seen such a small baby. He was moved to the next level of care that day, a step down, and the mood was immediately lighter.

Jackson needed oxygen piped through nasal prongs to help him along and it meant he had no chance of getting home until he was at least 100 days old. Life had become a routine of waking up at 2am and 6am, expressing milk, ferrying it to the hospital, spending all day with Jackson, Andrew popping in after work and then me coming home late at night. The nights were hard. More than once I woke up in a sweat, heart banging in my chest, frantically looking for my baby.

March 23, 2004. 100 days old. When I walked in this morning you had a banner above your bed: “Happy 100th day Jackson”, complete with balloons. The lovely nurses did that for you. I brought in a chocolate mudcake and we all sang Happy Birthday to you – I cried. I can’t believe what you’ve been through and I can’t believe you made it.

April 9, Good Friday. You’re home! We walked in the door and put you in your pram and both cried. I feel relieved, scared, frayed, and altered by the whole experience. You’re home now, my darling, bless you and this house and I thank God for answering all my prayers. Your discharge weight: 2.49kg – five pounds.

Autumn in Sydney is spectacular. I hooked up the portable oxygen tank and went for a walk along the harbour foreshore each morning, taking in the sunshine. It had always been my favourite time of year and now it was just perfect. I was so excited about showing Jackson the world: the green grass, the trees, the blue harbour, the boats. But he loved his walks so much that as soon as I got him out the front door he’d shut his eyes and snooze for the duration.

May 10. You smiled at me today for the first time. You looked up at me, smiled and cooed. I got a tear in my eye. Very, very rewarding and oh, what a smile.

A few weeks after my 40th birthday, Jackson slowed down again. It took an hour to feed him a bottle of expressed breast milk one morning. The next day in hospital he threw up his milk and appeared to be choking. The fear and panic in his eyes rocked me to the core. He went into respiratory failure. Dr Osborne, the neonatal paediatrician on call that weekend, said we would have to ventilate him. From the corridor outside the neonatal intensive care unit, I heard my son scream like never before and then there was quiet. I collapsed into Andrew’s arms; fear had taken my breath away.

Jackson stayed on the ventilator for ten days. Doctors theorised he had had his first cold. He was now five months old, or “two months corrected”. We had to stay in hospital until he fully recovered and during this time he entered that wonderful phase of gurgles and giggles. He had a smile for all his favourite nurses. I passed the long hours drawing him pictures to stick on the plastic sides of his cot. I drew elaborate snails and ladybirds. He’d open his eyes and see his new picture and a big smile would spread over his gorgeous little face.

After five long weeks, we were told it was time to go home again. As soon as we got home, though, I could see fear in his eyes again. He was having what looked like panic attacks. He wouldn’t take his evening feed. Something wasn’t right.

As I wheeled Jackson back into his old ward, I looked down at him and he was looking up at me, smiling a strange, knowing smile. Cheeky monkey! Tests showed he was on the brink of another respiratory failure. Plans were made to transfer us to Westmead Children’s Hospital as soon as possible.

June 28. The head of ICU says you’re on a knife-edge, a cliff, lots of analogies, but perilous is the best word to describe this dreadful combination of chronic lung disease and pulmonary hypertension. I’ve spent all day trying to keep you calm when my own knees were knocking under the cot. I have faith in you to pull through this, you’ve shown me many times you desperately want to be here. My job is to help you do so. Now, hurry up and get well, little man.

On June 30 they found Jackson had acquired septicaemia; the dreaded superbug golden staph had entered his bloodstream. It is a killer infection and he was already on his knees. I only had one page left of the journal I had been keeping ever since I fell pregnant. It simply couldn’t end there. Jackson remained in a drug-induced coma for weeks, hanging on precariously. My arms ached from not being able to hold him.

July 2. I spend my days here with you, humming songs, laying my hand on your head and just letting you know I’m here. I keep telling you I’m here and that soon we’ll go to the beach with a bucket and spade and have a nice time. There are wonderful gifts to be had in life. I fear all these drugs, etc, may have an effect on you. It won’t stop me loving you, but I hope you never suffer any cruelty.

July 19. In seven months, you’ve had just six weeks at home. It’s so depressing when I think about it, so it’s a good idea not to think about it. You’ve been ventilated now for 25 days.

The next morning, the specialist walked into Jackson’s room accompanied by palliative care expert and intensive care specialist Dr Jonathan Gillis. “There’s no real improvement,” the specialist said softly. “We’re going to keep treating him, but I think he’ll probably die.” Dr Gillis sat there, shaking his head.

“What?” I couldn’t believe my ears.

“I think he will probably die,” he repeated, again softly, but there was nothing soft about those words.

July 20. I don’t want to commit to writing what the doctor said today, but it wasn’t good. You discovered sticking your tongue out and in and it’s fun. I think you even smiled this evening. I was sticking my tongue out and you were sticking yours out and you found it funny. Precious boy. These moments are so special. Your dad and I have to reaffirm our faith in you. Your dad says if anyone can make it, Jackson can.

Jackson got another serious infection, and again he was put into a drug-induced coma for his own survival. Days turned into more weeks. Andrew took time off. We moved into a family room in the hostel and we split the 24-hour bedside vigil.

Paediatric intensive care wards are scary places. The children are too sick to cry. The only cries you hear are from desperate parents facing their worst nightmare. I mastered the silent scream in that toilet down the hall to let the madness out.

On August 9, we got “the talk” from Dr Gillis. He spoke in the hushed tones we had grown to hate. “Look, this isn’t working. He’s in 100 per cent oxygen, his pressures are high, he has five chest drains in, he is in a coma. He can’t climb out of this,” he said. We knew we were being asked to consider what no parent should ever, ever have to think about: turn off the life support on our own child. No, no, no, no, no. Never . . . I just have to get him out of here. He’s only eight months old.

“This is not acceptable,” I said with hushed outrage, my fists clenched.

“Of course it’s not acceptable,” he replied, like that somehow made sense.

August 24. I climb into bed with you each morning and attempt to give you a cuddle as best I can. I hold your hand with one hand and put my other hand under your right leg and buttock and I put my lips to your head and dream that we’re at home and you’re in bed with me having a morning cuddle. As I write this I feel so ripped off. Why? I’m so angry at the world, I want to absolutely pull my hair out and yell and scream and kick. Why. Why, why?

On August 29, Jackson’s temperature was high and despite the multitude of painkillers, he was crying – hard. He hadn’t really cried at all for the whole 9½ weeks out at Westmead, his personality bombed out on diazepam, morphine, clonidine and more. Now, he was crashing fast. He would probably have a cardiac arrest within the day. Jackson quieted for a moment and looked up at me, a long, long look with his beautiful grey eyes. I instinctively knew he was saying goodbye. Tears welled in my eyes.

Andrew did the night shift and went to bed at 6am. I woke him at 10am. We went to a little room down the corridor from Jackson’s room. There we made the only loving decision we thought we could – to sedate him, hold him, love him and let him go peacefully.

I held Jackson’s hand. Andrew found the doctor he liked the most. “We can’t do this to him anymore,” he stammered. The doctors and nurses moved quickly. They closed the curtains with the cartoons all over them. It was a sign we had seen many times in that ward, a sign that all had failed. They placed my precious baby in my arms. It had been such a long time since I held him. I sang to him. Andrew, sitting next to me, broke down. I told him not to cry yet. I tried to hold it together so Jackson would not know.

I don’t remember how long we sat there. The world stopped. Jackson’s world. Our world. I felt him leave, though, and he had the life force of a giant. He so wanted to live. Then the tears finally came.

It grew dark, and it was raining outside. The window reflected the image of me holding my own baby. I was rocking, the way a mother instinctively does. The image that stared back at me, it was so inconceivable. I could see the horror in my own eyes.

That Christmas, I had my first Jackson dream. I went sleepwalking, looking for him. When I couldn’t find the bassinette, I went to Andrew’s side of the bed, frantic, and woke him. “I can’t find Jackson,” I said with panic. “I know,” he said sadly. I woke up at that point and remembered he was dead.

A few days later, I discovered I was pregnant. I felt pure terror, but also a fragile glimmer of hope. Maybe there could be a life worth living after all. It had only been four months since we lost Jackson. Plenty of people said it was too soon. But I was grateful. I knew I would grieve Jackson for the rest of my life – nothing would change that.

August 29, 2005. My darling Jackson, a year has passed since I held you in my arms that dreadful afternoon. I would have thought the passage of a year would lessen the pain. It has not. I miss you, long for you. Your loss created a beast I had to learn to live with – grief. I fell pregnant shortly after losing you – too soon no doubt, but Andrew and I told each other you had something to do with it. On 20 July your baby brother was born. He has everything I failed to give you: his health from being born full-term. Samuel makes me smile, but he is not a replacement for you. I love him very much and I’m so glad I faced this day with him in my arms. The hope he has given me is so, so important.

I’m so tired now, little man, emotionally drained by the events of the past year. I don’t know if I’ll ever be whole again – all I know is that I miss you terribly. It scares me sometimes that I’m starting to forget little bits; I try hard to keep memories alive. It’s such a double-edged sword – the pain is alleviated with some memory loss, but memory is all I have left. n

Edited extract from Three Seasons by Jane Hansen (Macmillan), published September 25.

Article from: Courier Mail

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