Details on Jena’s Withdrawal


First come the disclaimers:  I am no expert on withdrawals, so all this information is second hand, from the nurses and doctors to me, from me to you.  All babies withdraw differently, so a baby can be on a much less potent drug, and have a more difficult time withdrawing.  Dose amounts don’t play a huge role here, addiction is addiction and no matter the dose amount or type of drug, a baby has to go from dependency to living life without.

Every four hours Jena gets scored by the nurses.  The more signs of withdrawal, the higher the score, so the goal is to keep her scores low.

They are scheduling Nazis here in the NICU too, every four hours they do assessments and if there are no problems, the babies are supposed to sleep between the assessments.  (Something tells me Jena will be my most scheduled baby by far)

There are four things that Jena  is scoring high in consistently, that are all signs of withdrawal.
1.  Stiffness
2.  Poor Feeds
3.  Low grade Fever
4.  Mottled Skin

From day one Jena has been stiff.  If you pull her arm away from her chest, she pulls her whole head and chest into a sitting position.  I asked if there is therapy or massage or anything I could do to loosen her muscles, but the docs say it’s a problem from the inside out, there is nothing to be done.

Jena has a very poor suck, we give her a bottle every four hours and so far she has never drank an entire ounce.  What is normal is for her to drink (with lots of coaxing)about 10 mililiters (about 1/3 oz) in a half an hour, and the rest goes through her NG tube (tube from nose to stomach).

She consistently runs a low grade temp but her skin on her arms and legs looks blotchy like she is freezing.

Not the best picture in the world (surprise surprise!) but you can see her mottled skin on her arm.

Those things drive her scores up.  What is keeping her scores lower is that she is sleeping well, she does not seem to have problems with overstimulation, and she does not cry a whole lot.  If she doesn’t settle in less than an hour after a feeding, it adds points to her score.  If she seems bothered by noise it would add points to her score.  If she sneezes more than five times an hour it adds points to her score.

No she is not drug-free, on Day one the Doc administered phenobarbital (anti-convulsion and sedative) when they thought she may have started with light convulsions.  She will be on that drug for a while, and most likely it will be sent home with us to wean her off.  And of course that’s probably why she is sleeping so well. 🙂

Since she has gone now a full six days without any methadone, her body is craving the drug.  Yesterday for the first time I could tell she was wanting something in between her feeds and was not satisfied. The phenobarbital does not satisfy that craving at all, and an opiate withdrawal is treated with another opiate.  Enter morphine.  So far the doc has been flirting with Morphine, and telling me not to be surprised if I come in one morning to discover she ordered it through the night.

I would love, love, love (and pray pray pray) if we could pull through without having to give her that.  It would fill her need, and calm her so she could coordinate her sucking instinct, which would be a positive.  It is addictive, so it would be another strong drug to be weaned from before she can be released from the hospital.  Our doctor is a cute little Thai lady, and most mornings she asks me how I’m feeling about the baby.  Most mornings I remind her that I had one extremely fussy son who screamed for two hours every night, and we would not have dreamed of giving him morphine.  Then she reminds me that she won’t administer it unless she thinks it’s necessary. Then she smiles and says: “Lets see how she scores today, and we’ll decide from there”.

So those are the nitty-gritty details.  My mom is here right now doing all my work for me, (baking, cooking, cleaning, mowing, shopping, plus keeping the three older children a little stable) so I’m spending most of my day time at the hospital.  I leave the hospital in the evening usually around 7:00-7:30.  By then I’m ready to see the older kids, so its not hard for me to leave the baby overnight. The night duty nurses are awesome; but when I wake up in the morning, all I can think is that I have a baby laying all alone in her bassinett, and all I want to do is jump in the car and get to the hospital as fast as I can.

Gene has been home a lot more the past couple of weeks, he often spends the morning at home before he goes to work and then He’ll come to the hospital towards evening then too.  We are so blessed.  It has gone so much smoother than I dared to dream or hope.  Oh, and the NICU has us in our own private room with a cot, chairs, bathroom, and yes wifi(!).  And its evident that on the weekend they bend their rules and we are allowed to sneak our kids into the room to see their sister.

Thanks so much if you have breathed a prayer for us. We are being held up!  Love to you all.
Andrea

What Went Down

I’m sitting in my little room in the NICU trying to find words for the last few days.  Talk about an emotional rollercoaster.  By the wall in her little cart is my new daughter Jena (five days old) attached to monitors and feeding tubes.  She is peaceful and sleeping, like she has been since she was born.

How can I describe how it was to wake up at 5:30 one morning with my message light blinking on my cell phone, and hearing that birth mom was in labor and on her way to the hospital.  Instead of a feeling of excitement and happiness, it was almost a panic and dread that took over me.  No! Not today, I’m not ready for it to be today.  It’s Brandt’s first day of school, He needs ME to get him on the bus and to snap that all important picture of him climbing the school bus steps.
No! Not today, we are remodeling our upstairs and there are painters and plumbers and trimmers walking through my house, and I can’t let anybody else see what a mess my house is right now.

So for the next hour I ran around my house trying to do things, but in the end, not really doing anything. Gene shoved me out the door with promises of kindergarten pictures, and an arrival at the hospital as soon as he could.  I called my mom in Ohio and said, “If you want to come that would be great! You can look in any direction at our house and find at least ten things to do. And sorry but our bathroom is not usable, so we’ll all showering in Gene’s gross farm shower.” (Always try to make things seem as un-appealing as possible, that’s my motto)

I found dear birth mom and her boyfriend a half an hour before she was taken for her c-section.  (The baby was breach, in case you are wondering at the discrepancy of first going into labor, and now a c-section)  If you are wondering what an adoptive mom talks about with a birth mom and birth dad just before their baby is born, there are plenty of things to discuss, namely the strong odor the anesthesiologist was emitting.  Side note to those of you in the medical field:  Just SAY NO to the garlic herb and cheese bread that sounds so good.  Your patients will thank you.  It was also fun to laugh at the incompetence of the nurses, who are raising and lowering the IV poll willy-nilly, like it was an Olympic sport.  In other words, we kept it light.  Anything deep and dark should have been said by now.

Some doctors and nurses seemed to know why I was there, others didn’t.   The IV pole raiser said I wouldn’t be able to be in the operating room because there was no room for more than one support person.  Since I had seen her skill first hand first hand with the IV’s it didn’t bother me much.  I don’t know about you, but everybody has their own style, and my personality is not necessarily to yell out: BUT I’m not a support person! I’m the mommy! Let me in!  When the time came five minutes later, I asked again, this time to the OB, and he gave me the scrubs without a problem.

As it turns out, I did end up being a support person. They had two metal stools perched right beside birth mom’s head where birth dad and I sat.  I have never been so grateful for the presence of a man who I only met twice before in my life.

After the baby was born I was little confused as to what to do.  The nurses didn’t know that I was the adoptive mother, so the whole NICU staff (or what seemed like it) was crowded around checking her out, that I literally couldn’t see the baby except for her little blue feet up in the air.  Do I follow the NICU around panic stricken hollering questions? Do I disappear from the birth mother, who is also my friend?

It turns out I had to do neither.  I wasn’t allowed into the NICU until the baby was admitted and stable, and the birthmother was highly sedated, so she didn’t need me either.

So as we settled into the NICU, nurses were chatting and asking all the right questions:  So what is this baby’s name?  If you remember my previous post, I had said the birth mom gets to name the baby.  We had decided to just go with whatever the birth mom named.  Our birth mom was heavily sedated and slept all day.  So yes, we had a baby who was not officially named for three days.

On Saturday morning I helped birth mom fill out the papers with the baby’s name; but I think that’s another story in itself.
Until next time…you all have a good week!