Around 5 am, three hours after James was born, we were finally able to go see him in the NICU (Newborn Intensive Care Unit).
Exhausted from labor and delivery, as well as the 48 hours of contractions / not sleeping from the weekend, we find out heart wrenching news from Dr. Mohammed Tamim - James is very ill with meconium aspiration. This means that he essentially inhaled his first black tarry stool (meconium) and amniotic fluid in the womb, during delivery. The meconium and fluid filled his lungs, inhibiting his breathing. This was why we never heard the loud cry we expected to hear in the delivery room; his poor lungs weren't able to expand. Unfortunately, James needed full assistance from an oscillating ventilator to breath and recover.
Although about 20% of full-term babies pass their first stool in the womb (they are fully developed and ready for the world, anyway), this unlucky respiratory condition only occurs in roughly 1% of full-term babies. Even though it isn't a rare occurrence for the NICU, it is definitely uncommon to inhale as much as our little man did. That is never settling news, especially coming from a NICU doctor. Right from the beginning, James proved to us that he was an individual who would take the path less traveled in life.
When we see James, he is on a respirator with many cords and tubes attached to him, including a breathing tube down his throat. He appears sleeping, as he is on high doses of pain medication and sedation. The doctor explains to us that he is very sick, and uses the words "critical condition." Words you never want to hear about anyone you love, let alone your newborn baby that has only been in the world for a few hours. We are told not to touch him, as any startling could send his body into stress and disrupt his vitals. However, although his condition was deemed critical, the doctor tells us he is optimistic that James will recover given the amazing resilience of babies.
James on Day 2
(no pictures were taken Day 1 in the NICU, as we were in total shock)
We go to bed in our post-partum room stunned and exhausted. Passing other new families on the way to our room, tears fill our eyes as we see other families dotting over and sleeping with their healthy newborn "rooming in" their rooms. I remember hearing cries of nearby babies, waking for early morning feedings, and realized that we never even got to hear what James' cry sounded like yet. With a million thoughts running through our heads, we finally settle down to a very brief sleep at 6:30am. We were scared and not sure what to think about the timeline on James' recovery.
We are woken up at 9:30 am by a social worker telling us about the NICU; and she tells us to go down to the 3rd floor and talk to the doctors about the James condition, given the "doctors' rounds" were done around 10 am.
A new doctor, Dr. Wasim, one who we would come to like very much, briefs us on James. He tells us that James is still considered to be in critical condition (being the first 48 hours of life), but he reassures us he is "stable." While James is very sick, the doctor keeps reminding us that it "could have been a lot worse." The initial tests run reveal the high likelihood of no neurological (brain) damage due to lack of oxygen. Thank God.
Dr. Wasim explains all of the medication and support James is receiving to us (oxygen to breathe, nitrous oxide for vessel stimulation, fluid IVs for nutrition, morphine for pain, dopamine for blood pressure, antibiotics to reduce possibility of inflection, and most importantly - surfactant). Surfactant is a complex naturally occurring substance made of six lipids (fats) and four proteins that is produced in the lungs, but can also be manufactured synthetically. James needed this pumped into him to reduce the surface tension of fluid in the lungs to help make the small air sacs (alveoli) more stable. This prevents the lungs from collapsing when an individual exhales.
Although we aren't sure which questions to be asking, Dr. Wasim does a wonderful job of explaining things to us in words we can understand; and doesn't mind repeating himself several times, as we try to process and understand it all. The doctors and nurses tried to prepare us for a "roller coaster ride" of a recovery, which could take up to several weeks. We were told to expect James to take 2 steps forward and 1 step back; the recovery would be slow and hard to predict what his little body could handle - he just has to take it hour-by-hour, one day at a time.
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