And I thought that was hard

Big Man was born 3.5 months too soon, and spent ninety-three days in the NICU. I spent countless hours driving back and forth to spend countless hours sitting by his isolette. I watched him forget to breath, watched his heart rate drop, watched him turn gray, watched him battle his own infections, watched machines keep him alive, watched him fight to survive. And I thought that was hard.

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Big Man on his birth day

Big Man came home from the NICU, and we had a home health nurse out every other week, a developmental specialist out every month, bi-weekly doctor visits for weight checks, monthly doctor visits for synagis shots to keep him from getting RSV. My life, my schedule was not my own. He didn’t want to be put down, ever. I had to learn to let go of my want for routine, schedule, time. And I thought that was hard.

When Big Man was four months old, I discovered I was pregnant with the Princess. I faced a pregnancy certain we were going to be back in the NICU. I was full of fear and anxiety. I saw a specialist OB (perinatologist) every other week, until we got past the gestational age Big Man was born. Then she had to be induced at 41 weeks 1 day. And I thought that was hard.

Big Man was developmentally nine months old when the Princess was born, so I basically had two infants under one roof. They are twelve months and nineteen days apart. Sleep was at a premium. Bottles were everywhere. We all three cried for hours every evening. And I thought that was hard.

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Big Man had high muscle tone on his left side, and a mild speech delay. Enter therapists visits to the weekly routine. And I thought that was hard.

When Big Man was nearly two, and the Princess eight months old, we moved….400 miles away.  I left my career of ten years. I left my family. I left my friends. I left my church. We moved in with spouse’s  (awesomely amazing) parents for eight months while our new home was being built. I found a new job I hated. It took forever to build new relationships. I had two toddlers in a new place, and I wasn’t entirely happy…yet. And I thought that was hard.

I had two toddlers under one roof – two toddlers who were like the wonder twins. I couldn’t keep up with their creative disasters. They finger-painted with baby shampoo in the middle of Big Man’s room. Baby shampoo NEVER comes out of carpet, ever. They unraveled a Costco-sized package of toilet paper up and down the upstairs hallway. They threw another Costco-sized package (out of the plastic wrapping) into my big jacuzzi bathtub. They ran away, down the street and around two corners, while I fed their six-week old baby brother. Big Man cut ALL of the Princess’ hair off, to the scalp, twice. They colored the underside of the pool table. I caught them, frequently, eating frozen waffles underneath the dining room table. Ditto bags of candy they’d climb on top of the fridge to retrieve. And I thought that was hard.

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I had three kids under four. I can’t even list all that drama, but I thought that was hard.

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The Herd in earlier days

There was a time they were all three involved in multiple sports….baseball, soccer, dance, piano lessons, golf. I lived at whatever field it was the season for.  I spent hours and hours in the car getting them each to whatever practice, game, lesson, or recital. And I thought that was hard.

Big Man was diagnosed ADHD, and with a mild visual processing disorder in second grade. We chose to medicate the ADHD. He fought the medication for the first year. I’d find pills hidden in the kitchen drawer, under the lazy susan in the middle of the kitchen island, and pretty much anywhere but in him if I didn’t watch him take it and make sure he actually swallowed it. He got glasses, and we got an every-six-months schedule of appointments with the pediatric opthamologist. And I thought that was hard.

I had three in elementary school. I went on field trips. I taped, glued, cut, copied, read to kindergartners and third graders, ran the book fair, was on the PTA, and basically lived at the school. We lived in nightly homework hell. And I thought that was hard.

Little Man was diagnosed on the autism spectrum, and ADHD, in second grade. It nearly broke me, but we finally had an answer, and a plan, and help. We entered the world of IEP’s, special education, accommodations, speech therapy, psychiatrists and therapists. And  I thought that was hard.

We moved on to middle school for the older two – ugh, middle school and middle schoolers. They each got their first phones, and we had to start talking about internet safety, data plans, and had to come up with rules of how we would handle things. And I thought that was hard.

Now here we are…..two days away from having three teenagers under one roof. Two are in high school. I was ill-prepared for the drama, the angst, the emotional rollercoaster, the pushing back against rules we’ve had in place forever, the angry words that instantly bring tears to my eyes, the eyeball rolling, the intense search for independence, the life-lessons they are learning through which I just want to help but know I need to stand back and let them have at it, come whatever the natural consequences will be. I’ve watched my biggest baby boy struggle to find his way academically when it used to come to him so easily I think he took it for granted. I’ve watched P fight to find herself – somehow losing (hopefully temporarily) the brave, bold, confident girl we used to know. Then, recently, came the day Big drove himself and P to school, his driver’s license finally earned. And I think this is hard.

Within the next five years, I will watch as they have all the rest of those “firsts”, as they graduate, and leave for school, only ever to come back for what will essentially be visits between semesters and school years. I know I will look back on all those things I thought were hard and will know that was nothing, because watching them go be their own people, away from us, my heart living outside of me (possibly far away from home), now that, that will be hard.

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It’s his, but he doesn’t remember

I met with a  new local March of Dimes staff-person last week. As is typical, I shared why we volunteer, told our story – how we’re connected to the mission of the organization. She asked if Big Man does his own fundraising, tells his own story. Um, no. He walks, but when it comes to the talking, he leaves that to me. Why? Well…..it is his story,, but he doesn’t remember it, thank the good Lord. He knows my version of his story. He’s heard it a billion times. He did live it, but he has no memory of it. The baby in all the photos is him, but like any other baby, he has no memory of his early years, much less his too-early, dramatic entry into the world.

He does get why  his story matters. He does  understand prematurity was, is, and always will be part of who  he is, but all the emotions attached to his premature birth belong to others, not to him. Does that make sense? He lived it, but we lived the fear, guilt, pain of having failed him in any way. He was the feisty fighter who made it while we stood by, watching and praying. He did it, but we are the ones who remember.

He compared it to when people say I’m strong for having gone through all we’ve gone through.  My response always is, “You never know how strong you are until you have to BE strong.” He just lived – he doesn’t see anything amazing in that coming from him, but instead places the credit upon us, his nurses, his doctors. I say he had a strong will to survive right from the very beginning.

I keep encouraging him to own his story. I think he’s there now. He  had to write his own obituary in his psych class recently.  He did include his premature birth in his narrative. I was a little surprised by the inclusion. If you don’t know his story, you’d never guess his story. You can’t look at him and say, “Oh, yes, he was a preemie.” You can’t tell by looking at him, in other words. Well, I have to edit that a little bit – many preemie moms I know can tell by looking at a kid, but we know what to look for as we see it in our own preemies. The general population can’t look at him and know, without being told, he was born 3.5 months too soon.

I’m thankful he doesn’t remember at all, this story of his. I’ve always said I remember enough for both of us. But I’m glad he’s owning it, making it his, because it is his, even if he doesn’t remember one second of it.

Those Nights – Empty Crib

I’ve written lots about the days I spent on hospital bedrest, Big Man’s premature birth day, and his many days in the neonatal intensive care unit (NICU).  There’s one thing I haven’t really ever talked much of, except for with friends who experienced it themselves, and that’s all the nights I left his bedside and drove home, leaving my son behind to the care of doctors, nurses, and machines.

I was released from my hospital five days after Big Man was born. I’d gone five days without seeing my son in person, staring at the two polaroid photos we’d been given, and watching video of him on the 2 x 2 inch screen of the video camera Spouse had bought the day our sweet boy was born. We sped to his hospital where I saw him, and held him, and began a “new normal” routine.

My days were full of routine – wake up, pump, get showered, eat breakfast, pump again, and begin the forty-five minute drive from home to the NICU. I was typically there by 9, and I’d sit there with him until 3 or 4, only leaving to pump again or go have lunch during shift change. To get to and from his hospital, I faced all the commute traffic the Bay Area could throw at me, so I generally tried to get out of there before rush hour started, or stayed until long after it was over.

I hated those drives home. I hated walking away from my baby boy to go home. I hated leaving him. Many of those nights, I cried nearly all the way home. I can’t even really begin to tell you what I did at home each night…I’m sure I made dinner, maybe stopped on the way home to get groceries, paid bills, returned phone calls, walked the dogs, fed the cats, watched tv. But mostly, my brain was wrapped up in the fact my too-small boy was not with us. We were a family, but a split family. He was not under our roof because my body had failed him. He was 4o miles away. His crib in his room was empty.

Blessedly, I didn’t have to walk past his room to get to mine each night, but too often, I found myself in his room, sitting in the glider beside that empty crib, thinking about all I could have done, should have done, all we’d lost, all we were waiting for, all that could go wrong, had gone wrong. When I was with him in the NICU, I focused purely on him – how much weight he’d gained, how many times he’s stopped breathing during the night, where he was on the developmental chart, how he looked. But at night, with no baby right there before me, I felt all those awful things I wouldn’t let myself feel when I was with him during the day.

The empty crib, my empty arms, are the things I remember of those many long nights before he came home. I don’t talk about them often because those are the really dark memories of that time. But they happened, and they are part of the reality of having a baby in the NICU.

The Hand We’ve Been Dealt

Some might say we’ve been handed a less-than-stellar parenting hand. Trust me, before we got pregnant with our oldest, I didn’t intentionally sign up to have a micro-preemie nor an autistic child. And I know well too many parents who live a much more difficult parenting road, some too painful to even think about. So I don’t complain, much. Are our lives easy? Nope, but there’s never a promise of easy when you start down your life path.  You deal with the hand you’re dealt. That’s my take anyways.

I suppose we did have a choice. We could have told the doctors to not take any extraordinary  measures to save Big Man.  We could have quietly let him pass, fears of what his future might  hold taking precedent over his chance of survival. We could have walked away. We could have chosen not to fight. But I knew him – I knew his fight, even before I saw him face-to-face. I’d felt him within me, I’d heard his strong, fast heartbeat. I’d seen his tiny arms and legs on the ultrasound screen so many times. I knew long before he took his first breath we would fight as long as he had fight within him. We didn’t  know, even when we brought him home from the NICU, what his future might hold, but honestly, do you ever know what your child’s life is going to be? Life holds no guarantees. We took him as he came. We loved him, we watched him, we cried, prayed, laughed. We continue to advocate for him, raise him, fight with him and beside him.

The day (and admittedly for a few days afterwards) we found out we were pregnant with the Princess, I cried, so not ready to face pregnancy again so soon after Big Man’s birth. He was 3.5 months old. Our babies would be just a year apart, if I made it to full-term this time. I fretted, I worried, spent days full of anxiety, so sure we were going to end up back in the NICU again. I eventually reached a place of knowing our family was going to look a bit different than I’d planned, but we were blessed. And oh  how I fell in love with that little girl.

I recall so clearly the drive home from the psychiatrist’s office the day Little Man was diagnosed autistic. I called my friends. How would I do this? Why was this happening to him, to our family? What had I done wrong? Why did my baby have to suffer? A wise friend reminded me my baby was still my baby – a diagnosis did not change who he was. I would have to fight for him at times, I would have to find the strength inside to deal with the hard parts. I would go to the deepest depths when my nine-year-old told me this was too hard and he didn’t want to live anymore. I’d have to remind myself all the amazing things he’s capable of when it seemed all I was hearing was what he couldn’t do.

I guess I could have walked away, said this was too hard, too much, could have chosen not to fight for him and his needs. But I  never saw that as an option. I’m not amazing. I’m not extraordinary. We aren’t special because we continue to parent him. We deal with the hand we’re dealt. Our hand  may not look like yours, but you take what you’re given and you deal, or you don’t.  We just never imagined there was a choice for us, never considered any other option than loving our babies.

I Found My Voice – Prematurity Awareness

I wasn’t much for causes as a young adult. Oh, I had opinions, and I respected people who fought for what they believed in, but I just never spoke out. Nothing drove me to that point. I participated in walk-a-thons and read-a-thons for MS and other things, but I wasn’t engaged. Nothing mattered enough to move me that far.

And then I had a very  premature baby. Life as I knew it was upended, changed forever. All my dreams were shattered. I had a baby fighting for his life, dependent upon me to advocate for him. I prayed, I begged God to save him, I watched him battle for every breath, every second of every hour of every day. I thought to myself, “If this tiny boy can fight this hard, I can fight just as hard for  him.” I discovered a voice I didn’t knew I had – a strength in myself I never knew existed.

Fast-forward four years, and my discovery of how research funded by the March of Dimes had essentially saved his life. Add to that their providing of an online support community in which I found others who spoke my preemie-mom language, who understood my fears, my anxiety, my grief, my pain. And then an outlet, a focus….we formed a family team to fundraise and walk in that organization’s annual March for Babies. I haven’t looked back. We’ve served as a local Ambassador Family, speaking at numerous events, participating in radio, news, and print interviews, my precious boy’s photos splashed across all sorts of media.

Then there came the autism diagnosis for Little Man, four years ago now. I had to again learn to advocate for my child, reach down deep inside and gather a strength I didn’t know I was capable of, to fight for my child’s needs and a place in a world completely NOT designed for him.

My voice – both written and spoken – was found through my children. I didn’t choose this path. I didn’t choose these battles. But they are our story. I speak out. I write. I advocate. I research. I help others just starting similar journeys. More than this, I’ve been given the courage to use my voice in other areas of life.

Today is World Prematurity Awareness Day. I’m wearing purple in honor of my beautiful survivor, for all those other precious babies who have come out the other side of a too-soon birth, and those for whom their early birth took them from this earth. We in this house are perfectly aware of Prematurity. We’ve lived it. But the voice I gained sixteen years ago, and the voice I have continued to develop over those same sixteen years, enables me to reach out and help others around me be aware of the severity of the problem of prematurity.

The Little Things – PTSD and the Preemie Parent

There have been numerous studies showing parents of preemies suffer from PTSD. Makes sense – you go through something so full of trauma, guilt, fear, anxiety, living minute-by-minute – you’re going to have ongoing emotional and psychological fallout. Most days, I don’t think about what we went through; it has been sixteen years after all since Little Man was born so early. But all it takes is one little sound, smell, sight and I am right back in those moments. I feel it, all over again. I forget we’re where we are, and I’m back in those days of fear, highs and lows, two steps forward and three steps back, having everything out of my control.

My mom had open heart surgery in 2009.  I went up shortly after the surgery itself to be there for her. She was in the critical care unit. I was in her room with my sister, all of us talking, when someone in a room nearby must have dropped oxygen sats and heartrate. The bonging alarm went off. My heartrate accelerated, and I broke out in a cold sweat. I heard that bonging every single day in the NICU, often coming from my own son’s monitors. You go into panic mode every time you hear that sound. I can still hear that sound in my mind. I will never forget that sound. I doubt I will ever hear it without reacting with panic.

I shave my legs almost every single day (TMI – sorry not sorry). If I go more than 48 hours without shaving my legs, I get twitchy. The reason? When I was on hospital bedrest, I went over  a week at a time without having my legs shaved. I can’t stand that feeling. It reminds me of laying helpless, lonely, bored, and terrified in that hospital bed. Same goes for washing my hair. I can barely make it 48 hours without washing my hair because it takes me back to those 16 days in that hospital room.  Seemingly little things, yes? But still – little things that can set me off all over again.

I spent months reaching for the foot pedal every time I went to wash my hands. If I smell that antiseptic soap ever, I’m back in the NICU, washing my  hands before I walked through the double-doors into the NICU pods. Half the time when I wash my hands, I still mentally sing the ABC’s as we were taught early on the NICU – because that’s about how long you’re supposed to lather and wash to make sure your hands are really clean. If I come across a foot-pedal sink, I’m back in the NICU too.

Seeing pictures and videos of preemies in the NICU send me right back to Big Man’s early days. There’s a distinctive way NICU babies move with all the wires and tubes connected to pretty  much every extremity. I’m reminded one of the things I hated the most – that board strapped to his arm or leg to keep the lines straight. God I hated that board. I hated the mass of tape over and around his mouth to hold the ventilator and feeding tube in place. I hated the nurse who ripped the tape off his face one night, tearing off layers of his too-thin skin, leaving him with a dark splotch on his face he carries to this day. I hate that I still cry when I think about this.

We played music for him throughout the day as soon as he was able to tolerate the stimulation. I had to toss those cd’s when we got home from the NICU. I couldn’t stand to hear those songs anymore. When I heard them, I could smell and hear the NICU again. I still get the sweats when I hear any of those songs, which blessedly isn’t often at all, but still.

Most days, I don’t think about the NICU, or hospital bedrest, nor all the attendant fear, grief, anxiety, pain, heartache, stress. But those little things, man, they’ll do  me in in a heartbeat. PTSD for parents of preemies – it’s a real thing.  Just ask a preemie parent.

Is this the next shoe?

I spent the first five or six years of Big Man’s life waiting for the next shoe to drop. When you have a micro-preemie, there are lots of shoes involved. Because I felt like we’d escaped his early birth and subsequent NICU stay relatively unscathed (physically and developmentally), I was certain there would be plenty of shoes falling from the sky. We couldn’t be that lucky, right?

He was diagnosed with high muscle tone on his left side when he’d been home just a few months. High muscle tone can be an indicator of cerebral palsy, often a result of very premature birth. We used massage and physical therapy, and within a few months, the high tone was gone. He had a speech delay at 15 months. We used sign language, sang and read to him constantly, incorporated some speech therapy, and by 2.5 years, we were begging him to stop talking. At four, he was diagnosed with reactive airway disease, which became full-blown asthma at 5 years old.This wasn’t unexpected – there was damage to his lung tissue from the oxygen he needed to survive. It was still a big speed bump for us. He would go from zero-to-pneumonia within a matter of hours every time he got a cold, an allergy flare, or the flu.  But then daily maintenance meds, and extreme vigilance became the norm. We tossed aside that shoe. At eight, he was diagnosed ADHD, and we learned he had something of a visual processing disorder. He got meds, and he got glasses. He became much more successful in the classroom, much more confident in himself. He was at 80% higher risk of ADHD just by fact of his prematurity. Genetics also played into that hand.

He’s a small guy. When he fell off his own growth curve a couple of years ago, we started with x-rays, bloodwork, a trip to the endocrinologist, protein shakes, diet changes, etc. Turns out he’s just dealing with delayed puberty. Again, fabulous genetics, from both parents. But it was a process. And I couldn’t help but wonder if this wasn’t another shoe. You know that growth chart doctors parade in front of parents at every visit? Yeah, that. Well, he wasn’t even on that chart for height or weight until he was well past three years old, and even then, he hovered below 3%. He still hangs out down on the lower end. His BMI isn’t close to being on the chart. That teeny, tiny, 2 -pound, 15 inches long baby is still a long, skinny young man. Another shoe….a handle-able shoe, but it still feels like a shoe.

With some consistently funky bloodwork, we were sent to a specialist at Children’s who put him in a study. Part of that study was a body scan, including bone density. I thought nothing of it. The initial purpose of the scan was to compare muscle mass, bone mass, and fat mass in his body to determine if he were at healthy levels. Do you see another shoe? I didn’t, until the results from the study came back. He has severely impaired bone density. I didn’t know what to do with that. I was calm about it for a couple of days, then kind of started to process what that might mean. Impaired bone density = easily broken, right? He’s an active kid. And he’s a normal kid. Rough-housing, falls, trips when he’s racing – they’re all normal parts of his day. So now we have supplements, and a trip back to endocrinology.

I thought  I was doing okay with this. It’s just another bump in the road, right? But then my preemie-mom-mind went there….Could this be another shoe? He’s a 16 year old, former 26 weeker. He’s kind of on the front end of micro-preemies being considered viable, and fought for. The medical community is still learning the long-term outcomes of saving these littles. Trust me, in NO WAY am I saying not to save them, give them a fighting chance. I’m just saying, when your baby is born at 24, 25, 26 weeks, they can’t tell you how that’s going to look when he’s 15 years old, 20  years old, 50 years old. Of course, not any one of us, preemie or no, knows what our lives are going to be like long term. So there’s that. But I couldn’t help but ask, could this new thing, this impaired bone density, be a result of  his premature birth? Is this some outcome they didn’t know could happen?

I wouldn’t change a thing done to save him way back then. Oxygen, steroids, lipids, caffeine, blood transfusions, vitamins, and antibiotics were a way of life for 93 days. Those are the things that saved him. But did one of those things do this? We’ll never know. And in all honesty, it doesn’t matter. I wouldn’t undo it. I have my baby. He came home, and he’s a thriving, normal teenager.

I do see that shoe hovering over my head. I keep looking up at it, waiting for it to fall. I don’t know if this new wrinkle is a shoe, but when you have a micro-preemie, pretty much everything the rest of your son’s life will look rather shoe-like.