The Bilirubin Files

As mentioned in the previous entry, Adik was going to experience some complications in his young life. On Saturday January 7, we took him to see the doctor because his left eye was gunking up despite our best efforts. His usual pediatrician was unavailable given that it was a Saturday but we saw one of the other doctors in the practice. She looked at Rafe’s eye and prescribed an antibiotic ointment to put on his eye. She also expressed concern over his color and sent us to the satellite Dayton Children’s Hospital that was in our town to get a check on his bilirubin levels. So off we go where Rafe gets his feet poked and blood taken for said test. Then we got his prescription filled and went home.

That afternoon we got a call from Rafe’s regular pediatrician, telling us that his bilirubin levels were too high (21.2) and he was jaundiced and needed to be taken to the main Dayton Children’s Hospital in Dayton and that she would call ahead so they would be expecting us.

So it began. I took Rafe in while Vin and Yaya stayed in the car. I would keep Vin updated via cell phone. It seemed unnecessary to bring Yaya into the ER and get everyone exposed to who knows what in there. First Rafe had his foot poked again for another blood sample for the bilirubin test. Then he gets strapped into this contraption:

[[image:2012-01-07-rafe01.jpg:”Wearable” blanket with lights under him:center:0]]

Note: Mouse over the pictures for captions

I got to nurse him and hold him a little but mostly he was either on that light tray or the ER staff were examining him.

[[image:2012-01-07-rafe02.jpg:He manages to look like a cool surfer dude:center:0]]

Finally when the results of his bilirubin test came in (again at 21.2) the ER doctors decide that he should be admitted. We had to go through some stuff to get him ready for admission. Getting the IV in him was heartbreaking – his little veins kept collapsing on them. He was poked on both wrists, both ankles, his arms, etc. Everywhere they could find a vein I guess. Finally they had to get a NICU nurse to help get the IV in. I was a blubbering fool during this time. It was quite stressful to watch and not be able to do anything. I tell Vin that we’re going to be admitted – and we decide that he and Yaya should go home and I would stay with Rafe. Vin did have to make a painkiller run for me later as I had not brought any of my lovely pain meds with me (and I was definitely in need of them by then).

In the NICU, a routine is established. Rafe would be under the lamps at all times except I would get to nurse him for 30 minutes every 3 hours. After my allotted 30 minutes, I would pump milk for 20 minutes, and Rafe would be supplemented with this and enough formula to make 60 ccs. He was weighed before and after every nursing to estimate how much milk he drank straight from me, which would determine how much he would receive in supplements. It really was a very strict routine. We had a rather interrupted night. At around 10 PM that night they took another blood sample to determine how he was reacting to the lights, and he was down by 1 point (20.2). The nurses warned me that there was a chance that the doctor might require a second night’s stay, depending on his 6 AM bilirubin test. Did I mention stressful?

[[image:2012-01-07-rafe03.jpg:Funky lights in the NICU:center:0]]

[[image:2012-01-07-rafe04.jpg:Poor exhausted baby sacked out at 4 AM:center:0]]

So both Rafe and I were woken up every 3 hours to go through the feeding cycle, throughout the night. I was at the lactation room pumping away when they took another blood sample at 6 AM. Results came back – his bilirubin levels were down to 15.8 which was much better! However the doctor felt that he should stay under the lights for a whole other night in order to ensure that everything was fine. They also had concerns – apparently he didn’t have enough wet diapers. So we kept up this 3-hour feeding cycle for the next 24 hours. Zombie time! It was so bizarre.

That afternoon, Vin and Yaya came to visit us. Yaya discovered that Dayton Children’s had a bunch of fun stations of indoor play, as well as an awesome outdoor playground! The weather was gorgeous – sunny and in the 50s (about 10 C) which is quite atypical for January. But what a blessing for us! Here is Yaya enjoying herself at the hospital play areas:

[[image:2012-01-07-rafe05.jpg:Inside some funky toy or other:center:0]]

[[image:2012-01-07-rafe06.jpg:Slide!:center:0]]

[[image:2012-01-07-rafe07.jpg:I love to swing!:center:0]]

I had a late lunch with Vin and Yaya, and hung out while Yaya played, until it was time to begin the feeding cycle again. I then went back up to the NICU and Vin and Yaya would continue to play and come up in about an hour to give Rafe and me time to do our thing.

[[image:2012-01-07-rafe08.jpg:Papa and Yaya look at Adik in the lights:center:0]]

When they were leaving, Yaya asked if I was going to come with her in the car to go to the blue house. It really broke my heart to say no to her. How do kids know exactly what to say to bring on the waterworks? So Rafe and I settled in for another night of lights and feeding cycle.

[[image:2012-01-07-rafe09.jpg:Second night of sleeping in the lights:center:0]]

The next morning’s bilirubin test: 10.4! I witnessed the doctor doing rounds with his students (I guess it is a teaching hospital) and we got the happy news that we would be discharged later that afternoon! Hurray!!!! (Or as Yaya would say “Purrayy!!!”) Vin and Yaya would come in the mid-afternoon and hang out until we were discharged (lots of paperwork etc. so the nurses said we wouldn’t leave until mid or late afternoon at the earliest). Yaya did not complain as this meant more play time at the hospital for her!

After the doctors made their rounds and Rafe was cleared, he got to come out of the lights and get dressed. He still had monitors on him and they left the IV in just in case:

[[image:2012-01-07-rafe10.jpg:Dressed, finally:center:0]]

Eventually he was allowed to have the IV removed. He was given a bath and a change of clothes. I admired his newly-regained pinkness.

[[image:2012-01-07-rafe11.jpg:Only heart monitor is left:center:0]]

Meanwhile, Yaya and Papa are having fun at the playground.

[[image:2012-01-07-rafe12.jpg:Yaya in the rocking Stegosaurus:center:0]]

A nurse helps us load up the wagon (they had cute red wagons everywhere, so Yaya got to ride in the wagon that Papa had corralled to take our stuff down). We left with quite a bit of stuff, including a rented hospital-grade breast pump (woohoo!). The nurse made sure that the car seat was installed properly, and off we went! Home again, home again, jiggety jig! When Yaya asked if I was coming home to the blue house that day, happily I was able to say Yes, I am!!! (Purray!!!!!)

And p.s., his gunky eye had also cleared up by this time! Purrayyy!!!

[[image:2012-01-07-rafe13.jpg:Rafe and Papa, at home at last:center:0]]

Seriously, quite a trying 48-hour period for us all. Luckily Papa and Yaya were fine at home together, the weather cooperated, and Rafe did well at the hospital with me. This was the first time any of us had ever seen the inside of a real NICU and I have to say that the nurses at the NICU are the best ones ever! A huge thank you to all of you (Kerri, Runella, Melanie, et al)!! We couldn’t have done it without you! Thank you also to the lactation consultants and everyone at the hospital and the ER who were ever so kind to a stressed out mom. ūüôā

Adik had a follow-up checkup with his regular pediatrician the next morning, and is doing well. Thank you also to all friends and family who gave their (virtual) support while we went through this. Thank god for the iPad so I did not feel cut off from the world and was able to email/chat/facebook with Vin, as well as everyone else. Again, thanks for all your support – we truly appreciate all your encouraging words.

[[image:2012-01-07-rafe14.jpg:Yaya and her now-pink-again Adik:center:0]]

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