Homegoing

On October 3, 2010, in Julia's Journey, Personal, by Chris

It amazes me that a child that was watched and nurtured by a team of highly trained health professionals has now been entrusted to a clueless white guy. It’s probably mitigated by the fact that he has a very attentive wife and a registered nurse mother-in-law with 40+ years’ experience in his corner. Yeah, that’s it. It’ll be hard for him to screw this up.

Thirteen days, eighteen hours and fourteen minutes after her birth, Miss Julia Paige Cook greeted the world outside William Beaumont Hospital. Turns out she didn’t need a car bed after all and we took her out in the car seat we came in with. She has lots of doctors’ appointments between now and her heart surgery; but for today, our family is together and at peace.

I think the pics say it all…

Thanks for following us through this part of the journey. There will be much, much more to come. I’m going to go kiss my baby and thank our Creator for the way He has helped us thus far. And the future? I say…

Bring it.

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Julia’s just over a week old and she’s already going to school. Grandma Nancy is a fantastic addition to the support system that has been surrounding our family. A nurse with 48 years’ experience, she has not taken the easy road into retirement. She is on the faculty at the School of Nursing at Texas A&M and recently lead a medical mission trip to the Dominican Republic.

Aside from her naturally calming role as a mom, perhaps the greatest asset Nancy brings to the table is her years of experience as a lactation consultant. Apparently, she has the home number for K. Jean Cotterman, a nationally known authority on the subject. This was a real Godsend for us, as getting Julia to feed from the breast has been quite a challenge.

It was not long (I figure it was less than twenty minutes after she hugged Jocelyn hello) before the consummate teacher and coach in Nancy came out. After surveying the situation for a few minutes, she offered a few adjustments to Jocelyn’s breastfeeding technique, encouraged her faithful efforts, and even offered a helping hand to get her started. School was definitely in session for our little girl and she was being put to work!

It really wasn’t long before Julia and Jocelyn started working together and daughter was drawing nutrition from mom. There is still a lot of learning that needs to happen, but they are well on their way.

The last 48 hours have really been a game changer for Julia’s progress and Jocelyn’s stress level – and school hasn’t even really begun. Not only are the mechanics of breastfeeding beginning to fall into place, Jocelyn’s sheer enjoyment of Julia has increased tenfold. It’s not just about getting nourishment into her body, but simply being together in the quiet give-and-take of relationship; and it’s been a joy to experience.

Case in point: whether she’s on the breast or the bottle, we’ve found that Julia likes to take a little break after suckling. She may even totally zone out and nap for a few minutes before taking another draw.

We never would have known that if we had remained task-focused on getting her the calories she needed to hit her discharge goals, because almost force-feeding her is a real possibility if we aren’t watchful. In the end, we had to slow down, not only to hear from other perspectives, but to let Julia communicate the best way for us to feed her.

The truth is, school’s in session for all of us. Jocelyn and I, like the generations of parents before us, are merging into the stream of wisdom that comes from hearing the good experience from trusted friends and family, along with simply slowing down and truly hearing the unique wisdom that our child wishes to offer us.

There is other exciting news: Julia is continuing to gain weight (over two ounces in three days!) and is currently weighing in at four pounds, fourteen ounces – a full five ounces over her birth weight. Her volume intake is continuing to trend upward and it seems that another hurdle before her homecoming has been cleared. She’s also maintaining her body temperature and will have no need for an incubator.

I was listening in on this morning’s rounds, where all of the doctors come together at the bedside to review cases. After hearing about Julia’s progress, the attending neonatologist (basically a tiny baby doctor) asked out loud, “Why haven’t we sent this baby home?” I gotta tell you that my heart skipped a beat when I heard that. There is still the issue of the blood platelets that will require close monitoring, but it is the consensus of the NICU team that it can be monitored on an outpatient basis and should resolve on its own. They want to get one more platelet count tomorrow morning, but as long as the results are not too low, the hematologist (blood specialist) will follow up with a more detailed treatment plan sometime next week.

So I’m glad you checked in today. I wanted you to get here before I told her the good news:

Hey Julia – Guess what? You’re coming home with Mama and Daddy tomorrow!

Oh, yeah. There’s going to be a new adventure beginning tomorrow around noon. We’re taking our little girl home and school will really be in session!

I will be posting pics of the homecoming tomorrow! Stay tuned!

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Grandma Nancy’s in Town

On September 29, 2010, in Life, Personal, by Chris

8:15 pm: Nancy Sue Torian-Goodman, mother of my wife Jocelyn and grandmother of my daughter Julia, landed on the fifth floor of the South Tower at William Beaumont Hospital – Royal Oak. Words cannot describe how everything feels like it’s coming together. For the first time in over a week, I have seen my wife totally… Relax.

Within a few minutes of arriving, Nancy’s natural teaching gift came out; and in one short coaching session, there was a quantum improvement in the breastfeeding interaction between Jocelyn and Julia.

Even now as I prepare for bed, Nancy and Jocelyn are in the baby’s room and the coaching and learning continues. And I know that our family is truly, truly blessed. Feels like the cavalry has arrived.

There’s still a lot of work to do, and the expertise, concern and professionalism of the hospital staff has been nothing short of magnificent. But in the past few hours, I have been reminded that there is stuff only a mom can do.

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Sorry for the lateness of this update. I’ve been choosing sleep over creativity lately; but I did want to give you a thumbnail sketch of the goings on over the last couple of days. The good news is that although Julia’s platelets are still an issue, the consensus seems to be that it is a transient thing. She may require further transfusions, but apparently these issues eventually work themselves out and all she’ll need is a little “top-off” once in a while.

I wanted to give thanks to the women who made the burden of the last few days a little lighter (and certainly saner). Robyn ran interference with our fragile emotions on Jocelyn’s discharge day when we had to leave Julia in the NICU. The weekend visit with Aunt Jennifer – Jocelyn’s sister – went great and she did her best to load us up with marvelous, carb-laden food and made quick work of our laundry. Jo-Ann is a close family friend and encourager of Jocelyn’s and took over when Jen headed back to Dayton on Sunday. Both took time from work and family to do something I simply could not. They provided experience and context to Jocelyn and a necessary back-stop against the mass of information and advice coming at her. There are no finer friends than those who come when you need them – even when it’s inconvenient. Jennifer and Jo-Ann are pictured below.

A lot has happened in the last couple of days. Julia has been moved out of an incubator and into a “big girl bed”. The goal is for her to maintain her body temperature for a minimum of 48 hours, and another hurdle for bringing her home will be cleared. They have also removed her intravenous fluids, so the only way she is getting nourishment is the natural way – by the breast or the bottle.

We had a consultation with a lactation specialist, neo-natologist and a pediatric cardiologist today and basically have our marching orders. The number one goal (once the body temp thing is assured) is taking advantage of the “honeymoon period” I mentioned in a previous post where Julia has enough energy to feed and grow. Calories are number one here, and goals have been set to make sure that happens – even to the point of supplementing with fortified formula when Mom’s milk supply can’t provide it. Volume is also a priority. Julia’s belly is only so big and can only take so much. A plan for a baseline of just under an ounce per feeding, with a goal of going over that as soon as possible.

Julia is happy to take nourishment from the bottle, but a little lazy when it comes to taking it from Mom. Coaching and encouragement from Maria, our lactation specialist has helped. We also have another secret weapon coming into Detroit Metro Airport this afternoon: Grandma Nancy – a labor and delivery nurse with forty years’ experience, lactation consultant, and professor of nursing at Texas A & M. When Grandma comes to town, little Julia ain’t gonna know what hit her!

Bottom line, we are hearing a shift in tone from the medical staff – from optimism of how well she’s doing to a focus on getting her growing and thriving as soon as possible. It’s encouraging and a little chilling at the same time. We’ve moved from simply clinging to life to the new challenge of preparing for the oncoming surgery and the tougher days in between.

And Happy Birthday to my sister Lauren! Sorry this is the best I could do for a b-day card. Can’t wait to see you next month!

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One at the NICU and One at Home

On September 25, 2010, in Julia's Journey, Personal, by Chris

Big day yesterday for the Cook family. My wife came home – here’s a pic of her feeling the sun on her face for the first time in four days. She had her incision staples (yes, staples) removed early Friday morning. There was a little apprehension on both our parts, thinking that it would be more painful removing metal than it would silk sutures. But in less than two minutes, they were gone and she was ready for Steri-strips. In the meantime, I was looking for the red “That Was Easy” button (pun totally intended).

We went down to see Julia after her overnight Blue Light treatment, and she looked like a different kid. Her color was much better, she was more alert and active and (okay, guys – breastfeeding talk ahead) she latched! I sent a text message of the good news to women of our families and you would have thought I had announced an 80% off shoe department clearance sale at Nordstrom. I have to resort to humor just because I’m a little awed by the whole thing. I really do appreciate – but have the self-awareness to say that I will never totally understand – the kinship that binds all women together when it comes to childbearing and breastfeeding. Kind of like the male camaraderie surrounding the Superbowl…

No. That’s not it.

Give me an uninterrupted year or two under a tree and I might come up with something. All I can say now is that it truly is beautiful and indescribable. And all the sistas say, “Amen.”

We were thinking that we might be able to stay one more night on what is called “Maternal Stay-over” where we would have had access to the hospital room to crash in between feedings. But we found out that if the room was needed, we would have been asked to leave immediately – even if it was 3am. In the end, we decided it was best to sleep in our own bed. And leave our kid where she needed to stay.

That created a lot of really complicated feelings in both Mom and Dad. It was a very, very weird feeling leaving a part of you behind in the hospital. We had known going in that Julia was going to stay behind and had each prepared in our own way for the reality of it. My sister, Lauren, told me that she needed actual physical support from her husband to leave her son in the hospital after giving birth. But now the inevitable was right up in our faces.

So we did the best we could. The flurry of activity before discharge – especially procuring the hospital grade breast pump – got us focused on the tasks instead of the emotions behind them. I asked an especially intimate circle of men to pray for me as I made myself available to whatever my wife needed from me. One texted back to me with what he heard:

Be encouraged, this is good for the two of you.

No truer words could be spoken – even though the thought of it hurts. We’re going to be leaving our little girl many, many times in her life; and she will eventually leave us. It didn’t make the keen pain of the moment recede, but it did give it a little context. Some company and assistance from good friends that night – along with Buddy’s pizza, a chick flick and two milk runs to the hospital (11pm and 4:30am) by Dad while Mom got some shut-eye kept us occupied and the “My Baby’s in the NICU” blues somewhat at bay. Along with complete exhaustion!

The morning brought a new rhythm (Pump – Drive – Nurse – Repeat) but also some much appreciated reinforcements to this beleaguered little outpost. Jocelyn’s sister Jen drove up from Dayton to bring some much needed support in the form of lovingly prepared food, a womanly perspective that I simply cannot give, and the fun of having my sister-in-law around. She is the consummate child-raising pro and helped Jocelyn out as we got Julia accustomed to breastfeeding. Baby is doing well – we were able to do a full feeding from Mom today. We still use the bottle sometimes, but only when we don’t want to waste the good stuff that Mom is producing.

Jen will be leaving us tomorrow, but there will be other reinforcements that you will be meeting as we go, and great support from our community. As I am writing this in the dim half-light of the nightshift NICU, I am humbly watching my sister-in-law quietly dozing after a day of giving it her all. The late night milk runs, the breast feeding frustrations, and the messy house is all worth it when I watch my little girl sleeping peacefully, and it makes the pain of our time apart a little less keen.

Jocelyn has produced enough breast milk tonight to get Julia through the night time feedings, so Dad will not have to jump in the car for a milk run tonight. Thanks sweetie! We have the first truly restful night in front of us!

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