Zeke was ALWAYS getting ear infections. I remember because it was always like, “hey Zeke, you look a little red, wait a minute, don’t pass out from that 105 DEGREE FEVER, oh. wait. It’s just another ear infection…ice him down, he’ll be fine”

Poor little dude. Zeke’s doctors diagnosed his ear problem as “unusual” and “rare” he had “stalactites and stalagmites growing in his eardrums.” I still don’t understand it, but we all had the images of them from his ear x-rays. There they were clear as day…little rock-like formations in my brother’s ears.

I remember the odessey my family took to get Zeke some of those “new fangled” tubes. I think we ended up at Children’s Hospital in Philly for the surgery and how nervous my parents were. And oh I remember the drama if you got the poor kid’s ears wet. The silly putty ear plugs and the no-fun beach time. God. That sucked.

And then, poor Zeke, there was that episode with the He-Man Sword and the eardrum. Word to the wise, it turns out that small boys should NOT be given anything smaller than their ear canal, or their nasal passageways for that matter, because just maybe, said small boy might need to stick that small and pointy object, in their ear, or up their nostril. Now I am not saying I know anybody who has punctured their ear drum with a He-Man sword or visited the hospital TWICE to have popcorn kernels removed from their nose. AND I certainly don’t know someone who still has a tiddlywink stuck way up in their left nostril. Nope, no one that I am related to, no way.

*God, I so want to make an “I HAVE THE POWER” joke and somehow tie it into tiddlywinks but I can’t seem to make it work, thoughts?*

So yes. I know my way around an eardrum. Eustation tubes and I, old pals.

When Jack was on his third ear infection in so many months I pushed for a referral for an ENT. “Wait,” said our pediatrician, “he might outgrow it…” and lo, 3 weeks later the child has another ear infection, a double doozy it seems (his ears are GREEN, no lie) and lickity-split we’re in the ENT offices.

After a faster than the speed of light examination and a hearing test, where we determined that the kid couldn’t hear a damn thing, we ended up with the head of Pediatric ENT surgery at Mount Siani telling me that normally he doesn’t recommend immediate intervention but in this case he’d like to get Jack into surgery in the next 2 weeks. Fine, “sign us up “was my exact response.

April 7th. Tubes dude. Tubes.

We were referred to the neurologist because Jack has hypotonia in his trunk and his legs. He is very “floppy all over,” a pretty common description of former preemies. His physical therapist also noted that he had ankle clonus. Both of these conditions are associated with Cerebral Palsy in premature babies.

Jack had very good luck and very good care in the NICU. He had no diagnosed brain bleeds and for a long time we thought that meant he was totally in the clear for long term neurological damage. And then comes my curiosity and my friend google. According to a variety of medical experts, of the preemie babies with CP, 50% of them did not show brain bleeds but, still have some form of Cerebral Palsy.

You can see why I was awake last night.

The Neuro was very young, very nice, and laughed at my encyclopedia like knowledge of Jack’s medical history. We had a long physical exam where all of Jack’s reflexes were tested extensively and some weird things were done (tuning harp to the foot anyone?)

Long story short. He looks “real good” for an ex-27 weeker, but he has to be followed. It’s too soon to tell for sure, but he looks too good to have an MRI. Too good to do a head ultra-sound. Too good for a diagnosis of CP… For Now (gosh, where have I heard those words before?)

We were riding home in a cab from 165th street and I was thinking that the NICU roller coaster has not really ended, it’s just that the peaks and the valleys have gotten further apart. Just when we think that all is well and we can get off the ride, we’re upside down all over again.

The neuro did give us one solid diagnosis. Jack has a genetic abnormality, hammer toes, courtesy of Archie’s side of the family. Bummer toes I called them.

Considering what we could have heard today, I’ll take the news of bummer toes with a smile.

* Edited to reflect Liz’s description of the data. Damn statistics, they are my worst enemy

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Anyway, enough about present day… I can’t remember how many days I spent on Labor & Delivery towards the end. 2 days? Maybe 3? I do know that the situation was labeled “emergent” and I was no longer allowed to get out of bed for any reason.

Instead of traveling to the maternal fetal medicine center for my daily high-res ultra-sound, they were coming to me. They used these ultra-sounds to measure the separation of the placenta from the uterine wall. Again, we were lucky. In many placental abruptions it is almost impossible to detect what is happening via ultra-sound. They were actually able to watch the placenta folding off, and using that data they were going to make a decision as to when to do a c-section. They were very cautious as they didn’t want Jack to be in any distress but they also didn’t want to deliver him until it was certain that he would be safer outside of me, than in the womb.

On the evening of the 26th, Dr. Playforth came in with the one of the maternal fetal medicine specalists and I watched them watch the ultra-sound machine. They looked at the screen together and then both kind of nodded at each other, than they turned the screen so that Arch and I could see. It was clear to everyone that the separation had gotten much more severe. Dr. Playforth explained that the placenta was almost 30% separated and that rather than wait and do an emergency c-section, that they wanted to do a controlled c-section the next morning. She sent Dr. Klein in to tell us what to expect with a 27 week old preemie, and she told us we should probably pick a name.

*We had been calling Jack, “Baby Jo-Jo” since we found out we were pregnant. We had been debating names between the two of us for several months and in the past couple of days we had settled on several finalists. We had to pick one, quickly, and we quickly narrowed down our field to the winner, Jack Kaden. A cowboy, kick ass, fighter name if there ever was one. We figured he was going to have to be a fighter. *

The night of the 26th was surreal. Arch slept next to me, I was wide awake. Anesthesia had given me a new, bigger IV, and it was hurting like hell. It was oddly quite on L&D and I had a not very nice traveling nurse who seemed to think that my need for a bedpan every two hours (despite the wide open bag of ringers lactate next to me), was a burden to her. I still think of her and want to scream. I mean, the one night that I really needed one of the lovely nurses who knew and cared about us and I got stuck with this one?

They started prepping me for surgery at 6AM and the waiting room was filling up with friends and family. I didn’t want to see anyone other than Arch so he had the unpleasant job of guarding our door and kicking all of the well-wishers out. Dr. Playforth came in and explained the surgery, which would be a modified classic c-section because Jack was in a breach position. She told Arch that he couldn’t be in the room while they were inserting the epidural but that they would bring him in right before they were ready to start, then they wheeled me away.

I don’t remember a lot of the details of the surgery. I remember that they had trouble inserting the epidural and it seemed like forever until they brought Arch in. There were a lot of people in the operating room. Surgical residents, Dr. Playforth, a NICU team and several OB interns who were observing. Dr. Playforth narrated as she went along, telling us when she was making an incision, what layer of muscle they had cut through etc. I was concentrating on only looking at Arch but I could hear her in the background at the same time. Then she told me I’d feel a lot of pressure and then we heard someone say, “He’s such a little wiggler” and then we heard a baby cry.

And then we cried.

We heard the NICU team working on him and then all of sudden on my left side, a nurse appeared. She was holding what looked like a small bundle of blankets. I didn’t really understand what was happening, so when I turned my head, I was shocked to see my son looking right at me. Tet, one of the NICU nurses had brought him up to see us before whisking him to the NICU. He was so small, but he looked absolutely perfect and beautiful.

It felt like it took them 10 minutes to get Jack out and another 50 to sew me back up. The epidural was making me incredibly itchy and after seeing and hearing Jack, and knowing that he was alive, all the adrenaline that had been keeping me calm drained out of my body. I started freaking out on the table. Arch did his best to calm me down but it wasn’t until they gave me a sedative that I felt like I could deal.

The rest of that day and the following are very blurry. I was given morphine as soon as they wheeled me into recovery. I know that Arch visited Jack in the NICU as soon as the drugs started working on me, but I didn’t see Jack until later that evening when they wheeled me into the NICU for the first time. I wish I was more lucid for that meeting but I really wasn’t. I was a hormonal, medicated mess. I remember that Jack had a spot by the Window in Room #1 and how scared I was of all the wires and alarms. He was SO little.

Those first days are sort of fuzzy around the edges. Dr. Bradley managed to keep us in the hospital for 4 days (the longest allowed by insurance) so that we could be close to Jack. The nurses would bring me reports on him every 3 hours and as soon as I could walk I was in the NICU 4, 5, 6 times a day.

They say that parents of preemies go through different stages of denial, grief, acceptance and, if they’re lucky, joy. Those first few weeks Arch and I were walking around in a state somewhere between joy and anticipatory grief. We knew how lucky we were, but we were scared that he still wouldn’t make it. It was a weird place to be. Feeling guilty for not being happy that your son is alive, feeling guilty at how his arrival came to be (a sensation that has not left me, and, I suspect never will), scared to become attached to him, yet somehow only feeling calm when you’re next to his isolette, being so proud of him, but then seeing the expression on other people’s faces when they visit the NICU for the first time.

Now, when you look at Jack it’s kind of hard to imagine him as a premature baby. The only clues are the flat spot on the right side of his head and the huge bald spot on the back of his head. He’s large for a 2 month old although very small for a 5 month old. He’s alert and engaged and he grins, yes grins, with delight at his mobiles and toys and at our faces. Yet we’re reminded every day that he is different. From the surgical masks when we’re sick, to the isolation during RSV season, to watching his eyesight with the help of Early Intervention, he is not a normal baby. I wish I could say that I wouldn’t want Jack any other way but that would be a lie. I wanted him to have a normal begining to life. I am sad that he did not. I feel like I let him down. I also feel guilty for feeling sad, because I know that despite all of our ups and downs, that we’re quite lucky to be together as a family.

Okay. I am a notoriously bad “story ender,” all of my stories tend to just sort of trail off…I am not sure what else to say. “you know the rest of the story” seems a little to tidy and fairytale-y (making up words over here). But, um *scraping my toe against the ground* you know the rest of the story.

I was put in the big room in the back of triage. I was still bleeding heavily. A bunch of residents crowded into the room while they gave me a dose of steroids to develop the baby’s lungs. Arch arrived and he held my hand as we found out from the portable ultra-sound that the baby was okay. His heart rate was 144 and he was alive and was at 25 weeks 2 days gestation. That is about when I started breathing again.

Dr. Playforth, Dr. Bradley’s partner came in and said that they assumed that I had suffered a placental abruption and they wanted to keep me in the hospital to see if it would resolve or continue. We were lucky, we were told, that I had external bleeding because usually in an abruption the placenta collapses around the fetus, suffocating it, without revealing any external symptoms other than small contractions that could have been mistaken for Braxton Hicks. I was on constant fetal monitoring until delivery.

Later that night Dr. Bradley came by and told us that 72 hours of no bleeding meant I could go home but that I would be on bedrest and would need to see her twice a week for ultra-sounds, for the rest of my pregnancy. Going back to CT was out of the question, I needed to be within 10 minutes of the hospital and near a level III NICU. She told us the goal would be to make it to 32 weeks. She told us if we delivered that night we’d have choices to make about his care. She was sending one of the neonatolgists to talk to us about what to expect with a 25 week old preemie...

Well, that night, the bleeding didn’t stop and I started contracting in the early morning. Contracting to the point where I could really feel it. They gave me some tocolytics but told me I could only be on them for about 24 hours. 2 Senior residents came in with the anesthesiologist. We had to sign a consent form for an emergency c-section. They seemed to think the surgery was going to happen SOON but they wanted to get another 24 hours out of me, because they wanted to give the steroids a chance to work on Jack’s lungs.

That second day and night was the worst of my life. It is well documented that my husband can sleep through anything. Me? Not so lucky. The L&D floor was very busy. There were women on either side of our room giving birth, without epidurals. It.was.very.noisy.

But I didn’t deliver that day, in fact we made it almost two whole weeks. Two of the longest weeks in the history of man.

St. Luke’s is one of the busiest if not the busiest maternity center in NYC. SLR’s bread and butter is birthing babies. We thought this was a huge upside when we decided we wanted to give birth there, but there really is a BIG downside to high volume…

There are 35 L&D rooms at SLR with fetal monitors in them. Dr. Bradely wanted me on fetal monitoring constantly to watch Jack’s heart rate, but the hospital needed the rooms for women in active labor; I was bounced around ALL the time. If I had two hours with no bleeding they would send me down from Labor and Delivery to post-partum until the next bleeding episode started, and then they would move me back upstairs and re-attach me to the machines.

Anyway, in two weeks we were in 19 different rooms. We spent two nights in triage (being monitored) and heard a 1st year med student catch a baby; we spent a day and a night in the Operating Recovery Room, BEFORE giving birth (being monitored); we spent 1 night in a shared room with a couple that had just given birth to their full term baby. The rest of the time we were just bouncing back and forth between the floors. As soon as we secured a private room where Arch could spend the night I would get sent back to Labor & Delivery. In retrospect, everytime they moved me to L&D they were prepared to do an emergency c-section, but that fact didn’t really register on me at the time.

Almost every night, Arch was there by my side. He went out and bought an inflatable camping mattress so that he would have someplace to sleep. Some nights he would sleep at Amanda’s, but mostly he would just head back there for a quick shower and a change of clothes. He charmed the nurses and would bring them coffee from Starbucks and trashy magazines. He greased the wheels inside SLR the same way he greases the wheels to get us a good parking spot at the garage. He made me eat food (a major accomplishment) and he continued to work remotely while supervising the construction that was still going on at the apartment. He was doing everything and I was just lying on my back concentrating on not having a baby. If there is a hero in this story, other than Jack, it’s my husband.

I heard a pop, I looked down at my awesome shoes and beautiful white pants to see them literally, and I mean literally covered in blood. I looked like I had been shot in the stomach and all the blood had run down my legs. It didn’t hurt. Or at least I don’t remember it hurting. But it was one of those moments were you could either panic and freak the fuck out, or GET MOVING. I chose the latter.

I remember, I had several thoughts running through my head at the same time:

1. it’s way too soon. way too soon. I could feel the boy kicking furiously and I could tell that whatever was going on was really, really bad.
2. I had to get to a hospital. I knew calling an ambulance would waste time and I’d have a better chance getting to the hospital in a cab. As a New Yorker you sort of instinctively know that if you’re in an ambulance you’re either dead, dying or very stupid.
3. I needed my husband.

Somehow with all of this running through my head, I decided that there would be no way for me to get out of my office building with my white pants soaked in blood. I needed to get to the hospital ASAP and being stopped in reception or in the lobby because I looked like I had been shot wasn’t an option. I changed into my black pants from my overnight bag, but I didn’t have a change of shoes.

I called Arch and told him to meet me at the hospital. I didn’t tell him what happened, I just told him he had to leave now. He must have known something was very wrong because he just hung up the phone and walked out of his office.

The cab across town felt like forever. The baby was kicking furiously, I kept talking to him and telling him it would be okay. I was also thinking of my other friend Katherine, who gave birth to her baby boy in a cab on the way to St. Luke’s Roosevelt because getting through mid-town took forever. I told the cab driver he would get $50 if he ran all the lights. He got $50.

When I made it to Labor & Delivery triage I walked in to a full waiting room. I was shaking and my head was hurting and I had a funny smell in my nose. A nurse named Iris saw me standing at the front desk, I remember seeing her eyes travel down to my blood stained shoes and then back up. All of a sudden I had skipped the line and was in triage. We’d spent some quality time in L&D triage before, during my 1st Trimester, but this time was different. You don’t skip the line unless you’re like 8 cm dilated, or, there is something very, very wrong. They take that line seriously.

We did not have an “easy” 1st trimester. Low beta levels, progesterone supplements and a weird shingles scare early on, along with my RH negative status, meant that we saw Dr. Bradley quite a bit more often than most “normal” 1st time parents.

Yeah. I am downplaying it. The 1st Trimester was awful. I actually spent 5 days quarantined at St. Luke’s Roosevelt because the infectious disease team was worried that my “shingles” (which turned out not to be shingles but this.) were going to infect our baby with chicken pox and kill him in-utero. Good times were had by all during this experience, let me assure you.

Fast forward to the end of the 2nd trimester. My health was good, my skin was clear, we got the all clear at the nuchal screening and the anatomy scan and had breathed a sigh of relief. We started thinking about names, touring day-care centers (yes, this happens very early here in the land of competitive parenting) and planning for November. We scheduled our natural birthing classes and did our tour of the birthing center. We skipped the NICU part of the tour to make a dinner reservation.

We were also moving ahead with plans to renovate our brand new apartment. On August 12th, we moved to Arch’s Dad’s house in Connecticut with demolition in NYC scheduled for the morning of August 13th. And demolish they did. Our bathroom, our living room and kitchen were torn down in less then 12 hours. It was impressive to say the least.

The next morning in CT, I put on my very fancy Cadeau red dress over my brand new white (seriously, what the hell was I thinking!) maternity pants and slipped on my new gold sandals. I remember feeling quite happy that morning:

a) I had figured out that the only way to rock the dress over pants look was to be pregnant.

b) I got to wear my snazzy new gold sandals to the office.

I packed my bag, which included an outfit to wear the next day. I was spending the night at my friend Amanda’s house because I was taking an aquamom’s swim class in the city and was not doing the commute back to CT that night with Arch.

We drove in and got to our offices in the city in record time. Around 2ish Amanda called and we discussed what we should have for dinner. I suggested scallops and she said she’d pick some up. As we were talking one of my fabulous gold grecian sandals fell off, I hung up the phone and when I bent over to pick it up, I felt a pop.

I looked down and of course couldn’t see anything because I had a 25 week pregnant belly in my way, so I stood up. As I stood up I felt a gush. I looked at my feet and my beautiful white pants and gold sandles where covered in blood. Bright red blood.