Neonatologist with a sense of humour

The day before I had mentioned that this week’s appointment included an appointment with the neonatologist. I wanted to fill you in on the broad strokes of what our NICU stay will look like.

I had mentioned before I will be giving birth at the Foothills hospital in Calgary. Now that there is no visible heart condition, this is the most likely case. As beautiful as the maternity ward is at Edmonton’s Royal Alex, I am very happy to get to stay in town. When baby is born, there will be a NICU doc, nurse and a respiratory specialist waiting. They are our baby’s first line of defence once she comes into this world. They will assess her breathing and her heart, clean her up, and put her under the warmer and stabilize her. They will do a heart ECHO on baby and make a call whether or not she can be transferred to Calgary’s children hospital or if she needs to go to Edmonton. Again, I am feeling hopeful we will get to stay here. They will also put in a long line IV, which goes all the way near baby’s heart. This is how baby will get medicine if she needs it and nutrients for the first little while. If breathing is a problem, baby will not get “bagged” – the term used for the over the mouth oxygen – because in that scenario there is too big of a risk of rupturing her bowels. They will intubate, which is where they stick the breathing tube right down to the lungs. Once she is stabilized within 12-24 hours, she will be transferred to wherever she needs to go, most likely Calgary’s Children’s hospital’s new state of the art NICU. I will stay at the hospital to recover and daddy will follow babe in his car. Dads are not allowed to go in the ambulance with babies because the neonatologist says he doesn’t know what to do with big people in case they get into medical trouble, like faint or throw up or hyperventilate.

Baby will most likely get no feedings by mouth for the first couple of days. This is because they are not sure if the surgeon is going to want to do a first surgery right away. So baby will get all her nutrients via IV. When it is time, they will feed her via a nasal gastro tube, which is a tube the goes from the nose to the tummy. This way they can control the feeds until they know her intestinal system is working well. Hopefully I will be able to produce lots of breast milk for my baby since that is the preferred choice for her feeds even though she will be fed through a tube. Once the doctors decide it is time for baby to try oral feeds, we will do lots of practice like putting a few drops of milk on her tongue and letting her try the breast when it is empty. “Mom, you are such a tease!” “Just don’t want you to drown when you aren’t ready sweetheart”.

The doctor mentioned that aside from this, infection will be the most critical thing we need to watch for because baby will have foreign objects in her body and also be in a hospital where there are lots of germs that are stronger than germs out in the world since they do so much sterilizing. The NICU has very strict cleanliness protocol with hand washing, yellow robes, masks etc. Also they will be monitoring and treating for infection aggressively.

The doctor thinks the stay at NICU will be between 6 weeks to 2 months long best case scenario. The criteria for going home will be that she doesn’t need her IV anymore, can breathe well on her own, her omph is healing up well and she doesn’t need to be fed by tube anymore. If we end up staying at the hospital long term, we would move out of NICU at around 40 weeks into another unit in the children’s hospital.

NICU doesn’t allow overnight stays but as mom and dad we get in and out privileges whenever we want to visit. We can also bring visitors but they must be accompanied by one of us. They discourage kids under the age of 6 from visiting because they are too germy but siblings are ok.

At the end of the visit the doctor asked me what was my background. At first I thought race – I guess I am conditioned to think that way when so many people ask haha. But he meant what do I do for a living. Oh. My bad. When I told him I was an engineer he just smiled knowingly and then asked what my husband does. When I told him Mark is an IT analyst he just went “ohhh the worst combination”! He went on to tell me how he has lots of engineering cousins and also babies with engineering parents and that it’s hard for him to discuss things with us because being a baby doctor means there are so many grey areas and different paths to take, but engineers and IT folks think linearly, cause and effect, how they never understand that in medicine things aren’t always if/then statements. I looked down at my paper and my questions were generally linear and if/then statements. He totally caught me out. His reaction was just so funny to me. It reminds me of my dad and how he is always teasing my doctor uncle. I love when people in very serious positions don’t take themselves too seriously. It makes everything more bearable and enjoyable. Thanks for making me laugh doc, hope all you baby docs are so light hearted.

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