Recently in preemies Category

Today Liam turns eight. Often on birthdays, parents trot out the baby pictures - here you are with mommy in the hospital; here you are the day you came home. But with Liam, as is perhaps the case with other preemies, we've hesitated to show him those pictures because - well, frankly, some of them are a little scary.

Take this picture, for example:

I mean, despite the caption printed on the bottom, he's really not adorable. That camera, with its ridiculous captions, gave us all a few giggles in the dark days after Liam was born - someone had gotten it in a hurry at the hospital gift shop, not realizing that all the alarming photos - of Liam with tubes and monitors and bandages - would be automatically printed with "It's a boy!" and "He's so cute!" and so forth. Added a note of the absurd to an already surreal experience.

After ten days on bed rest and two days in the hospital, I'd been delivered of Liam in an emergency c-section - the doctors had seen his heart rate decelerating and so bam! we were zoomed into the delivery room. So while on the one hand, Liam wasn't particularly adorable, he was, on the other hand, alive. 

Liam spent two months in the hospital after he was born and none of the dire predictions we were confronted with in the first weeks after his birth came to pass: no liver failure, no kidney problems, no vision problems, no respiratory problems, no infections. He became a "grower and a feeder" - a baby who simply needed to achieve the magic weight of four pounds before he could be safely discharged.  But let me tell you, when your baby starts at one pound, ten ounces, four pounds seems utterly unattainable - seems huge.

Clearly I wouldn't be nursing right away, so I bonded with my Medela breast pump, a machine designed to remind women of their links with the bovine world. I hated that machine but I was determined that Liam would get breast milk when they were ready to wean him off the IV nutrient line in his arm. I pumped and pumped, freezing the small plastic bags of breast milk and carting them up to the hospital in an insulated satchel. I found those frozen bags, like little popsicles, in the freezer for months afterward. 

Liam started taking breast milk in a tube through his nose, which the nurses insisted didn't bother him (I never believed them), and then, when he was a little older, in a tube down his throat - starting with 2cc. Do you know what an infinitely small drop 2cc is? Like a flyspeck - another reason why four pounds seemed light years away.

Drip by drip, ounce by ounce, Liam gained weight and after he'd been in the hospital about six weeks, they let me try to nurse him. It was damn near impossible - Husband was sure I was going to suffocate the poor thing. The proportions were all out of whack: imagine a cantaloupe. Now imagine a tangerine. You can see the problem.

(Things got so bad that after Liam came home, in fact, that we had a woman from the La Leche League come over for a consult - now there's a weird job, hmm? Travel around the city fondling women's breasts in order to help them nurse their babies? I've always thought there's a sitcom premise in there somewhere...)

We spent hours in the surprisingly noisy confines of the NICU (monitors beeping, intercoms squawking, babies crying, timers buzzing) doing "kangaroo care": swaddling baby Liam in our shirts, next to our hearts, holding him close to give him some semblance of the stillness and calm that he missed out on by being born so abruptly. We held him and marveled, like all parents do, at the perfection of this new being, but somehow his tiny-ness made him all the more remarkable: he had none of the soft creases and rounded folds that most new babies have. We could see where his bones joined together, covered by a layer of skin so thin as to be almost translucent.

He came home on the dot of four pounds, the day after an operation to repair a double hernia. We plopped him, still swaddled in his car seat, in the middle of our living room floor, then plopped down next to him and just stared. Home. Dubya had been declared president, but we didn't care (much) because Liam was home.

 Eight years later, my formidable son gazes at the world with wit and intelligence, and a certainty of self that I don't think I found until somewhere in my mid-thirties, after years of therapy. I know Liam can't consciously remember those two months in a plastic shoebox, being stuck with needles on an almost daily basis (red blood cell count, white blood cell count, electrolyte levels, infections, on and on). But sometimes, when I smooth back his mop of hair, I remember that tiny, oddly wizened little baby, and I can see the same thin web of blue veins in his temples that I used to trace with my finger when I reached through the little door of his isolette to say good-night.

Sometimes, when I think about Liam, I remember the closing lines of a poem by Robert Frost, "Putting in the Seed," which is ostensibly about a farmer doing his spring planting - but is also about birth:

How Love burns through the Putting in the Seed
On through the watching for that early birth
When, just as the soil tarnishes with weed,
The sturdy seedling with arched body comes
Shouldering its way and shedding the earth crumbs.

Liam came into the world too early, but his tenacity and grace have rooted in our lives; I watch him, wide-eyed and curious, to see what he will become.

This election - and maybe all US elections going forward, until we institute serious voting reform measures - will occur in the long shadow of What Happened in Florida in 2000 (and, to lesser degree, in Ohio in 2004).

Much of what happened in 2000, however, I didn't realize until I saw the HBO movie "Recount," which is a fabulous - and maddening - dramatization of the grand-scale theft of Gore's victory (and concomitant disenfranchisement of who-knows-how-many US citizens).

It's not that I didn't want to pay attention to what was happening while it happened; it's just that I was distracted. I was about thirty weeks pregnant in early November; my baby was due in early January, everything was going swimmingly, absolutely according to plan. And then, suddenly, all our careful plans went kaflooey. November 18th marks Liam's 8th birthday, but he began to be born, in a fashion, the day before Election Day 2000, with a doctor who clearly failed "Bedside Manner 101" in medical school.

So now imagine that rippling effect you get on soap operas when they segue to a flashback - come with me, if you will, to a dark ultrasound room somewhere in midtown Manhattan, where I'm flat on my back, blue goo smeared on my six-months pregnant belly, and a doctor is about to interpret the flickering bluish picture on the ultrasound screen.

"Basically, you have a crappy placenta," the doctor said, snapping off her rubber gloves.

Pregnancy had been astonishingly easy thus far, so it took a while for her words to penetrate my mushily gravid brain.Crappy placenta? Howzzat?

"So you need to be on bed rest." Bed-rest? Wasn't that something for 19th century heroines, or maybe that crazy lady in "The Yellow Wallpaper," who by the end of the story is crawling around the attic attempting to escape her "rest cure"? But now? in the 20th century? ME?

"Starting now. For at least ten days, and then we'll see. Who's your doctor?"

I gave her the name of my midwife. "Oh," she said after a long pause. "You have a midwife."  As if somehow that explained the crappification of my placenta.
 
(Just for the record, the ob-gyn who ultimately delivered my tiny baby in an emergency c-section credits my midwife, the amazing Sylvie Blaustein, with catching the problem early - Sylvie was the one who sent me to the ultrasound and who, at the risk of sounding dramatic, may have saved Liam's life with her knowledge of babies and women's bodies. If I were ever to move out of New York, I would probably travel back from wherever I was in order to have Sylvie be the person I go to for checkups and all that lady-plumbing stuff. Midwifery of Manhattan - MOM, get it?)

The idea behind bedrest, as near as I can tell, is to give over all your bodily resources to the entity that has nested inside it (in much the same way that all financial resources will be given over to this entity once it's born). And yes, bedrest seemed like a great idea - sprawl against the pillows, be waited on hand and foot - for about ten minutes. Then the itchy, scratchy, maddening reality set in: I was allowed to walk to the bathroom, but that was about it. I had to beg Sylvie for permission to leave the bed in order to vote, and she only said yes because the polling place was literally around the corner from our apartment.

So on the second day of bedrest, I shuffled to the polling place, pulled the lever, then shuffled home to my pillowed prison, certain that in the next twelve hours Al Gore would become the next president.

The next ten days - the next two months - were an astonishingly surreal convergence of the body politic with my maternal body: both in suspension, both hostage to forces beyond their control. I had no way of knowing if my horizontality was helping "Burbage," as we called the blob inside me (a name courtesy of Dick and Nancy Horwich).

Bed-rest rubbed my face in the hardest part (for me, anyway) of being a parent: the part where, basically, you're not really in control. I mean, you might think you're in control because there are rules about this or that, or because you can take away "privileges," or because your children think you can magically cure the pain of a boo-boo. But it's all a charade: they are their own people from the moment they first breathe air. 

Parenting is more like lion-taming, you know? The trainer gets in there with the whip and the stool and the occasional treat of raw meat, and the lions kind of go along with it because, well, frankly, what the hell else do they have to do? But at any moment the lions could totally take over. The trick is not to let them know that they outnumber the trainer ... (this analogy holds true, by the way, even if you are the parent of only one child. One child is more than a match for two parents, which is why those of us in two-parent households should bow down and worship in awe at the feet of single parents).

A week passed. Still no president, still no baby - but an increasingly angry electorate and an increasingly angry mommy-to-be. I was FINE and bed-rest was STUPID and there was nothing WRONG.

Ten days of bed-rest later, still no president, still no baby. Husband and I go for a follow-up ultrasound (not with the "crappy placenta" doctor but with the perinatologists at Babies Hospital). In the tiny exam room there is barely room for a table and the technician, who announces that she can't "see" the baby with the conventional ultra-sound tool so she brings out ... The Probe. And boy, that's just a whole lot of fun. Makes me hope I'm never abducted by aliens. So she's probing and looking concerned and not answering my questions. She calls in a bunch of doctors and if I hadn't been so terrified, I would've laughed: in this tiny room there are four doctors, the technician, me, and Husband, although we were clearly last on the list of priority: the doctors only wanted to see the ultrasound screen.

Suddenly we got a whole new set of vocabulary words to match the other new set generated by the election - to hanging chad and butterfly ballot, we added S/D ratio, doppler, deceleration.

The doctors talked about whether to induce labor, to wait, to do a c-section...a blur until someone told me that I needed to be admitted immediately so that they could monitor the fetus.

So boom! there I am in the hospital, with the central question being whether this now thirty-two week-old baby would be better off in the NICU or in me. At 33 weeks, babies are considered "full term" but this baby was only the size of a twenty-five week old baby - and they weren't sure how he would fare, were he to be delivered that small.

To my host of aches, pains, and anxieties, steroid shots were added, to help develop the babie's lungs. "You know, his lungs are like little smears of jelly right now" said a particularly jolly resident. Lovely. Thanks for that image.

The  residents tied themselves in knots trying to figure out what was wrong with me. Usually IUGR (intra-uterine growth restriction, which is apparently the fancy name for "crappy placenta") happens to people with high blood pressure - or to drug addicts, alcoholics, and prostitutes. As I answered no to all their questions - no high blood pressure, no alcohol, no placenta abruption, no placenta previa, kicked that nasty heroin habit years ago - I imagined  the residents madly flipping through the medical textbooks in their brains, trying to figure out what was wrong with me.

And the answer is...medical anomaly. There is NO REASON for what happened, other than the fluke of a crappy placenta that refused to nourish Burbage the way it was supposed to.

You know, like the t-shirt says, Shit Happens.

Liam was born before the presidency was decided - and I promise that I made no bargain with the gods about exchanging the country's well-being for the well-being of my baby. Promise.

When Liam was born, at dawn on November 18, in an emergency c-section because the doctors saw that his heart-rate was decelerating, he weighed 1 pound, 10 ounces, a little bit more than a full-size loaf of bread. He looked like Gandhi, like Yoda, like the most fragile baby bird you've ever seen in your life.  

They wheeled Liam away in the little plastic shoebox where he would spend the next two months and we were given a long list of the potential afflictions that such a tiny body might face: respiratory problems, heart problems, liver and kidney problems, developmental delays.  He simply wasn't ready to be in the actual world, poor thing, so we held our breath and prepared for the worst.

But in spite of everything he became the tiniest, healthiest baby in the NICU. He flourished. Would that I could say the same for the country.

Liam turns eight in a little less than two weeks; his days as a medical anomaly are - I hope - behind him. And at the risk of stretching a metaphor to the breaking point, perhaps tomorrow's election will demonstrate that the previous two elections were not part of a systemic infection but were in fact anomalous: the crappy placenta that may yet give birth to something amazing. 

*Oh, and those teensy feet at the beginning of this very long post? Liam's, the day he was born. In actual fact, the footprint is slightly less than two inches long. And yet he STILL had toenails. Miracle.