Happy Birthday, Boys!

The boys turned 1 today. Our only plans were to go to the hospital and say hello to the staff. We’re regulars at the NICU—I’m around at least once a month for committee meetings, so the doctors and nurses always get the latest news on the twins. It just seemed right to make a victory tour.

In 2009, 7800 babies were born at Alta Bates. You think that they wouldn’t remember us down on the Labor & Delivery floor. You’d be wrong. I think it was the combination of mono-amniotic/mono-chorionic twins plus the births at 25 weeks plus almost-New-Years-Eve. Everyone remembered us. Some even by name.

Our first stop was the nurses in the antepartum ward. The nurses don’t remember me so well (not even as the person who brought chocolate chip cookies on Christmas Eve for the night shift) but they all remembered Matt. Maybe because he spent every night in Antepartum 12 with me. I think he even had his own shelf in the ward’s refrigerator, filling it up with pepper crusted beef and fresh Straus Family milk from Whole Foods—the desperate culinary requests from a pregnant wife.

The first person we saw was the doctor who’d given the boys their Apgar scores. She knew us well. She was the doctor who decided that the boys would have the ligation surgery three weeks after they were born and the doctor who helped us pick a pediatrician. Next we saw my favorite nurse, Mariann, whose grandson is the same adjusted age as the boys.

Everyone said the same thing: “I was just thinking of you today!”

I had called ahead to see if the doctor who delivered the twins was working today. She was. (Actually, there were nine doctors there in the room when the twins were born. Three for each of the boys and three for me.) This doctor was the one who called the shots and wrote up the report.

She was floored to see what the twins looked like a year later. And so happy! You would have thought that I had just given her a check from Publisher’s Clearing House.

“You just made my year,” she told us, more than once. She couldn’t stop smiling.

“We never see this. We know that most of them do pretty well when they go up there [on the 4th floor], but we never know…” she trailed off.

Every once in awhile I do a good deed (like those Christmas Eve cookies—which Matt baked, not me), but the simple act of showing the attending obstetrician that her handiwork resulted in two miracles with stellar health—twins born three months ahead of schedule, one with the umbilical cord wrapped twice around his neck, the other with a knot in his—feels like the best gift I have ever given. Who would have thought.

I’m glad she knows. I’m glad she knows that miracles happen and that she was at the starting line.

Wagner and Michael in their matching Penn State onesies from Cousin Lawrence

Memories of Last Year: Sneaking Suspicions

Last year this time Matt and Chiara were in Tampa. I was at home addressing Christmas cards and watching back-to-back episodes of “Celebrity Rehab.” I was 24 weeks pregnant. I had just finished writing and posting “Survivor Mom,” my most-read blog post in the whole blog,* blithely anticipating the chaos that would ensue following the twins’ arrival.

*I get about a hit a day on this post. Judging by my stats info, it’s getting emailed around. 2nd and 3rd place go to the two posts following “Survivor Mom.” Worth mentioning is that in 4th place, very close behind, is the post on the “Michael & Wagner Kovac Christmas Gift Drive.”

Before they made the trip I called my doctor to make sure it would be OK for my husband to be so far away from me. The nurse laughed to reassure me.

“Don’t worry. You are not going to go into labor at 24 weeks. I mean, never say never, but the chances are so small that I can say it’s just not going to happen.”

She reminded me that my high-risk condition: monoamniotic/monochorionic twins had nothing to do with early labor. The only reason the boys would be born between 28 and 34 weeks—in other words, premature—would be to prevent cord entanglement. But I had absolutely no factors that put me at risk for early labor.

“If anything,” the nurse continued. “You’ll get more rest with your husband and two-year-old away.”
I did get more rest. I went to two holiday parties. I read some books. I started to sort through the six trash bags of baby clothes that folks from the ballet studio had given us.

I was sooooo tired. And sooooo huge. I was starting to feel the babies move, starting recognize one movement as the Red Baby and another as the Blue Baby. And I kept pushing away the thought that I was feeling very much the way I had felt in the weeks leading up to Chiara’s birth. But that was impossible. It had to be my imagination. After all, I was only five and a half months pregnant.

Michael and Wagner Kovac Christmas Gift Drive

Little did I know it, but a year ago today I was about two weeks away from having very premature baby boys.  I spent Christmas and New Years in the hospital and the boys were born the night before New Year’s Eve. 

I’m grateful that Matt was able to stay with me in the hospital every night.  I’m grateful that my brother and his girlfriend could stay with Chiara to make this happen.  I’m grateful to the family and friends who visited, sent presents, made phone calls, and kept us in their prayers.  I’m grateful that I got such fabulous care.  And I’m grateful that as the twins approach their first birthday, that they are thriving.

Now it’s time for me to give back.

My niece and I have started a gift drive similar to the Loki Sky and Friends Gift Drive.  Loki Sky and Friends gives gifts to new parents who will spend the holidays in the NICU.  Our gift drive will benefit chemo patients at Grandpa’s hospital in Florida. 

Here’s what we have planned:

For the patients: great tote bags from Bed, Bath & Beyond.  Socks and a snuggly blanket—while supplies last!

For the families of patients and for the doctors and nurses who have provided such great care: A “Tower of Treats,” an assortment of goodies, probably from Target.

All that plus hand made cards from the kids in my niece’s neighborhood.

Wanna be a part of it?  You can.  Here’s how:

We’ve set up a registry at Bed, Bath & Beyond: http://www.bedbathandbeyond.com/regGiftRegistry.asp?wrn=-2092630138&

We’re “Michael & Wagner Kovac Christmas Gift Drive.”  The tote bags will be mailed to Grandpa & Grandma.  You can also send gift cards (BB&B or Target) to their address.  Email me if you need the address. 

It’s the best kind of Christmas giving!  Fast, easy, inexpensive, and fits the need. We'd be so honored and grateful if you helped us help others.

Take care and take naps,

the East Bay Kovacs

Ten Bucks

Now that December is here, it’s impossible for me to think about the holidays without remembering what we went through this year. Last year this time going into labor was the furthest thing from my mind. After all, I wasn’t due until April. But life is funny that way. Four days before Christmas I was admitted to the antepartum unit of our neighborhood hospital and stayed there until the twins were born nine days later—at 25 weeks’ 3 days’ gestation.

Talk about your life-changing experiences. How can you thank someone adequately for saving the lives of your children? And how can you help other Moms who haven’t been through the worst of it?

I don’t know either, but I’m trying to find out. I have become the parent liaison for our hospital’s Partnership Council and our hospital’s Family Advisory Council. From time to time I talk to parents in the NICU or moms in antepartum. Just to do what I can to help.

From time to time my husband still bakes cookies for the NICU nurses, even though the boys got out of the hospital seven months ago. On Thanksgiving he cooked a whole turkey along with gravy, potatoes, and asparagus, and for dessert, fresh pineapple. We brought it to the NICU and Matt carved the turkey for the nurses who were working that day. Just as a small way to say thank you.

I’m not the only one looking for a way to give back. In October of 2008, little Loki Sky was born at 24 weeks’ gestation and weighing 1 pound, 5 ounces. He spent his first Christmas in the NICU. In fact, he spent his first four months of life in the NICU. After he went home, his mother Kat became very involved with parent/hospital relations at our Alta Bates NICU (the role that I now have since Kat and Loki and Dad moved back to the Netherlands in August).

Kat knows what it’s like to spend the holidays in the hospital, so last year she started the Loki Sky and Friends Holiday Gift Drive. She raised over $1500 and put together gift baskets for families who were in the NICU over Christmas. (We just missed this party by a week as the boys were born on Dec 30th). You can read all about it here. And if you’d like to give, she’d love to have your donation. Kat is very organized. The site even takes PayPal!

Moms on hospital bed rest are scared, depressed, bored, and uncomfortable. And if they’re in there over Christmas, even when they try to make the best of it, they’re probably still scared, depressed, bored, and uncomfortable. I know; I’ve been there. If you’re a nurse working on Christmas, yes, you get the holiday pay, but it’s still a drag to work on Christmas.

This is why my twelve-year-old niece and I are starting our own gift drive. She and I won’t be together for Christmas; the twins can’t travel during flu season because of their delicate immune systems. It’s a bit tricky, but my niece and I have selected a hospital in Tampa (she will be spending Christmas with her family and my in-laws there in Florida).

My niece has complete creative control. She’ll buy presents for either: Moms on bed rest during Christmas or nurses working on Christmas day. Our gift drive doesn’t have a name (yet) and right now my niece only has one donor (me), so our budget is significantly less than $1500.

Today, just a month before their first birthday, the twins are happy and healthy and chubby. I know you’ve been following on the blog tracking our progress; you’ve shared the ups and felt the downs. Vicariously, our joys have been your joys; our victories have been your victories. Now let your thanks be part of our thanks. If you’d like to help us give back to the nurses who work during the holidays or help us give to the Moms who will have to spend Christmas in the hospital away from their families, we’d love to have your contributions. After all, you’ve supported us this far. Why stop now?

Drop me a line and I’ll tell you how.

Thanks for reading,
janine

Secrets of the Twin Mom

Here’s a secret: I was so afraid that I wouldn’t be able to take care of twins that I actually dreaded the day they would be well enough to come home from the hospital. Terrified to the point of tears. But here’s another secret: twins are awesome. Nothing against the rest of you out there, but if you don’t have twins, you are missing out. And being a twin mom is just about the funnest thing I have ever done (next to performing in Piazza Barberini for Italian television or dancing at McKelligon canyon, but that’s a blog post for another day).

First of all, the bar is set really, really low for twin moms. Wearing two matching shoes? Ate breakfast before 2 p.m.? Bathed yourself and all three kids this week? You are an overachiever!

And twin moms who also have a preschooler are on the short list for sainthood. It’s awesome—because it’s much easier than it looks.

Actually, that’s misleading. It’s not that having twin babies and a three-year-old is so easy, it’s that motherhood—parenthood—is SO hard. On a transition scale, going from no kids to one kid is like going from zero to seventy. Going from one kid to three, however, is not as big a leap as people would think. It’s like a seventy-five.

But because everyone who has kids has at least one kid, (duh!) moms are expected to do all kinds of crazy things. They wake up for every feeding. They drop off and pick up their kids from daycare. They buy baby clothes and wash baby clothes and read bedtime stories. They rock their babies and sing them to sleep. They have jobs. And they do it all themselves.*

* OK OK OK! I KNOW there are Dads out there who step it up—who do dishes and fold clothes and make dinner and drop off at daycare and rock their babies and sing them to sleep. But they also have jobs. Two parents who work in tandem is a better deal than the responsibilities of the single parent, but it’s nothing compared to the help and support that is shown to twin moms (and dads).

It’s like Stone Soup. Maybe it’s just my selective Mommy Memory, but we are getting so much help, that having three kids is easier than when we had just Chiara.

For one, back then I was working thirty hours a week, going to school fulltime, and commuting back and forth to school. Matt was working 40+ hours a week and commuting 80 miles a day. Granted, that’s a lot, but it’s nothing out of the ordinary. What’s out of the ordinary is that now I am not working and Matt is working from home more so that he can be around for the morning shift and be here when Chiara gets home from daycare. What’s out of the ordinary is that my mom came and stayed with us for five months out of the last ten. So I never had to get up to do every feeding. On Wednesdays one of the moms at daycare picks up Chiara and brings her home. So we don’t have to do every drop off and pick up. On Saturdays, Matt takes the whole brood to Nutcracker rehearsal and one of the moms babysits. For free.

Speaking of free, aside from diapers and formula, to date we have purchased: one teether, one ball toy, six baby spoons, (thank you, IKEA) and two high chair trays. Everything else was given to us. Six bags of boys clothes, ages newborn to one year. Blankets, bibs, Stokke Tripp Trap high chairs (two), a crib, two carseats, two different double strollers, a Moby wrap, a second Ergo. Baby hats, crib sheets, bottles, you name it. Free stuff is awesome, absolutely. Also awesome is never having to take inventory of what we need and figure out how to get it. That’s a lot of saved time.

People open doors for the twin mom with a stroller. When was the last time someone did that for a single stroller? Neighbors we barely knew dropped off food because they knew we had twins. On my first flight with the boys, the pilot deplaned and carried on Wagner’s carseat himself. We were actually able to get special passes from TSA so that my family could escort us to the gate. Crazy – take one baby on a plane and you get a dirty look. Take on two and people buy you a drink because they think you could use it.

So we’ve gotten more help. We’ve gotten more free stuff. We’re cut more slack. All this helps us be more organized and efficient with our time. Which gives us more energy to give back to others. It’s crazy. We’ve actually hosted more playdates (read: babysat someone else’s kid) and sleepovers in the last six months than we have in the three years before that. (We have three babysit/playdates next week alone). And since we’re twin parents, we get even more credit!

As Matt likes to joke, “Set expectations low. Exceed expectations.” Well, let me tell you, expectations are set pretty low for the twin mom. The punch line is, because expectations are so low, people help you out. You exceed expectations, impress everybody, and actually have the time and energy to help them out. Amazing, this non-zero sum stuff.

Next up: why taking care of twin boys is easier than taking care of one Chiara, OR Dancing in Piazza Barberini.

Fan Appreciation Day

It’s Nutcracker time. I danced my last Nutcracker in 1996, but my husband Matt is still performing. This is his sixteenth year dancing the Sugarplum Fairy cavalier for Pacific Ballet in Mountain View. He has known some of the ballet students since they were soldiers in the Battle Scene.

Every Saturday from September to December, my husband coaches the girls he will dance with. As an extra bonus for me, he takes our children with him. Our daughter Chiara has been attending Nutcracker rehearsals since she was seven months old. She loves it.

By the time she was a year and ten months, she was able to sit through two-hour dress rehearsals without incident. So I thought nothing of taking her to an actual performance to see Daddy dance.

As soon as she saw him jeté onstage at the beginning of the second act she yelled out, “Dadd-deeeeeeeeeeee!!!!!!!!!” Not in a “bravo” kind of voice, but with the voice you use to warn someone that they’re about to be hit by a bus. All the dancers onstage smiled a little wider. One of the candy canes suppressed a giggle.

When Matt exited into the wings, Chiara burst into tears.

“Where Daddy? Where Daddy?”

Poor thing. She must have thought that he fell off the face of the earth.

I explained: first there’s the Spanish variation, then Arabian, Chinese, Russian, Merlitons, Mother Ginger, Waltz of the Flowers, and then Daddy dances again.

After the last flower waltzed away, the lights lowered and the soft music of the Sugarplum Fairy pas de deux began to twinkle.

“Dadd-deeeeeeeeeeee!!!!!!!!!” Chiara yelled when she saw her father escort the Sugarplum onto the stage.

“Shhhhhh. . .” from the row behind us. It was the ushers. To us.

In my day, the ushers knew their place. They wouldn’t have dared to shush the guest artist’s entourage. In my day, the ushers could separate the insiders who don’t even need backstage passes from the bottom-feeders, the ticket-holding public. But we aren’t in Berlin anymore. And Matt is a great cavalier, but he isn’t much of a diva. He has actually purchased tickets for us. A ticket means that we enter from the front instead of the back. It means we are nobodies, Chiara and I, because no one knows that we are related to the star. That is, until she yelled it out for all to hear:

“Da-dddddddeeeeeee!!!!”

An usher hissed at us again.

Maybe he had a point. She was kind of loud.

I scooped my daughter up into my arms hastily exited the theatre. Wiggling with that toddler ninja move that makes them both slippery and brick-like, Chiara broke free and ran to the doors leading back into the theatre.

“Da-dddddddeeeeeee!!!!” She pounded her tiny fists on the door, doing her best Brando from Streetcar.

She was even more hysterical there in the foyer, so we went back in. Even in the dark I could feel the ushers’ steel glares. Would we be asked to leave? It is a kid’s ballet, after all.

Chiara stopped sobbing, but she continued to call out from time to time. On stage my husband gracefully promenaded his lovely partner. He was beaming. He’s dancing for his little girl. Why should we leave?

Every time Chiara called for him, Matt and the Sugarplum smiled a little broader, sharing this inside joke with everyone else in the theatre who had seen our daughter every Saturday sitting at the front of the rehearsal studio next to the mirrors, eating her morning snack and watching her Daddy dance.

Chiara is a fixture at these weekly rehearsals in Mountain View, but the real fixture is my husband. If you are a parent of a kid in this show, you know him. He entertained your daughter backstage when she was an angel in the prologue. He taught her how to do finger turns and supported lifts during pas de deux class. And if your kid is a boy, my husband taught him fart jokes. If you are remotely involved with your child’s pre-professional ballet career, you adore my husband. And you probably know Chiara as well.

So if a little girl crying for her daddy is ruining the show for you, maybe you should lighten up.

Which is more or less what I told those ushers.

A NICU Visit

Today we had our six month follow up appointment with the NICU.  Technically the boys are six months and two-thirds (adjusted) and they are right on track.  They are transferring objects from one hand to another.  Their fine motor skills (scoop and hold) are just what we should expect from 6 2/3 month olds.  They can sit unassisted and rock back and forth on all fours.  They are very social, almost too social to be able to do some of the testing (they paid attention to the doctor doing the testing instead of the test they were supposed to do). 

Their one “fail” was that they don’t attend well to ambient noise.  That means that if there’s a sudden noise, the boys don’t turn to see what it was.  This isn’t uncommon in preemies, as they are used to tuning out noises that they don’t think are important.  It’s something we’ve got to “work on.”  (When we got home, Matt dropped a book behind the boys.  They didn’t flinch.  Then Michael burst into tears and cried for ten minutes.  So I guess that’s good?)

OH - and Michael is CRAWLING.  He's getting to be quite the fidgeter, too.  I think I might have to look for a changing table with a five-point harness.  Wagner just sits there, content to just play with whatever's in front of him.  He'll sit there for an hour, while Michael (literally) crawls circles around him.


Here are some of the latest pics.

Wagner

Michael (& Matt & Chiara)

Wagner (& Chiara)

Michael

A Teachable Moment

I’m walking the streets around our neighborhood looking for a woman and her dog. I want to reassure her that the scare she had the other day resulted in some invaluable life lessons for my daughter.

Chiara and I were walking with the boys in the bulky double stroller (the double snap-n-go; it’s like pushing a small fleet of shopping carts) and we came upon our neighbor and her dog. I don’t know where she lives, but I see her walking her dog all the time, a little black and white pixie dog. I usually see them on their evening walk when I’m putting out the garbage bins. The dog has this fancy collar that emits a blue light. Very handy in the dark.

We stop and talk and I point out the fancy collar to Chiara. We discuss its uses.

“When it’s nighttime, the collar shines a light and then his mama can see where her dog is.” (I might have called it a “doggy.”)

The owner and I make jokes about the day the twins will be running around and I might need a similar kind of collar for them. We smile and nod see-you-later. My entourage and I turn to left; the owner and her dog keep walking straight ahead.

Halfway down the block, Chiara gets mad about something or other. It doesn’t matter what; something that’s fueled by her empty stomach, in spite of the almonds we brought along to stave off the tantrums. She stomps her foot and takes off running.

Takes off running.

I am 100% sure that she is going to wait for me at the corner. She turns the corner, still running.

Oh no, you didn’t.

I know that even if I could leave the boys and run after her, that would be a mistake. I have to call her bluff and wait for her to come back to me. She’s on the short side of the block right now, the width, not the length. There are no driveways on this part of the block, so I can let her run and still know that she is safe.

I wheel the twins to the corner and stop with my hands on my hips. She is still stomping away. When she sees that I am following her, she turns to me, shakes her fists in the air (this was actually kind of funny) and turns and runs again.

I am 75% sure that she is going to wait for me at the next corner. I am wrong.

Why, you little . . .

Now she is running down the length of the block. I’m hoping to follow as closely as possible without being seen. She stops from time to time to look for me. Then I make a tactical error—I inch forward just enough so that when she turns around, she sees me. She shakes her fists at me some more and takes off running again. Now my heart drops.

Oh my God.

I am 50% certain that she will not try to cross the street by herself, which is to say that I have no idea what she’s going to do next.

The streets in our neighborhood (and this street in particular) are very narrow with speed bumps every 30 feet. We are close to the BART station (subway). It’s the hour before dinner. In other words, this is the time when commuters are walking home from BART, walking to Market Hall, walking their dogs, their strollers. Little people are crossing the street to their ballet class. Big people are trying to fit in a run before dinner. Pedestrians are legion at this hour and the cars creep by to let the walkers have the run of the road. This is probably the safest time of day for a runaway preschooler. I just don’t know where my preschooler is going run.

When I was eight weeks pregnant with Chiara, I thought we were going to lose the baby. I had cramps; there was bleeding. Matt and I were headed on an overseas trip and we stayed up all night worrying about what might happen.

So this is parenthood, I remember thinking. Worrying about another human, knowing that there’s only so much you can do. Trying to find faith and hope in what you can’t control. I’d better get used to this feeling, I thought, because this is my new life.

And so here I am again, worrying about another human, knowing that there’s only so much I can do. I am watching my daughter challenge my authority; she is flaunting her independence in the big wide world of a single city block. From my vantage point, both literally and metaphorically, I can see the world beyond, the other blocks, other possibilities, other dangers. This is my new life: dancing the balance between keeping my daughter safe and close and letting her run free even if it means she falls.

Before Chiara gets to the end of the block, a neighbor I do not know sees her, tries to stop her and ask her where her mommy is. Chiara backs away from the stranger. I’m relieved because it slows her down so I can catch up. Chiara turns the corner AGAIN, but this time the neighbor is keeping an eye on her to make sure she doesn’t run into the street.

The neighbor and I talk. She assumes that Chiara is acting out because of the twins. Chiara is walking very slowly now, watching me, pacing on the sidewalk in front of the corner house. The neighbor and I are on the side of the corner house. We are separated from just enough bushes for Chiara to feel like she’s far away and for me to feel like she’s close.

And then it happens. The woman and her dog are coming back from their walk. The little dog has scampered ahead, very fast. And into the street. A car comes. The woman screams. There are a handful of witnesses in various stages of walking, running, commuting, and chasing children. We all freeze. For a moment I think that Chiara, at the tender age of three, is going to see something that I myself, have never seen.

I try to anticipate what she will see. Will the dog be thrown into the street? Will there be blood?

The car slams on its brakes and the little dog scuttles to safety. The woman runs after her dog. Chiara runs back to me. As fast as she can.

“Mama, Mama! I was so scared!”

Good.

Me, too. I tell her. We talk about what happened to the dog who ran away from his Mama. We talk about fear and trust and how next time that Mama will probably put a leash on her dog. It transitions nicely into a discussion of how I was a scared Mama, too. What I might do next time.

Matt joins us a few minutes later, an opportunity to retell the story.

It is suggested that maybe Chiara shouldn’t be allowed to spend the night at her friend’s house tomorrow night. What if she runs away from her friend’s Mama? How do we know she will stay close so the Mama knows she’s safe?

Nooooooooooooooo! Chiara begs us. She points out that she did not try to cross the street by herself.

We decide to give her a second chance: we will walk to the market and back and Chiara will show us how she can stay close.

“I will walk right behind you the whole time!” she promises.

You'd better.

That’s what supposed to happen. You watch your kids; you teach your kids; you give them the tools to stay safe; you hope they use them. And then you let life happen. I can’t shelter her; I can’t keep her on a leash. I can only prepare her, support her, and dance the balance.

As she pouted and pitter-pattered around the block, several ideas had crossed my mind—from yelling at her to running after her to giving her the beating of a lifetime. I had to keep reminding myself: I know my neighborhood. It’s safe. I know my kid. She’s not going to do anything dangerous. Running after her is not the way to teach her to stay close. Rationally, letting her run was the right thing to do. And yet, it felt like a gamble. An irresponsible gamble on my part.

Today Chiara and I talked about the event. She calls it, “When I got lost.” She said she dreamt about it last night—she’d run away from me, run toward me, run away from me, toward me. Over and over. How’s that for metaphorical?

I’m so happy with how everything unfolded. Chiara tested the waters, misbehaved and in the end, redeemed herself. And best of all, she saw firsthand the real reason you stay close to your Mama—because it’s safe. (On second thought, best of all is probably the fact that the doggy made it safely across the street).

I’m so happy, too. Because I don’t know what I would have done if she had tried to cross the street. I don’t know what I would have done if I had gambled and lost.

© 2010 Janine Kovac

A Prayer for M & M

A Prayer for M & M

I know they must wake up each morning with their questions
I pray that their questions become their quest
That the quest opens their eyes to new possibilities and new assurances

I pray that from this comes new encouragement and strengthened resolve

I pray that they bask in the love that is sent from all over,
from our hearts and minds through our keyboards and cell phones

This is what we share together
This is what we own
This is what we give to others

And in turn, this love feeds back into the quest—for each of us

Like sunshine
Or a dancing tree

Prompting us to connect
Inspiring us to nourish our souls
Encouraging us to have faith in our faith
Embracing the whole enchilada

And again, feeding back into the cycle of loving and living and learning

Amen

© 2010 Janine Kovac

Stevie the Wonder Preemie

Maybe it’s because by the time I came on the scene Stevie Wonder was singing dopey duets with Paul McCartney. I just couldn’t take him seriously. (My dad and I used to sing, “I just called . . . to say . . . you smell bad.” We thought we were so clever). Stevie Wonder was like fingernails on the chalkboard. I hated Stevie Wonder. What was all the fuss about?*

* Except for “Superstition.” That was always a pretty rockin’ song.

But all that changed in January.

Stevie Wonder was a preemie. And my boys owe their sight, in part, to Stevie’s blindness.

It’s a condition called ROP—Retinopathy of Prematurity. It happens because oxygen, like everything in excess, is a poison. In the early days of keeping preemies alive, they were given higher levels of oxygen in their incubators, the rationale being that more is better. Room air typically is only about 21% O2. These preemies were getting 70% or even 100%. The long story involves stuff about vascularization. The short story is that preemie’s eyes aren’t fully developed and too much O2 blows out their blood vessels, resulting in blindness.

These days, oxygen levels are very closely regulated and at-risk preemies are checked regularly for signs of ROP. There’s more stuff about stages and regular checkups (the twins had three such checkups in their first three months) and if necessary, there are interventions—the most invasive of which is eye surgery.

Bottom line is, everything we know about growing healthy preemies is learned from the mistakes of preemies past. In the field of neonatology the guinea pigs are the preemies themselves. Each generation stands on the shoulders of the previous ones. When Little Stevie Wonder was in his little greenhouse, the goal was to keep ‘em alive and keep ‘em breathing; his blindness was a small price to pay for life itself.

As soon as I found out that Stevie Wonder was a preemie, my attitude toward his music changed. I think of Stevie’s mom, biting her lip and praying for her tiny son who is fighting for his breath. I want to hug her.

“You can’t imagine how great things are going to get,” I want to tell her. “Your son is going to do amazing things. He will inspire generations of musicians. People will drink his music like wine. His contribution to music will pale in comparison to his contribution to science. He will help advance the field of neonatology simply by his existence.”

Thanks, Stevie. Thanks, Mrs. Wonder. You guys rock.

© 2010 Janine Kovac

Write Your Thank-You Notes

I’m writing something for the new NICU website and I’m stuck, so I thought I’d use this forum to muse.

The purpose of the new NICU website is to have loads of resources for parents. I have been very vocal in support of a “How to Take Care of Yourself” section, and it’s now one of eight main sections on the site. Since it was my suggestion, it falls to me to write a rough draft of what I think should be on it.

It’s an interesting exercise in offering tips without preaching. I’d like to tell parents that it’s very important to thank every nurse they see, everyday, but of course, I can’t. Or if I can, it must be said verrrrry diplomatically.

I was going to spend this post talking about the illusion folks have about causality. I call it Domino Causation: one event causes another to happen. This false illusion leads to the false assumption that big actions make big results and therefore big actions are more worthwhile. Big actions are like islands. They carry no momentum. Little actions are ripples. I want to call them “seedlings of tidal waves” (how’s that for mixing metaphors).

Going back to the gratitude attitude. On the third day of our NICU stay, total strangers were telling me how great my Aunt Rita was. Now I knew this already, but I didn’t know how they knew it, too. It turns out that Aunt Rita (everyone needs an Aunt Rita, by the way) had sent the nurses a huge edible fruit arrangement and note thanking them for the care they were providing to her nephews.*

*It was gone within about a half an hour. Except for the kale. Apparently even healthcare providers won’t eat kale. Even in Berkeley.

I was floored. “You can do that?” I thought, “Send nurses thank-yous? But isn’t this just their job?”**

**Something else you can do that Aunt Rita taught us: send a birth announcement to the President. I did this and got a hand-addressed card from the White House

This little gesture changed the tone of our stay at the NICU. For one, it meant that everyone knew us right away. They knew of us—25 week old twins aren’t really the norm in the NICU, and Rita’s gift helped match our faces to the twins’ isolettes. It also gave the nurses (right or wrong) a first impression of us: we were the kind of family that was happy and grateful and appreciative. Which meant that we had to act happy and grateful and appreciative. There were times when I wanted to be snippy and dismissive, and truthfully, the nurses expect the parents to be snippy and dismissive. But since the nurses all knew us and smiled at us and called us by name and expected us to treat them like humans, it made me be a nicer person. It’s hard to be a bitch to someone who’s unguarded and smiling at you. So then they were nicer to us, which made us that much more grateful and appreciative that such nice people were giving our boys such expert care. After all, it was their work that kept our boys alive. And that made us happy.

(I think we were also extra nice because Rita’s gift became a reflection of us, even though we didn’t give it and so by that token, we wanted our behavior to be a reflection of her, since the nurses would never meet her).

Being happy helped us relax while we there. Because the nurses felt compelled to thank us for Rita’s Thank You, we learned their names and faces and backstories. Knowing all the nurses by name helped us acclimate faster. Being happy made us seem more approachable. Nurses were more inclined to introduce us to new, scared families because we seemed happy, we were approachable, and the nurses knew who we were. Meeting other families helped put our minds at ease in small ways, gave us new NICU friends and contacts. Which made us more relaxed, more approachable, more inclined to introduce ourselves to new families, all of which made us more grateful to the nurses.

Rita’s gift also setting a giving precedent; we had to keep thanking the NICU staff. We gave them fudge (well, to be fair, Matt’s dad bought the fudge; we just handed it out). We wrote notes. Matt baked batches and batches of chocolate chip cookies. After the twins went home we sent birth announcements to each of our main nurses (ten of them) and attending doctor and respiratory therapist and lactation consultant and social worker.

I’m confident that we would have gotten the same great care regardless of our gratitude attitude, but it was our attitude that helped us make NICU life a rewarding experience.

© 2010 Janine Kovac

What a Wonderful World

 And I Think to Myself, What a Wonderful World

I see trees of green, red roses too
I see them bloom for me and you
And I think to myself what a wonderful world.

I’ve heard Louis Armstrong’s “What a Wonderful World” a million times.  But there are three occasions that stand out in my memory. 

The first was in Venice.  It was September 25, 1994.  I was living in Rovigo at the time and we took the train there.  We had forgotten to change the clocks to standard time from daylight savings; we didn’t even realize until we got to the train station.  I had never been to Venice before.  This is pre EU—another world, another time.  Hardly anyone had a cell phone.  No one had an email address.  Pre-EU meant that all the merchants were Italian, if not Venetian.  (I went back a couple of years ago and was supremely disappointed.  It was like a dirty Disneyland.  All of the vendors were immigrants from somewhere else.  Venice was just another rung in the their labor ladder)

As you probably know, there are no cars in Venice.  It is a labyrinth of canals and bridges and alleys.  In winter when the fog sets in, it’s like trying to navigate through a fairytale.  This trip I watched movers lift a piano through a window from a boat in a tiny vein of water.  Around another corner we saw workers laying high fiber optic cables.  In Venice.

I didn’t know where we were headed; we couldn’t even see the water from our path.  But my friend knew.  All of a sudden I turned the corner and there it was: Piazza San Marco.   I lost my breath.  My senses were inundated simultaneously with the ancient and the contemporary: in the distance, the Byzantine water architecture of San Marco.  In my ear, a tuxedoed jazz quartet played Louis Armstrong’s “What a Wonderful World.”  Shops and cafés lined the shores of a sea of pigeons.  It was so unexpectedly beautiful that I actually cried.

This single scene was like a montage through the centuries.  This was the Venice of Marco Polo, of Casanova, of Othello’s sweet Desdemona.  And yes, of Louis Armstrong.

I see skies of blue and clouds of white
The bright blessed day, the dark sacred night
And I think to myself what a wonderful world.

Flash forward to November 16, 2002, St Paul, MN.  My brother is getting married.  As all wedding are, the reception is a perfect reflection of the bride and groom.  We’re at the Landmark Center, the old courthouse building with impossibly high ceilings, almost as high as the young couple’s aspirations.  The lights are dimmed and the tables are sprinkled with purples and oranges and chile peppers. 

The couple is baby-faced and fresh out of law school.  Their first jobs—clerking for the State Supreme court and the Federal district court—might be the pinnacle of success for other mortals, but for them is merely a good start.

They take their first dance as husband and wife, sweeping over the ballroom floor as Louis Armstrong croaks.  They are beaming and dreaming and thinking to themselves, “What a wonderful world.”

The colors of the rainbow so pretty in the sky
Are also on the faces of people going by
I see friends shaking hands saying how do you do
They're really saying I love you.

On January 5, 2010, I walked into the hospital lobby and heard it again.  It must have been a Wednesday because that’s when the harpist comes and plays for the patients.  It must have been that Wednesday because I was discharged on Monday and the boys weren’t back up to their birth weights yet.

Have you ever really listened to harp music?  It’s like listening to water sing.  The instrument itself is so heavy, so burdensome, like a murder weapon.  Its notes resonate sometimes like thick gold mud, other times like dewy droplets on a spider’s web.  Harp music carries you.  It cradles you.

I remember the opening of Waltz of the Flowers with Mr. Gibson conducting and Mrs. Gibson playing the harp.  The opening is all harp music.  The harpist takes her time and chooses her tempos and the twelve of us must all listen very carefully.  We must obey her timing.  It’s the best part of the dance: glowing, full of life.  You haven’t made any mistakes yet.  You are a flower’s life reincarnated.  The harpist carries you to the beginning of the dance and leaves you to dance your six-minute flower’s life.

At some other point in time, I would have loved to have sat and listened, really listened, to these golden notes, to the volunteer harpist playing “What a Wonderful World” in the hospital lobby.  I would have teared up with two-dimensional sentimentalism.  Happy to be happy.  Grateful for her musical offering.

I feel so strongly about how classical music transforms our lives.  I am so sad when people rush by, hardly taking note of how the heavy harp has drenched the air with music. 

It truly is a wonderful world, even on this, the first Wednesday morning of the twins’ lives.  I can appreciate that.  I am up and about.  After nearly two weeks in bed and a c-section just a week ago and I am already climbing flights of stairs.  But today, if I stay to listen, I will lose it.  I will explode into hysterics and they will have to peel parts of my flesh off the ceiling.

This would have been a good time to let harp music cradle me.  I could use a hug.  I bite my lip so hard, so hard, so hard.  I am locking all my tears in my jaw.  Trying not to cry is like putting on a sweater made out of pins and needles.

I hear babies crying, I watch them grow
They'll learn much more than I'll never know
And I think to myself what a wonderful world
Yes I think to myself what a wonderful world.

All I can do is run to the elevator.  I bang on the ‘up’ button and try to escape as quickly as possible.

© 2010 Janine Kovac

Let Them Fall

Today I am happy because I let my kid fall.  Both boys are rolling, but Wagner’s the one for whom rolling has become a mode of transportation.  Toy out of reach?  He knows he can roll toward it.  Brother’s foot smacking him in the face?  He knows he can roll away from it.  Tired of being on the blanket on the floor?  He knows he can roll off of it onto greener pastures.  He reminds me of that meatball that rolls out the front door.

But sometimes it isn’t greener on the other side of the blanket.  Sometimes it’s hardwood.  The first time he rolled, at breakneck baby speed, off the blanket (toward a particularly angular object, to boot), my foot jutted out to cushion the blow.  But the next time he rolled off the blanket, I just watched.  And, as one would expect, he smacked his head on the floor and cried very hard.*

* I actually did not expect this.  Chiara was (is) famous for smacking her noggin loud and proud and not noticing.  So I thought that was just something my offspring can do: hit their heads and not notice.  I was wrong.

But then an amazing thing happened.  He learned how to protect himself.  He doesn’t do it when he’s rolling on the bed or on the blanket, but when he’s rolling on the hardwood floor, Wagner rolls at normal speed onto his side, stops himself precariously balanced on his baby fat, and then rolls veeeeeeeeeeeeereeeeeeey slowly—he even squeezes his eyes shut—onto his back so that he doesn’t hit his head.  Not bad for not quite six months (adjusted, of course, chronologically he’s nine months).

It’s amazing to watch.  Even better, it’s intentional.  This morning I watched Wagner roll to the left from back to tummy and then back to the right from back to his tummy over and over and over for about fifteen minutes.  Each time he stopped himself just before his head was going to bang on the floor and eased himself down.  And then he giggled hysterically. 

The urge to protect our children is primal (and that’s good) but sometimes we take it too far and in preventing them for getting hurt, we actually keep them from learning.

And we keep ourselves from learning, too.  Today my child taught me that he knows a little something about cause and effect and intentional action.  He demonstrated that he knows he can control his destiny.  Today—rolling!  Tomorrow—Harvard!**

I can’t wait to let him fall again tomorrow.

** I’m still a little chaffed about this so I will remind everyone that one of the first doctors we saw when we found out we were pregnant with mono-mono twins insinuated that preemies born before twenty-seven weeks would likely be retarded.  Twenty-seven weeks was, in her estimation, the cut-off point to expect that the preemie might be smart enough to get into Harvard.  (Leaving no lee-way between genius and irretrievably stupid)  Our boys were born at twenty-five weeks, which puts them in the “wool-cap-delivering-for-the-florist” category”*** I know I’m supposed to be in this gratitude phase, but I still have it out for this doctor. 

*** name the movie.  I’ll give you hints if you want them

Giving Back

Giving Back

A long time ago, just a few days before my eighteenth birthday, I had a really bad day.  A terrible day.  The kind of day that makes you take a break from dancing and makes others suggest therapy for you.  The kind of day you still think about twenty years later. 

Some tough months followed that bad day, filled with nightmares and stiff upper lips and when nobody was looking, I screamed at little spiders.  The only advice to which I was amenable was that from my guardian angel; she was the only person who could make me feel better.  That guardian angel was me at some impossibly old age—like thirty.  The old me would comfort the distressed me with fantastic stories of how good things were going to get one day.  Just you wait and see.

The years passed and the screams faded until one day I thought about the distressed me and decided to pay her a visit.  I could see her so clearly, surrounded by eggshells and much shorter than she thought she was.  I told her how great things were going to get: how beautiful Iceland was and how tall she’d feel. 

In the years that followed, I’d go back from time to time and “pay the bank,” as it were.  Italy, San Francisco, a beautiful wedding by the bay.  There were lots of good things to look forward to.  Then one day it seemed like the little girl was now the Iceland girl and didn’t need me anymore.

And then yesterday, my jaw dropped and my shoulders sank and I wept. 

Not for the teenager—she’s fine now.  I wept for the mother of three and her stiff upper lip.  I wept for all the things that didn’t happen but could have.  Autumn 2010 is weeping for Winter 2010.   

January, February, March.  I couldn’t cry then.  There was too much to do.  If I had let myself think for a second about the odds, it would have crippled me.

Ninety-two days of dodging bullets.

Yesterday the nurses and I were discussing one of the bitter moms.

“She’s grieving for her pregnancy,” one of them observes and we all nod, as if pregnancy is a living thing that is separate from Mom and Baby.

The funny thing is, she had a pregnancy.  And she had a healthy (albeit tiny and premature) little girl.  Everything is fine now.  Her pregnancy did what it was supposed to do.  But her grief is real.  All grief is real.

Who am I grieving for?  My boys are so healthy, so chubby.  They are off the charts—literally.  We don’t even think of them as six-months (their adjusted age).  They are actually doing things that nine-month-olds do—their actual age.

It’s like I put my composure on lay-away with one of those “take it home today—pay later” plans that they have for mattresses.  I took home heap-big composure and now yesterday was my first sadness installment. 

I can visit all the islands of “What If.”  I can take on all the fear and worry and hysteria from those ninety-two days because I know how the story ends.  And since it’s a happy one, I can flatten the dimensions of time and space and lend today’s optimism, confidence, and composure to that short little mom in the NICU, the Me of early 2010, ‘cause she could sure use it.  And I’m her only hope.

© 2010 Janine Kovac

The New NICU Days

I’m a little shell-shocked right now.  I’ve just come from the NICU, from a meeting of the “Partnership Council,” a non-descript name for a group of medical staff and the occasional parent (me) that makes decisions on all NICU matters aside from specific medical decisions and union issues.  It’s a big deal.  They’re even getting a badge for me.

I hardly recognize the inside of the hospital’s front entry.  I know that I’m in the right place only because I know the front desk security guard.  There are walls where there used to be open space and huge shiny bronze-y colored pillars where there used to be walls.  They are remodeling.  It’ll take another two years.

Looking at the huge pillars, a cynical “so that’s where my two million dollars went”* comes and goes through my brain before I can stop it.

* that was the total hospital bill for both boys, but that’s not what the insurance paid.  Their negotiated share was less than 10%.  I still can’t believe that there’s an actual debate about reforming health insurance.  But that’s a post for another day.

Is it right for a hospital to look so flashy? 

That’s another thought to squash.  After decades of mistrusting hospitals and doubting doctors, eschewing them for yoga and leafy vegetables, I am on the other side now.  My boys owe their lives to this hospital, these doctors, and the miracles of expensive western medicine.  I am one of them, now.  Out of solidarity and loyalty, I must love these pillars. 

I greet the rest of the security guards by name.  The 4^th floor guard, the NICU guard, the one in the elevator coming back from her break. 

Today the council is discussing the new discharge pamphlet (which happens to feature a picture of the twins—our twins—on the cover).  We discuss the wording, what changes need to be made to the Mandarin and Spanish versions, who still needs to sign-off (I’ve already given my seal of approval), when they’ll go to the printer’s. 

At the meeting I know everyone except one nurse.  They all know me. 

Then we discuss the new NICU website that is in the process of being revamped.  I am in charge of taking notes for the group.  The photos of moms and babies on the new site are actual former patients.  I know all of them.  They all know me.

We discuss possibilities, menu navigations, submenu items, the ordering of such items.  For instance, we all agree that “Birth Defects” shouldn’t be the first item under “About Your Premature Infant.”

Then we get to the section of the site that discusses medical conditions: RDS, ROP, PDA, NEC, PHV, all acronyms with which I am already familiar.  The acronyms are misleading.  They look so benign when reduced to three letters, but they are anything but.  RDS is a dangerous respiratory virus (the boys will get 12 immunizations apiece over the next two years to protect them against this virus).  ROP refers to the arteries of the eyes that get blown out from too much oxygen (this is why Stevie Wonder, another NICU grad, is blind, btw).  PDA is the heart valve surgery that both boys underwent.  NEC refers to the condition of an underdeveloped digestive system.  Last week a woman stopped me in the street to tell me about her twins (now twelve years old) who were born at 30 weeks.  The girl was fine ,but her boy had NEC.

I feel my heart in my throat.  I am remembering. 

Now I know why so many intelligent, grateful, generous NICU moms refuse to be a part of the partnership council.

At one point I give my opinion: “We need the ‘what to expect’ section to reflect some of the things that parents can actually do while they’re in the nursery,” I gesture toward the website projected on the wall.  “All the things I did when I was here, every day for so many days—none of that is reflected in what we’ve seen so far.”

I see nodding.  A note is made.  I get “volun-told.”*  I am now in charge of this section of the site.

* new term coined by one of the nurse’s teenagers.  It means volunteering for something that you are told to do.

We get to the statistics.  For 23 weeks.  24 weeks.  25 weeks.  40% of babies born at 25 weeks have notable cognitive delays and physical disabilities that are detectable at age nineteen.  For now we will use the national statistics although Alta Bates’ numbers are better than the national average.

I am choking on my heart.  I don’t feel like one of them anymore.  I feel like a mom suddenly realizing that if this were Vegas, she would have walked away from the tables rather than play. 

After the meeting I go to the NICU to “make my rounds.”  I’m looking for one mom in particular.  (“Tread lightly,” I am advised.)  The last time I talked to this mother she hung up on me.  She’s in her son’s room.  I know her nurse; the nurse knows me. 

The mom has just finished pumping.  She vaguely remembers talking to me.  Details about my kids round out my profile.  She remembers everything about them.  The three-year old, the twenty-five week twins.  She’s very “with-it” today.  Makeup, nice clothes, strong voice.  Her baby’s going to be fine, she says.

She’s right.  Her baby looked great, over five pounds  I resist the urge to evaluate him by his numbers on the monitor. 

I congratulate her. 

“He looks so peaceful,” I offer.  I don’t know why, but I want to cry for her.

She thinks I should talk to the mom in Room 14.  That mom has a baby like mine.  It sounds like a dismissal.  We don’t shake hands (unspoken NICU rules) but I do squeeze her arm when I leave. 

I don’t go to Room 14.  Not today.


© 2010 Janine Kovac