Saturday, March 27, 2010

Home Stretch

Home Stretch

We are truly in the home stretch.  We moved to Nursery 3 (where the big five pounders are).  Both boys have been off oxygen for over a week and are getting all their feeds by breast or bottle.  Earlier this week we moved to “ad-lib” feedings, which is not, you may be disappointed to read, a improvised concoction of whatever the nurses find in the fridge.  Instead it means that the babies eat when the babies say so.  Which are all indications that the twins are doing great and will be home soon.

But the best barometer of how you are doing in the NICU is the reaction you get from the folks who work there.  At first all we got were solemn, thoughtful nods followed by the occasional gentle touch on the forearm (you know things are serious when a nurse intentionally commits an action that forces her to wash her hands again).  After the ligation, we knew things had taken a turn for the better because even though to us, the twins looked and acted exactly the same, the nurses and doctors were all smiles.  Even nurses we hadn’t met were greeting us by name and smiling.  Until then, I didn’t know that people who worked in the NICU had smiles.

Well, if they were smiling before, you can’t imagine what they’re doing now.  Every day is like walking into a sea of adoring fans chanting your name, “KOVAC!  KOVAC!  KOVAC!”  Any day now I expect to ride into Room 22 on the shoulders of nurses, social workers, lactation consultants, respiratory therapists, physical therapists and LVNs.*  Seriously, it’s all hugs and high fives here in Nursery 3.  (And then we all wash our hands again, of course.)

* LVNs are special nurses who only work in Nursery 3.  And once you get there, you can get your own LVN.  But I don’t know who they are or what they do because we weren’t in Nursery 3 long enough to find out.

I am also getting quizzed by the nurses at every turn.  Just walking to the fridge to get fresh milk I have to field three or four trivia questions:

How many breaths to chest pumps for infant CPR?
2 to 30!

What vitamins are you going home on?

What do you do when the pharmacy changes the dose of your iron supplement?
Check the concentration!

And of course, endless corrected gestational age questions.

When your baby sits up at seven months, how old is he really?

How old, in both corrected and biological months do you expect your baby to be when he walks?

In August, how old will your baby really be?

Answers: 4 months, 1 year, 15 months, 5 months

Corrected gestational age is basically just counting from when they should have been born instead of when they were born.  This is especially important because they were born so early.  In fact, even though they are almost 3 months old now, we are still counting in gestational weeks.  (They will be 38 weeks this Sunday).  It’s easy to look at them now and think of them as newborn babies and not as three month olds, but months from now, it will be hard not to compare their progress with other December babies.  The nurse hurl their corrected age questions because they want us to remember that the twins are actually April babies.**

**I have been trying to work in this joke about writing an overloaded correctedAge() method for the date class in Java that would take as parameters birthdate, duedate, and a datearg and return the corrected gestational age.  But outside of Pete, I don’t know if there’s anyone else out there who would get such a joke.

Careful observation also tells you how long other parents have been here and how close they are to discharge .  The faster the gait, the closer the date. 

On one end of the spectrum is the slow shuffle of newest moms still in their hospital gowns, still tethered to their IV drips.  They waddle around in an anguished daze still dealing with their own recovery.

There are the angry, impatient walks of the parents of the term babies—parents who never imagined that they’d end up here and act as if just being here is an impediment to parenthood rather than another stepping stone in the road.

Then there are the slow, steady, stoic paces of the long term parents.  Parents like us, who knew that they might end up here.  Knew that it would be a long haul.  Parents like Sam, whose twins were split up weeks ago because the girl was healthy enough to go home but his boy was not.  A month ago Sam stood upright and made jokes; now he slouches around in a sleep-deprived haze with unshaven face and smudged-up eyeglasses.

Parents like Elle, who had her little boy at 26 weeks—a week after the twins were born.  (Which means that we have the same corrected gestational age).  She’s going back to work Monday because little Thomas will be here another two months.  You know Elle has a long way to go.  Her slow stride tells you so.  Elle’s a fixture here.  Spends every moment trying to stay there: in the moment.  Tries not to think ahead, tries to block out what could happen to her boy.  She even tries not to think of a day when her son will be healthy.  It’s just too far away.  Too much of a tease.

We are on the other side of the spectrum.  I have taken to wearing this huge shawl since we’ve been in the NICU (great for discreet pumping) and these days, I walk so quickly down the halls of the nursery, my shawl flies behind me like a cape, like Super NICU Mom!  Able to switch pulse-ox sensors with a single flick of the wrist!  Able to Kangaroo Care in a moment’s notice!  Able to dodge flying poo!  I skate so quickly through the NICU halls that sometimes I feel as if I’m moving to dodge the potential setbacks that could keep us here longer. 

We are in the final countdown.  Literally.  Hearing screening tests.  Done.  Carseat tests.  Done.***  Discharge class (for parents)  Done.  CPR class.  (Baby!  Baby!  Can you hear me?)  Done.  Pediatrician’s appointment.  Made.  Final eye exam.  Tomorrow. 

***The carseat test has to be done on all preemies under a certain weight to make sure they can still breathe on the incline of the seat.  Here’s how it’s done: they feed the baby, stick him in a carseat and monitor him for ninety minutes.  To pass you must breathe for the full ninety minutes.

Now it’s up to the twins.  In order to be cleared for discharge (that just doesn’t sound right, does it?), they need to have five consecutive days without apneas, bradys or major desats.  (apnea = stop breathing, “brady” or bradycardia = severely low heart rate, “desat” or desaturation is measure of quality of breath).  Wagner had a brady early Wednesday morning, which puts us at Tuesday at the earliest.

It feels like the week before school’s out.  And then the fun really begins, right?

Oh – Wagner just hit six pounds and Michael’s not for behind at five pounds & thirteen ounces.  They’re almost 4 times their original birth weight!

© 2010 Janine Kovac 


  1. Michael and Wagner are lucky to have you and Matt as parents. All the skill and knowledge of everyone in the NICU can not offer the third most important ingredient....attitude. Your spirit and love had carried them through and will continue to. I think of all the scary times we had as parents and nothing compares to what you have let this be the worst behind you and Michael and Wagner perfect little boys and your best friends from this day forward!

  2. Super! Super NICU mom and her Cavalier will be taking their super twins home soon!

    Let the fun begin!


  3. I love the Super NICU Mom image and the great news about the boys' health!

  4. Janine,

    Thank you so much for creating and keeping up the blog. In the middle of everything, you still manage to not only write beautifully, but keep all of those who love your family so much, in the loop!

    I can still see you writing down your thoughts on paper with that left hand, superhuman strong fingernails, and a smile on your face.

    Having kids changes everything. I now look forward to a noisy, chaotic house and think "they are the reason we built this big house, not an interruption of my peace and tranquility" (some days I enjoy a little bit of that, too). Our kids fill our home with their laughter, petty arguments, dirty feet, morning hair, creativity, adventures, artwork on the chalkboard wall, teddy bears and treasures, and so much more.

    I love you, Matt, Chiara and now our wonder twins, very much!

    Un gran abrazo y muchos besitos, Sofia