Nanette Jo Cooke

Tuesday, April 25, 2006

Skin

They call it Kangaroo Care. The concept is simple and ancient. Place the baby skin to skin on mom's chest, with baby's ear against mom's heart.

JoAnn has always had power in her skin. I remember the first time I held her hand, walking down Southwest Broadway a cool October evening with the lights of Portland towering above us and floating around us. I reached out and took her fingers in mine, and then our palms met, and I felt a flow of healing energy. I couldn't describe it at the time, but now, after these eleven and a half years, I know it. She's healed me in ways she doesn't even realize. Maybe that's fodder for some other post. Anyway, I think that Nanette has some of that same gift. She might even have more of it, if that's possible. We'll all have to wait and see.

If you could see energy flow, I'll bet the NICU was alive with it when the nurses placed Nanette's perfect skin against JoAnn's chest. Jo said that Nanette was fussy, and that the nurses were talking about putting Nan back on Morphine and maybe even the respirator if she couldn't get settled down.

She snuggled up to JoAnn, locked her dark eyes on her mom for while, and then drifted down into a deep, peaceful sleep. That's all she wanted. To see beauty, to feel skin against skin, to hear the beat of life, to be wrapped in love.

It seems so logical, and yet for a long time hospitals wouldn't allow it. A couple of doctors in Bogota, Columbia, back in 1983, struggling with a 70% morbidity rate on their premature babies and a horrific lack of funding said "what the heck, can't get any worse," and so they plopped the babies down with their moms and guess what? The morbidity rate dropped to 30%.

"Duh," as Katie would say.

JoAnn heals Nanette, and Nanette heals JoAnn. And Nanette becomes a Joey...

It's hard not being there. The kids and I rattle around like Keystone Cops in slow motion. Even Carter seems subdued (which means that you can actually keep up with him some of the time.) We went to visit the new fire station last night with his preschool class and the EMS tech pulled out a little black clamp and put it on Carter's finger. It displayed his heart rate and oxygen saturation.

Carter wasn't impressed. Nanette's heart rate and SATS are in color on a big screen.

There are some cool changes going on too. At one point on the way home from Portland I glanced back and saw Katie and Carter holding hands. This morning, Katie took the last of the corn flakes and Carter started crying. I poured him Cheerios and he calmed down, but when I stepped out of the room, Katie traded bowls with him.

Every morning the kids ask how long it is till Friday. That's the day we go back to Portland. Back to our JoAnn. Back to Nanette.

Compared to what she's been through, Nanette's challenges may seem minor, but she's still in level 3 intensive care. Level 2 is called "feeders and growers"; those are the babies getting ready to graduate. There is no level 1 - that would just be regular Labor and Delivery. Our little girl faces at least three big hurdles now - morphine withdrawal, breathing and eating.

A baby can develop a tolerance for morphine in just five days (doctors say that alcoholics have a "tolerance" for alcohol.) It can take up to 21 days to taper them off. Morphine withdrawal can cause agitation, sleep-wake abnormalities, feeding difficulties, weight loss and seizures.

Maybe when I get back to Portland I'll start a weekly 12-step meeting for all the NICU babies. We'll wheel them all into a seedy, smoky back room and make thick coffee and tell stories of strength, hope and inspiration. Crying is okay, but no cussing or foul language and no poopy diapers.

Fortunately, Nanette's breathing improves every day. She's off C-PAP now and hopefully she'll stay on just a bit of oxygen through her nose.

Feeding might be the biggest jump she has to make. Kids with CDH often end up with a bit of acid reflux. Tomorrow she'll get a feeding tube stuck down her nose so she can start on a dribble of colostrum (JoAnn dutifully froze it right from the start, so Nanette will have an ice cream habit like mine in addition to her morphine habit.) If she can keep the milk down for a day or two the next step is to get her sucking on a bottle and then, hopefully, she'll breast feed. And then, we're bringing her home.

But for now, the healing continues with skin.

3 Comments:

  • At 8:32 PM, April 25, 2006, Anonymous Anonymous said…

    Thank you for this blog, Joe. I think I am addicted.

     
  • At 10:09 PM, April 25, 2006, Anonymous Anonymous said…

    A 12-step program for infants? It wouldn't surprise me if that took off right away.
    As usual, best wishes for your family. Only 3 days until you guys are back in Portland!

     
  • At 4:50 PM, April 26, 2006, Anonymous Anonymous said…

    Joe,
    I appreciated yourToastmaster speech.
    "This is the true joy of life: the being used for a purpose recognized by yourself as a mighty one." George Bernard Shaw
    Take a little time to rest.
    EP

     

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