Wednesday, May 20, 2015

Welcome to the world, Richard Joseph - from Daddy's eyes!

“Babe, doctor said you can go ahead and eat,” I said, walking from the door to her bedside, “she’s putting the order in now so let’s pick what you want.” Kelli loves breakfast. Maybe it’s her love of diners, the fact you can have a bite of everything or just that she’s a morning person (more so than me), she just seems to get excited about going out to breakfast. You can imagine her elation when she’s let off the chain after two days of lite/liquid/not-really-just-kidding-you-can-have-ice-chips cuisine.  “I’ll have an omelet, bacon, a bagel, potato stars and juice.” The bacon was a curve-ball, I would’ve guessed sausage, but that’s what makes this all fun, makes this all worth it. “You got it,” as I dialed the phone.

Fun fact: CHOP has great omelets. I’m serious. Not great for a hospital, great for anywhere. I actually sought out and thanked the person who made it. His name is Mark. Thanks again Mark. Breakfast, as per usual, arrived timely, was hot and delivered with pride and kindness. So…she ate, she’s happy, and she’s sleepy, let’s make this alone time. I closed the door to the hallway, turned down the lights and went to pull the shades (stop it). She was snoring before I reached the window. Nice. If anyone’s earned a nap, she has; what a soldier she’s been. What a mom she already is. What a hero she is to us both. I helped myself to the rest of her omelet. Wow. Good stuff.

Sleeping in the hospital was…there is no sleeping in a hospital.  A series of drift-offs, nods, napper-do’s, dips and dozes, but nothing which constitutes sleeping.  I’m not complaining.  I’m not a sleeper anyway, never have been. We could’ve been at the Four Seasons with ear-plugs and blackout shades.  I wasn’t sleeping, no way. A nap though; a nap never hurt anyone.

Napping in the hospital was…there’s napping at the hospital, sure, but it’s all about intel gathering and a precise plan of attack, because a hospital room is a battery of different sounds. IV done? Beep, beep, beep.  Automatic blood pressure taken? Honk, honk, honk.  Time for meds? Knock, knock, knock followed by the midday heaviness of a fashionable clog clomping under foot at 4AM.  And then there are the fetal monitoring devices. CHOP must have stock in JBL, Kenwood, Bose or Beats, because the monitors hide what are clearly concert quality acoustic devices being run by multiple amps. Let me paint you a picture: you’re at Ozzy Ozbourne’s sound check and he’s blowing directly into the microphone while scratching it with his black fingernails at just a decibel short of jet engine volume. The kicker is, when the monitor doesn’t like what the little fella is doing with his heartrate, Ozzy decides to scream at full volume followed by a rush of nurses into the room to listen to his latest hit while reading the lyrics off of a never ending roll of paper. It was so startling that I may have peed a little bit on more than one occasion from the sheer force of the sound waves. Little did I realize how much louder a room devoid of those sounds could be, but I’m jumping ahead.

If you haven’t watched Bojack Horseman on Netflix, and you’re looking for something to watch, give it a try. I decided to watch a few episodes on the old iPad, hopefully to be negotiated into catching a few minutes of sleep while momma bear is zonked. Looking back, I swear the fetal monitors were affixed to my eyelids. I remember feeling that wave of sleepiness, the conditions were right and I was in a comfortable enough position to doze off when I hear Ozzy warming up. OK, no big deal, the little guy has been having decelerations since we got here, just relax. After what seemed like 30 seconds, the next deceleration hit. Settle down, he’s done this multiple times before.  He’s fine, maybe he’s settling in after a big breakfast. No sooner did I lower my head back down to pillow level when the third deceleration hit. I was standing at this point, my eyes affixed to the monitor, my ears picking up every sound. As if he was cued, the fourth deceleration hits as I’m staring at the monitor when in marches the cavalry.

The nurse walks into the room, heading straight for the fetal monitor, followed closely by Drs. Johnson and Ntoso. Dr. Johnson is of average build, wears glasses, great mustache and grey hair, typical appearance of a man aged around 60-65 years old. His physical appearance is where typical stops and, like the other doctors on our team, extraordinary begins. Dr. Johnson started the Special Delivery and the Fetal Diagnosis and Treatment units 14 years ago. The boss is here…on a Saturday. He’s what medical directors should be; in this I found oodles of comfort. His personality is somewhat dry, with an overwhelming understanding of what he’s built and what he knows, but he has a sense of humor that is as welcomed as it is unexpected – this is our second run-in with him today, the first being a follow-up ultrasound. On a Saturday! “Hello,” he says with a wry smile which does a decent job of masking his concern so as to not incite panic, “what’s the little guy trying to tell us?” “I’m not sure what he’s trying to say, but I’m not doing this all day,” booms Dr. Ntoso in her home-town Haitian accent, “good morning, I’m Dr. Ntoso, please call me May-Ange, and it’s nice to meet you!”

Dr. Ntoso is a mix of all good things I've grown to love about physicians. She gains command of her audience without effort or smugness, she exudes confidence with great humility and seems to love almost unconditionally.  Yes, I said love. I don’t think the word “like” means the same to her that it means to most of us. Dr. Ntoso can “like” your shoes, but I don’t think she can “like” people. People, to her, are to love, we’re all God’s children, and I firmly believe that is why she became a doctor. She has the face and energy of a much younger doctor, but her command and composure betray her as they tell the story of a seasoned medical professional with far too much talent and ability to go unchallenged. She is much shorter than I am (99%  are), she’s not afraid of hugs and when she speaks you hope its a long sentence because her accent is a treat to hear. “I counted 4 decels in less than 5 minutes plus he had three prior to the cluster making it 8 in 30 minutes,” I told the doctors since A. Helping in a medical setting makes me feel comfortable and B. Kel will hopefully focus on my words rather than my increasingly nervous body language. “Yeah, we counted about the same,” says Dr. Johnson, “give us a minute, we’ll be right back.”

I know everyone likes to think and say they thrive under pressure or during a crisis, but I do. I love pressure and the hyper-focusedness  it brings, but rarely does life call for that sort of thing. HA! This isn’t a rough touch football game. There’s no putt to sink on the 18th hole. Pressure situations apply to sports, betting and anything not involving your wife and kid. These are unchartered waters. I’m not sure what to do way out here; alone, afraid, small. Praying to whatever god has time to listen. One of them, all of them, any of them? “Please....please. I can’t be here without them. I can’t lose my family, not now, we’re supposed to watch him grow up together.”  Wave after wave it just beats on you, the utter helplessness of it, the terror of not knowing, the gravity of it all. Just lose it, they’ll understand, break down, it’s ok, no one blames you, it’s a tough situation. Nope...what are you doing?. They need you. You’re not going dark when the light is right around the bend; fought too hard already to let it get out of hand now. Man up, bitch, and compose yourself before you turn around, you big dummy.

My head panned from the door to my indomitable wife and, right then, I realized my strength was only a blip compared to hers. “They’ll be back to take you,” I said, “I’m right here babe, we’re ready. This is a piece of cake compared to the past 3 months.” No way she just bought that. “Figures...of course this would happen right after I eat my first meal in three days. Nothing easy,” Kel says sounding nervously exasperated with a touch of excitement. Excitement?! Are you serious?! Thinking about it now, I understand why she was excited. My wife was going to meet our son today, regardless of the outcome, she was going to meet him and that was enough to squash the panic and allow for excitement. If someone was going to disembowel me with a machete after stabbing my spinal cord with a slasher-flick sized sharp, I’d be the wrong excited. New shorts excited.  Speaking of the monster needle thing: Kel eating breakfast allowed me to be in the OR for the C-section since anesthesiologists don’t like intubating mommies with full tummies. SCORE!  At least I can be terrified and WATCH instead of being terrified outside waiting. Can you imagine? I mean, no, really, can you imagine having to wait outside through that!  My sincerest appreciation for your courage and resolve if you were the one waiting.

“Wait here,” says the nurse, “and put these on.” Wait where!? Didn’t I just explain the whole “waiting” thing!? “Once your wife is prepped and ready we’ll bring you back.” Normally I would’ve made the connection but today I was reading into every word uttered, inflected voice, eye contact; body language.  Nothing cryptic or underlying with the nurse. Of course this would happen 10 minutes before her shift ends; she wasn't subtle about it. Not unprofessional, but not aware that her hour being late could be our finest hour, or our darkest. She tore the final piece of paper from the fetal monitor before striding to the hallway without an afterthought of how she just left me there, waiting.  No more Ozzy. No more blood pressures. Gone are the IV pumps, down the hall with my family. All of those noises meant that my family was safe and here, with me, not in a cold operating room with strangers.  As I slipped into the coveralls with my Jaws shirt on, black gym shorts and my electric blue sneakers I couldn't hear myself think. I couldn't hear myself at all. A “thunderous silence” had only been known to me as an example of oxymoron in high school- I have a new-found emotion for how much noise the quiet can bring.

Who doesn't yearn for those days when mom would give you a bath, towel you off comparing your new smell, or lack of the collection of smells from a day in the life, to a flower or something carrying as such a fresh, clean scent? One step further, mom helps you into your favorite footie pajamas and tells you to watch TV until she finishes delousing your siblings. Remember way back when? I don’t really have a specific memory as much as I do a general feeling of comfort and contentment. While footie pajamas are no longer an option (one size may fit MOST) my mom still is. My mother can be an accountant, book-keeper, restaurant proprietor or a circus clown and one thing will always be abundantly clear: she’s a professional mother first and everything else is a hobby. Somehow she knew to be in the state, right down the road, instead of two plus hours away. Somehow she knew to get to the room right before I was beckoned to the OR. Somehow she trusted her son, a third of her entire life’s body of work, to not only be the man she knows but to be the rock she knows they need.  My mom didn’t give me comfort, she gave me strength, she gave me what I needed not what I wanted; vintage Murph. If I didn't know any better I’d say she was sizing me up to convince herself one last time that I had “the stuff”. A brief, nervous interaction between me, my mom and my other mom, Jo, preceded what would be the longest walk of my life. This is my last walk before it all changes. One foot in front of the other, big fella...and away...we...go…

Cold. The OR is ice cold. Thank God. I mean, I’m sorry for my half-naked wife, the petite nurses and anyone else who was cold in there, but I dig the cold and I didn't need another reason to sweat. The OR is roughly the size of of an old-school Wawa, devoid of all the treats and the year-round Thanksgiving palette. I suppose ORs intentionally have two visual distinctions: surfaces that reflect light and surfaces that absorb it.  Painted flat-white walls coupled with faded linens and gowns washed 200 times, bright stainless steel furniture and instruments reflecting the lumens of light, monitors and technologies only found here. I entered through the side of the room, Kel perpendicular to my position on her stainless steel Tempurpedic and beyond her, another door labeled “Resuscitation Room” with a masked face looking through the letters at me. Thanks guys, couldn't have guessed what that room was for, appreciate you’re leaving nothing to the imagination. Well, if they have a specific room for it, they must have a lot of practice. Still, made me uneasy because I know kids have died in there; angels now watching over MY son. He’ll be an angel someday, but not today. Today he’s Rocky Balboa, and he’s going to shock the world.

Busy little bees, all over the place. Busy little bees working at a frantically controlled pace. The cast consisted of: Dr. Ntoso, Dr. Johnson, both whom you've met, the anesthesiologist,  the first-assistant NP, a scrub nurse, a circulating nurse, the OR manager, the chaplain, and the resuscitation team in aforementioned room (4-6 people, tough to remember). I sat down next to my wife in a narrow space, right next to her head, over her left shoulder, with the anesthesiologist standing to my back right, studying a monitor with monitors on it. IVs running, oxygen flowing, huge blue curtain separating us from Rocky up and ready; I can hear them counting the surgical equipment. Kel and I didn't say much to each other, mostly looks or some silliness to break the gravitas. We talked about this a hundred times. We've watched educational videos. We already got out what we needed to get out. We knew today would take all that we had left to give and that we’d mortgage more if it meant we stayed a family. Kel was as cool as a cucumber, eerily so. I mean, she cries at commercials, but right now, Rock-o and Kel have some serious moxie. Some serious, serious, moxie.

“Baby’s out. 11:39,” recites Dr. Ntoso, her vocal clarity now muffled and low still giving orders. And now, we wait. Again with the waiting; I hate waiting. I’m not only fighting the urge to periscope the curtain but I’m also waiting for some not adult sounds to come from somewhere, anywhere. Were they right? Was it over before it started? Come on man, not after the Rocky speech. I’m just watching my wife, my beautiful wife, because we’re seeing him together, and I’m a known cheater when it comes to surprises. I figure if I watch her eyes I’ll know when she sees him and then I’ll look. She loved him first, it was only fair she saw him first, if only for a blink before I stole a peak of my son. I tried not looking...but the kid starting screaming like any normal, wet, naked-in-front-of-a-room-of- strangers person would. Babies on TV sound like they’re cold, or hungry - he sounded legitimately pissed! Mommy and I looked at each other, not sappily or happily or even with concern, with complete shock. That funny shock like when great-grandma rips one out of nowhere when she saddles up her walker. Unexpected, even a little gross, but completely hilarious. He was covered in goop, obviously not pleased about it and was not expected to have pipes like that. 

We were asking for a whimper. We were answered with a roar.


    

Tuesday, April 28, 2015

Welcome to the world, Richard Joseph III - from Mommy's eyes!!!

A few people have asked us, so I wanted to take some time to write out Richard Joseph's entrance into the world.  I will be posting on the hospital admission that led to his arrival in another post, but here is the story as I remember it!

Saturday, March 21st, 2015 is a day that I will never forget!   Early in the morning I was given the OK to order some breakfast to start our day.  We ordered room service - a western omelet, bacon and potato "stars" and an order of chocolate chip pancakes.  I was so hungry when the food arrived after being on a light (mostly no) food restriction for the past 2 days, I was excited for food.  Rich and I were sitting there hanging out just talking, playing on our phones and iPads.   Dr. Johnson came in around 9:30 and did a follow-up ultrasound to see how my amniotic fluid levels were and to check out the little man.  My fluid levels did increase, but not by much - they went from a 3.4 to a 5 - which confirmed what we already knew - that I was most likely going to be in the hospital until he made his arrival.

About 15 minutes after Dr. Johnson left, the heart rate monitor on RJ indicated he was having a deceleration in his heart rate - we were used to this as his typical pattern was about 1-2 an hour.  Shortly after the first one, he had another - I rolled from one side to the other, adjusted the monitor a little on my belly and went back to playing Candy Crush.  Shortly after the second, another one came along...that is when Rich got up and was looking at the strips of output from the machine and in comes the nurse.  She asked me to move again from one side to the other, and we got him back on the monitor.  A few minutes after that, Dr. Johnson and Dr. Ntoso came in and were looking at the output strips of the heart rate and contractions, which is when Rich and I looked at each other and basically communicated that we think "it's time", which was confirmed a few minutes later by both doctors.

At that point I was calm, but waves of panic started to flood.  I think I teared up a little, took some deep breaths when the nurse gave me a hat to cover my hair and I started to remove all of my jewelry. I also got nervous belly and asked if I could use the bathroom.  While in there, I took a few more deep breaths, said a prayer and gathered my strength.  I walked out and Rich was starting to dress in his scrubs and I sat in the hospital bed, gave him a kiss and off they whisked me to the operating room.  After the monitoring, it was determined that when RJ told us it was time, he was going to arrive via c-section.

Once we got into the operating room, I was introduced to the anesthesiologist (who was fantastic!) and instructed that they would be prepping me, giving me a spinal and once everything was set, Rich would be coming in to join me.  I was nervous but all I could think of was my baby was going to be here.  If you know me, you know I am terrified of needles...I think I was more worried about the one they were putting in my back than the fact that they were going to be slicing open my belly!  During the prep of the spinal, the nurse stood in front of me and talked to me - I was taking in my surroundings - how cold the room was, how the nurses kept their discussions and preparations lighthearted, the brightness of the lights.  I only remember feeling one pinch in my back and then everything under my chest being numb.  I was shivering in my arms so they draped a heated blanket across my upper body and arms.

Rich arrived and sat next to my head and they began the c-section.  I don't remember how long we were in there, but I do remember staring up at the ceiling, looking at Rich (who I remember his leg shaking the way it does when he is nervous or thinking about something) and listening to the doctors.  After a few minutes, I felt a little tugging under my boobs, and then Dr. Ntoso saying "11:39, baby arriving" - he was making his way into the world.  I'm not sure how many minutes went by - it felt like an eternity until the nurse said "Mom and Dad, look to your right your baby is here" - and then I turned my head.

My heart stopped. Tears filled my eyes as I turned my head and saw the tiniest little person I have ever met.  And then he let out 5 loud wails and it was the most angelic song I ever heard. It was like time stood still during those precious seconds.  They whisked him off to the stabilization room next too the operating room and I turned my head back to Rich and said "He wasn't supposed to do that!" Our little miracle was here and he took his first breaths.  It was time for them to finish up my surgery, to which Rich asked if he could peek over the curtain to watch.  I can safely say that he has seen parts of me that no one else has!

As they were finishing up my csection, there was a lot of activity around the room.  Dr. Johnson kept coming back and forth giving us updates - he was stable and breathing, they were waiting for the ENT group to come up to intubate, the chaplin was ready for baptism, that RJ had these big hands and thumbs and was being a feisty little bugger when the nurses were trying to do their assessments. All of this was music to my ears!

When all of my stitching was completed, they wheeled me back to my room to wait for them to bring RJ to us before heading to the NIICU.  As I was arriving to my room, we were welcomed by lots of smiles and tears from our families - my mom and sister, Rich's mom and Jo, his dad and Holly, my Aunt Louise and Uncle Bruce.  It was wonderful (and a bit overwhelming!) to have them there to share in his birth.  

After about a half an hour, the nurse came in to let us know the team was bringing RJ in to meet us! Since I was still a bit loopy and couldn't feel my legs from the spinal, they wheeled him right into the room and right next to my bed. The neonatologist talked to Rich to explain that he was stable and all I could do was reach over and touch his tiny little hand.  At that moment it hit me just how tiny he was.  2 lbs, 2oz. Everyone got to see him and say hi and then he was off.  

It was a truly magical day - being surrounded by our families - having him arrive safely into the world and coming out as feisty as he did truly showed us how blessed we truly are! 


Welcome to the world Richard Joseph III! 


Here are some stats: 
Time of Arrival: 11:39
Height: 13.4"
Weight: 2lbs 2ozs