There is a certain look I recognise when fathers walk into the NICU for the first time. Bewilderment is too easy, as there are doses aplenty. Screwed brows in concentration, waiting for the familial recognition to descend and point to their offspring. Yet often it is the gentle voice of a nurse, familiar with the look and certain the required outcome, that guides these men to the right kennel.
The NICU is a fascinating place. Warmer than the rest of the hospital (often around 22-24 degrees) with lights on and off in different places, the space so often seen as sacred in hospitals, doesn’t exist in the NICU. Adult ICU has clearly defined rooms, able to be sealed to prevent the spread of disease or retain the noises of medicine. In the NICU, babies are around an adult arm-span apart. Each has it’s own bank of monitors, oxygen leads and usually an array of fluids. In other parts of the hospital where nurses are rarely together, away caring for patients in isolation, in the NICU the sense of the nursing team is immediately apparent, often communicated with both words and looks, as the situation of their young charges unfolds before them.
Against this backdrop Zac is involved in a medical dance. The monitor checks four vital elements. Heart rate, breathing rate, oxygen saturation and kennel temperature. As his young body works through 6mL of Kate’s finest per hour, the pressure on his breathing increases as the stomach and the lungs fight for precious real-estate. To help with the breathing, the CPAP delivers pressure to hold his lungs open and additional oxygen is delivered to his nose, allowing the amount of oxygen in his body (the oxygen saturation) to remain around 96%.
The dance is performed through the pressure of the CPAP and the amount of oxygen delivered to his nose. Too much oxygen and eye health could be compromised. Too little oxygen, brain and body development are threatened.
Add to the mix Zac occasionally forgets to breath. The part of the brain responsible for automatic process, such as breathing, is not completely developed. To assist the process, Zac is delivered caffeine. About 10 espresso the dose until he can do it on his own.
Binding the whole lot together, the nurses will watch Zac’s heart rate (currently resting at about 150 beats per minute) and oxygen saturation. When both are in tune, he is doing well. Where one drops or increases, they will intervene to correct back to the accepted range.
Kangaroo time, or skin on skin time is strongly advocated by the NICU as a way to help Zac sleep and bond with both parents. However this time is outside the kennel, which places stress on Zac’s body. Hence kangaroo time is limited to once or twice every two days, depending on Zac’s progress.
To enable Zac’s ability to continue receiving oxygen and lung pressure via the CPAP, this remains in place. Kangaroo time can be a number of hours and Zac is still monitored, hence the leads need to stay in place.
Yesterday I was lucky to have over two hours with Zac resting on me. We wanted to share, with that context, the incredible skill of the nurses to scoop up wee Zac and transport him to my waiting chest.
At the end of our time together, as I walked to put my shirt back on, air was my pathway, my grin a mile wide.