Saturday, January 8, 2011

The first two weeks of my daughter's life.

As you already know, Madeline was born December 15th, 2010 at 11:23pm, perfectly healthy. 
We were released from the hospital December 17th. The first night home was wonderful - she slept like a charm, eating only every 3.5 to 4 hours through the night, and eating every 2 to 2.5 hours during the day. We even went out for breakfast with my family the next morning. It was wonderful.
December 18th, around 8:30pm, I tried to wake her up to feed her. I had a very hard time getting any response from her, so we called the pediatrician, left a message, and headed to the ER. (We suspected Jaundice, but were unsure). Halfway to the hospital the pediatrician called back and we discussed Madeline’s symptoms, we were then advised to go to the ER.
Once we arrived at the children's hospital, they ran some tests, put Madeline on IV fluids and told us they would keep her over night for observation. Her bilirubin levels were average for a three-day-old, coming in at 13, and she seemed to be responding well to the IV fluids. The diagnosis was dehydration due to a lapse between my colostrum production and my milk production.
The doctor visited and checked her out, he gave us the option to have a 48 hour blood culture done, to test for any possible underlying cause for dehydration - just in case. Over the 48 hour period, Madeline was doing so well, that I finally felt comfortable leaving her to go home (a 30 minute drive) to check on the cats. When I returned to the hospital, I went up to the NICU floor and signed in. As I was signing in, I hear a baby my baby screaming. I rush back to her room to find a nurse catheterizing my infant daughter. I asked the nurse what she was doing, and received the explanation that she needed a urine sample, and had to use a catheter to get it. I pointed out that Madeline had already been catheterized - hours earlier - for a urine sample, and asked what happened to the previous sample. The nurse said something about the prior sample getting lost. I was furious.
Not only were they needlessly putting my baby in pain, but they did so without my consent, or even notifying me. When my husband got up to Madeline's room, I explained what had happened. He then confronted the nurse who told my husband that the reason the urine sample had to be taken was because they needed to take a urinary drug screen, and that 'catheters don't hurt the babies, the reason they scream like that is because they hate their feet being touched.', she also mentioned that she somehow didn't get enough urine for the UDS and may need to put another catheter in.(Luckily, she managed to get her urine sample using cotton balls in the diaper,) The next morning, Monday, the doctors made their rounds and Madeline was doing so well that the doctor even made jokes ("My diagnosis? acute baby!") They told us that Madeline would be cleared to go as soon as the 48 hours were up and the blood culture came back. Tuesday morning at around 7:30am, Madeline suddenly spiked a fever of 39.4 degrees C [about 103 F].
They decided to keep her another 24 hours for observation, 12 hours (or so) later she spiked another fever of 39.4 C. At that point they knew she had some sort of infection, and ordered a Lumbar Puncture (to test for bacterial meningitis/infections in her cerebrospinal fluid), urine culture (test for UTI), and a second blood culture (test for bacteria in her blood). As a preventative measure, they put her on 3 different IV antibiotics, and an IV antiviral.
The LP came back negative, no meningitis. The urine culture came back positive for gram-negative rods (which we later learned were E. Coli), and later her blood culture came back positive for gram-negative rods. So, the infection started in her urinary tract and spread into her blood. 
Luckily the antibiotics she was on had an almost immediate effect, and once they narrowed it down to E. Coli, she was taken off the Claforan, Gentamicin, and the antiviral. She was receiving only IV Ampicillin every twelve hours, and she was on a 10 day regimen.
She had another set of cultures done after three days of the antibiotics and they came back negative, but they needed to finish her course of antibiotics before she could be released.
Due to the fact that Madeline was in NICU, both my family and Jacob's family decided to postpone celebrating Christmas until she was released, but the lovely folks at the unit decided that the babies all deserved to get a visit from Santa.
The rest of the stay at the hospital was relatively mild, with the only scares being when Maddie pulled out her IV lines. She ended up having a total of 8 IV locations and some were just badly placed so they were hurting her, and had to be removed.
On December 31st, 2010, at 10am Madeline received her final treatment of Ampicillin. The doctors made their rounds and cleared us to go home, saying that Madeline was a trooper. "She didn't even know she was sick!" and how proud they were that I had brought her in when I did, because apparently most parents would have waited until there was a fever to bring her in. (I maintain the theory that the ITU/sepsis was a direct result of being badly catheterized - Madeline's pediatrician agrees that that's probably what happened.)

1 comment:

  1. Poor thing, glad she is okay now. What a difficult two weeks for you guys.

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