· By Tiny Hearts Education
Meeting William Anthony: An ICU Story
When I was pregnant, my husband Charlie would laugh about how organised I was. Pregnancy nesting was a real vibe in our house. By 25 weeks, the nursery for our first child was ready to go, complete with hand me down pieces of furniture, shelves for the baby's inevitable swarm of soft toys and books and even a number of onesies hanging in the closet. We now say thank goodness I was so organised.
I had experienced morning sickness for a lot of my pregnancy. That awful hungover nausea that causes you to fall into a heap every afternoon and forces you to eat Cruskits and drink Berocca like your life depends on it. I was tired my entire pregnancy, like all women are, but I powered on; working, training, travelling, even skiing (yes - I know there'll be a few raised eyebrows at that one!). I had had this feeling all throughout my pregnancy that our first baby would be big. While I am not a tall human, my husband is 6'4". It was a gut feeling. We also didn't know the sex of the baby, but I was carrying low and neat. Everyone guessed it would be a baby boy. We both tended to agree.
I got to about 33 weeks without any serious issues or complications; an early bleed was scary, but in the end, nothing to worry about. Then we got to a Saturday in mid-April, that I remember extremely well. It was a big race day in Autumn, and I had contemplated heading to Randwick in flat shoes. But it felt all too much; my tummy felt tight and uncomfortable. I opted to sit on the couch and watch from home. That afternoon, there was a moment where the baby did some sort of flip inside me. I suspected the baby had 'dropped'. Who would know? All I knew was that it felt different.
The next day, Sunday, we went off to family lunch, and I was asked by my sister in laws mother how I felt. I said I thought the baby was big and that I didn't think I'd make it to 40 weeks. It was a hunch. There was no science to that thought. That evening, I went to work at Fox League. The morning after, I went to exercise like I had my entire pregnancy. It was Monday afternoon that everything changed. I was at home getting ready to head to our final prenatal class at the hospital when I went to the bathroom. I noticed a mucus-like substance. It was clear, no blood. I was confused and a little nervous. I told Charlie and said that before the class that evening I would like to get checked out because I felt something had changed. He agreed.
We endured our final prenatal class, and I mean endure. I was becoming increasingly uncomfortable and agitated. I knew something was up. It was 9.30pm when I was finally checked out by a midwife. The baby was great, my cervix was closed, but yes, there was an odd discharge. My OB came into to check me out. She too agreed I probably wasn't going into labour, but I may have lost my mucus plug. They decided to keep me in hospital overnight for observation and then to put a plan in place to manage the rest of my pregnancy. I was administered one dose of steroids in case the baby did decide to arrive soon, to try and quickly mature its lungs. Charlie and I were fairly calm, thinking this would be a minor hiccup and we'd meet our bub in 5- or 6-weeks time. My waters broke naturally two hours later. I was panicked. My initial reaction was 'What the fuck'.
The next 18 hours are clear as day. I floated in and out of silent panic, pain, but also a very odd sense of calm. 'What will be will be'. The baby was monitored constantly. My contractions were strong and close together from the get-go. Charlie and I did old quizzes from the Saturday SMH to bide the time. I ate hospital jelly and kept our families in the loop. We laughed, chatted, smiled. There was the odd moment of concern, but generally, the mood was high. Our baby would be born soon. We knew that the baby being early – approximately six weeks early – would mean some time in hospital. I thought I was prepared for that. I really wasn't.
At 7.06pm on Tuesday 16 April after an 18-hour labour, William Anthony Rundle was born. I had pushed so hard in that final hour that I burst every blood vessel in my face! I looked horrific but felt proud of what Charlie and I had bought into the world. A beautiful baby boy. 2.5kg and 49cm, he was considered 'a good size for a preemie' by our paediatrician and the OB. For a surprise, early labour, in retrospect, it was still a 'good' birth experience. But when Will arrived, I remember not hearing a cry. It was a whimper. We knew there was a very high chance he would have early lung issues because of his prematurity. The next 12 hours would show us that to be correct. Charlie and I cuddled Will for 5 minutes before he was whisked into the Special Care Nursery. I was a little emotional about not having my baby with me that evening but knew he was in the best care.
I tried to get some rest after an exhausting two days. It was tough. I had hand expressed a tiny bit of colostrum on the advice of the hospital staff and at 4 am, decided to go see our new little friend to feed to him, likely with a syringe. I almost bounced in there with excitement. I knew it wasn't the ideal scenario, but I was so in love with our baby that I just wanted to see his precious face. I walked through the door, and the paediatrician was there. "What are you doing here?" I asked with concern. "Emma, I need to show you something," he said. I started to cry, knowing something was wrong. He then showed me an X-ray of Will's chest. "Are they meant to be his lungs?" I asked. The response was yes. They were a cloudy mess. Will had Respiratory Distress Syndrome. Very common in preemie babies. I hadn't had the chance to have to second dose of steroids which may have matured his lungs, and this was the result — a baby who couldn't breathe on his own. The reality of Will's physical condition was a lot worse than the initial diagnosis.
It was decided he needed to be admitted into ICU for some serious help. I was shattered. I hadn't fed my baby or had time to stare lovingly at him. I hadn't held his tiny feet or stroked his head. This is not how I envisaged motherhood beginning. I understood it could be an emotional and tricky time, but expected it to be filled with joy, relief and excitement. I felt robbed. I felt sad, scared, confused. I was terrified our little guy would have ongoing complications, or worse. A few hours later, Charlie, along with a team of doctors and nurses, transferred Will into the extremely busy ICU at SCH. I was asked to write this piece about being in NICU. But the fact was, there was not a single bed in the state in a NICU available for Will. Instead, as a last resort, before possibly being transferred to Canberra, he was admitted into the ICU with Sydney Kids. They rarely take preemie babies. While the care would still be great for Will, it wasn't the ideal situation.
It was advised I go and see him in a few hours. It was the right choice. I first saw Will in ICU, hooked up to countless machines, I couldn't stop crying. My poor baby in pain, unable to soak in the world properly. It broke my heart. I felt guilty for having him early (the doctors still don't know why he did decide to come early), and I felt like I couldn't help my baby. It almost felt at times that I couldn't help myself. Thank god I had Charlie.
The next ten days were the toughest of my life so far. Seeing your baby sedated in Intensive Care is rough going. Along with the emotional rollercoaster of giving birth and the hormones associated, I had this to contest with. Will's condition got worse over the first day or two. I was receiving calls from the doctors in the middle of the night giving me updates, all negative, all while I was still admitted into hospital recovering from the birth. I would hear other people's babies cry in the night. I would see their parents pace the hallways looking sleep-deprived after long first nights. I would have given anything to hear my baby cry, or writhe around in hunger. I bought earplugs to block out the cries. They just made me more sad.
I was determined to breastfeed Will eventually, so I had to express from his birth until I could eventually try and feed him. It wasn't the easiest thing in the world, but it felt like the only thing I could do to help my little boy. Giving him my milk would help him one day recognise me as Mum but would also boost his immunity. It was administered via a nasal gastric tube. I had people say to me "Well, at least you can get some sleep!". Yeah right. Along with the stress of not knowing when Will would turn the corner while setting the alarm every 2 – 3 hours to express made for a very sleepless time. I honestly think I may have had 6 hours of sleep the entire first week. There were a couple of nights I didn't sleep at all.
For the first five days, Will was ventilated with a tube into his lungs. He was in pain from the tube, so was also on morphine. He had jaundice, so was under the Billie lights to help it. He was vomiting up his feeds because of his tiny tummy. He hated to be touched. Moving him to change his nappy was a four-person job. Every stat was monitored constantly. I became immune to the beeping machines eventually, but every time one would alarm, I would look at the screen in distress. And then there was the fact he hadn't passed meconium in over 96 hours. The was a completely different issue. One that caused some very panicked conversations. When he eventually did a poo, it was the best shit of my life. I will never forget it! I've never been so happy to clean a nappy. That one took seven people to do; it was massive.
The nurses were unbelievable in explaining everything to us, caring for Will meticulously but also keeping me company during the day. I was by Will's side as much as I could be. I just wanted to be with him. I thought that maybe me being by his side might help him. Maybe it did. But ICU is a place no one wants to be. It's full of machines, constant buzzing and beeping, cables and cords. You become good at a few things while in there. I knew the best area to park in and became an expert in getting 'poll position'. I became extremely proficient at hand washing. As Will was in the hospital for over a month all up, I used that disinfectant gel more than I'd like – my hands were shot by the end of it! It's hard to remain patient and positive. But that's what you at least have to try and do.
We were always told by the Intensivist that one day, at Will's own pace, he would turn a corner. It was up to Will when that would happen. We had to work with him when he was ready. The doctors had some sort of idea when that would happen. But our little tortoise took more steps backwards in that first week than he did forward. He was a frustrating patient for all. Cute, but slow. I would get close to his little face, keeping in mind I couldn't pick him up, and talk to him. I would tell him how much we loved him and how much we wanted him to get better. People probably thought I'd lost my mind. I actually think I did for a time.
There were small milestones along the way. When he opened his eyes, when he wouldn't lose the plot when touched, when he pissed everywhere during a nappy change, that lifted the mood and made us laugh. It's a tradition he has continued to this day.
Through all of this, Charlie was our rock. He didn't have any paternity leave in place, and I wasn't receiving any maternity leave either as I operate as a contractor, so it made sense for him to go to work each day. He came in to see Will twice a day. I know he would have loved to have been there more, but sometimes in these situations, you have to make sensible decisions as well. He was calm and measured. Obviously, he was stressed and worried, but he dealt with it a lot better than me at that time. The emotional rollercoaster was for real. I would be great one minute, a mess the next. The smallest setback for Will would set me back too. It took me a few days to be able to push through those issues with composure. Isn't it crazy how intense your love is for someone when you've never really been with them? That still blows my mind.
The way I dealt with ICU was to be with Will as much as I could. That might not be for everyone. If you ever end up in that situation, just figure out what best serves you. If it's being there around the clock, do it. If it's going in once a day, do it. The other decision I made was to shut off from the rest of the world a bit. I needed to focus on Will. I didn't have the energy or strength to update everyone constantly. We would provide high-level updates to all our family nearly daily. But we found too much information was overwhelming for everyone, especially when it would change constantly. Again, choose how you want to communicate. People will ask you all the time when he is getting out. The fact of the matter is you just don't know, and that's an answer that doesn't satisfy anyone. We made the decision that as soon as Will was looking like his stint in ICU would end; we would open up a bit more.
There were other things I did to get through it all as best I could. I would go and get a coffee for myself and the nurse looking after Will that day. We would chat about all matter of things to distract me. They were all angels. I weirdly miss their company sometimes. We always had the radio on next to Will, continuously dialled into Smooth FM. We would joke it was Will's favourite station and that he was hugely into Michael Buble and Robbie Williams. I would bring in T-Shirts that I'd slept in, soaked in my scent, so that Will could sniff me when I couldn't hold him. I would read books to him. I would hold his little hand. I would do cross words and sudokus while sitting next to him. One night, I even watched the footy on my phone next to him, commentating the game to him. I did every nappy change because I could. To this day, Charlie and I never argue about who's turn it is to do a nappy. Helping Will is the greatest gift of all. We both are more than happy to do them.
Eventually, with a lot of attention and care, steps forward and back, Will graduated from the ventilator to the C-Pap and eventually the High Flow (I became an expert in ICU terminology!!). Seeing him with only a nasal gastric tube was incredible. We were so thrilled to see him breathing on his own.
When we finally got discharged from ICU, it was one of the greatest feelings in the world. But what would follow was another three weeks in the Special Care Nursery. Learning to feed was the primary goal as babies born prematurely aren't born with a suck reflex. It's basically a little garden to grow babies. To get those rely poly thighs and totally squeezable cheeks. This period had its own challenges. Mainly how slow it was. But it was nothing compared to ICU. One of the highlights was giving Will a bath, about 12 days after he was born. He bloody loved it. Floating in the warm water in the arms of his father was one of the most heart-warming things I've ever seen. Finally, our little guy had experienced a moment of pleasure. Again, we became extremely close to all the wonderful nurses in there, who I leant on constantly for emotional support and guidance.
I know this blog reads pretty sad. But I wanted to give an honest and open account of my experience. Believe me, bringing William into the world has been the greatest joy of our lives. He is a brilliant little boy. He makes the best cute noises, smiles with his entire body and thankfully, seems to enjoy his sleep (I realise I have just jinxed this and soon I will have a nocturnal child – idiot). I love being a mum so much.
If this were to ever happen to us again, I would feel more prepared. It's a major patience game. But if you ever end up in this situation with your new little friend, find someone you trust who has been through the same situation to talk to. For me, that was my Aunty Anna and Uncle Michael. They had triplets 17 years ago and endured many months in NICU. I would chat with Anna regularly, in person and on text, while Charlie and Michael would often chat too. It helped me a lot. If I can be that person for someone in the future, or if this blog helps someone going through the ICU process, that too would be a massive gift.