Ultrasound

For some, the arrival of a premature baby happens suddenly and without warning. For others, there is time to prepare for the inevitable. Although we did not know the exact date Buzzy would be born, we knew that she would come before 34 weeks, which is the longest the doctors would let me continue with the pregnancy.

During the four weeks I stayed in the hospital, the doctors and nurses watched both me and Buzzy closely. Frequent ultrasounds helped them to determine what kind of environment Buzzy was in and how she was faring in it. Instead of looking to make sure all the parts were in the right place and to determine the sex of the baby, the ultrasound looked to see how much fluid I had and to estimate Buzzy's weight.

Before my water broke, there had been some other complications with my pregnancy. Each time something seemed wrong, we had an ultrasound, and each time, we were fearful of the outcome. It was on one of these occasions that Buzzy seemed to give us a sign that all was indeed well.

As I will be gone for the next three days, I leave you with this. Happy Thanksgiving!

Thanksgiving

I know the official holiday is not for a few days, but I thought I would take this opportunity to list the things that I am thankful for as far as Buzzy is concerned. First, I am thankful that she is alive. The day my water broke, we both thought that we would lose our baby. However, we were able to get a few more weeks of development out of the pregnancy, which increased her chances of survival. It also decreased the chances of major complications. This is the second item on my list. I am extremely thankful that Buzzy shows no signs of problems.

Also on my list of things to be thankful for is the support system we have had over the last two years. From the OB who came to the ER on a Saturday morning to personally tell me that I would be transferred to a facility that could care for me and my baby to the friends and associates of my friends and family who prayed for our little family even though they do not know us personally, I am thankful for the people who have done what they could to ease our burden.

Last, but certainly not least, I am thankful for growth. Buzzy has come a long way from 2 lbs 9 oz, and I have come a long way both as a person and a mother in that time. Without thinking about it first, I have done what I had to do, and I am a stronger person for it. I also see the strength both of my girls possess, and I admire them for it. What more could a mother want?

Sanitizer

Last year, during flu and RSV season, the nurse who came to our house to give Buzzy her RSV shots gave us a small tag we could attach to the car seat. It read, "Please wash your hands before you touch mine." This is more than just a friendly reminder, though. It is the mantra of the household that has a preemie.

Conventional wisdom says that a baby should be exposed to other people and their germs in order to build their immunity. This is great advice for children who are born with an immune system ready to work. Following such advice with a preemie, however, could prove fatal. Preemies are not ready to fight off infection, and an illness that would manifest itself in a full-term baby as the sniffles would almost certainly put a preemie back in the hospital. Thus, the number one rule around a premature baby is to sanitize.

When visiting Buzzy at the hospital, we had to stop at the sanitizing station to remove all jewelry, push up our sleeves, and scrub up to our elbows. Only after doing so could we go back to our daughter's room where we also used the dispenser of hand sanitizer on the wall before touching her. When Buzzy's sister was allowed to visit, she, too, learned to use the "tanisizer."

Parenting in a sterile environment presents its challenges, especially when there is a school-age sibling. It was impossible to control Buzzy's exposure because I could not control what germs came home with her sister. Therefore, any cough or sneeze was accompanied by the admonition to cover, then sanitize. If she later develops a fear of germs, we will not have any problem identifying the cause of her neurosis.

Outsiders may indeed think that the parent of a preemie is neurotic. Obsessive hand washing can be a sign of such a problem, and the instruction to others to do the same may not be well-received. However, the person who does not receive the instruction to sanitize will likely not be received into the household again. It's not a neurosis. It's a necessity.

ROP (Retinopathy of Prematurity)

ROP is yet another acronym the parent of a preemie will learn and hope does not become part of the baby's diagnosis. In serious cases, ROP can lead to blindness. In fact, I recently learned ROP is what caused Stevie Wonder's blindness.

The March of Dimes explains ROP as follows:

ROP is an abnormal growth of blood vessels in the eye. It occurs only in babies born before 32 weeks of pregnancy. ROP can lead to bleeding and scarring that can damage the eye's retina (the lining at the rear of the eye that relays messages to the brain). This can result in vision loss. An ophthalmologist (eye doctor) will examine the baby's eyes for signs of ROP.

Most mild cases heal without treatment, with little or no vision loss. In more severe cases, the ophthalmologist may perform laser therapy or do a procedure called cryotherapy (freezing) to eliminate abnormal blood vessels and scars. Both treatments help protect the retina.

(Source: "Common conditions treated in the NICU." March of Dimes website.)

Born at 28 weeks, Buzzy was checked for signs of ROP both in the hospital and after leaving. Our departure from the NICU was actually delayed because we had to wait for the opthamologist. After we went home, we had to return to the clinic for yet another check, which required my infant to have her eyes dilated and then to have a horribly tortuous device placed over her eye so that the doctor could get a proper look.

After having Buzzy, I quickly learned that the care of a premature baby involves several different doctors. An opthamologist is only one of the doctors we have seen in the last 22 months. At one point, I jokingly told people that my baby had more doctors than an 80 year old. Certainly, prematurity means careful monitoring and a detailed medical history before the baby reaches his or her first birthday. Fortunately, in Buzzy's medical history there has never been a diagnosis of ROP.

Questions

From the moment a pregnancy test yields a positive result, expectant parents begin asking questions. Will he have his daddy's eyes? Will she have hair? Where are we going to put the crib? How will we pay for college? When prematurity enters the equation, the questions are a bit different. Will my baby be able to see and hear properly? Will she suffer permanent brain damage? When will he get to come home? What if our insurance doesn't cover the hospital bill?

When my oldest was born, my first question was whether or not she had hair. "Does she ever" was the response I got. When Buzzy was born, I asked if she was breathing. Her kitten-like cries gave the answer I needed. The answers to other questions (some of which we did not yet know how to ask) would have to wait.

Having a preemie means not only asking questions but also answering those of concerned friends and family, which is no easy task. The question as to when a baby can come home involves a detailed explanation of the requirements he or she has to to meet. This explanation likely raises even more questions.

For each of the questions I never thought I would have to ask there was someone to give me an honest but gentle answer. For that I am grateful. I am also appreciative of the dozens of friends and family members who patiently listened as an exhausted mother tried to answer their questions to the best of her ability.

With Thanksgiving less than a week away, I realize that I have much to be thankful for. Though we still have plenty of questions, many of our original ones have been answered beyond our expectations. So far, Buzzy appears to have suffered no permananent damage, and except for her small size, there is no evidence that she missed an entire trimester. That, in itself, answers an even bigger question, one that the skeptic in me has always had trouble answering. Do miracles really exist? It certainly is hard to deny the existence of such when one looks me in the face and calls me "Mama."

Purple

Today marks two important occasions in my household. First, Buzzy's father celebrates his birthday. (Happy birthday, old man!) Second and more globally important, today is the first ever World Prematurity Day, the purpose of which is to raise awareness for the millions of babies worldwide that are born prematurely each year. The March of Dimes estimates that there are 13 million such premature births. That is 13 million babies whose lives are threatened from the instant they first draw breath. It is 13 million mothers who may blame themselves for an event they likely had no control over. It is also 13 million families whose lives will forever be changed in ways they may not immediately understand.

In honor of the occasion, I am wearing purple, the color associated with the cause and also my favorite. Buzzy is also dressed in purple, and as we go about town, many may think we are simply a cute mother and daughter who are dressed alike. (I can live with that. We are a cute pair.) I, on the other hand, will be proud to be dressed like my beautiful daughter because at her young age, she represents hope and survival. She and millions like her are fighters. Born into a world they are not yet equipped to handle, they struggle against the odds and inspire us all before they are even aware of themselves and their surroundings.

There is a great poem by Jenny Joseph that begins with the line, "When I am an old woman I shall wear purple." In this poem, she speaks of the things she will do when she no longer has to care about what others think of her. For her, wearing purple is a celebration of her life. Today, I do not have to wait until I am old to celebrate life. Today I shall proudly wear purple.

Oxygen

Going home on oxygen is a reality for many families with preemies. In the weeks and months following Buzzy's release from the hospital, we found ourselves at the hospital's clinic for various follow-up appointments, and each time I would see at least one baby on both an apnea monitor and oxygen. This makes for a lot of equipment for a parent to cart around. Grateful we only had the apnea monitor to worry about, I would think back to the sometimes uphill battle we had in getting Buzzy weaned from her oxygen.

Immediately after Buzzy was born, a member of her team placed a tiny oxygen mask over her face. Her first picture captured this moment.

While in the NICU, Buzzy remained on various percentages of oxygen saturation. Each day we visited, we checked her machine to see what percentage she was on. On a good day, her percentage would be a little lower than the previous day, or it would at least remain the same. Disappointment and worry would set in when the number was higher because we had been told that too much oxygen could cause permanent damage to her eyes.

As she grew stronger, her breathing became more steady and the numbers on her monitor more stable. There were times that we would find her without her nasal cannula. She would take it out herself, and no one would know. Yet, when we tried to remove it, she would protest with an apnea or a desat. In the weeks prior to Buzzy's release from the hospital, one of our biggest questions was whether or not she would go home on oxygen, but just a few days before her release, she finally came off. It was the first time we could walk into her room and not hear the tell-tale hiss of the machine, and it was the first time we saw our baby without tubes.

Two days after this picture was taken, Buzzy went home.