The second day in the hospital, the pediatrician practice sends the on call doctor to check out the newborns. He walked into our room and glanced at a sheet of small paper in his hand and said "Um, your baby seems perfectly healthy; where are you guys from?" After he left, Jamey and I looked at each other and declared it the least helpful conversation with a doctor ever, and it was obvious he had no clue which baby was ours. Thirty minutes later when Jamey and mom were in the other room, I got a phone call from the same doctor. He said "Oh yes, I forgot to mention your baby has jaundice and will need light therapy. The nurses are coming to get her now." (Mind you, we had sent Ruby to the nursery for the night and had only had her back 10 minutes when the call came.) He went on to explain that Ruby had a bilirubin level of 12 and there was no cause to worry until it is 20. This would be like me saying don't worry because it is 12 hot outside and it won't kill you until it is 20 hot. I mean what is the scale here? He also mentioned it is an extra bad case of jaundice because our blood types are different. Not sure what questions to ask, I hung up and debriefed mom and Jamey. The nurse came as promised and took Ruby off for what came to be her first day of two days of light therapy. Ruby got to test out her first eye wear accessory, a blindfold. EEK! Imagine not being able to see for nine months, then able to look around for a few hours, then being blindfolded. Who knows, maybe it was comforting.
Jamey was my hero and went to the nursery to check on her several times and made sure that we got her for feedings. (Apparently, if you bottle feed, the nurses assume they can feed her instead of letting you bond.) Jamey completely charmed all the nursing shifts to the point where they knew him and would buzz him into the nursery as soon as they saw him in the camera. Now, I am a eternal optimist and there were several good things from the light therapy. Mom went to the mall and got me some walking pajamas (the ones I had packed were fine for walking around family but not the hospital) and I was motivated to get out of bed and get moving so I could see her sunbathing. Ruby did very well under the lights and learned to sleep by herself with no swaddling tricks or anything. Of course, there were issues too. To maximize skin exposure to the light, they didn't put a diaper on Ruby. All babies in the hospital wear a tag that sets off an alarm and turns off the elevator if they get close. At one point, when the nurse called for security to turn off her ankle tag with the quote "I've got this baby and there is crap everywhere!" Eventually, they were able to clean her off with Jamey's help. By day 2 the nurses had given up on no diaper and who could blame them? We were discharged late on Day 2 for maximum light time and Ruby finally got to go home with orders to sunbathe in indirect light several times a day.
We winded up seeing 4 pediatricians in her first 5 days of life and I liked all but the first one. Our pediatrician is a very laid back guy but was able to explain why my blood type of O+ was an issue with her blood type of A+. The first two pediatricians were unable to answer my question of "If O+ is a universal donor to + blood types, why is her blood fighting it?". They gave me vague answers of "Infants are different." Mom's favorite pediatrician (because he was cute and a genuinely caring charismatic doctor and did I mention cute?) said he would look it up. Say what you want about medical advise from the Internet, but in the first few days that was (sadly) our best source for what was going on with our baby.
Here were her bilirubin levels as an example of the path they can take. The three really low numbers are when she was under the light. The good news is that once the levels go down (and the liver is up and functioning) they don't go back up so the peak is what you try and control. I added the helpful scale that the doctors gave me.
1 comment:
Love the graphic.
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