Tattoons and other random thoughts tonight

The thing about hospital stays is how magnified everything feels. The smallest bit of good news warrants a parade down Main Street. The smallest bit of disappointing news has you sitting in sackcloth and ashes. At least it’s been that way for me. 

Mary Katherine’s fever disappears and I’m on cloud nine. Her oxygen levels drop a few percentage points and I am tearful all evening. The facts of our general situation stay relatively unchanged, but my heart is swinging back and forth like it’s dragging behind MaryKat’s little purple swing.

Just to give you an update, we are generally in a good place. Her temperature, heat rate, respiration rate, blood work and overall demeanor are all great. She is eating and sleeping well and has even smiled a time or two at the nurses. But her oxygen still isn’t what it should be. They want her over 90 (I’ve heard someone say 94…?) and she is jumping back and forth from 82 to 87. So right now we are really just waiting for those blinking digital numbers on the screen to stop dropping once we turn her oxygen off.

I am so grateful for the good medical care here and am in no rush to take a still-unwell baby home. I am no longer sick with worry now that she seems more like her old (still-quite-new) self. And as something of an introvert I haven’t minded the walls of this tiny room 24/7 and four days of no sunshine nearly as much as you might think. Now that I am a bit caught up on sleep I read a lot and piddle around on the internet. Thank goodness for Kindles.

Even so, last night I went to bed with a knot in my stomach I felt like I could feel with my hand if I wanted to. (My emotions and body often get their wires crossed like that. Homesickness feels like thirst to me, a weird thing my sister claims to experience too.) The blah-ness may have something to do with hearing the little kid crying in discomfort next door or reading an eerie book about genetic research and civil rights abuses that made me feel yucky (a Kindle special. Go figure). But more than anything I think I am just missing Bryan and Annabelle, my firstborn who is still just a baby too. The nursing staff don’t really want her to get exposed to more germs up here visiting, especially as she is just getting over something too, and she isn’t really happy stuck in a little room with sick baby sister and no toys anyway. She adores her Papa and is having a blast with him. But generally, our little family doesn’t do well apart for too long.

That being said I had the great joy of having a lunch date with Annabelle today. Bryan hung out with MaryKat while Annabelle and I crossed the street to a Java House where we finished off lunch with ice-cream cones and milk-shakes. I still can’t believe sometimes that I can sit in a restaurant booth and have hilarious conversations with my not-quite two year old. My favorite thing she does these days is ask a question, (“That is?”), receive the answer (“That’s an external hard-drive for the computer,”), after which she thinks for a second then throws her head back in affected laughter and says “Oh yeah…” as though she had just momentarily forgotten something she had known all along.

 

Before she left the hospital Annabelle and I each put on one of her stick-on tattoos (“tattoons” she calls them, which seems appropriate to me). She picked out a koala bear for her tummy. I got a butterfly for my hand. I told her it would help me not miss her so much while we are apart. And even though her Papa says she is a little clingy and emotional while I am away, she says goodbye very matter-of-factly and doesn’t make a big scene. This helps my heart.

So I crawl into bed tonight so thinking of all the families that have to do this for weeks or months even and say thank you that only five days apart feels so sad. I kiss the baby beside me in her little hospital gown that makes her look like an old-fashioned baby doll; I talk for a long time to Bryan on the phone and then tell him I love him; and I kiss my tattoon. 

It will be good to have all this behind us.

Back to the Hospital

It seems unfair to the last month to be writing in the pale glow of a hospital room again, with the soft ripple of bubbles in an oxygen filter nearby and my baby’s raspy breathing in the cot next to me. I have had so many blogs churning in my mind that never made it out – blogs about long walks on the beach of my childhood with my baby, leaving footprints in the damp fanfare of sand strewn from crab holes; blogs about three weeks with my mama, drinking chai after we finally got the girls to sleep and talking and crying about mothers and daughters and the fierce connection between them; blogs about the steady ache to be back in North Africa instead of the comfortable drift of roaming from one nice house to another here in Nairobi while we wait for a place to call home.

But I never wrote the words down, mostly because of the chaotic beauty of being a fulltime mother these days. Blogs, like sleep, have been hard to come by. But, one of the odd upsides to being in the hospital is a little more time to myself to do things like write. Time that I would happily give back.

Bryan was the first to come down with upper respiratory crud but Annabelle and Mary Katherine quickly followed suit. The mysterious super-shield that keeps mamas’ immune systems up in order to take care of the family has held up for me so far (though I am preparing for the inevitable crash when this is all said and done.) We took everyone to the doctor on Saturday morning and by Sunday Annabelle and Bryan were improving. But MK was not. She had fits of violent coughing that made my heart stop and then she started vomiting. All day Sunday I could hardly rouse her to eat much less do anything else. By evening we started deliberating whether or not we could wait until morning to see our pediatrician or if we should go ahead and take her to the ER. But when she started looking pale and frighteningly lethargic, our decision was easy.

It was around nine when I threw the diaper bag in the car and strapped a listless MaryKat into her seat. Bryan stayed behind with Annabelle who was already in bed, though I could tell it was killing him not to come with us. But with a toddler and a nursing baby there was little choice. I haven’t driven in Nairobi at night before and I was a little nervous. As I made my way through poorly lit round-abouts, harrowing high-speed two lane roads and a couple of wrecks I was just imagining scratching out the eyes of the corrupt cop that pulled me over to ask for a bribe. Normally I am an intimidated mess around police (at least on the inside) but God help the unsuspecting person that chose to mess with me that night. Thankfully, no one did and I made it to the hospital in good time. Mary Katherine was coughing the whole way and as I turned into the parking lot she started vomiting and choking. I screeched into a parking spot and scrambled to get her inside.

By the time I got her into the hospital she was white as a sheet and limp on my shoulder. Her breathing, which I was obsessively checking, was shallow and irregular. After what felt like months of paperwork I was directed to the pediatric waiting area where I sat down with a dozen coughing kids and their sleepy parents listening to a journalist wax on about the looming Kenyan elections on the TV above. Eventually a triage nurse called me back to look at MaryKat. Moments after checking her out she was ushering us down a hall to a room full of curtained off beds and fitting an oxygen mask over my baby’s face. At the time the number “65” didn’t mean anything to me. But now knowing that it should have been over 94, I feel sick to my stomach.  

The 48 hours after that have been a blur. I feel like I remember everything that has happened – the breathing treatments, the x-rays, the visits from Bryan and Annabelle - but I have no sense of chronology or time. I sleep when MaryKat sleeps, which is often only 20 minutes at a time with no respect to night or day. I can’t remember what was an hour ago or a day ago. She and I are both exhausted.

But, thank God, her heart rate and respiration rate have settled and on oxygen she is alert and hungry. The chest x-rays showed this was not pneumonia but just a really bad virus so now we just wait until she can pull enough oxygen into those little lungs on her own. Tonight when they took her off O2 her numbers were at 78 – still not good enough to go home. But her congestion is clearing, just slowly.

My precious cousin Terron who is working here for a year spent the day with Annabelle (having tea-parties and comforting baby dolls no doubt. She has a huge crush on her cousin-uncle) so that Bryan could be with Mary Katherine and me. Just a few hours with him and I think we both feel like we can go on with a little more grace. Four am last night was not our finest hour with all her tubes only allowing about a three foot circle to pace in when she (we) was crying. At one point a poor nursing student tiptoed in to take MK’s vitals and when he saw me I could see him mentally scanning his textbooks for the chapter on “What to do when you walk in on a bawling sleep-deprived anxiety-ridden white woman at 3am.” But tonight I think she and I are both encouraged and optimistic about a few hours sleep. She’s squeaking away in her little swing that her Papa brought up and I will curl up under the circus sheets on the hospital bed. We’ll see how the night goes.

As always, thank you for your prayers. 

Post Script: I ran out of internet credit for my computer last night so I didn’t get to post this until now, twelve hours later with about six hours of sleep under my belt and almost double that for MK. Plus her O2 levels are now at 90%. I am so happy!

This Time Around...

When we were pregnant with Annabelle, all our friends with kids said, “Get ready. Having a baby changes everything.” At the time, I had to be careful not to roll my eyes. Of course it changes everything. Who gets pregnant thinking that everything will stay the same? But then nine months later I was the wild-eyed crazy woman clinging to my pregnant friend’s arms saying in the raspy voice of a disregarded prophet, “No, really. Having kids changes everything.” I think for a while there I really thought I might die from lack of sleep. Like one of those contestants on a radio program who stays awake for four days straight and wins a million dollars only to spend the rest of his brain-dead life in a nursing home. Yeah, I thought I was going to be that guy for a while.

So when those same friends said, “Your second baby is so much easier than the first,” I was both skeptical and hopeful. Experience told me I was in for a sleepless marathon. But their counsel had proved reliable in the past. I stepped into motherhood the second time around with trepidatious hope.   

And, granted, I am only two weeks in. But it has been two weeks of living in one-room as a family of four, changing two sets of diapers, and recovering from a touch-and-go week in the hospital with a preemie. And you know what? I still think this is easier than the first time around.

I have only cried irrationally once (by my count anyway; Bryan might define “irrationally” differently) and if you find civil war particularly heart-wrenching then maybe you would have cried at the opening scene of “The Hatfields and McCoys” miniseries too. The point is, overall, I have just been really, really happy.

Expectations have a lot to do with it. There is nothing like that first experience of being jerked by your hair right out of contented selfishness. By now I am already used to privacy in the bathroom being a rare treat and sleep being something that only comes one someone else’s terms. Confidence is another. I remember half of my sleeplessness a year and a half ago had less to do with Annabelle and more to do with me staying up panicking over my mothering skills. Am I letting her cry too much? Too little? Is she getting enough to eat? Is she too fat? Is she already destined to a lifetime of counseling because I wondering if she is too fat at two months old? But now I hardly wake up for nighttime feedings at all. I feed her when she is hungry and let her sleep with me when she wants to. And I don’t stress about it. I’m a mama, her mama. And right now, that’s enough.

But maybe more than anything, the peace I am experiencing this time around has to do with living just a little bit longer. When Annabelle was born I actually spent time thinking about things like whether she had enough cute outfits with matching bows for her first couple months of church, or how much I regretted not having access to a photographer who would take black and white portraits of her asleep naked in a basket sitting in a field of flowers. But this time around those things have scarcely crossed my mind. She hardly fits into any of her sister’s hand-me-down newborn onesies much less anything else and I couldn’t care less. Why? Because this time around I have friends with months and years of disappointments and maybe even a handful of miscarriages behind them, and still no big round belly to show off. Because this time around I have friends with babies due mere days before their husbands are deployed for months overseas. Because this time around I spent time in the nursery with women who had been coming though those swinging doors every day for two months to pump milk for the two pounds of life they still couldn’t even cradle in their arms. Because this time around I have seen the bush hospital where, with just a few days difference, Mary Katherine could so easily have been born and maybe forever changed in a heart-wrenching way, our experience of Christmas day.

But she didn’t. She forever changed it in a beautiful way. (On a side note, several Americans who have heard about MK’s birth story have said things along the lines of, “Oh, poor thing! She was born on Christmas? Now she will get jipped on presents for the rest of her life!” But I love the way Africans have responded. Almost without exception their answer has been, “She was born on Christmas Day? Wow, how lucky! She must be so special.” As though in some mysterious way that none of us can quite put our finger on, her birthday means something. I love it.)

This time around I feel just a little more grounded, a little more open-eyed, a little more aware of just how priceless the treasures in my arms really are. So even in those crazy-mama moments of wondering how in the heck I am going to do this (I still have them), I feel an overwhelming sense of peace and thankfulness. In this crazy world of imperfect beauty, I know just a little more fully how blessed I am.

Now if I can just keep in my mind my friends’ third piece of advice. I think their exact words were, “I don’t care if your comfort drink of choice is chamomile tea or gin and tonic, but you better have plenty of it on hand for that first year of having two under two.”

 Oh boy… 

Mary Christmas!

The pain started around 3 o’clock on Christmas Day. At first it was just a few regular contractions tightening painlessly across my stomach. But in minutes the tightening became achiness and then gradually cramps until eventually even the allure or Turkey and apple pie to a very hungry stomach couldn’t keep me up. I guzzled a few glasses of water and went to lie down. After 30 minutes I started watching the clock. After an hour Bryan started loading the car.

Even though I already couldn’t talk through contractions on the drive to the hospital, I still wasn’t convinced we were in actual labor. Our baby was due January 20^th, and this was Christmas Day. Surely, just a few days of running just a little too hard were catching up with me. I was already preparing myself for the awkwardness of the “No, honey. Just go home and put your feet up…” speech from the nurse on call. What I got instead was the “Yup. You’re dilated to a five. I’ll go call your doctor…” speech to which I think I stupidly replied, “You mean this baby is coming today, for sure?” The nurse smiled and said, “This baby will be here in a couple hours.”

As you can imagine I experienced a dizzying blur of emotions in those moments. On one hand there was the incredible excitement of thinking how close I was to holding my baby in my arms, of meeting her for the first time and looking into her eyes. On the other hand there was the fear of her coming too early. What if she wasn’t ready for the world yet? What if something was wrong? I also felt a pang of guilt mixed with gratitude because for weeks I had talked about our daughter coming early. I was concerned about her showing up while we were still in North Africa and even back in Nairobi I had my doctor perform a couple unnecessary pelvic exams just to make sure she wasn’t showing any signs of coming while Bryan was still a thousand miles away. Now I was so thankful I had sensed this for so long. But I also worried, had my seemingly needless concerns prompted the very thing I feared?

As much as I missed my mother while the contractions gathered and grew, I have to admit, there was something incredibly intimate about being alone with Bryan as we labored to bring our baby into the world. I sank deeper into my own little world of hurt, bent over the bed, counting my breaths and moaning the almost comically inadequate word “ow” over and over again while Bryan led sips of water to my mouth, whispered encouragement in my ear and constantly, endlessly, faithfully rubbed my back. It was just the two of us together working side by side to usher into this world the life we had created.

Mary Katherine was born ay 8:35pm on Christmas Day at 5lbs and 14 ounces, 19 and ¾ inches long. From the first pang to the final push, my labor lasted just over five hours. Though she came out squealing, under the harsh glare of a heat lamp the pediatrician quickly decided that her weak grunts were not sufficient for breathing and carted her off to the NICU. Shaky and weak myself, I just got a glimpse of long bluish legs and big dark eyes before she was taken out of the room. Bryan got a closer look but didn’t get to hold her either.

The past forty-eight hours have felt like an eternity. In fact I still can’t believe I have only been a mother of two that briefly. Having both of my babies out of my arms and body leaves me feeling naked and alone. In all honesty, the sheer novelty of complete solitude was a bit of a luxury at first, but it didn’t take long for the ache in my heart to replace the aches in my body. I have been grateful for the culture of breast-feeding that I find myself in. The walk down empty corridors with blinking Christmas trees at 3am to go pump in a quiet nursery full of impossibly tiny babies attended by sleepy nurses is strangely comforting. I think I have been grateful for a physical outlet to express love for my little one when the only other thing I can do is sing lullabies through holes in an incubator while stroking her toes.

I was especially sad earlier this evening when Mary Kat’s breathing was still uneven and the latest test results on her infection still unavailable. I sat in my Easter-green hospital gown pumping with only partial success while a cheerful Kenyan woman chattered away to a bundle in a bassinet across from me. Eventually we struck up a conversation. I noticed her business shoes under the hospital robe and realized she must have come from home to nurse her baby. When I asked her about it I learned that her son was born several months early and has been in the NICU for almost two months. He was supposed to go home tomorrow but instead are going in for surgery to try and remove an accumulation of water on her baby’s brain. I asked her what her son’s name was as she said, “Gifton. But of course we just call him ‘Gift’.” I can’t imagine.

After supper and a bath tonight I got my own gift when I went back to the nursery to pump. A nurse was changing my Mary Katherine who for once was wide-awake and rooting with her IV bandaged fist. When I asked if I could please try nursing, expecting yet another, “Not yet” I was overjoyed to instead hear a “yes.” A chair was pulled up to her little incubator an IV stand, and swaddled and bleary-eyed, my beautiful daughter was placed in my arms for the first time. It was heaven.

My tiny daughter has a surprisingly strong suckle and we were soon working together perfectly. I never cease to be amazed at how much more than mere individuals we are, how even our biology seems to exist in community, in relationship. She created in my physical body what no machine could. Her tiny mouth pulled more milk from me than I knew existed and the thirst I had yet to feel after two full days of pumping soon had me guzzling water. She eventually fell sound asleep in my arms but only after a long time did I begrudgingly returned her to the nurse and her little pretend-womb. Hopefully she is only hours away from being free to stay with me. Until then I am counting the hours until I can get back to her.

I better go to sleep now while I can. In just a few hours my alarm will go off for another walk down late-night hospital halls and after that is a day-full of conversations with doctors and visits from precocious almost-two year olds who still don’t know exactly what “big sister” means. I’m not even going to read back over this before I post it because I know I will probably trash it if I do. I just had to get something up in the moments I had. Thank you all so much for your prayers. This has bee one of the most amazing Christmases ever. We have been given such an amazing gift.

(And if you think about it tonight, say a little prayer for Gift who is in the nursery with my daughter and his mama too. I know she would appreciate it.)     

Fever

So Annabelle’s fever didn’t go away.

Dr. Rob, an American doctor working at a clinic within shouting distance, made a couple of house calls to check out our lethargic baby with chills. Two malaria tests came back negative. There was no visible sign of a bacterial infection anywhere. Probably just a virus easily picked up from one of the hundreds of kids she has played with in the last two weeks. All you can do is keep her fever down and wait it out. 

Bryan and I weren’t overly concerned. After all, kids get sick no matter where you are, right? In fact, we have probably already missed out on several rounds of daycare and playgroup bugs that have worried our peers. Night-time syringes full of ibuprofen are just a part of the parenting package. So we waited.   
  

But by day five her high fever was still breaking through the ibuprofen after only a few hours and she wasn’t eating. And to make matters worse, Bryan got sick. Really sick. A quick finger prick showed that he had a good solid case of malaria and now that we were past the point of a virus’ lifespan, it was deemed prudent to treat both my babies for malaria. Annabelle’s coartem pills were crushed up and disguised in smears of peanut-butter only begrudgingly swallowed. She didn’t get any worse, but neither did she get better. Bryan swallowed his fistful of drugs willingly and got significantly worse. His fever soared and I woke up in the night to the bed shaking he was shivering so violently. But in 48 hours he was revived, eating and moving around again. Such a relief.

After a week and a half of the roller-coaster hope of seeing Annabelle up and playing or eating a cracker only to watch with worry an hour later as she lay in bed miserable again we decided to take her down the road to the nearest hospital. Dr. Rob had left by this point for his R and R and the mere doubtful mention of the word typhoid by his nursing staff was enough to make the fifteen minute drive by motorcycle seem like a pleasure ride (yeah, we’re not the more impressive NGO in these parts when it comes to transportation right now…). If my baby hadn’t been so hot and my belly so tight with harmless contractions, the image of me seven and half months pregnant with a one and half year old strapped to my back jostling behind my husband through the dust kicked up by land cruisers and herds of cows, I would have been laughing the whole way there. 

The hospital is a cluster of oddly built cement structures staffed by one doctor a couple of nurses and a handful of dubiously trained lab techs, surgical assistants and the people who take your temperature and clean up all manner of things from the floors. As we walked in the courtyard we stepped around people lying on mats in the shade while their relatives cooked sorghum porridge over small fires. We were welcomed with hugs by a lab tech who was a dear friend throughout our time across the border and he quickly ushered us around the corner to see the doctor. We picked our way through the steady flow of men, women and children and waited for a moment while our friend knocked on a green door. In a moment a man in scrubs, boots, gloves and a shower cap peeked his head out and gestured for us to remove our shoes and then follow him back inside. I stepped into the dark room in my bare filthy feet and realized with a feeling close to dread that we were in the OR. A young girl was lying naked on a bed and crying, more from fear than pain I think, as she was being prepped for surgery. Various people in surgical masks scooted politely around us as plastic chairs were scraped across the floor for us to sit in. 

The doctor took his time examining Annabelle right there in the OR and eventually grimaced apologetically and said he would recommend putting her on a quinine and heavy antibiotic drip immediately. He moved his head in the direction of the wards we had seen literally overflowing with people and said quietly, “But I don’t know if admitting her here is really what you want to do. We could put her in the maternity ward but even that…”

It’s a very disorienting sensation to experience two extreme and opposing truths simultaneously. On one hand I was struggling to be brave in the face of my moderately sick baby being touched and greeted by people in a place where a thousand different diseases festered in the very air she was breathing. I was feeling pretty proud of myself managing to do that too, until I entertained the prospect of her being hooked up to IV for a week in a bush hospital. And that scared me. On the other hand I was painfully aware of a kind of shame that came with the only doctor treating a thousand people infinitely more sick than my child being pulled out of surgery to give us his attention because of …what? The color of my skin, my friendship with hospital staff, my connections with the hospital donors? Those two realities felt like they were going to rip me in half in that moment.        

At this point all I could think was, I am not tough enough for this, I am not tough enough for this, I am not tough enough for this. My daughter might be but I don’t think I am.

While someone went to gather the medicine for Annabelle we sat outside on a bench and talked about options. Annabelle sat quietly on my lap and watched while a girl only a couple of years older than her on her own mother’s lap on the bench next to us was given an IV in her tiny wrist. Dingy bandages bruised with iodine covered severe burns across her back and torso. 

Life in North Africa seems to constantly throw serious decisions at us that must be made in approximately 30 minutes. (Or as it was politely pointed out to me recently, maybe Bryan and I just attract/are attracted to those scenarios in the first place…) After some deliberation we decided to take advantage of a cargo charter flying in the following morning with fencing materials for our new compound. We could give Annabelle an injection of antibiotics that night and then she and I would be on our way to Nairobi the following morning. A week of intravenous meds without lab work seemed like overkill for such a little girl. But ignoring her fever was out of the question. Our whole family flying out in twelve hours’ notice seemed unnecessary with so much left to be done in North Africa in the next two weeks. But us all staying in, especially a pregnant mama and sick baby seemed equally silly.

So after a short night, Annabelle and I said a modest goodbye to Bryan on Wednesday morning at the airstrip while a cluster of kids watched on and WFP helicopters reverberated overhead. By the time we hit Lokichoggio she has already gone her first twelve hours in ten days with no fever. We were unable to get a ride out of Loki so a friendly taxi driver helped me find “the best” local clinic (think one yellow room with posters of happy Chinese children overlaid with trite sayings about happiness fraying on the wall and wet basins stacked beside boxes of cough syrup in the corner) where an obliging doctor administered the second antibiotic injection.

By the time we reached Nairobi the following day and finally made it to our pediatrician’s office and shared our story, we were both fried. 

But, my baby was healthier than she has been in two weeks. 

Thank you God.  

Once again, I find myself battling mixed emotions. I am overwhelmingly thankful that she is healthy again. I breath such a prayer of thanks every time that cool little forehead snuggles into my neck. But a part of me wonders too if we overreacted. Now that I am in Nairobi for two weeks without my husband and with a perfectly healthy little girl, I can’t help but think, should we have given it another day or two? Plus, I suspect rumors have flown around the world (as much as we try to contain them) that my daughter was dying of some terrible refugee camp disease and had to be medically evacuated out. (If you could talk to the bush pilots who had to scrape three hours of cartoon stickers off their windows they would assure you that Annabelle was just shy of fine by the time they got to her.) And I also think about that doctor in North Africa who has seen it all recommending to put her on IV drugs immediately, and I know that while we can be thankful for a quick recovery, there are some things you just don’t mess around with in this part of the world.

I guess more than anything I am grateful. Grateful for the opportunity to overreact, underreact…just to act at all is more of a privilege and a gift than I could have fully imagined before last week.

Thank you so much for your prayers. We are richly blessed.