When last we met, beautiful Violet Eloise had been born at The Birth Place in Orlando on August 27 at 3:14 am. All was well- she was nursing well and I was enjoying cuddling with her. We all got cleaned up and checked out frequently. The birthing assistant was checking my vitals and my uterus. She would also check Violet's vitals- temperature, respiratory rate and heart. Her temp and heart rate were very good. She had great color- she had started out blue-ish but was now really pink with a great cry. Her Apgars were 7 and 9. Shannon, the birthing assistant, told us that her respiratory rate was on the high side. She even called Anne, the midwife, about it (she had already gone home after we were settled.) Her rate was about 80 breaths a minute (in and out), and should be closer to 50. We were not allowed to leave until all her vitals were normal. Eventually, her respiratory rate calmed down and we could go home. We were told to keep a close eye and count her respiratory rate. If it was still high in a few hours, we should call Anne.
Around 9am, we left Orlando for home (a 90 minute drive.) I was elated that I wouldn't have to spend the next two days in the hospital for no real reason. I was extremely excited to be going home and introducing Violet to her big sister Charlotte. After a stop at Chick-Fil-A for breakfast 2, we arrived home. My parents and Charlotte were waiting in the driveway for us with balloons. Charlotte was so excited- we had been away for three full days with all the false alarms. I cried when I finally got to hold her. She loved Violet right away. She kept calling her 'little sweetie," which made my heart burst. She was even more excited about the toys Violet brought her- Elefun and a Magnadoodle. She still says, "Baby Violet bought this for me."
We kept counting Violet's respiratory rate and at this point, it rose to 125. Way too high. I don't know if it was the stress of having given birth only seven hours before, or just sheer exhaustion from being awake so long, but I wasn't worried about it. I mean, I knew that she had to be checked out, but I really didn't think it was a big deal. I mean, she was clearly healthy. She wasn't blue, but a hearty pink. I was sitting on the couch nursing her and literally falling asleep when Jason called Anne to report her respiratory rate. He had to wake me up and tell me that Anne said we should head for our local hospital to get her checked out. I was really surprised. I now don't know why that was my reaction-but I had been through a lot the last three days. I can't really speak to it now, because I am in a totally different headspace three weeks later. I had Jason call Dr. Hiremath, our pediatrician, because I knew they had Saturday office hours. I though maybe he could see her. He said the same thing- head to the hospital.
My head was spinning, but through my exhaustion, I wasn't really processing things well. We had been home with our precious little one for 20 minutes. I had been without Charlotte for three days and was missing her so much that my chest literally ached. I had just gotten her back and we were leaving her. Charlotte kept asking where we were going now. We had to tell her that we had to take Baby Violet to the doctor. She was almost as confused as I was. We packed a diaper bag and drove 20 minutes to Inverness. 8 hours after she was born, we checked Violet in at the ER.
Even though there were many others waiting, Violet was called first. I guess when you have an 8-hour-old, she gets first dibs. The nurses that triaged her were in love. They couldn't believe how tiny she was. She still hadn't had a bath, and still had vernix in her hair. I had planned to bathe her at home. We were put in a private room at the ER, which was nice, as there are several "rooms" that are only curtained-off areas. Two ER doctors came in fairly quickly and looked at her. They mentioned that this was probably something transient- something common with newborns that would go away. They told us that respiratory was called and would be down.
A few minutes later, two respiratory therapists came in. The guy was basically a jackass. He kept calling Violet "it." I mean- even if the pink outfit isn't a give away, you could at least say "the baby." He did say that he sees this all the time in newborns that are born at the hospital, and they started putting her on oxygen through a cannula in her nose. I thought- okay, this isn't that bad. She'll be on the oxygen for a little while, then she'll be fine, and we'll go home. No big deal.
The ER doc came back and told us that he had talked to our ped, Dr. Hiremath. He said that Dr. Hiremath told him that babies born at the hospital with a fast respiratory rate were transferred immediately to a neo-natal intensive care unit. Our county doesn't have one. He said they would run some tests and arrange for transport.
When I think back to this moment, I can feel that same confusion and numbness settle in. I just kept thinking, "WHAT?" Jason and I could barely look at each other after he left. What? This is just fast breathing, right? Is this really that bad? Is she really sick? Where are we going and how will we get there? I couldn't understand what all of this meant. I was now terrified for my new, tiny baby, just a few hours old.
Before we could get any real answers, that little ER room exploded with activity. There were no less than 6 people in there, doing all kinds of things to Violet, who was lying on the gurney shrieking bloody murder. I was sitting in the one chair, staying out of the way as they put monitors on her, organized her oxygen, and worst of all, attempted to put her IV in. They had called down an ob nurse to help with this, but they were still struggling to get it in her tiny veins. They even told me that they had called Dr. Hiremath and that they might have to do an umbilical IV instead. After many heartbreaking minutes, they got the IV in her hand. Someone came and did a chest x-ray. They took lots of blood and did several heel pricks. She screamed throughout all of this. I was now openly sobbing. I was trying to be brave, but there's only so much that I can take. Jason disappeared for a while. He told me later that he couldn't watch me watching her. There was nothing either of us could do. We just had to stand by and watch.
Things gradually settled, and Violet slept. The nurses were wonderful. One helped me to hold her with all the cords and helped me nurse her to keep her calm. Another nurse brought me juice and sent for food for me. She recognized that I had just given birth. We were told that an ambulance would be arriving in three to four hours to take us to Tampa General. We were told that I would not be able to ride with her, as there is no room. Dr. Hiremath arrived soon and did a lot to calm me down. He said that more than likely, Violet had some amniotic fluid in her lungs that needed to be absorbed into her body. This is called Transient Tachypnea (fast breathing) and was harmless. This just happens sometimes. They had already determined that her oxygenation was more than good. He told us that there was a small risk of infection, and we wouldn't know if that was true until cultures came back in 48 hours. Until they knew for sure, she would be on IV antibiotics and would need to be in a NICU- not because she was very sick, but because on the off-chance that it was something worse, she needed to be in a more sophisticated facility. I was still scared out of my mind, but it was better than it looked.
A social worker for the hospital told us that she was working on securing us a room at the Ronald McDonald House in Tampa. This helped ease our minds even more, because we had no idea what we would do in Tampa. Jason went home to gather three days worth of clothes and supplies, and I climbed up into the gurney and held my poor baby for several hours. The nurses brought me food and kept offering to help me in any way they could.
Jason returned and shortly after, the transport team arrived. I remember being very relieved that the RN and respiratory therapist were women. I had assumed they would be men. It made me feel better to know that my baby would be in the care of women. Sexist? Yes. But that's how I felt in that moment. The team took off all of the hospital's monitors and cords and replaced them with their own. They worked quickly and were very compassionate. I was actually (almost) okay while they were working, but then they moved her into the larger ER, where the transport unit was waiting. This scared the hell out of me. They strapped her into the huge, equipment laden isolette. Violet was in the plastic part with hand-sized hole doors for them to work on her. It looked so scary that I just broke down. All the ER was watching this. Several people brought me tissues. After saying goodbye to her, which I could barely do, we parted ways and went to our car. We were able to find the ambulance bay and follow them the hour and a half to Tampa.
Next time, I will give you the breakdown of what happened in Tampa.
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