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Fri
17
May '13

Story of Ella

Ella, a preemie by 6 weeks

Ella, our preemie angel

And the moments of her courageous fight in NICU (Neonatal Intensive Care Unit) through my lens.

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A mother's broken heart

A mother's broken heart

I never expect to capture negative human emotions on my camera. To me, it’s a challenge I would never want to take up and I doubt any one would hire me to photograph their most vulnerable side. Who doesn’t wish to keep only the good memories and forget all the bad ones?

Until I saw Annie Leibovitz’s postmortem photo of her long time partner, I was not only shocked by her action but I was also admired by her determination to photograph under the worst emotional state and courage to face her fear. It was an unforgettable picture of a casket with a lifeless body. It has no artistic taste, but it means so much in terms of documentary. In our life, we only have one chance to photograph our subject.

With Ella, it was not a life and death situation but it was that only chance for me to document this special moment. My state of mind was at its lowest because it was the most stressful time of our life. NICU is a sad place. The babies were sent here to fight for their life without knowing what death and illness are. The parents fought alongside their babies endured the indescribable amount of emotional stress without knowing when they will bring the baby home. In here, so many tears were shed but they only strengthened the bond between parents and child.

Whew! Deep breath! Here we go.

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“She might not be breathing when she is out. I will need to tell you that. This is common for preemies because their central nervous system is not mature and breathing is part of that system”

The neonatal doctor, Sarah, spoke calmly like nothing, like telling a person she just had a few slices of salmon and a glass of wine for dinner. A few feet away, I was displaying a total opposite expression after I heard her. The delivery room that was once noisy from the discussion of Ella’s condition between the two doctors and six nurses. The finest from the NICU and delivery unit were all here. But now it has become dead silent to me. When I was about to ask her if I might lose the baby, Sarah spoke again as she could sense my fear by reading my eyes. Most of my face was hidden under a mask. I just recovered from a flu and I had to wear the mask to prevent transmission.

A NICU nurse helping Cora and Ella

A NICU nurse helping Cora and Ella

“It is my job to prepare you for the worst. But don’t worry, the NICU team is here and we will put her on oxygen if she can’t breathe on her own”

Million things went through my mind and I couldn’t focus. Struggling with my wife who was in extreme pain and a newborn daughter that I might not have a chance to hear her cry, I was lost until I heard Cora’s panting which she used to control her contraction and then followed by a loud scream. She already had several intense contraction.

“I can’t hold it anymore!” Cora yelled.

That jump-started my brain back into reality. As I held her hand, she gave her first and last push when the OB, Ken, just finished gowning up. Ken didn’t expect the baby to be crowned with a single push. He just put on the gloves and with his blue sterile gown still untied, he caught the baby. This is the moment when my little girl, Ella, starts fighting for her life.

Hi Mom! I am okay!

Hi Mom! I am okay!

The moment of truth was coming. Can she breath on her own? Would we see a blue baby with signs of oxygen desaturation?

Welcome to the world, Ella!

Welcome to the world, Ella!

Gladly, she was pink and she started crying the first moment she was caught by Ken. Her cry was so loud and people can hardly hear each other in the room. Ella’s situation was quickly assessed by the NICU team. From the smile on their faces, I was relieved. Ella must be doing fine.

Ken the baby catcher!

Ken the baby catcher!

We had just a minute to spend with Ella. She was quickly taken away. Then everyone left. No NICU team, no doctors. It was just the two of us as everyone else is busy with the paperwork. We felt empty. Cora did an awesome job to bring Ella to the world but within a minute, she is with someone else.

Under Monitoring

Under Monitoring

Back in the room, it was just the two of us. The baby had to stay in the NICU until she is released. For how long? We wouldn’t know. It’s up to the baby if she can do what the full term babies do. Cora immediate went to NICU to see her. I was not allowed to enter because of my flu. She could barely walk and she was still in pain, but the force of maternal love fueled her will to bond with Ella.

A NICU nurse explaining Ella's condiiton

A NICU nurse explaining Ella's condition

In there, it was a not a pretty scene. NICU is a large room and divided into 3 section. Each section consists of 8 “bays” and each baby gets to stay in one. Ella was energetic but she was kept in an incubator. Her little arm had a needle stick into her vein for IV injection. The nurses secured her arm with a hideous cast so the needle does not move. It was already heartbreaking to see the IV and that was not it. On her chest, sensor leads were attached to her to monitor her heart rate, breathing and oxygen saturation. When the reading is outside of the alert level, the monitor beeps to warn the nurses to take action. She was more like a laboratory guinea pig then a baby. Cora was there by herself, watching the incubator as her tears rolling down her cheeks.

Ella's IV injection

Ella and her IV injection

“What did I do wrong? Why me? Why Ella?”

As of today, I still feel so bad for not being there. I still blame myself for being sick and that started the entire chain reaction. I was totally wiped out by the flu and lying in bed most of the time. From her daily routine with Giselle to care giving to me, Cora took over when I was out and she was doing everything on her own. It was the over work that caused her water to break.

Father and daughter

Father and daughter

Ella faced several challenges. She had premature apnea – her breathing would stop once in a while due to the central nervous system being premature. She was so skinny and couldn’t keep herself warm. She had jaundice and she was just too weak to eat on her own. In order to be discharged from NICU, she can’t display any of the symptoms.

Little Fingers

Little Fingers

Little foot with my wedding band

Little foot with my wedding band

We were admitted into the hospital on Friday night. Over the next 3 days, Ella impressed us with her will to fight. On the 2nd night in the hospital, we got a call around 11:30pm from a nurse named Diana. She is with NICU and she said that Ella needs mom right the way. She said that Ella is turning the place upside down with her “screaming cry” and she needs Cora. Once Cora got there, the place was in chaos. They had several babies crying and Ella was the riot starter. She cried so loud and she made other babies cry. Diana told us that Ella is ready to be breastfed because the pacifier was simply not working on her. They could no longer trick Ella with the pacifier.

Ella inside the incubator

Ella inside the incubator

Diana took this up to the doctor on duty. The doctor was reluctant to have Ella breastfed and the reason was to conserve her energy. Diana had to argue with the doctor that Ella is ready based on her gut feeling. Thanks to her experience, Ella latches on for the first time with no issue. She did it so well for the first few minutes but she felt sleep because she was too weak. Diana got the permission from the doctor for having Ella to be breastfed twice a day. This night was the most important night ever and Diana’s early action is the reason that Ella got to go home way early than other babies.

Ella on Day 2

Ella on Day 2

During our stay in the hospital, we had support from family and friends. Mom created a healthy menu for Cora to regain her stamina so I get to eat all the good hospital food. Our friend, Kris and Zoe visited us on the day Ella was born. Our friend Debbie, who is also a nurse from the hospital, took good care of Cora. Not to mention all the friends and family who gave us support over the phone, facebook and email, it means a lot to us during the difficult time.

Visit from Zoe and Kris

Visit from Zoe and Kris

Debbie, Cora and Ken

Debbie, Cora and Ken

Grandma is here!

Grandma is here!

and grandpa too!

and grandpa too!

The liquid cold – colostrum is the most valuable gift from mom to baby. The yellow milk contains rich antibodies to help the baby to fight the nasty disease out there. Colostrum was only produced during the first few days after the birth. Then the regular milk will kick in to replace it. It only works from the birth mother to the infant.

Cora's liquid gold

Cora

Ella enjoying the liquid gold

Ella enjoying the liquid gold

I was finally allowed to visit the NICU after the quarantine period was over. I am flu-free and no longer needs to wear a mask.

Having a feast in the hospital

Stealing patient's food

Of course Giselle gets to be the big sister. She showed up on the second day to meet the little one. Her attentiveness amazed us and she immediately knew that she has to be gentle and quiet to the preemie sister.

Putting on the Big Sister Badge

Putting on the Big Sister Badge

The big sister is here!

The big sister is here!

Shhhhhhh.....the baby is sleeping, mommy!

Shhhhhhh.....the baby is sleeping, mommy!

We had or first family picture in the NICU. Taken by Meredith, the NICU nurse.

First family photo

First family photo

Goodbye Ella, for now. We were discharged from the hospital on Monday. It was a sad feeling that we can’t bring Ella home. But that was just for a short time. Ella continue to impress us and the hospital staff.

Goodbye for now, my princess!

Goodbye for now, my princess!

The next few weeks become the most challenging weeks in our life. We had to visit Ella twice a day to breastfeed her. It was tough on Cora because she was still recovering. Balancing the hormones makes her to have chills and hot flash most of the time, few times a day or even at the same time. Going outside was tough on her during the cold winter weather.

A card made by the NICU staff

A card made by the NICU staff

We get to learn more about Ella and her condition. She gets to be a pilot under the pretty light. The photo therapy took care of the jaundice in one shot. The bilirubin level was 9 to begin with now it went back down to 5. The nurse told us that Ella is the pooping queen and that was the reason why her live function came back right the way.

Tanning for babies

Tanning for babies

A pilot and her pacifier

A pilot and her pacifier

Her weight was monitor on the daily basis. She needs to gain weight or she won’t be heavy enough to maintain her own body temperature.

Gavage feeding was something hard for us to accept. She was taken off from the IV. As her stamina was low, she couldn’t finish one meal on her own. So she had to be tube-fed. Cora said it was cruel because it’s like making foie gras. She always knows humor to cheer me up during the difficult time.

Gavage feeding

Gavage feeding

Smiling Ella with the gavage tube

Smiling Ella with the gavage tube

Last day in incubator. We noticed the set temperature of the glass house was adjusted from 30C to 27.5C by the nurse. The nurse, Merry-Ann, told us that Ella is ready to sleep in a crib. The incubator was a noisy place – the magnitude of sound in there gets multiplied in the confined space. She woke up from the sound of her fart sometimes. 🙂

Last day in incubator

Last day in incubator

The most excited time during these two week was the visit from Cora’s mom and dad. The early arrival of Ella threw everyone’s schedule off. My in-laws have to fly early and thanks to the resourceful brother-in-law, Hei, mom and dad were able to make it. The first moment between Ella and the grandparents was quite touching. Ella smiled while being held by grandma. Cora caught this moment on camera.

Smiling at grandma

Smiling at grandma

Grandma and grandpa

Grandma and grandpa

Ella displays her personality at her first few weeks. She is a happy-go-lucky person. She loves to laugh and smile – a gesture not only entertaining herself , but also loosening us up during the difficult time. I never capture an infant’s smile at this early stage. The earliest I have done was at the one month age.

Smiling Ella

Smiling Ella

Hearing test – she passed with flying colors. With all the wires attached to her, it looks like they are reading her mind.

Hearing test in progress!

Hearing test in progress!

Cora’s massive milk production shows her determination to raise Ella. The hospital fridge and freezer were out of room for her. We were told to bring only a few bottles each time.

Bottles of milk

Cora's massive production - so many bottles of milk

Giselle pumping milk

Giselle pumping milk

Giselle is taking the responsibility of nursing the little sister. She grabbed Cora’s pump and told everybody that she is now in charge of supplying the milk! 🙂

We tried to distribute our attention evenly to both girls. I tried to have some fun with Giselle, but there was no place in hospital for us to start a riot. So we decided to tour the hospital with my famous shoulder ride.

Alternative use of hallway blind spot mirror

Alternative use of hallway blind spot mirror

On Valentine’s day, we got a gift from the hospital. The NICU doctor, Paul, informed us that they are in the process to release Ella. It came to us as a surprise because most of the preemie stayed here until they are full term. He said that Ella is doing so well, they are pretty much just feeding her. The insurance company is not likely to approve a $13,000 / day bill for having trained medical professional to just feed her.

So off we go, time to get busy again!

So small!

So small!

First we had to get a car seat that supports babies with low weight. Ella is only 4lb 8oz. We needed to buy one to replace our 5lb car seat for Giselle. Once we put her in there. OMG, she is so small!

With Michelle

With Michelle

The car seat was just the beginning, NICU gave us a laundry list of items and chores to do. We will need to get her iron and vitamin supplement since she has preemie anemia. Then we would need to schedule with our pediatrician to have her check-up. We also need to get a special medicine, Synagis – a monoclonal antibody injection to fight RSV. Respiratory syncytial virus is a common virus that causes cold in children but it could be dangerous to dangerous to preemies.

with Meredith

with Meredith

The temperature in our place needs to be controlled since Ella is still small. Everyday, we  have to feed her every 3 hour on the clock and she needs to be checked for temperature once a day for fever and hypothermia. Since she couldn’t regulate her temperature well due to her low body mass. We had to take extra care of her.

with MaryAnn

with MaryAnn

We developed a good habit of cleaning our hands during our visits to NICU. Now it’s time to make sure the good habit is staying with us.

With Julie

With Julie

Now we are ready to get her back. On her last time, it was a happy moment for us.  The nurses who took care of her came by and said goodbye. It was quite something.

With Meredith

With Meredith

What a moment!

What a moment!

Goodbye, little one!

Goodbye, little one!

Yea! Ella gets to go home!

Yea! Ella gets to go home!

The hospital never let patients walked out of the door. They always have to be on wheelchairs for liability reasons.

Time to say goodbye to NICU!

Time to say goodbye to NICU!

Once we got home, Giselle once again, showed how much she wants to take care of the little sister.

Giselle Feeding Ella

Giselle Feeding Ella

Once Ella got home, we are going to another phase of our life. With the leisure of staying at home, we can focus more on the recovery of the mom and daughter. We also enjoy the company of the grandparents from both side. Ella means “complete” in German. I think she brought us altogether as one big family.

All the ladies in the house!

All the ladies in the house!

So what’s next? I would say just enjoying every moment with the family. Now with the new member, we are going through a phase of managing changes. I never know how big of impact it could be with the addition of a newborn.

Lifting her head, she is only 3 weeks old!

Lifting her head, she is only 3 weeks old! That's Anton's chest, btw :)

While Cora and I went back to the sleepless nights with the baby, Giselle on the other hand, is managing the changes of attention reduction. She used to get all the attention from everyone. That has changed. She was not used to it in the beginning, but now I am surprised to see how well she manages the new environment.

Giselle's Lashes - taken during every night story time

Giselle's Lashes - taken during our every night story time

My advice to all the parents who plan to have their 2nd child, the trick to ease the older child’s urge for attention is to get them involved. We asked Giselle to help us in many things. She holds Ella, feeds her and discards her dirty diaper. We let her take ownership of simple tasks and the purpose is not only to train her, but also to let her know how important her contribution is. With this way, she is part of the team.

Welcome Home, Ella!

Welcome Home, Ella!

Smile while sleeping

Smile while sleeping

We can’t split our love but we can give it to both of them at the same time.

-the beginning

Smile away!

Smile away!

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