Wednesday, April 24, 2013

Wait till you have kids..

You know how parents always tell you when you are child-free "Wait till you have kids, then you will understand". I used to find such people extremely annoying and used to mentally promise myself that I would never turn into one of them.

Well, now I have become a parent myself. While I will never ever unleash the "wait till you have kids" line on hapless souls, I can now understand where those parents were coming from at least in some scenarios.

I used to be anal about being punctual. I used to the be the first arrival at any gathering. I used to wonder just how the tardy people could be so disrepectful of other people's time. Short of being hit with a truck or something on the way to an appointment, there was no excuse for being unpunctual in my world. Then arrived Baby A. In short order I realized that A (i.e. me ) proposes, BA disposes. In a baby's world there is no concept of time. BA eats when he wants to, sleeps when he wants to, poops when he wants to. If it interferes with your plan of getting somewhere at some particular time, too bad. In the intial days we thought we were doing pretty good if we managed to get to at least doctor appointments within an hour past the scheduled time. Nowadays, we have become more efficient and start the getting out the door process about an hour before the actual time. However, getting anywhere on time is no longer a given.

Talking about baby
I never thought I could have so much to say about a tiny little being who communicates mainly by crying, who cannot get anywhere without help and who spends the majority of his time eating and sleeping. But I do. I marvel at the way he curls his little fingers, at the way his ears are perfectly formed, at the tiny toes at the end of adorably chubby feet and can talk about them for ages. However, I realized I still generally find other parents gushing about their respective offspring quite boring. So I limit my gushing to the BA's grandparents and immediate family who are more then happy to listen and infact encourage me to gush. I am also pleased to report that I refrain talking about baby to the other folk till they bring up the topic themselves. So, formerly being at the receiving end of baby-gushing still has some effect!

Taking pictures of baby

My phone has hundreds (literally) pictures of BA and several videos as well. I love looking at them. I sometimes take 10 or 15 shots in a row, each of which differ from the other only in the slightly different angle of the baby's hand or the way his foot is placed. Yet I save all those 10 or 15 shots AND love looking at all of them too. Babies look adorable in every snap! Only saving grace is I do not upload them all onto Picasa and send the link out to all my contacts.

Being paranoid
Till BA arrived on the scene, I barely noticed when anyone coughed or sneezed. Now, I am keenly attuned to any sign of illness around me. I  obsessively use sanitizer and wash my hands and give a wide berth to coughers and sneezers. The other day, someone at work was coughing quite a lot and I found myself getting really angry - why could they not stay home instead of spreading germs around? I was quite surprised at just how badly I wanted to march up to that person and ask them to please go home since I could not afford to pick up their germs and then pass it onto my baby - thus acting like one of those totally crazy, obsessive and paranoid parents. I blame it on BA being an ex-preemie and how it is very important for him to not catch infections during the early years. But I suspect I would have been the same regardless of BA's preemie status.

I always knew that the parenting gig was not a walk in the park. But it has taken actually living through it for me to realize that you are on-call ALL THE TIME. And that means, you cannot simply take a day off because you are too tired or too sleepy or just because you needed a break. This was especially hard the first few months since both S and I were constantly short on sleep and I very badly wanted to be able to sleep in at least one day. Now we are more used to it and of course, BA sleeps for longer as well (touch wood) and it is easier.

Forget about you unconditionally loving your baby - your baby unconditionally loves you and you are the center of his world. This is an indescribably warm and great feeling. But it also comes with a huge sense of responsibility. Yesterday I managed to do a small screw up which left the baby uncomfortable for a few minutes. I was miserable and picked up the baby to comfort him. I turned his face towards me to say sorry. He took one look at my face and smiled broadly at me through his discomfort. He was simply so happy to see my face! I thought my heart would burst with happiness and guilt at the same time. I love that little boy and would do anything to protect him.

There are a lot more little things - will save them for another day.

ROP - Retinopathy of Prematurity

Till I had a preemie myself, I had never even heard of the term ROP (Retinopathy of Prematurity), let alone know what it was. In the preemie world though, being affected with ROP is pretty much par for the course, especially in case of extremely early as well as extremely low weight preemies - two categories into which Baby A (BA) very squarely fell.

We got an amazing ophthalmologist to treat BA. When we gratefully thanked her at the end of it all, she simply said "You can best show your gratitude by spreading the word about ROP. Too many innocent preemie babies go blind due to lack of awareness about ROP." I am doing my part here.

If you or someone you know has a preemie, please make sure that the preemie baby is looked at by a ROP speciality ophthamologist as soon as possible. Typically, the monitoring starts at about 4 weeks after birth for the very early preemies. Later preemies get looked at pretty much as soon as soon they get into the NICU. Thereafter, make sure to diligently follow the advise of the ophthamologist and keep up all the follow-up appointments without fail.

Here is a primer about ROP as culled from Wikipedia and personal experience:

What is ROP?
ROP statnds for Retinopathy of Prematurity.  It usually affects the eyes of premature infants and is thought to be caused by the disorganized growth of retinal blood vessels.

Who is at risk of ROP?
All premature infants are at risk of being affected with ROP. Very low birth-weight infants (infants weighing less than 1.25kg at birth) and/or at very low gestational age (less than 31 weeks) at birth are especially at very high risk.

How is ROP detected?
The ophthamologist uses tools to look at the eyes and the retina. This procedure is not painful but very uncomfortable for the baby. So, typically, babies cry a lot during the test which usually lasts for less than 1-2 minutes. It is a good idea to not feed the baby upto an hour before the test since the excessive crying might lead to the baby aspirating (getting food into the lungs) the feed.

What is the treatment?
Once ROP is detected, depending on the stage ROP is in, the severity is determined. Lower severity ROP might resolve on its own without treatment. In that case, the ophthamologist simply monitors the baby periodically to make sure everything is still alright. In case of ROP of higher severity, the treatment could be laser ablation (to remove the abnormal blood vessels) or injection into the affected eye with Avastin.This treatment needs to be started as soon as possible after detection since severe ROP progresses rapidly.

What is the prognosis?
Provided ROP has been detected early enough and the treatment started promptly, success rate is pretty good in most of the cases.

What is the risk of not treating ROP?
If the preemie has a severe version of ROP that is left untreated, it eventually leads to retinal detachment and blindess.

So, please, if you know of someone who had a preemie recently, make sure that they are aware of ROP and they get their baby looked at by a ROP specialist. This is especially true in countries like India where not all  hospitals make it standard protocol to get preemies checked out for ROP. You could be saving an innocent baby from a lifetime of blindness.

Sankara Nethralaya Eye Hospital, Chennai, India has excellent ophthalmologists who evaluate, diagnose and treat ROP in dozens of preemies from all over India and from other countries every day. BA was treated at Sankara Nethralaya. 

In general, the neonatologist attending to your preemie should be able to direct you to the appropriate specialist for evaluating ROP.

Tuesday, April 23, 2013

Catching up

I know I have dropped off the radar for almost a year. A few things happened in the interim:

1. S and I had a baby boy.
2. S, baby boy A and I relocated. Again.

S and me being ultra special and all, number 1 was not the usual 9-months culminating in a squirming baby arriving wailing into the world with smiling faces all around. Not at all.

Baby A arrived early. Really early at 26 weeks. He spent a few months from birth in the NICU at the children's hospital before he was well enough and later, weighed enough to be able to come home. A's entire NICU stay was the most intensely stressful experience of our lives so far. I would not have believed it if anyone had told me that I would have the strength to face the first one month especially. But we did. Baby A is a fighter and his fighting spirit and courage humbled and inspired us. He is our big miracle and is doing well now :-).

We relocated back to the US recently. I guess it is in our destiny to keep moving back and forth between India and US. Let's see how long we stay this time around! Relocating with a baby, a very young one, and a former preemie to boot, was no joke. But the support from family and friends made it as painless as was possible under the circumstance. Baby A was a trooper and behaved beautifully during the long flight journey as well through the setting up process in a new country. Now we are almost all settled in.

So here we are, back in the US, with new baby in tow. That's what was happening with me. What were you folks upto :-)?