The "End" of Prematurity Awareness

November is over.

Which means all the trite little facts and posters regarding Prematurity Awareness Month will go away.

The problem is, those facts don't stop being facts just because an awareness month has ended.

1 in 8 children are born premature, yes, even in December.

In the USA, about 7.5 babies are born each minute, from January to January.

That means, almost every minute a baby is born premature, every hour of every day of every week of every month of every year.

Prematurity is the number one killer of babies-- every day of every year.

It's nice to have a month to focus on prematurity. I appreciate every opportunity to increase awareness, to help others understand this crazy world. I think it is important to have a time of year that everyone is focused on a topic. However, just because November has come and gone does not mean that we get to stop taking Charlotte to doctor appointments. It doesn't mean that parents get to stop burying their children. It doesn't mean that therapists stop working with severely handicapped children. It doesn't mean that parents stop worrying or that neonatologists can stop working. It doesn't mean that NICU's are empty.

Prematurity doesn't end when Prematurity Awareness does.

Which means, we're not going anywhere.

Lucky you, huh?

:)

The Face of Prematurity

The March of Dimes is an incredible organization. It has helped to provide funding and research, and has saved the lives of many, many babies. Did you know that prematurity is the number one killer of babies? The March of Dimes hopes that one day, all children will be born full term. I pray for that day as well.

However, there is one problem I have with the MoD. They lead you to believe, with their nice posters and pretty pictures, that this is the face of prematurity:


And it is, to an extent. But what you won't see, what many don't like to acknowledge, is that this, this is the real face of prematurity:


Too often we look at babies like Charlotte and believe that she is "prematurity".

She's not.

Charlotte Amalie is the result of it. Prematurity is the 8 specialists she sees every other month. Prematurity is the three therapists she meets with once a week. Prematurity is the shots she gets every 4 weeks to avoid the common cold. Prematurity is the purell dispensers on my wall. Prematurity is missing Thanksgiving dinner or Christmas Eve parties with family and friends because there are too many germs.

Prematurity is recognizing that Charlotte is the outlier. She is doing remarkably well for a baby born 16 weeks early.

For so many others, prematurity means ventilators in their homes. It means a child who cannot speak, who cannot hear, who cannot walk. Prematurity means children who will never draw their parents a picture. It means children who will never be able to even hold a crayon. Prematurity is devastating.

Charlotte is a miracle. We are grateful everyday for her ever growing list of abilities. But for some, those abilities are not reality. When you pass those March of Dimes posters, please, feel inspired to give. Please donate to their cause. Their research, without question, saved our daughter's life.

But remember that the children pictured on the posters are not the face of prematurity. They are not the reality that many live with. As you read Charlotte's blog, keep in mind that she is what many parents would give anything to have.

So please, during this month of Prematurity Awareness, give to the March of Dimes. And remember. Remember what prematurity really is.

The Luck and/or Guilt

The night Charlotte hit her 24 week viability marker, a doctor from the NICU came to speak with me in the hospital.

She explained the risks. 30% of babies born at Charlotte's gestation survive. 70% do not.

The week after Charlotte was born we had a meeting with another doctor from the NICU. He explained the risks. 90% of babies born, who do survive, at Charlotte's gestation have a morbidity.

Those were the statistics, but not the reality.

By all means Charlotte has not only survived, she has thrived.

Sure, she has a g-tube, is on oxygen and has visual impairment (the level of which is unknown). Yeah, she's developmentally delayed.

But there's an equally long list of things that didn't happen. Things that SHOULD have happened. Things like death, brain bleeds, shunts, trachs, and NEC. Charlotte has a general sense of her surroundings. She can move her arms and her legs. She has made progress in every area.

We have every reason to believe that even if Charlotte develops Cerebral Palsy, she will have a mild form. We can, with caution, say that Charlotte both hears and sees well enough to lead an ordinary life. {Everything we say is with caution... there seem to be NICU gods who laugh at our successes :)}

We feel incredibly lucky. Scratch that. We feel blessed.

We also feel guilty.

We escaped things that we should not have escaped. Statistically, we should have buried our daughter. That's the reality of Charlotte. She should not have survived. But she did. And every time I hear someone's baby lost their NICU battle, I feel guilty that Charlotte did.

Not that I would trade away our success, well, for anything. But I feel guilty that we have been given so much. when others have lost so much. I wonder, why us? Why is that wonderful, loving, caring family going through so much? It's not even a comparison between babies who lived and babies who didn't. I feel intense guilt when I meet a preemie who is blind and deaf. It eats away at me when I see a child with a trach. I could go on, but I won't.

I know there is no rhyme or reason. Charlotte did not come early because of anything I did. She did not live because she's a fighter-- believe me, I've seen more "fighter" in babies who have passed away than in any child who has ever lived. Charlotte lives because she does. And that's what it comes down to. She has a purpose here and she has been given the skills she needs to complete it. Other children have different purposes. And they need different skills. We are given what we need.

And that's the reality of parenting a preemie. You are living in a land of limbo, somewhere between being incredibly angry at the hand you have been dealt, and feeling incredibly guilty for all that you have survived, all the while being so grateful you've even been given the chance to try.

And so, we remember that that is the moral of parenting in general. Whether we are parents of a preemie, a full term child, a child with disabilities or a child who has passed away, we simply try. Sometimes we are overwhelmed with guilt. Other times we feel incredibly blessed to have such a special individual as a part of our lives.

But we try. We don't always do it properly. But we try.

The Whole New World

The past few posts have been a bit of a downer, so here's your dose of smiles.

Being a parent of a preemie opens a world to you. A world you had no idea existed. Sure, you read about things like viability and premature labor when you (or your wife, or your friend) were pregnant, but they didn't mean anything to you.

It's like how you can never understand how much you'll love your own child until you see them there, dirty and sticky, covered in a lollipop, reaching up for you, saying, "Mommy, I wanna snuggle." Anyone but a parent would run the other direction (alright, even as a parent, I've been guilty of doing JUST that... but I digress). But as a parent, the dirt, the snot, the poop, the cries-- they don't get in the way of seeing this little human as something miraculous. And you just cannot understand until you are a parent yourself.

So it is in the preemie world.

You just cannot understand how much these parents devote their lives to their children. Being only a few months into this world, I feel very much like an outsider. Like a new kid at school, I'm not sure where to sit at lunchtime. But not in a "they don't like me" kinda way. More in a "I wish I could be as cool as my older sister" kinda way. I am, by all means, a novice. And I wish I could explain the power that these parents bring to the table.

Have a question regarding an IEP? I can give you the names of 5 parents, 3 lawyers and 3 school board officials who will go to bat for you.

Have an inkling that something might not be right with your kid? You'll get an answer of 15 different possibilities with 15 detailed experiences of kids with the same symptoms.

Need information on a medication? A medical device? A nursing agency? Wondering how to confront your insurance company? Not sure what to expect at an appointment with an Ophthalmologist? Or an ENT? Or what will happen during your child's surgery? No worries. I have people to help with that, too.

These people are incredible.

The most incredible part of this New World is that the civilians of Preemie World are living right under your nose. They go to your grocery story, they shop at your mall, they work with you, their kids go to school with your kids... they are everywhere.

Before Charlotte, I really, honestly thought that people went to the hospital at 40 weeks pregnant and came home three days later with a child. When I was in labor with Caleb, Peter and I walked through the parking garage on our way to the hospital. I looked at him and said, "When I walk back here, we'll be carrying a baby!"

I was totally ignorant of the world of the NICU. I hadn't thought that some people make that walk no longer pregnant, but without a child. I didn't realize that people walked back to their car and called a funeral home. I never though that we might not have need of the nursery at home. In that sense, we are incredibly lucky (yet another post, for tomorrow). Charlotte has come home. She uses her nursery. We know her. And no matter what happens to her tomorrow, or the day after that, we know her. We will always know her.

As much as this journey has pained us, I am so grateful for the world we now know exists. I am a better person because of the people I have met through all of this. And when I don't live up to the standards of this Whole New World, I know there are people surrounding me who will assist in whatever way I need.

The Comparison

It's inevitable. Every parent does it. Especially those parents who say that they don't.

As parents, we compare our children to others. We track their progress by seeing what other children are doing. We smile when our children are ahead. We worry when our children are behind. We calculate how long we have to make milestones. We don't necessarily do it to be competitive (but we all know a parent who does...) we do it to keep track, to keep on top of the next goal, the next big deal.

For preemies, the comparison game is always lose-lose. Compared to children her age, Charlotte is grossly delayed. Compared to children her adjusted age, Charlotte is generally delayed. Compared to other preemies, Charlotte is above average in some cases, below average in others. But even if she is "better" at something than another preemie, how can you be happy about it? For one thing, it doesn't necessarily mean your child is doing well, and for another, you are trying to one up a micropreemie... how pathetic is that?! (Not to mention the guilt it induces... but that's a whole 'nother post) It's easier to avoid the comparison game. But it's not always possible. A friend will have a full term baby. So will a brother or a sister or a cousin. There is always going to be a reminder of where your baby *should* be.

And it hurts. Sometimes, you are prepared for it. Sometimes you aren't. And you never really know when it will hit you. You'll see a baby breastfeeding, or a toddler walking up the stairs and you'll realize my baby will never eat normally, or my second grader still can't walk up the stairs correctly. People will make comments like, "Next year at this time, when your baby is running around everywhere," and you have to choke back the tears.

Charlotte won't be running around anywhere next year. She's eight months old, and she doesn't roll over. But that's OK. I'm fine with where Charlotte is.

It's where she isn't that hurts.

It's not a pity party. As parents of micropreemies, we are more proud of our children's accomplishments than most. We yearn for the day they finally "get it." Today, Charlotte looked at her hand and her therapist and I did a happy dance. Seriously. We danced. I told everyone. "Charlotte looked at her hand! She's starting to recognize her own body!" I'm as proud of her as I would be if she was accepted to Harvard.

But we mourn the loss of "normal." We wish these accomplishments could go unnoticed. Because we want the most for our children. So we mourn the things our children will never know. And we worry.

We worry that someday, they will compare as well.

The Laughter

I like to joke about Charlotte's prematurity. It's the way I handle things that would otherwise find kinda depressing. The thing is-- we have some pretty funny stories.

Not funny like "Knock, knock, Who's there?" kinda funny. But funny like, "Seriously?!? Can you believe how many stars had to align for that to even be possible?" kinda funny.

And when I joke about it, it's OK to laugh. Because I wouldn't be joking about it with you unless I felt comfortable with you. Because NOT laughing at it, makes the situation really, really sad. And I don't want to cry with you. I've cried enough on my own. I want to laugh with you.

What's NOT OK? Making jokes yourself. I know, it makes things unfair, but it's a simple rule. You can laugh at my jokes, you cannot make jokes yourself. My kid. My jokes. Got it?

'Cause really, when you say things like "Oh, you just didn't want stretch marks, eh? Ha ha ha," it makes me want to hit you. And I'm not a violent person. I would give anything to have a full term child-- yeah, even stretch marks. Yes, I'd love to be 60 pounds overweight if it meant my baby came at 40 weeks. So, No, I didn't deliver early to avoid weight gain. Those kinda jokes? Bad.

When I make light of something, it's because I have been through hell to get there. It's a rite of passage. And I need to be able to laugh about this journey sometimes, because otherwise, if I cannot laugh, the past 9 months have just been horrid. If I cannot find some humor in this journey, then I don't want to think about it at all.

But I'm not ready for your humor yet. Maybe in about 15 years.

Maybe.