Grandma Preston visits

Zoë has been doing very well at home. Unfortunately, I have been on-call every other day since our return home with mom and peanut. I just finished one of the busiest services of Comer Children's Hospital in inpatient pediatric neurology and went directly into another busy service, inpatient general pediatrics. I've noticed half the photos of me are when I'm post-call - exhausted, disheveled. Pictures that look like I seriously need coffee by IV. Today was my first day where I had some rest - I was able to leave the hospital early and spend time at home with mom and peanut. I fell asleep next to Zoë after an early dinner, and it was great. Unfortunately, tomorrow, I am on-call again and won't be able to see the family until saturday, but I've already resigned myself to the fact that this is part of the challenge of balancing between a medical career and family.

The great news is that Lisa's mom is with us now. She came on sunday to stay with us a couple of weeks to help out. Grandma Preston has been a tremendous help here especially when I'm away at work. Lisa is very close to her mom, and I know she is enjoying the visit. Most importantly, this is a great opportunity for Grandma and Zoë to bond. I've noticed Grandmas usually have a gift in calming babies. Is it the gentle grandmotherly touch? The wise experience of motherhood? Who knows, but I'm enjoying the rest I'm getting at home in the meantime.

Blue light special

We brought Zoë to her first official pediatric check-up at my pediatric training program, the Comer Children's Hospital at the University of Chicago. We feel fortunate to be associated with 2 hospitals in the city because we are familiar with their systems and house staff, and the quality of care of our hospitals are top notch. It was a wonderful experience bringing Zoë to my clinic, the Family Friend's Center, which is an outpatient pediatric clinic associated with the University of Chicago that serves all of South Chicago. I love the nurses and physicians there. Furthermore, most of my fellow residents work there once a week, so it was an opportunity to see some friends and to introduce Zoë to the University of Chicago pediatric residents "family".
At the appointment, the pediatricians noted that Zoë looked particularly jaundiced which is not uncommon among preemies. She is also at greater risk of jaundice because she is breast feeding, her parents were jaundiced as babies, and she has Asian genes coursing through her veins thanks to yours truly. We were therefore asked to get blood tests at two different days to monitor her bilirubin trends. The results indicated that her bilirubin levels were increasing; however, you really didn't need lab tests to make this conclusion because by this time, the parents started to notice that Zoë's pink skin had turned a smooth yellow-orange tone.
We were told by one of the pediatricians to bring Zoë to the hospital for admission and to receive blue light therapy (aka. bili-light treatment) to treat the jaundice. We went to the University of Chicago Comer Children's Hospital's emergency department where I had just finished my ER rotation 3 weeks prior. After almost 4 months of being a resident physician in the hospital, it was really strange to be on the other side of the table - the patient's family. The nice thing was that I was familiar with the nurses and physicians so we didn't feel like strangers at all. Zoë received wonderful care. In fact, many of the doctors who cared for her during this hospital admission were my friends and fellow residents. Zoë received so much love and attention; Lisa and I were very touched by everyone's investment into her.
While our room in the hospital was being prepared, Zoë was started on her blue light therapy in the ER with a "bili blanket" which is essentially a rectangular shaped interface that emits blue light but can be placed under clothing or blankets.

Upon admission to the hospital floors, she was placed in an incubator that allowed for blue light exposure to the majority of her body. In total, Zoë received almost 12 hours of treatment, and she slept through almost the entire process (good girl!). Her blood bilirubin levels were also monitored throughout the night which also showed that her bilirubin levels were decreasing. By the next morning, her cute, pink sheen had returned! She was discharged by that afternoon. Lisa and I not only were relieved but also enjoyed our stay tremendously. The house staff were excellent. We also had visits from friends in my residency program. We really felt like we were at home.
Zoë is healthy and active. We owe a lot to the nurses and physicians who cared for her. The experience has taught me that medicine is so much more, and I have so much to learn as a pediatrician.

Arrival kicking and screaming

October 12 started like a normal morning for us. Lisa and I got up at 5am for work expecting it to be like our previous hospital work days. I remember finishing pre-rounds on my patient at around 7:50am. "Perfect," I thought, "Plenty of time for me to have a leisurely cup of coffee before morning report." I headed to the conference room where all the residents and teaching faculty met every morning at 8am for an hour of lecture. I was really looking forward to that cup of coffee. After grabbing my cup of Java, I was about to sit down next to my friend Emily when my pager started beeping. Dangit! And I didn't even get to get a sip of coffee. "It never ends!" I joked with Emily as I grabbed my pager. The smile from my face faded as I saw my wife's cell phone number displayed on the pager. It was unusual for her to page me during the morning at the hospital, and it was more unusual for her to page me at her personal cell phone number. At the back of my mind I braced for the worst as I dialed her number (i.e. something happened to the cats; the car is busted; Chris you're out of clean underwear). My wife's cheerful voice greets me after 1 ring (Cool, I know I didn't run out of underwear).
"Hey! Guess where I am?"
"Um, in the hospital?" I half-joked.
"Yeah, but you know where?"
Chris, don't say labor and delivery.
"Labor and delivery?" You're an idiot Chris.
"Ready to have a baby?"
[pause scenario]
Ok, so at this point, I was not expecting a baby for at least another 5 weeks. Was I ready? Holy crap, what do you think? Me? A working, breathing dad? Hyperventilating. Hyperventilating. Mental images of me in fetal position under a shower. Snap out of it man!
[play scenario]
"Holy cow! Are you serious?" A laugh at the other end of the line. "Ok, I'll be in the car in 5 minutes."
I hung up the phone and ran (actually I speed walked, but it's so uncool to see a grown Asian guy speedwalk. It's like watching a naked fat guy change a flat tire) to . . . my coffee. Took a sip. Did the caffeine break me out of this dream? Nope. I turn to my friend Emily and blurt out, "Lisa just went into labor. She's about to have our baby!" That sounded so weird. Emily's eyes turned into huge saucers. No time to hear her response. I turned and speed walked, I mean, ran out of the conference room. On the way, I saw one of the chief residents and a fellow senior resident. I think I said something like, "My wife just went into labor!" but in my head, I said, "blah blah blah blah blah labor!" I think I got through to them because they replied, "Holy f***ing sh*t! Holy f***ing sh*t!" The whole damn system is falling apart!
I rush out of the room passing by two more fellow interns. "Lisa is having the baby!" I can't remember their replies because this time, I was really running. I got into my car. Shut the door. Finally, some silence. Then I scream "Holy crap! We're going to have a baby!"
The drive to my wife's hospital was a blur. My body was at this point in automatic mode. My brain, however, was trying to retrieve lessons I learned in my obstetrics rotation - mainly, how and where do I cut the umbilical cord? I arrive at the hospital and walked briskly to my wife's delivery room. She was there smiling. The nurse and anesthesiologist were also in the room. Holy cow, this was real. We were really going to have a baby.
The next 7 hours were scary to say the least. Baby's heart rate fell to the 70s and 80s with every monster contraction. The severity of the situation was underscored by the presence of at least 10 other medical housestaff in our delivery room. Everyone was looking at the monitor. Lisa and I wished we hadn't gone to med school because we saw what the monitors were telling us - the contractions were stressing the baby. Finally, the attending made a decision to bring Lisa to the OR for a c-section. The team wisked her away leaving me in the room to change into scrubs. For about 10 minutes, I was left alone with my thoughts. I prayed baby and mom would be ok. Reality was sinking in that morning but the 10 minutes of solitude weighed most heavily than any moment that day. We were going to be parents. Our lives were about the change forever. I wanted to keep my mind moving, so I text paged my intern friend Lauren: Going in for c-section. I barely had time to press send when the nurse returned to walk me to the OR. I walked in and Lisa was prepped and alert. I sat next to her. She was nervous. Both of us were. Everything was so surreal to us up to this point. Then we heard Zoë's first cry.
"You can stand up now, Chris, and see your baby," said the attending. I stood up and peaked over the surgical drap. I saw a white, wet, bloody, messy ball of screaming, kicking fat. My first sight of our daughter. I sat back down and turned to Lisa. "She's beautful."
The attending brought Zoë around the drape for Lisa to peek. Zoë screamed and cried; music to our ears. She was brought to the neonatology team to be assessed. I left Lisa briefly to look at our daughter. I was just in awe. The moment was broken by one of the pediatric residents on the team. "Hey, I heard you're a peds resident too." I nodded. "Congrats! Were you working today?" I explained I was actually on-call that day when Lisa paged me, by which the neonatology attending standing next to me responded, "Well, you're now on-call for the next 18 years of your life." The attending and his neonatology team walked away laughing, congratulatory blessings thrown in my direction. I had no response. What the heck did he mean? I knew what he meant, but did I comprehend it? More on that thought down the road.
Fast forward an hour: The c-section was without complications. Zoë's APGARs were 7 and 9. Awesome especially for a 35 weeker born at exactly 5 pounds. She was perfectly healthy. Our peanut had arrived. Lisa was on her road to recovery (thank you hydrocodone!). The next 3 days were filled with wonderful visits from family and friends. Photos of these visits as well as many random shots of Zoë during her first days of life have been included. Mom and Zoë stayed in the hospital 3 days. Our life with Peanut begins...