To the hospital in a hurry

Silly of us to think that Luka would spare us yet another medically-necessitated rapid departure from Dili following our first episode.  Instead, we found ourselves, once again, scrambling to pack in 20 minutes flat, while praying the Internet connection holds to book plane tickets.

Now, now, fortunately this one is much more par for the course and not nearly as exciting and scary as the previous one.  Turns out Luka has Bronchiolitis which is an infection of the small air passages (as opposed to the larger air ways, or the bronchials as was explained to me today). Whatever it is, it makes for one miserable little trooper.  With a fever spike of 40C yesterday, we listened to the poor guy wheezing all night long. At the doctor's this morning his O2 saturation levels (sats) were down to 92%, which is below the 93% that the doctor says is acceptable.  After a few minutes on the torture device known as the nebulizer he responded well - so we were sent home with a home kit to administer ventilin.

All the while we were planning to send Chris and Luka to Darwin tomorrow as a precaution - then it dawned on me, hang on, they're headed to Singapore on Tuesday anyway on their way to South Africa - why not just change that ticket and head up that way - ah right, because the plane leaves in TWO HOURS!  Unfortunately it was also lunch time in Dili, which on an island, is taken very seriously. So we had to wait until after 13h00 before Chris could go back to see the doctor.  By the time he called me to say that she still thinks as a precaution we should take him out, I had under 2 hours to change a ticket and pack for both of them and get them to the airport.  Mind you, it's not just packing for 4 days in Singapore, no, it's packing all the winter clothes Luka and Chris has to take to South Africa for the trip we were originally scheduled to go on next week.

Thanks to Michelle and Judith, we managed to get it all sorted, and off we went to the airport where the Air Timor guys were absolutely amazing and just checked us in right in the office, no line, no counter, no nothing (that is after we showed them the 'fit to fly' medical certificate' of course).

I was devastated to watch the two of them get on the plane, but with my boss out of the country (yes, this always happens when I'm in charge), and the election observation mission I am overseeing arriving in 4 days for the upcoming parliamentary election, I had to stay behind :(

Fortunately we know this is simply precautionary - and soon Chris and Luka will be hanging out at the Singapore Zoo, eating fabulous street cuisine.  We'd just rather he be eating street cuisine down the road from a world class hospital, than wake up tomorrow morning and be out of departing flights for two days.  Just the cost of doing business in our line of work I suppose.

Still sucked putting them on the plane though :(

Due dates and other musings

So turns out there is a small, albeit vocal, following of this blog here in Dili (and yes, of course the family abroad are yelling out!) who implored me to keep writing.  While I realize the initial draw for most readers who were not somehow related to us, was perhaps something of the intrigue of the whole ordeal, and that - in all fairness, that has since pretty much worn off.  Which, after fourteen months, I have come to appreciate as a good thing.

Luka 22 March 2012,
Visalia CA

By way of a preface, I should point out that today, May 27th, is and was always supposed to be Luka's due date.  Of course, 'they' tell you that due dates are all a pile of smelly stuff, which in my enlightened state of pregnancy led me to respond to the big question with 'oh somewhere toward the end of May' - but secretly, every first-time pregnant woman hangs on to the notion of a due date like she last did for good weather on her wedding day even though 'they' tell you rain means good luck.

So, here we are, a whole two months and one week after we celebrated Luka's 1st birthday in the US with the extended US and South African families, and we have so much to be grateful for.  Chris and I recently reminisced about how much Luka has changed (matured if you will) in the past two months from this young man playing with his legos in grandma's house, to the toothy toddler rough-housing at today's bub club.

Luka, Dili 27 May, 2012

Of course, people point out what an amazing little creature he has become, and what a miracle the whole story is.  Which just reminded me once again over the past few days how incredibly, and indescribably fortunate we have been.  In thinking back to the dreadful day where we boarded a 70-minute flight to our future family, and measuring the difference between March 22 and May 27th, I am just blown away when I think of the whole thing one year ago.  I was not quite as able to take in the whole 'due date' anniversary last year as this day last year also coincides with the day that Luka was released from his second stint in the NICU, for his emergency surgery in Cape Town.

Consider that Timor-Leste, one of the poorest countries in Asia and where we currently live, is not the best place to be a child.  According to Save the Children, at least 54% of Timorese children under five have stunted growth due to malnutrition. In addition, it seems to me that most families I come across know first-hand the pain of losing a child(ren) at some point.  For most Timorese women, even the option of hospitalization is not always there, let alone one with the kind of care one would need for a premature birth.  My recent discussions and guidance to a colleague who's friend had a premature baby in the national hospital a few weeks ago and was being kept in a separate room in the hospital, away from the infant, with no instruction to touch, care for, or hold the small creature, alerted me to the breadth of support one needs in a situation such as the one we had.

Of course, I had a credit card and could access the internet to book a one-way ticket out of here.  I also had a US passport and health insurance to evacuate and get the care that my child seemingly deserved to give him the jump-start he needed.  As a result, I can't help but feel somewhat guilty when I bounce a healthy 11kg former preemie who more closely resemble 3-year old Timorese kids.  When I say 'guilty', I don't mean it in a melodramatic sort of way - but just that I can't imagine what I would have done without the caring instructions, guidance, support and encouragement I received from my midwives, pediatricians, nurses, lactation consultants and every other single person that guided us through that time in our life.

Today, we love watching Luka as he finally figures out this 'walking' thing, click his tongue, point to the light and hug our cat Gus.  I live for, and relish in his recent rediscovering of hugging and lap-sitting, especially at night, after his massage and bottle, when he decides he has had enough milk, hands me the bottle, sits up on my lap - throws his arms around my neck, and nuzzles his face, snuggling in secret  for a few seconds before pointing to his bed.

On his due date, all these many weeks after his actual birth date, I say a small prayer for all those who go into premature labor without the support network, care, encouragement and resources that I had at my disposal.  I also thank, once again, the doctors, midwives, nurses and administrators at the Royal Darwin Hospital in Australia, as well as my birth and antenatal coaches, and the staff and doctors at Vincent Palotti Hospital in Cape Town.  Luka is a product of his strong-willed parents, but he is also a testament to the difference world-class medical care make in our lives.

Remembering...

...where we were almost one year ago on Darwin, and how far we have come....

First portrait of our brave little soldier, approx 1 hr after
birth - 22 March, 2011

Post #200 - The Birth

Of all the blogs I've had (and for those who know me, you know there have been a few), I have never reached 200 posts before.  So it seemed only fitting that I should finally get around to writing the actual birth story.  It's perfect timing really - Chris is out of town for the weekend, Luka's asleep, and I have red wine and chocolate.

For those who have followed the tale thus far, you can see Part I: The frantic departure from Dili, followed by Part II: The panicked check-in to Royal Darwin Hospital, and falling asleep in each others arms on the floor of a birthing room in the public hospital in the Northern Territory...

As explained in Part II, the nurses came into the room every 2 hours to check my vitals throughout the night, which was fine since I was awake busy praying anyway.  I listened to Chris gently snoring as tears continued to soak my pillow.  Finally at 0700 on the 22nd, with Chris still asleep, I leaned over to get my phone so that I could start making a list of things we would need to get for our stay in Darwin. I figured worst case scenario, I am stuck in Darwin for a few weeks (and yes, more than likely not able to fly to Cape Town to have the baby), but that we would be holed up in a hotel room, in which case we are going to need a few basics.  You may recall that in my infinite wisdom I managed to pack my iPod, camera, phone (no charger), five books on natural child birth and running gear for Chris.  Note, no mention of pajamas, chargers, clothes, or other useful things...so, my list went something like this: "Aus sim card, phone charger, camera charger, pajamas, snacks...." and then it happened...

...amazingly, I actually heard my waters broke before I felt the warm gush of fluid soak the bed below me. Here I was, phone still in hand, now lying in a pool of liquid, on the floor of a hospital room, with Chris sound asleep next to me.  Trying to explain the emotions when your waters break 10 weeks early, is not something I am able to do, all I knew was that we were likely having this baby today, whatever that meant.  

Not knowing quite how to wake Chris without completely freaking him out - I turned to him and gently tapped him on the shoulder saying 'sweetie, I think you're going to have to ring the nurse, my waters just broke' - well, you've never seen a former prop go from horizontal to vertical in such a short time. When he rang the button, it was only a few seconds before someone came charging through the door.  I had not seen her before, but took an instant liking to her when the sixty-odd something midwife crouched down beside me on the bed, asked me what happened, and then reassuringly told me "my name is Dee, I'm the midwife on call and I'll take care of you".  I remember clutching her hand so firmly and looking into her eyes begging her to let nature run its course as long as it remains safe for the baby.  She assured me she would discuss this with the doctor and that she would do everything she could.  

Still lying on the floor, still in Chris' boxers (he'd managed to pull a pair of shorts on at this point), I laid there while they took my vitals and what felt like loads of people started pouring in, doctors, midwives, even a social worker to help us find a place to live.  I declined the internal examination, my reasoning being that my water had just spectacularly broke, I did not feel the need for anyone to check whether this baby was in fact coming, we knew it was coming, so just let it be.  

Attached to the monitor shortly after my waters broke**

After a while, I got up, and started moving around.  Dee was in and out of the room, as was the same doctor that saw me the night before.  It was on her second visit to the room when she once again offered me pain relief (mind you this was before I even had any pain), that Chris politely told her that if she offered me any more pain relief after we told her twice already that I didn't want any, he'd ask her to leave.  By this point I had changed into a dry pair of underwear and some more of Chris' boxers and was pacing the room eating the oatmeal breakfast they brought me in a plastic cup.  Chris was on the phone to my dad (the parent with the most favorable time zone at the time), who told us months later that he instinctively knew something was up when he took the call.  While I finished breakfast doctors came and went to take blood and the social worker kept popping in to ask questions.  At some point it felt like we were in Central Park Station, when Chris finally took a piece of paper and wrote a sign for the door that said "We are a Hypnobirthing couple, please respect our privacy and knock, and wait for acknowledgment before entering" kicked everybody out of the room, and shut the door.  Ah, peace and quiet at last. 

On my iPod, pre-shower

At around 10h30 my 'contractions' finally started in earnest, though quite honestly, it was not unbearable.  Dee had me on the bed briefly to take some more vitals, at which time we discussed the fact that she got clearance from the doctors that I could do the birth naturally, provided I agree to being attached to the ECG (the monitor that requires the two big belts around the belly to monitor the baby's vitals), and that I could do anything during labor, but I had to have the baby on the bed to be close to oxygen and everything else.  I agreed, and she helped us kick everyone out of the room from where it was just Chris, myself and her sitting in the corner.  

To get me in the 'mood', Chris popped my iPod out of the bag and instructed me to listen to my 'Rainbow Relaxation' track of my HypnoBirthing training.  After that I immediately switched it to the Birth Affirmations which I literally put on repeat and listened to constantly for the remainder of my birth.  So at 10h30 when the contractions got going, I planted myself on a yoga ball with my elbows and arms on the bed in front of me, and mostly lying with my head in my arms, gently swaying and rocking from side to side while hearing "...I look forward to a comfortable birth, my baby and my body knows what to do...".  In between 'surges' as we call them in HypnoBirthing, I was chatting to Chris, eating toast with Marmite and drinking tea.  Around 12h00 I said I wanted to take a shower so Chris followed me into the shower where I sat on the ball with him hosing my back down as a worked my way through the surges.  We must have spent about an hour in the shower (or it felt like it). By this point I didn't even bother to put any clothes back on, as I walked back to the room and planted myself back on the ball, gently swaying.  A doctor came in to take some blood (must have been in training as he did an awful job of finding a vein), and once the new head doctor came in.  I took one look at this unfortunate mix between Elmer Fudd and William H Macy and instinctively knew that we were not going to get along.  I am sure he is an excellent doctor, and I am sure that I would be eternally grateful for his brilliance if required during the delivery - but at that time, he was just trying to interfere with my birth.  He made me nervous, edgy and uncomfortable with his questions, attitude and constant reference to pain relief.  I tried to ignore him while listening to my birthing affirmations (need I remind you, I was in fact in labor at the time and if you've ever been, you will know that it is a rather otherworldly experience, and not one you want to snap out of because a man needs to ask you some questions).  God bless Chris, who finally stepped up and said that if he had any more questions, he needed to address them to him, and leave me in peace.  I think he didn't like that very much and marched off.  

Anyway, my labor progressed amazingly well.  It was so peaceful in the room, just myself (by now buck-ass naked), Chris (by now only in cargo shorts, no shoes, no shirt) and Dee sitting in the corner (reading our HypnoBirthing book mind you) in Bermuda shorts, sneakers and a golf shirt.  From time to time she would check my vitals and the baby's vitals, I would ask her how we were doing, and she would say just great.  The surges came and went, at which time I would go deep into myself, rocking on the ball, until they subsided - then have another bite to eat, and chat with Chris.  At some point I did get on the bed to rest, and managed to doze off between surges.  I never cried, screamed or doubled over in agony, it was truly a somewhat out-of-body peaceful experience.  With my iPod permanently attached to my head (except for the shower), I walked around, and managed to go to the bathroom a number of times (poor Chris had to come with me because I flat-out refused not to have him with me at all times).  

And so it was that I was actually sitting on the loo for the longest time (those who have done it will tell you it is very comfy while in labor) when all of a sudden, around 14h30, I transitioned into an incredible place...it is at this point that I looked at Chris, sitting in front of me on the floor, and for a brief second thought, oh my god, I can't do this.... and then, it was like the blood drained out of my entire body, from the top, down to the bottom - and then I felt it coming.  Chris (not wanting to fish a baby out of the toilet) yelled for the midwife to come.  The young midwife standing in for Dee who had gone to tea, came in and calmly said 'whoops, yes, definitely time to get you off the toilet and onto the bed'.  Amazingly I was able to stand up by myself, walk into the room adjacent, and climb onto the bed myself, even discussing the most ideal position with the midwife.  Dee arrived back and said that while she was supposed to go off at 15h00, she planned on staying because she was not missing this birth (I was ever so grateful).  She said at this point I had to do a vaginal exam to make sure that I was in fact 10cm dilated before we could proceed. I was.

Then logic kicked in.  I instinctively got onto all fours and asked them to lift up the backrest of the bed so that I could be on my knees and rest my elbows on the backrest of the bed.  As the surges started gripping my body, Chris was to my left encouraging me every single second of the way, and Dee was on my right, monitoring me and the baby, the other midwife also stayed because regulations called for two to be present.  To try and explain the place you go to when in labor is simply not possible.  What I remember is a clarity of mind that I have never experienced before. If I was a bit doozy and foggy during the first stage, the second stage rids you of any and all fog, and delivers *sic* you into the clearest, most intense, most indescribable place I have ever been.  I remember exactly what I said to Chris and what he said to me. I remember the midwife's actions as she checked our vitals.  I remember how I breathed when the surges gripped my body, and how I relaxed and smiled at Chris in between with my head on my arms on the back of the bed...

At some point, I sensed a presence in the room and later found out that the team of pediatricians, NICU nurses and doctors required to attend a premature birth were in fact in the room, but neatly tucked behind a curtain where they could not see me, and I could not see them.  So instead, I was able to peacefully, naturally, and amazingly, let the birth progress.  I recall vividly asking Dee between two of my surges whether she thought I was doing alright, or whether I should flip over into a 'squatting' position - she said that I was doing amazing and everything was progressing.  She allowed me to 'breathe' through the surges and I could feel the baby descend down the birth canal.  

The turning point of my life (note, not my birth) came when she took out a small handheld mirror to have a look and asked me if I wanted to see my baby's head crown - she stuck the mirror between my legs, and at that moment I looked up to see Chris' face as he saw the first glimpse of his baby...and his eyes welled up with tears.  As if I wasn't high enough on hormones and endorphins already!  Dee asked me whether I wanted to touch it, which at first I was reluctant to do because of some fear of infection - but after she assured me that was fine - I did, I felt him for the first time, and emotions just drained out of me.  At this point Dee said that while I was doing really well and the baby was fine, but that he has been in the birth canal for some time now, and that on this last surge, she wanted me to give just one good push to get him out and make sure he does not stay in any longer.  So with one rather vocal finale he slipped right out and plopped down on the bed between my legs with a good cry, and we learned for the first time that we had just had a son.  

Chris proudly doing what he said
he never would!

In a split second Dee handed him to me between my legs and I cradled this tiniest of miracles against my chest ever so briefly before the nurses and doctors appeared to take charge of my baby for the first time in what seemed an eternity.  They unceremoniously cut the cord and whisked him off to the corner for his Apgar and other checkups, Chris close on their heels.  Right before they whisked him out of the room to the Neonatal Intensive Care Unit (NICU), Chris begged them to bring him to me for one more second to hold.  Wrapped in the requisite plastic wrap and with a little cap on his bruised head to preserve his body head, it was incredibly surreal and almost unbelievable that this morning, I was still praying to keep him in, not even knowing who he was, and here we were - parents.  

Thanks to Chris' insistance, I get one more cuddle before
Luka is whisked away to the NICU. I cannot believe how
little he is, and that he is here at all....

Chris stood rather confused in the doorway for a brief moment, looking at them whisk him off across the hall, then back at me - before I told him "I'm fine!  Go to him!"   And just like that, it was over, and yet, it had only begun.  Here I was, sitting up in bed, I had just had a baby, but I might as well have just woken up from bad dream.  My belly was gone, there was a bit of bleeding, but not too much.  Dee and the other midwife flanked me as we waited for the third stage to be delivered, and I just looked up and said, I need a chocolate.

With Dee shortly after the birth, in high spirits (hmmm,
hormones....)

After they were confident that I had delivered all that needed to come out, they asked me to stay in the room for the next thirty minutes to make sure there was no hemorrhaging before I could go to the baby.   Chris came back from the nursery and assured me that our baby was doing really well, and did not require any oxygen, but that he was a little bruised from the birth.  At this point, we realized that we had never actually agreed on a name for a boy.  We've had a girl's name picked out for years (because I was always so convinced I would have a girl), but what on earth are we going to call this little boy.  After much back and forth on family names we had been playing around with, I suggested a name that recently came to me, it had no meaning to either of us, only that it seemed to be a good 'strong' name, and all of a sudden we knew it had to be Luka.  

Our little fighter bravely opening his eyes after being
placed in the incubator...

I got up, had a long, hot shower, then just about inhaled a shepherd’s pie for dinner, wolfed down the entire chocolate without leaving any for Chris while he was on the phone, talked to my parents, and then was given the green light to go to the nursery to see Luka.  I had apparently not compensated for what my body had just been through, because when I jumped up from the floor where we had been eating, the blood suddenly rushed to, and then from, my head and I literally hit the deck.  Fortunately for me, Chris noticed something was amiss and was able to catch me to break my fall, but he did not appreciate the terrifying scare I gave him as he shouted for help.

Turns out I just had to get up a bit slower next time, and we wandered over to the nursery where I came face to face with our reality for the next six+ weeks…

And so the legend began….

** Note, some of the photos have previously been posted. 

5am Musings from a hospital bed

They say you find out what real fear, worry and pain is when your child is sick or in trouble (yes Pa, I know, I know....after all I put you through), and I am coming to realixe that first-hand. While we anticipated yesterday's surgery (unlike the last adventure) and even came properly prepared (I am donning my pj's afterall), watching your infant being wheeled into surgery is not something you can ever be quite prepared for.

We are close to going home again, and as I lie here in Room 6A with Luka asleep in my arms, I cannot help but reminisce about some of the realities and milestones of this experience.

I put Luka to bed in a infant incubator in the neo-natal intensive care unit at 6PM, by the time we got back from dinner at 8pm, he had been moved outside the brightly-lit, always-buzzing humdrum of this most sacred spot where special people care for our special babies. Feeding him I looked in on all those tiny babies and realized that Luka will likely never be in the NICU again...heaven forbid he comes to hospital again, he will go to the pediatric ward.

By 2am I changed and fed him in the nursery, and by 5am he is lying withme in bed, fast asleep and peaceful. What an experience you have given us, perhaps enough for a while?

Update: Luka out of surgery

Luka is recovering after the procedure, he came out of thater wailing, like Chris said that anaethetist has a 'soft touch'. He was only interested in one thing (okay, two) and is now lying peacefully in my arms. He is in some pain but cannot have any pain killers for another three hours unfortunately.

The doctor explained that all went well, but that this sack was almost as big as the last one, so good thing we fixed it now.

No word yet on whether we get to go home tonight or not, either way, hope this is it for a while.

Here(nia) we go again - Luka goes back under the knife

Despite expecting this, it was with some disappointment that we confirmed via ultrasound yesterday that Luka does indeed have an inguinal hernia on the right side of his groin as well.   This means only one thing - back to hospital and under the knife tomorrow for yet another inguinal herniotomy.  Fortunately, unlike the last time this hernia is not strangulated, and is therefore a much less complicated surgery, but surgery under general anesthesia nonetheless.

We check in at 12pm tomorrow, but poor Luka is not allowed to eat after 8am - and guess who has to try and explain that to the growing little boy!  We are keeping our fingers crossed that he can be done shortly after 12pm and that there are no complications.  Unfortunately due to his premature birth it is highly  likely he will be kept overnight again, fortunately his parents do in fact learn from past experience and will be traveling with the requisite overnight attire this time.

Sorry little man - hopefully this is it for a while...

June 18 - Practicing my self-soothing techniques under daddy's
watchful eye.

Snack time!

After another long day with no feeds for the little guy, the surgeon agreed we could give him a 5-7minute 'snack feed' at the breast lunchtime today.  He was SO grateful as was I!  Now we wait and see whether his bowels have woken up enough and are able to process without vomits or worse.

Keeping our fingers crossed, and thank you so much for the good wishes from around the world!

We hope to be able to take him home tomorrow...get this, on his actual DUE DATE. 

Update: Luka in Hospital for Emergency Surgery

"Hello NICU my old friend...."

Alright, not exactly the post I was hoping to write today, but seems our boy needed to have one more bit of excitement before his due date this coming Friday.  On Tuesday morning he cried uncontrolably for the first time in the nine weeks he has blessed our lives.  We thought the dreaded 'colic' may have finally set in, but were corrected in our thinking when we changed his nappy to find a very enlarged groin.  Seems our boy managed to get a pretty inflamed hernia in the groin area.

We called his paediatrician who told us to be there in 45minutes (we live nearly an hour away considering the road, traffic and ancient car).  Long story short, he examined him then whisked us to the paediatric surgeon.  Must say, we were rather relieved to see 'Professor Rob Brown' on the door, with lots of degrees cum laude against the wall...I mean, if you are going to have your baby operated on...

Long story short, Luka went in for an emergency herniotomy at 1500 on Tuesday afternoon at the Life Vincent Pallotti hospital in Pinelands outside of Cape Town (incidentally exactly nine weeks after he was born at 1500 in Darwin).  After over an hour in surgery, we were told that unfortunately the bowel was extremely constricted through the hernia, when it was pulled back through it acquired a small tear. 

The good part is that we caught it early enough to avoide a 'incarcerated hernia' that would have required removal of part of the bowel.  The bad part is that the bowel did tear and we now have to wait for the bowels to function again before he can have something to eat.  He is currently on pretty hectic pain medication in addition to flagyl for the infection.  In addition he is on a drip with electrolytes, sugars and fluids - think living on gatorade for a few days when you are used to lobster and steak.  And mom, I'm feeding the electric pump again.

He is doing well, stable, slightly sedated.  Mom and dad are okay - the NICU is strangely familiar...more on that later.

In the past 24-hours we have not had any bowel action as of yet, we will follow up when the surgeon does rounds again tonight to see whether he is ready to be fed or not.  Either way, Chris and I have once again booked into a guest house five minutes away from hospital and surviving just fine on our new undies, toothbrush and socks we acquired yesterday.

How it all Happened Part II: Preparing for our Preemie

Continued from Part I here...

...as our flight proceeded southbound to Darwin, I was still trying to find some answers for the why, and most importantly, any positives on a prognosis for a baby born at this early of a gestation.  Unfortunately my natural birthing books emphasize the 'normal' in birthing (which is what I loved about it) and less so the 'what can go wrong' bits - so we were stuck worrying and wondering.  Midway through the flight Chris thought it a good idea to request we be let off the plane first when arriving, I quickly grabbed him and told him not to say anything until we were on short-final for fear the pilot might be mandated to turn the plane around if someone was in labor (which of course, we were still praying we weren't).

At the Darwin airport Chris and I disembarked the plane along with an elderly lady with a short connection.  We tried patiently to stay with her and the ground staffer, until we reached the gangplank into the terminal when we sped up our pace.  Armed with nothing but hand luggage and a freshly adhered visa in our passport we stood sheepishly in front of the passport control agent who asked for our arrivals cards.  Of course, we completely forgot to fill them in.  He was about to tell us to step aside and come back when they were complete when I suddenly blurted out "I might be in labor" - I have never seen an immigration officer complete two arrivals cards on behalf of passengers so quickly - within 15 seconds we were stamped and on our way to customs.  Again, they looked at us, I pointed to my belly, and they waved us right through (which is unusual for Australian customs agents!)

In the arrivals hall Chris grabbed cash, I hailed a taxi.  "Darwin hospital please" and off we went...

Sitting in the back of the taxi watching the sites of a foreign city we had only visited once before, go by as the last of the sun starts to dip, I was still praying and tearful, yet survival mode was starting to kick in.  "When should we call our parents, which ones do we wake up?"  I wondered out loud which entrance it was again that my doctor in Dili told me to go to when we pulled up outside the Emergency Entrance of the Royal Darwin Hospital.  At this time my courage sank into my shoes.  Having planned a tranquil all-natural HypnoBirth at my lovely home in Scarborough overlooking the Atlantic ocean, arriving at a state hospital in a strange place, where most of the visitors sat cross-legged on the pavement smoking a variety of legal and illegal substances under the no-smoking signs while drinking beverages from brown paper bags, was not my idea of a good compromise.

We rushed in the door to the window where we were immediately directed to go to the 6th floor.  Ascending the elevator to the 'pink' floor, how could I have known that I would be riding the same elevator for the next six-plus weeks, every single day.  We were slightly surprised that the wards were all behind strict security gates with cameras and buzzers, rather resembling a prison than a hospital.  We proceeded to the 'maternity' ward, where we were sent immediately over to the 'birthing center' to which I objected profusely explaining that 'no one is actually in labor here!'   At the birthing side of things were were shown to a room and interviewed by a young man in slacks and a white shirt with no identification.  He could have been a vacuum salesman for all I know, apart from the stethoscope around his neck.  The conversation centered largely around our family health histories.  We went through the drill of how I felt, what had happened, and what my symptoms were.  He said he would return with the doctor in charge, a young female named Dr. Koh, a more-efficient-than-bed-side-manner-oriented type.   This time the conversation went more along the lines of 'hm, interesting' from her side, to 'excuse me, how bad is it' from mine.

Things quickly progressed to include a vaginal examination and other vital signs being checked.  My world started spinning when she said that I was in fact 1cm dilated and that my cervix had started effacing (or thinning).  To confuse matters more, two separate tests for amniotic fluid came back with conflicting results, so we were still not sure whether or not I was leaking.  She had to leave to attend to another woman in labor and I was left trying to keep things together and remain calm, until we met Dr. Andreas. The nice German  had actually participated in the Tour de Timor the year before and we made some small-talk about the island we lived on. It was when he introduced himself as the pediatrician on duty that I panicked and realized that yes, there is a high possibility now that there is a baby in our very near future.  He was also the first one to explain to us not only the risks involved, but also that should it be the case that we have the baby in the coming hours/days, it is very likely that he/she will have to remain in hospital until the due date - that was almost ten weeks away!

When he left, Chris and I had a few minutes to try and grapple with the reality we were possibly about to become parents.  I started crying again, Chris tried to comfort me and we started making a list of all the questions we needed to ask.  Then we turned our attention to the first matter at hand, birthing this baby, if it turned out to be the case that the Bun was in such a hurry.

As it turns out, Australia, much like the UK, has a very strong midwife culture therefore all the nurses on staff in the birthing center, are also midwives.  Having planned a midwife-only assisted birth in Cape Town, we quickly turned our attention to the young midwife assigned to take care of me after admission.  Not only did she bring us dinner (which, at the RDH at 1900 on a Monday evening consisted of a vending machine sandwich), she also tried to make us as comfortable as possible (which, in a birthing room with a single bed and one chair was not easy).  We immediately started talking to her about the perfect pregnancy we had experienced up until 24-hours before, and the equally perfect birth we had been training and hoping for, and whether or not, in the event I did go into labor, I would be able to have the baby naturally.  She comforted us and said that unless something was wrong (cord, breech, low vitals etc) there should be no reason I could not.

Next up was the small matter of logistics.  Here we were, in a hospital at the far northern side of a town where all the hotels were located in the southern end of town.  We had no friends or family, no reservation, no local phone, no internet access, no car, no place to go.  It was nearly 9pm and I may or may not be in labor.  The most important thing for us was to be together and I could not even bare the thought of staying behind in hospital alone, which is exactly where they wanted to keep me for observation overnight.  So we did what every insured person would do -  inquired about a 'private room'.  (Note: At this point, we did not even know whether my insurance would cover any of this, I mean - does one get pre-approval for this sort of thing? who knew?)  Unfortunately we were told, the maternity ward is completely full, so there was no way Chris could stay.  The midwife must have seen the panic on my face because she promised to try one more thing.  When she returned she informed us that we could spend the night in Birthing Room 6 down the hall, unless at some point, someone actually needed to birth in it.  We thanked her and watched them drag a mattress in for Chris to sleep on the floor. Looking over at the bed, I thought to myself there is no way I am sleeping on a hospital bed, since in my mind, I was not exactly 'sick'.  Instead, we removed the couch cushions and created a makeshift bed on the floor for both of us.

In my haste to pack and make the flight, I managed to pack every book on labor and child birth I could carry, as well as a number of other items like my iPod, camera, and a handful of Balance bars.  What I did not pack, were hospital necessities like pajamas, so in addition to the t-shirt I wore over on the flight, I changed into a pair of Chris' boxer shorts.  At this point we knew we had to let our families know what was going on. Due to the timezones we decided not to wake Chris' family at this time until we knew what was going to happen, but opted to call Susan's dad in South Africa - who, months later, told us that when he saw the phone ring from my Timor number so early on that Tuesday morning, he knew that something was wrong.  We explained to him what was going on and promised to keep them updated along the way, explaining that we were going to spend the night in hospital, but that the midwives were still hopeful that the labor would be delayed thanks to the nifidapine I was receiving.  

The midwives who took care of us that night were in a word, angels.  They dragged a lamp into the room so that they could turn the lights off, encouraging us to get some sleep between the two-hourly vitals checks I was receiving.  So once we had brushed our teeth (I did manage to pack toothbrushes), we curled up in each others arms on the floor of a cold birthing room at the end of the corridor in a hospital in a strange city in a strange country far away from anyone we knew, and everything familiar, and we prayed together that this baby please remain inside of me for a few more weeks, or even days.  Tears ran down my face pretty much permanently at this point as we vowed to each other that we would try and get some sleep because whatever tomorrow might bring, it was bound to be exhausting.  I listened as Chris drifted off to sleep and then turned on my back and resumed praying, the constant stream of tears soaking the pillow behind my ears...

Stay tuned for Part III, our birth. 

How it all happened...Part I

Alright, after all the comments we received from people begging us not to stop the blog now that Luka is home, and also the dozens of requests for the story of how it all happened, I thought I would use my new-found freedom from the confines of the nursery to jot down how it all happened. After all, how does a South African and an American who currently live in Timor-Leste, expecting their first baby at the end of May, end up delivering in Australia in the middle of March?  Seems logical no?

It all started on the 20th of March, incidentally also my father's 60th birthday which we sadly had to miss due to our impending trip to South Africa for our extended maternity leave.  In order to uphold a long-standing tradition of trying to throw Chris a surprise birthday party every year (any of our Iraq friends remember the one I arranged for Chris' 30th in Baghdad, while I was in Pretoria; who here went to U2 for his 23rd in Johannesburg; and the SMRC gang, who can forget the fabulous Big Bear weekend where we all met Stu's girlfriend (now wife) for the first time) I arranged the first-ever charter of the new boat of the dive shop in Timor where Chris is a part-time instructor.  With twelve divers and two pregnant girls on board, we set off for the island of Atauro for a day of diving, lunch and birthday fun.  The trip was a huge success (despite an auspicious second dive) and some fun snorkeling for those of us no longer 'fit' to dive.

When we got home, Chris made dinner and I sat at the kitchen table. I noticed mild 'cramping' and told him that it must mean I was experiencing 'practice labor' also known as Braxton Hicks contractions.  These mild contractions are common in the second and third trimesters and prepare you and your uterus for the real deal. At 30 weeks gestation, I was quite excited to experience them, thinking that my uterus must be working just fine.

I became somewhat concerned when the cramping did not go away overnight, since these generally disappear when you change positions or whatever activity you are doing, however mine persisted throughout the night.  The following morning I phoned one of the midwives who conducted a birthing class for all the pregnant couples in Dili that Chris and I attended. and asked her whether she thought this was something I should be concerned about. She said probably not, but to be safe, I should call the doctor I had been seeing at the Australian Embassy.  I did so and was informed she was at a meeting until 10am, I told the friendly receptionist to please tell her I was experiencing mild cramps, to please call me back. Promptly at 10am I received a call asking me to come in at 11am when she had a cancellation. In the absence of the Country Representative of my organization in Timor, as the Deputy Country Representative, I was currently in charge of almost sixty staff members and in the middle of a host of programmatic and logistical tasks.  I momentarily considered not going to the doctor, when I thought better of it, so I excused myself from my 10:30am meeting, and told my colleagues I would be back in an hour to finalize our discussion, I never returned to the office.

In the car on the way to the doctor I first felt something wet. I desperately hoped it was the heat and humidity causing me to sweat profusely in my old car with the broken aircon.  However I cannot deny I was secretly terrified that my amniotic fluid might be leaking. At the doctor's office she took my vitals and we discussed the symptoms, but she was unable to check the fluid because she does not have testing kits for amniotic fluid. I was instructed not to return to work, rather to go home and rest, that she would call me in an hour to check on me.  She also asked me to start timing my 'cramps'.  I started writing down the times and duration of the cramps in a notebook. When the doctor called and I mentioned these 'cramps' had moved from being 10 minutes apart, to roughly 5 minutes apart.  I would say that this is when I first heard the concern in her voice. She asked where Chris was, I mentioned he was on his way home from work - she said we needed to get to Australia ASAP.  The only problem was, it was Monday afternoon at 1pm, and the next flight left at 5pm - or so we thought.  Turns out the last flight for the next two days was scheduled to leave Dili for Darwin at 3:30pm.

When Chris got home he grabbed my passport and rushed off to the Australian Embassy to process the emergency visa I am required to have in order to receive medical treatment in Australia.  In the meantime, I continued to time my cramps, while jumping online to buy plane tickets, and pack for who knows what!  I remember standing in my dressing room thinking, what do I pack?  I mean, I could come back a mom, I could just come back a few days later, I might never come back, or I might come back in six months?  What exactly does one pack in these circumstances?  In my case, turns out to be my iPod, a camera, all my books on natural childbirth, and running gear for Chris (I was smart enough to think he might need to blow off some steam at some point), and the locket my dad gave me for my 21st birthday before I moved to the US with Chris.

A driver from my office picked me up and took me back to the doctor who had since been in touch with a doctor at the Royal Darwin Hospital. Based on the instructions from a specialist there, she administered a dose of nifedipine to try and slow the contractions down (and hopefully avoid pre-term labor), as well as a dose of steroids to assist in lung development of the baby in the event I did deliver early.

Thanks to the doctor and the Australian Embassy in Dili, Chris managed to get the emergency visa within the hour and met me at the doctor's office at 3pm, where he took the reigns of the vehicle and rushed us to the airport for the 3:30pm flight (note: as with most first-time dads one of his biggest fears was some mad rush to the hospital with me in labor).  At the airport we checked in, then spotted the midwife and doctor charging into the terminal, there to make sure I was still stable, and to check my vitals one last time before I boarded the flight.  

With my hopes up and my heart in my throat we boarded the 70 minuted Air North flight TL519 from Dili to Darwin.  While still experiencing the 'cramps' I clutched Chris' hand as I desperately paged through my books trying to find something comforting about pre-term labor...details were sparse.  Instead, we prayed that everything would be okay and that the trip only meant being out a few hundred dollars in plane tickets and a few days spent in Darwin....

to be continued....

Finally, the very special day...

Last photo in the nursery before walking out the door,
baby in hand.

As we sit here watching the wedding of Prince William and Kate Middleton, I am reminded fondly of one of my most poignant childhood memories.  The wedding of Prince Charles to then 20-year old Diana Spencer in July of 1981 remains vividly etched in my mind.  I was four years old. My mom took myself and my infant sister to watch the ceremony on my grandmothers tiny black-and-white television in her brick house with the red front stoep in the Johannesburg suburb of Boksburg.  It was a frigid day in Johannesburg, and I slipped in a puddle of water on the polished stoep then spent the entire ceremony next to an old asbestos (ugh!) heater draped in a tiny bath towel.

Walking out of the nursery for the last time we felt
almost awkward, like we were doing something illegal...
(photo: Nurse Jools)

Today, three months (to the day) short of exactly thirty years later, will in turn become one of my most poignant adult memories, this time however, not for the matrimony of a young prince to a beautiful commoner and future queen of England, but rather, as the day Chris and I brought our own little prince, our young Luka home from hospital.

After spending the first 38 days of his life in the Special Care Nursery at the Royal Darwin Hospital in northern Australia, Luka literally saw the light (and felt the wind, and the sun) on his young skin for the first time today.  Born nearly ten weeks early, he has fought and exceeded our every expectation as he is released from hospital a mere 5 weeks 3 days later, at the young age of 36 weeks and 1 day gestation.

The magic number that secured
our release - a gain of 65g
last night!

He has taught us more in five weeks than our combined educations multiple universities has, but most of all, he has taught us humility, perseverance, and the importance of a fighting spirit.  As we watch the spectacle of the Royal Wedding unfold on television, we wonder what Luka's life will hold for him, and for us.

There are so many people to thank for the support, love, care and prayers over the past six weeks, we will attempt to recognize you all in the coming days and weeks as our new life takes shape as a family.

God bless Luka (and the Queen too)

Walking towards the elevator on the 6th floor
 (photo: Nurse Jools) 

Still a long way from Cape Town, but at least we
are all together now...

Taking Luka back from the hospital

Leaving the Special Care Nursery

Leaving our corner spot in the Special Care Nursery
on Day 37

One of the Paediatricians shows Susan what to listen for
during the examination to determine if Luka is strong
enough to leave the nursery

As with so many steps along the way, it is really hard to explain the feeling when you are about to leave the Special Care Nursery, with your baby, for the first time.  Although we only migrated across the hallway to the Maternity Ward (known here simply as "6A") the psychology of packing up the stacks of preemie books, granola bars, tiny nappies, water bottles, gift teddies, deflated balloons still pasted to the wall, is once again - indescribable.  An odd mix of emotions run over you yet again.  "Are we ready?", "what if he doesn't eat well tonight and they bring him back here", "why is this taking so long?", "why isn't anybody saying 'goodbye' to us?"...to the empathy that washes over you as you bid your neighboring mom and her battling little breastfeeder farewell.

Wrapped in blankets in the freezing ward room, Susan and
Luka are at it to ensure sufficient progress 

The reality is that this day sneaks up on you almost as much as the birth does.  Just when you have the system all figured out, and you reach the point where you think you cannot stare out the same window at the same patch of the same town any longer - you are ushered one step closer to the door.  And so it was that at 13:30 on April 28, 2011 - Chris, Luka and I loaded up his cot and departed the Special Care Nursery for our overnight test known as 'rooming in'.  Essentially a controlled independence (to quote Stacy again) to ensure that mom can read the preemie's cues for feeding times, and that the baby is strong enough to take his feeds from the breast instead of the tube.  A required weigh-in will determine whether the preemie has gained (or not lost) sufficient weight to proceed with the experiment, or if he is not yet ready.

Bacon and banana pizza with good mozzarella....aaaah

As for our first rooming-in night, what a relief not to have to leave him behind.  Those of you who know me well know that I have a certain aversion for going to the doctor, and in particular for hospitals - I assure you, I have never been as thrilled to book myself in to hospital as last night, and promptly asked the nurse in the nursery where I would get another bracelet! (I did).  Chris moved us over here, then ran to the mall for some sushi for lunch.  Here we spent the afternoon cuddling, reading and blogging.  Chris returned later with home-made pizza and sparkling water (though I am sure the stewed meat-surprise with green jelly and custard pudding and a side of sliced white Wonderbread and margarine was delightful).

Way past the 8pm cut-off for visitors, Chris quietly changed Luka's nappy, and then dressed him as warm as possible to protect him from the frigid temperature in this room.  I changed into what little warm clothes Chris managed to scavenge for me at home.  We said our nightly prayer for Luka, and then poor Chris had to leave both of us behind.  It was really quite emotional as he said this was the second hardest night to have to leave the hospital.

Left behind, but right next to Luka for the first
night together

I admit that I was a little nervous, knowing that Luka had to prove himself overnight that he can feed on his own.  Considering he hadn't been feeding that well during the day what with the brain and eye examinations...I was a bit concerned.  Add to that the normal motherly fear of not 'hearing the baby' wake or heaven forbid stop breathing...it made me wonder, how did my profoundly deaf mother survive those long nights waiting outside my bedroom door, constantly checking with her hand over my mouth to ensure that I was still breathing.

Well, it is 07:30 now, we made it through the night with four good feeds in the last twelve hours. Chris is on the way over to the hospital now (hopefully with emergency coffee!) then we plan on weighing him together at the nursery...I guess the proof will be in the pudding when we put the little chubber on the scale.

Fingers crossed.

Day 3 Update: Daddy's first diaper change

Dear family, 

Daddy's first diaper change. Ever.

A little later than yesterday, but here is a brief update on Luka's third day (25 March 2011).

We continue to do 'Kangaroo Care' for approximately 10 hours every day, meaning bare skin-to-skin contact for Luka with either Susan or Chris.  

Feeding: Yesterday the little man had another great attempt at the breast, and managed to latch long enough to get a good couple of suckles in.  The most promising progress is his current trend of digesting food well enough to receive continuously increased amounts (considering we started with 0.5ml of colostrum on a cotton swap a mere 4 days ago, to now being able to tolerate 10ml of breast milk every 2 hours via the tube to his tummy - what he gets from mommy is a bonus)

Breathing and other vitals: Remains strong, still no need for oxygen and other assistance - though we had to recalibrate our own attention to the alarms yesterday when Luka got a little 'too comfy' on a chest and his breathing slowed - it was nothing to be concerned about, he corrects this himself, just his jumpy parents with alarms that don't mix well right now.  The good thing is that he does correct it, and then the alarm resets - but upsetting to rookies nonetheless.

Jaundice: His jaundice was low enough yesterday to be removed from under the light, but it is expected that it might return again for a bit more treatment before he rids his body of all the hemoglobin (increased feeding will help);

Medication: After clean blood screens, he was taken off all medication including antibiotics, and presently only receives some glucose through a drip to augment the feeds, again, as feeds are increasing, this is decreasing so we are hopeful to 'graduate' from another pipe soon (this one makes changing and snuggling particularly difficult)

First family portrait

Luka continues to amaze us every day, considering he was born somewhere between 30-31 weeks, and most nurses and doctors don't expect a baby to have the ability to coordinate breathing, sucking and swallowing necessary for feeding until around 34 weeks.  We are eternally grateful for his progress, and are slowly settling into that unmistakable bond that one can only ever imagine if you have lived through it.  For now, Luka has short 'awake' spells when we try and put him on the breast, or we change him.  Chris did a magnificent job of his first diaper change yesterday ever.  He simply walked in and said 'I'm determined to change my first diaper today' and then did an excellent job, despite his hands being far bigger than Luka's entire backside.  

Susan continues to do well, emotionally still a little rough around the edges, but Days 3-5 are apparently rough with the hormones all over the place.  Chris remains ready with snacks, chocolates and tissues pretty much on demand for which Susan is very grateful.

Camping out in the Special Care Nursery (SCN)

Good news is that we have secured a house to rent close to the hospital which will make our living situation a lot easier than being in a TravelLodge 20 mins away.  

Attached are some photos from yesterday.  Once again, thank you to each and every text message, email message and phone call we have received.  We appreciate your love and support.  Also, we have not yet managed to send out the wider distribution email to our friends around the world but we intend to do so tonight - you will also be on that list - once that is out, the 'Facebook ban' is lifted.  As always, we really appreciate your understanding.

Much, much love

Chris, Susan and Luka