• Paloma woke with cramps about 6 a.m.
• She went to see her OB, Margaret Moore, who confirmed that the cramps were contractions and that Paloma's cervix was slightly dilated
• Paloma was admitted to Dominican Santa Cruz Hospital around noon
• I arrived shortly thereafter (thanks to Karen who gave me a ride there from work)
• Paloma was given magnesium sulfate in an attempt to slow and stop the contractions
• She was given a shot of a steroid to help the baby’s lungs mature if he were to be born premature
• She was given an antibiotic since the first tests showed bacteria in her urine and sometime this is seen in cases of premature labour (a later test showed no sign of bacteria)
• By 5 p.m. her contractions were steady and rhythmic (more so than many women at full term) despite the magnesium sulfate and her doctor was certain that the baby would be born that night
• Paloma was moved to a larger labour room and the staff of the intensive care nursery were on hand to take the baby and look after him when he was born
• The doctor stopped the magnesium sulfate and the contractions became deeper and came closer together
• Around 6:30 p.m. her doctor started asking Paloma to push with each contraction
• After one such push her water broke forcibly spattering all those around (including me)
• A few pushes later and the top of the baby’s head could be seen
• One push after that and the baby was forcibly ejected
• Doctor Ismail, the Dominican neonatal pediatrician, began working on him right there in the delivery room
• Paloma and I quickly discussed names and, after considering Lyle Walker settled quickly on Lyle Bartley (Bartley was Paloma's father's middle name, Lyle is just a name we really liked)
• Lyle was taken to the intensive care nursery where he was put on life support
• I went to see him there
• One of the nurses beckoned me over and said that I should be the one doing what she was doing
• She had me put my little finger in his hand, he curled his tiny fingers around mine
• I stood there watching as tubes were inserted into him
• Around 9:00 p.m. the nurses from Stanford arrived to take him to the Newborn Intensive Care Unit (NICU) where they have the resources and talent to look after him
• At 9:30 Paloma was wheeled in to see Lyle before he was taken to Stanford
• She only got to look at him and touch him for a few minutes before he left
• I made a quick dash home at 10:00 to pick up some items we would need for the night (toothbrush, toothpaste, brush,… the usual stuff that one needs for a hospital stay which we would have packed had we known that we would be staying at a hospital)
• I put out the garbage, strange to be doing something so normal on such an abnormal day
• When I returned around 11:00 Paloma had been moved to a room in the post-partum wing
• She was exhausted but wired, I couldn't sleep, I read to her the last couple of chapters of Harry Potter and the Goblet of Fire (by J.K. Rowling) before we tried to sleep

I am sorry if this bald statement of the facts seems somewhat dispassionate. It is very hard to describe my feelings while all this was going on. Even thinking about the scene now brings tears to my eyes. He was so desperately small. Both Paloma and I wanted him to have the best start possible in life. It was frightening to think of him coming into the world while so unprepared. The doctors and nurses at Dominican were extremely gentle and caring. We will always be grateful to them for giving him such good help at such a crucial time. They were also very supportive of us. Their kindness made an unbearable situation somehow bearable.

• At about 1:30 in the morning a nurse came into our room to tell us that Lyle had been admitted to Stanford and that one of the doctors there would be calling us soon
• We learnt that Lyle was doing okay but that he needed a blood transfusion and she wanted to check with us before giving it to him
• She talked a lot about the safety of the blood supply and mentioned the possibility of having me donate blood for him
• I didn't realise it at the time but the amount of blood he needed was on the order of tablespoons full, I had a mental image of a huge bag being dripped into him but really it was just a small syringe worth
• We slept, or tried to
• I don't think Paloma got much rest, all night I was dimly aware of her getting up to go to the bathroom or adjust the curtains or something like that
• At about 8:00 the nurses started coming in to check on her, Paloma was ready to go, she wanted to see Lyle
• After much waiting and talking with all sorts of people (the birth certificate lady, the lactation consultant, her OB, various nurses) Paloma was released around noon
• We went home to clean up and get ready to see Lyle
• We packed as though we were going to stay up there to be close to him
• After making many phone calls and sending many emails we finally left the house around 3:30
• It's frightening to see your baby wired up to so many different machines, on meeting Barbara, the nurse in charge of Lyle, I told her that I really wanted to know what all those numbers and read-outs really meant
• She cautioned me to focus on Lyle not the numbers but was very good about explaining the important ones
• I can now read the important signals: heart rate, respirations and oxygen saturation
• When his oxygen saturation falls below 90% and alarm goes off and his nurse comes over to see what's happening, she calls it "de-satting", it takes me a while to realise that she means "de-saturating", I'm taking it all in but not really tracking very well at this point
• In our quiet time together, while Paloma's pumping, I begin reading The Martyrs and the Picts (by Arthur Ransome) to her
• Later that evening, after much agonising and guilt, we decide to return home, everyone has told Paloma that she needs to be rested and to look after herself and I feel (and she agrees) that home is the best place to do this, our night at Dominican was less than restful and that really tips the balance in favour of heading home

• Lyle is agitated
• Every sound or touch causes him to squirm
• His alarms go off continuously
• He knocks out his arterial line
• He is given some morphine to calm him, this only works temporarily, perhaps half an hour
• At one point his nurse decides to try another shot of morphine, it doesn't help
• The next thing we know he is surrounded by a team of doctors and nurses, we watch, I don't really comprehend what I'm seeing, I now understand, when your baby's in the NICU the response is quick when he's in danger

• On arriving at Stanford we were met by Dr William Rhine, one of the physicians looking after Lyle.
• He took us into his office and told us that Lyle had been bleeding into his brain, this was why he was so agitated yesterday.
• He explained that one of the consequences of this could be that the ducts which allow cerebrospinal fluid to flow freely could become plugged causing a build-up of fluid in his head and that this could lead to developmental problems, possible even cerebral palsy. He said that in the worst case we would have to decide how heroic we wanted his care to be. We would have to decide whether he should be removed from life support or not.
• Various tests were done: x-rays, an ultrasound of his brain and so on.
• During the shift change Paloma and I went to the rooftop garden to think about what we've heard. The news has been devastating. The outlook for Lyle seems grim. I tell Paloma that if Lyle dies I will be heartbroken and I will grieve but that I cannot make the decision to remove him from life support. She says that we will take him home and deal with whatever problems he brings with him.
• He was given Phenobarbital in hopes that it would prevent any seizures from happening.
• We stay with him until about 10:00 p.m.
• At the end of the day Karen, his nurse, has us hold his feet in our hand.
• He seems much calmer and doesn't flinch from our touch as before.

 Day 5 (Monday)

• Lyle has been transferred to an isolette
• He is much more stable
• He is breathing room air and is still getting enough oxygen
• The noises in the room don't bother him as much now (and sometimes there are three or four babies crying at once)
• We touch him and talk to him all day
• We really needed to see him looking this way after the trauma that was Sunday
• The EEG didn't show any signs of seizure
• He hasn't received any more Phenobarbital, this is a good sign

• We cringe whenever we see Dr Rhine, he is a good and caring man and has a wonderful smile but he has been the bearer of bad news and it's hard not worry when he wants to talk to us.
• The nurses are always upbeat, focussing on the positive parts of Lyle's progress, helping us to do so too.
• He's getting less ventilator support and needing less sedative.
• All is calm, we're starting to fall into a routine, it's amazing to me how we adapt to our circumstances, life in the NICU is anything but normal but it feels almost comfortable now.
• When we arrive we check all his monitoring machines, they are reassuring rather than frightening.
• We like it when the nurse is ignoring Lyle, it's a sign that he's doing well.

• He gets his first try at breast milk, Paloma has been pumping like crazy 8 or 9 times a day and finally he gets to have some.
• We watch as Linda, his nurse that day, inserts the tube down his nose and into his stomach, he doesn't like it.
• She tries to tape it into place but the tape won't stick.
• When she's not looking he reaches up and pulls the tape away from his nose.
• Later, when his nurse steps out of the room for a moment, he pulls the entire tube out of his stomach, that's my boy!
• Dr Rhine stops by to talk with us later, he has the unofficial results of the latest head ultrasound.
• To him it looks as though the ventricles in his brain haven't gotten any larger, it looks as though there is no new bleeding, it looks as though some of the old blood has been absorbed, this is about the best that could be hoped for.
• Lyle will have to be watched closely for the next few weeks to make sure that there are no signs of fluid accumulation in his brain, we are cautiously optimistic.
• After shift change that evening Lyle gets a new intravenous (PICC) line installed, it's inserted in around his elbow and threaded up into his chest.
• He isn't tolerating the breast milk just now, he's probably just too stressed out by the installation of the PICC line, they decide to let him rest overnight and then try again on Wednesday.
• Lyle gets his first visitor, Christine stops by to see him around 9:30.

Our friends and family have been wonderfully supportive throughout this entire trauma. The phone calls and emails have been overwhelming. I apologise for not answering them all yet. I will get there, I promise. It is the small kindnesses that make it possible for us to get through the day. We thank-you all and can't wait for you to meet our son.

If you want to stop by the NICU for a visit here is our current schedule:

We arrive in the early afternoon, generally between 1:00 and 2:00. We are politely asked to leave (kicked out) between 3:00 and 4:00 for shift change and doctor's rounds. We are kicked out again between 7:00 and 7:30 by another shift change. We leave for home about 10:00. Otherwise, if we're not in the room with Lyle we will be back shortly (Paloma's probably pumping). One of Lyle's immediate family has to be with you when you visit him (that would be either me or Paloma). He's only allowed two visitors at a time…

• When we arrived at the NICU Lyle had made all sorts of progress. Instead of having a tube down his throat to help him breathe he was on a CPAP (uh… Continuous Positive Airway Pressure, I think) machine. This was a wonderful change since being intubated has got to be uncomfortable.
• We spend a lot of time just touching him. One hand on his head, one holding his legs. He really likes this and we can see him getting calmer and calmer and as a direct result his oxygen saturation getting higher and higher; several times Cathy, his nurse, comes by to turn down the amount of oxygen he's getting.
• Cathy finds him a bunting on the theory that he would really like his legs to be confined. In the womb they would be. I pick him up, very gingerly, one hand under his head and one under his butt, while she places the bunting under him. He likes it a lot and again becomes calmer.
• I get to take his temperature. They use those digital thermometers. I stick the business end into his armpit (bet you weren't expecting that!) and then hold his arm over it until it beeps.
• I also get to change his diaper. Not once but three times (he is on IV fluids and so he has to eliminate a lot of extra fluid). The first time was hard. It was (quite literally) the first time I have ever changed a diaper. I'm afraid of breaking him. He's so small. His nurse cautions me not to lift his butt up higher than his head. I fumble around but manage it. The second time is much easier. The third time is when he's on his belly. It's a killer. His nurse says that in real life we would almost always flip him over for the procedure but that's difficult with his CPAP device in place.
• Finally, towards the end of the day, Lyle gets to try breast milk again. A syringe containing 4 cc's of liquid gold is attached to the tube going down his throat and a mechanical plunger device ensures that he gets it at the rate of 1 cc an hour.
• We head home happy that he is finally making some really good progress.
• Lyle is a week old today.

View Lyle's Guestbook
Sign Lyle's Guestbook