“Malia Mei: A Courageous Birth” is a memoir by Michael Moline, a college instructor, loving husband and devoted father, that includes his recollection of the joy, fear, and hardships leading up to and following the unexpected premature birth of his daughter. Jelly Bean Journals is honored to share their story in this multi-part, bi-weekly series.
MALIA MEI: A Courageous Birth
by Michael Moline
One of my first phone calls I made while on the road that morning was to Sophea to 1) let him know the situation and that his sister was about to have her baby and 2) hope to have him come down to help us out. My mom would arrive a few hours later, but in the meantime, it would be nice to have Sophea there to watch Ariah and to get my mom from the airport. Sophea initiated the decision to come down and he got on the road shortly after I did, subsequently leading him to arrive in Denver shortly after Malia was born. He would only be in Denver for a few hours, but as it turned out, his presence was vital.
Much of my anxiety about Malia’s health was suppressed by the medical staff in the delivery room. They assured me that Malia looked great. She needed a little bit of oxygen support but that was to be expected with a premature baby. I felt very relaxed and a little bit hungry. I knew Ariah needed to eat as well.
The old cliché “calm before the storm” comes to mind when I reflect on the hour or so between Malia’s birth and receiving the dreadful news. Ariah and I went to lunch in the hospital cafeteria, allowing Cherry to visit with her brother and recover, as well as allow time for Malia to get settled in at the NICU before I would go see her. Ariah and I had a pleasant lunch, providing us with an opportunity to have some bonding time before our growing family would limit those opportunities. It truly was a relaxing, peaceful, worry free time. Upon finishing our meals, we of course headed right back up to Cherry’s room, anticipating an opportunity to visit Malia as she was likely checked in and settled into her room in the NICU.
It is impossible to describe in words, pictures, videos, or any other earthly means just how I felt over the next seconds, minutes, and hours. It could only be done by crawling inside my body and mind during that time. And, considering all circumstances, it is unlikely that there are many who have ever had the same feelings. That’s not to say this is worse than anything many people have experienced, but rather, drastically different. Perhaps those who have believed they would lose their child may have been close. Those who have lost a child might find these emotions laughable in comparison. But ultimately, the indescribable emotions that soared through me were unique and this entire manuscript exists because of this particular experience.
After Ariah and I returned from our simple, peaceful lunch, Cherry requested that I call room service and order her lunch as she was recovering and finally ready to eat. As I sat on hold with room service, Ariah continued to try to walk into an area not thoroughly cleaned (I had seen a nurse practitioner stumble over a part of umbilical cord in that spot just an hour prior). Concerned about her around the biohazard material, I finally snapped, yelling at her to stay away. This set her off into a frantic, three year old, temper tantrum and all she wanted to do was come to me, through the blood, where I was on hold on the phone. Sophea was holding her, trying to calm her down, my stress was rising, Cherry was annoyed, and then it happened.
The nurse practitioner entered the room with a serious look on her face. Assuming it was a simple matter of discussing when we can head over to the NICU, I requested (and Cherry obliged) that I hang up the phone and call back to room service after the discussion. Then she rocked our world.
“She’s having trouble breathing. I think dad needs to come to the NICU right away and spend some time with her. I’m sorry.”
My knees buckled, sending me into a tucked, crouched position. I think Ariah immediately stopped crying. Cherry started to. Through labored, short breaths I muttered some sounds, intending to ask for more details. A nurse put her hand on my back to console me. The nurse practitioner did the same for Cherry. Countless times over the next seconds or minutes, under my breath I declared “no no no no no no” and “don’t don’t don’t.” I was speaking to God. It was a combination of raging demands and sorrowful pleas.
Somewhere along the way, the nurse practitioner mentioned something about getting information from the physicians. I did not know if this meant that only they were allowed to provide the specific, tragic news or if it was a sign of hope. Either way, I knew I needed to be in the NICU and I knew I needed to pray the entire way.
I told Cherry I would like to get over there to get some answers. She agreed it was a good idea. The nurse practitioner and I immediately left for the NICU, on the other side of the hospital.
The walk to the NICU:
Not much changed in my body and mind during the walk to the NICU. My body wanted to give up and pass out. I could feel myself wavering on the edge of lucid consciousness. Early in the walk, we needed to take an elevator. I once again crouched to a balled up position and briefly told myself “this is your one moment you can take to prepare yourself physically. As soon as those elevator doors open, your only physical job is to get to Malia.” My legs would continue to work no matter what; I made sure of it. That did not stop my vision from becoming blurry and my head from turning to mush.
As we continued the long walk to the NICU, I was able to decrease my demanding “don’t” comments to God. I controlled those thoughts and turned them into an increase in pleading prayers to save my baby. Although in that moment I still believed we would lose Malia, hope started to set in.
At the NICU:
It was probably a 5 minute walk to the NICU; we took the more direct, staff only, back rout. But it sure felt like 20 to 30 minutes before we arrived. My blurry vision from the previous 5 minutes became tunnel vision to a location where I saw several NICU medical staff members in and around the same room. As we approached, I was introduced to one of the physicians for about 3 seconds (enough time for him to tell me his name and that he is a physician working with Malia). Moments later, her specific physician came up to me and told me about her condition. She was requiring too much supplemental oxygen and needed additional support. They would treat her for an infection, though there was no way to confirm that was the problem until a later time. The next 12 to 24 hours would be critical.
During the conversation, I looked into Malia’s room and noticed six or seven people around her bed, working. At no point over the rest of our stay in the NICU did I ever see more than three medical staff members around one baby, more than two was very rare, and it was almost always one or even zero. In other words, six or seven is immensely serious and scary.
They wheeled Malia across the hall from her private room into a bigger room, suitable for four babies and larger, more extensive machines. As she was brought across the hall, I saw a nurse providing bag valve respirations for Malia as the team continued to work and move her. In the other room, they intubated her with a machine known as an oscillator, provided her with IV lines, and a line through her umbilicus to a major artery. I learned all of these facts later. In the moment, I simply sat and watched with a blank stare, continuing to pray to myself.
Over the course of her immediate treatments, several staff members sat next to me to try to explain what was happening. For the most part, I did not hear their specifics. All I wanted to know was the statistical prognosis of her survival. But I was too afraid to ask. I gave clues that I wanted to know, but no one would give me a number. “We are staying ahead of her condition. We lose if the condition gets ahead of us, but we are very good and plan to stay ahead of her condition.” Staying ahead of the condition, I came to find out later, included the aforementioned processes as well as opening her lungs with surfactin and pumping her with broad spectrum antibiotics.
Malia’s physician once again mentioned that how Malia reacted over the next 12 to 24 hours would tell us a lot. She was “stable but critical.” If the treatment began to work, we were in good shape. If something new popped up or she did not respond to the treatment, we were in trouble.
I spent a few hours at the NICU, despite the fact that after about one hour, there was nothing to be done except wait and see. But I didn’t know that for sure and frankly, it was hard to move. I tried to contact Cherry to make her aware of anything I knew, but she did not have her phone readily available. Luckily, Sophea had his and I could communicate what little I knew (it was later that I found out most of the medical details. To that point I just knew that we were in a wait and see situation). Having his phone available was the least of his vital role that afternoon. With Cherry having little to no information for quite some time, Sophea was able to provide invaluable emotional support for her while I was with Malia. They sat in the room, praying and crying together. As Ariah would later point out “mom’s and dad’s cry a lot at hospitals.”
After a few hours, I was told that there is very little chance of anything happening over the next few hours and if I wanted to be with my wife, it would make sense to leave. I was given a card to use so I could call them at any time, 24 hours a day. Because it would be easy for me to contact them and there would be no reason for the medical staff to contact me without much status change, I was told that they would not contact me unless something drastic happened. Therefore, for the foreseeable future, I had an extreme fear of phone calls.
While I sat at Malia’s bedside, I also had to try to coordinate communication between Sophea and my mom. She landed in Denver during that time and he was driving with Ariah to pick her up. Before she had arrived, I had told a few close family members about our situation, but wanted to wait to see her in person to tell her. Sophea had filled her in a little on the ride back from the airport and I described the rest (to the extent that I knew). She was never worried and had incredible optimism about Malia’s health, often reminding me that she is in the best place she can be to receive top notch care. Her presence and dedication to taking care of Ariah while we attending to Malia proved to be crucial over the next 2 weeks.
Monday evening progress:
Malia recovered from the worst of it pretty quickly but the outlook was still very questionable. She had been placed on an oscillator immediately following the health decline in the NICU. She started requiring much less oxygen over just a few hours on the oscillator, from needing 100% oxygen when I first arrived to only 40% that evening. The goal would be 21% as that is the oxygen level in room air. Unfortunately, her lung x-rays were poor and they wouldn’t start weaning her settings down until later in the evening. Her pulse rate was also very high as she had been through so much trauma so early in her life outside. And, it was yet to be seen if she was responding to the antibiotics they were pumping into her. We were still a long way away from reaching the end of those “critical next 12 to 24 hours” as her physician had put it.
As soon as we woke up, Cherry called the nurse to check on Malia. We had to take some bad with the good. The best news was that she was requiring less oxygen and they were likely going to wean down her oxygen settings. She would remain on the oscillator for at least a couple more days though. The bad news was that her blood pressure had dropped too low and they needed to add medication to fix it. The low blood pressure also caused a decrease in urine output so they had to add catheter. All of this made Malia quite uncomfortable (antibiotics, a line through her umbilicus, an oscillator down her throat, a catheter, blood pressure medication, a central line for the IV, and other measurement devices). So to top everything off, she was given morphine and other sedatives to help her relax and feel well. The beginning of her life in the outside world was not the greatest, to say the least.
Although this was still a scary day and Malia was in no way out of the woods quite yet, she did make some more vast improvements throughout the day Tuesday. By the evening time, they had decreased the blood pressure meds and continued to wean down the oscillator settings. She responded well to both and was hopefully on the road to recovery.
Cherry had been on the third floor of the A wing of the hospital throughout her entire bed rest, and through the delivery and beyond. There, she had a spacious room with some decent (for a hospital) furniture for myself and guests, and even a small refrigerator. Moreover, the 11th floor, where the mothers were supposed to go shortly after delivery was full on Monday so we got to stay in the nice, spacious room Monday night as well. However, when Tuesday came around, they gave us the boot. This mattered because on the 11th floor, the room was incredibly small. For example, you could only open the bathroom door about one third of the way before it bumped into the bed.
We did however get one piece of good news upon getting into the jail cell sized room; they offered a celebratory dinner for 2 which was quite nice. With my Mom and Ariah there was well, we turned it into a celebratory dinner for 4 and it turned out to be just the right amount of food. They gave us a sense of normalcy by serving it to us on a nice room service cart complete with sparkling water in flume glasses, opened by the server. The only down side to the whole meal was that we waited 30 minutes on hold to place our order in the first place. After 30 minutes on hold, we hung up and called back. Two minutes later, they took our order. I think they forgot they put us on hold.
Come back in two weeks to pick up on the next part of Malia Mei: A Courageous Birth.
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