Chapter 50
Everything Seems Great
Nolan 12, Ryder 8, Olivia almost 5.
Annabelle Grace, 3 weeks old
Victoria Rose, 1 week old
February 1st
Victoria Rose, as her parents had decided to name her, had successfully lived through a fairly frightening birth and some concerning initial days of life. However, each day provided a brighter outlook. After just two days on the ventilator, she was switched to a CPAP. When jaundice arose, just a few doses of phototherapy resolved the issue. Anemia continued to show up on her blood tests, yet she responded well to the initial iron supplements and only needed occasional doses afterward.
Within a few days after birth, Victoria's heart rate stabilized and her kidney function improved. Even though she did not appear to need any surgeries at this point, Alex served as a sort of General Contractor for her care. He was the doctor with whom all other doctors shared their insights, concerns, and results. The standard and repeated blood tests and ultrasounds were carried out under his orders.
Torie's experience of undergoing multiple medical assessments for a lifetime began the day she was born. During Victoria's first week of life, hardly a moment passed when she wasn't being tested, evaluated, assessed, or examined. Various specialists examined her daily, often teaching their resident's about Spina Bifida. She had a series of exams and tests on the day she was born, followed by further renal and bladder ultrasounds at 2 days old. After the ultrasounds, the two day old underwent a video-urodynamics test where special catheters measured bladder and abdominal pressure as well as output. Her first brain and spine MRI, also undertaken during her first week of life, would be the first of many MRIs she would have periodically throughout her childhood. Much to everyone's relief, Victoria's MRI, ultrasounds and urodynamics tests came back without concern. It appeared that she would not need surgery to insert a shunt and that her bladder, kidneys, and abdominal pressure were not going to be a concern for her. Her parents were thrilled that all tests and assessments appeared to be so hopeful.
Initially, with Amelia recovering from two abdominal surgeries and Victoria in the NICU on a vent, the baby's feedings were mostly pumped and fed to her through an NG tube. With the help of various friends and hospital staff, Amelia was able to continue breastfeeding Anna. So many people volunteered to help be Amelia's hands and feet until Amelia could easily walk, get out of bed, and pick Anna up for feedings. The Shepherd-Hunts were touched by the incredible volume of support.
Thanks in large part to Lynne and her assistance, Owen was able to spend most of each day at the hospital with Amelia and the girls. He rotated between Amelia's room and the NICU every few hours. While he held Victoria and rocked her as he held her against his chest in the NICU, the routine of rocking back and forth often caused him to begin to doze off. Even though he was not waking up for feedings at all hours of the night, his sleeping hours were often interrupted at home by the need to enforce the new "no kids or dogs in Mom and Dad's bed" rule. In his heart of hearts, Owen simply couldn't bring himself to completely shut off his nightly visitors. Instead, the kids were allowed to make blanket nests on the floor and the dogs had been given new overstuffed dog beds. When he wasn't enforcing the new rule, Owen slept better than he had in a long time.
Once she was able to leave her bed, Amelia fell right back into the routine that began with 1 hour in the NICU and 2 hours in her bed. Whenever Owen was not present, someone else was available to carry Anna to the NICU or to simply sit with Anna in Amelia's room when Amelia would make her way down to see Victoria. Amelia reluctantly resigned herself to the reality of having limited visitation time with her own baby, but the experience was disheartening. Between the post-partum hormones, the intensity of being a new mother, and the challenges of mothering twins, Amelia did her best to cope. She held on to the promise that within weeks, she would share her hospital room with both babies and that they would all eventually go home.
When Victoria moved out of the NICU and into Amelia's room at two weeks old, the girls shared one isolette. As Alex had predicted to Owen, the twins seemed to thrive and be happiest when in one another's company. When possible, they were snuggled together side by side. As they would stretch or move their arms, they would often grasp one another's hands. Anyone who witnessed that connection became teary.
Amelia's ability to breastfeed both babies simultaneously became the mother's next challenge. Over time and with the help of the lactation consultant, the trio found their positions and routines. With one girl was on Amelia's left and the other on her right, feeding twins became another new 'normal.' Like Victoria, Amelia had easily become a pro after just a few attempts.
One afternoon, as he began to stir from his nap on the nearby couch in the hospital room, Owen opened his eyes to see his wife chatting with their girls and smiling. He lay there beaming as he watched until Amelia spotted his open eyes.
"Hey, I know we're all compelling and beautiful over here, but I've got two babies to burp. Wanna come join me?" Amelia encouraged with a sultry tone and flirty smile.
Owen smiled but said nothing as he walked over to the bed. Once he was by Amelia's side, he asked, "Can I crawl in next to you or do you want me to pick one up?"
Patting the bed, Amelia grinned, raised her eyebrows, and said, "As long as you haven't been eating too much hospital food, I'm pretty sure you'll fit right here."
Chuckling, Owen slid in next to her and held Anna, who happened to be closest to him. "Hey, little monkey, how did you wake up and get fed without waking me up?" Owen prided himself on jumping up to hand Amelia the babies when necessary and on waking up when they cried.
"I was awake when they both started to stretch and stir – I picked them up and brought them over before any crying started," Amelia explained as she patted Torie's tiny back. "She didn't eat much this morning. Just kind of nodded off and ate a little and repeated that process a few times. Do you think that's ok?"
"How'd Anna do?" Owen asked, completely unsure how to answer Amelia's question. They were both doctors, but not pediatricians, and they were definitely both first time, fretting, over-thinking first time parents.
"She did great," Amelia laughed heartily, "look how uneven I am!" One breast was nearly bursting while the other was not.
"Hmmm…you want me to grab the pump?" Owen asked as he began to stand up from the bed with Anna against his broad shoulder. He was already half way to the pump before his question was complete.
Amelia smiled, realizing the pump was coming over regardless and thanked him. "I feel like a cow being milked when I use this thing," she sighed.
Owen looked at her with compassion and inquired, "How can I help?"
"Can you take Torie? I can set all this up if I have both hands," Amelia suggested.
Having mastered the task of holding two babies at once, Owen reached over and picked up his youngest. Amelia often became uneasy when he tried to walk with both babies in arms, so he went over to the couch to sit with them before she mentioned her concern.
He lay Anna down on the couch while he burped Victoria. Once successful, he held her in his arms about 8 inches from his face. He simply smiled at her in wonder and began chatting with her, "You have come so far, little girl. Here you are, in Mommy's room with your sister. No vent. No major wires and chords. You precious angel." Torie fixed her eyes on Owen's face as he spoke.
As if Anna could sense that her sister was getting all the attention, she began to fuss. Owen lay Torie next to her sister and began to marvel at both of them simultaneously. Meanwhile, Amelia gazed on with her heart bursting with love for her husband. She was happier and more at peace than she'd been in a long time.
Other than a visit to see Victoria through the NICU window when she was three days old, the kids did not come to the hospital to visit in the first two weeks after Victoria was born. Many pictures were sent to them via text, phone conversations with Amelia were a regular part of their day, and Owen always had a new video or story to share when he would join the kids for dinner and the family's evening routines.
Ryder was not pleased with this new arrangement, and he often protested it. He would call Amelia's cell whenever he could get his hands on Nolan's smartphone or on the house landline. The calls and conversations were challenging for Amelia because as soon as she would answer, Ryder would break down in tears and tell her how much he missed her or he would begin tattling on his siblings. His behavior at school and home swung between defiant and sullen; the regular happy-go-lucky Ryder who was full of joy and energy had become a rarity. In his place, an argumentative and sassy boy reigned alongside a recluse who preferred to be in his room alone and cry. Seeing the shift in Ryder was heartbreaking.
As Owen walked around Amelia's room with Torie as Amelia picked at her lunch, he broached the subject. "I know that when Victoria was in the NICU and after she was first born, you were in major recovery mode and incredibly tired. How are you now? What do you think about bringing the kids up for a visit?"
"I would love that," Amelia smiled, "as long as they aren't sniffly or sneezy."
"They're all healthy as far as I can tell. Will bringing all three be too much? Maybe I could rotate them."
"Whatever works best for you and Lynne. Ryder definitely needs to visit first. Maybe Nolan could come with one of you after soccer one day and have dinner with me. And, Olivia? I don't know, any thoughts?" Amelia playfully expressed. For a split second, Owen paused to try to sort out Amelia's giddy mood. He decided it was nothing and proceeded with his thoughts about the kids' visits.
Owen wondered aloud, "She's just upstairs at the hospital daycare today. Should I go get her?"
Forgetting the wise idea to have Ryder come to visit first, Amelia eagerly agreed. She missed her precocious red head girl and was happy to know she wasn't far away.
Owen walked to the daycare and peered in the window to see Zola and Olivia playing at the toy kitchen. Zola spotted Owen and pointed him out to Olivia, who beamed and jumped up and down when she saw her daddy. Smiling, Owen came into the room and knelt down as both Olivia and Zola ran into his arms, "I get double hugs?! I'm the luckiest guy around," Owen declared.
Behind Owen, Derek cleared his throat and then knelt down. "Anybody have any hugs left for me?" Derek begged.
Both girls ran to him as they giggled and hugged him.
As the girls ran off to go get some artwork to show their daddies, both men sat down on the floor with the arms around their knees. Owen, fairly unplugged from hospital details, asked Derek, "How's it going in neuro?"
"Busy," Derek sighed. "Really busy, but good. Everyone seems to be stepping up and working more shifts. Any chance we could get another surgeon on board before everyone burns out?"
Owen chuckled, "Talk to Richard. It's not my job right now."
Derek grimaced, "Thanks a lot." Owen turned his head to the side and shrugged with a grin.
"Do you want to bring Zola up and visit Amelia and the girls? I just came down here to take Olivia up there," Owen asked.
"That…would be great," Derek observed aloud. "I've been so busy in surgeries that I can't remember the last time I visited my sister. She'll probably have it out for me, but Zola and her cuteness can shield me from Hurricane Amelia."
The guys gathered their girls and headed up to visit Amelia. The entire way, like two mother hens, they took turns urging the girls not to run or yell in the room and encouraging them to be calm and gentle with the babies. Zola leaned over to Olivia at one point and whispered, "We play babies all day at daycare. They think we don't know what to do!" Olivia covered her mouth, giggled, and rolled her eyes in response.
When the group opened Amelia's door, she looked over and joy washed over her face. "What a nice surprise!" she exclaimed loudly and enthusiastically.
Olivia ran over to Amelia to hug her, but whispered, "Shhhh….you're pus-posed to be quiet around the babies, Mommy."
"Oh, right, thanks," Amelia nodded seriously. Owen kissed Amelia and then took the girls over to see the babies. He sat the big girls on the couch and handed them each a baby as they posed for a picture. Then the girls wanted to trade babies for another picture. After that pose, they began suggesting all sorts of possibilities for further shots.
While Owen and the girls held their photo shoot, Derek, unable to help himself, began reviewing Amelia's sats and IVs. "I'm ok, Dr. Shepherd. No need to fret. Now stop being a doctor and give your sister a hug," Amelia ordered with humor.
"Just a sec," Derek insisted. "Why do they have you on pain meds at this point? Is your pain still severe?"
Amelia shrugged, "Not really. But maybe that's because the meds are working. I mentioned I was a little uncomfortable this morning, but now I feel fantastic."
Derek pulled up a chair next to Amelia's bedside and grabbed his cell phone out of his lab coat pocket. Amelia looked at him with confusion as he held up a finger to stall her response. "Hi. This is Dr. Shepherd. Who is the neonatologist on duty? Robbins? Great. Could you page her to my cell please."
"What in the hell are you doing, Derek?" Amelia asked as she gathered her eyebrows inward.
"I don't understand their dosing decisions," Derek explained confidently.
Amelia lowered her chin and looked up at her brother, "And you don't think Owen and I are competent enough to consider such treatments?"
Derek stood back up, patted Amelia's head paternalistically, and grinned. "I'm going to go admire my beautiful nieces." Amelia rolled her eyes as her brother stepped away.
As the men and little girls ooh'd and ahhh'd over the babies, Derek leaned up to Owen and mumbled, "Did you see that she has a bag of low dose Demerol pumping into her IV? Who the hell ordered that? It's narcotic."
Owen leaned close to his brother-in-law, shook his head, and mumbled back, "She's only used Tramadol since she's been here."
"I know what I saw," Derek whispered with raised eyebrows. Arizona sent a text to Derek and he explained what was going on. Arizona assured him she'd be over shortly.
"What are you two up to over there?" Amelia asked from across the room. Both girls froze and looked scared, even though they were simply playing pretend and dressing up in yellow gowns. "Girls, you're fine," Amelia assured as she clarified, "I meant the Daddies."
Owen, trying to fake a happy expression, walked over to his wife and leaned down to hug her. His angle was strange and his hug was extended awkwardly as he tried to spy the meds dripping into her IV. Much to his chagrin, he confirmed Derek's observation. He walked to the other side of the bed and pulled out the attached meds, awkwardly and dishonestly commenting, "Looks like this is complete. I'll go see what's on tap next. Be right back."
Amelia was perplexed and looked at her brother who was holding Anna as he walked around the room. "Derek, what's going on?"
"What do you mean?" Derek attempted to respond naively. "I think Owen's just trying to help out the staff."
Meanwhile, at the Nurses' Station, the usually calm and understanding Chief was flipping his lid. "I need to see my wife's chart so I can understand why she was given this medication."
The head nurse who had just clocked in, jumped in to assist. She handed him the electronic chart, motioned to the office behind the counter area, and asked, "Dr. Hunt, would you like to come in here as we address your concern?"
Owen stormed into the office as the head nurse followed him inside. Arizona approached a minute later and could hear Owen yelling loudly from the hallway. She ran to the office, shut the door and ordered, "The yelling and ranting stops now, Chief." Her heart was beating fast as she stood up to her superior.
"Dr. Robbins," Owen growled with a lowered but still angry voice, "would you care to explain why my wife was given Demerol when her chart clearly states no narcotics?"
Arizona grabbed the chart from him and perused the notes. A resident had prescribed the meds earlier that day when Amelia shared that she was uncomfortable. The resident's line of thought was solid: switching pain meds might be an effective way to stop the break through pain. However, missing the note about restrictions was not acceptable.
Owen was pacing in the office as Arizona thanked the nurse and excused her. Just Arizona and Owen remained in the room. "How's Amelia doing?" she asked calmly.
"She's happy and high as a kite, no wonder I thought she was so jubilant and giddy this morning," Owen declared as he waved his arms in the air.
"And you have the meds there?" Arizona inquired as she reached out her hand. Owen slapped the bag into Arizona's hand and looked at her with a 'you'd better be able to explain this' expression. Arizona looked at the bag, estimating that about 1/3 of the bag had been administered. "I'm relieved we are talking low doses," she thought aloud.
"I don't care if it was one milliliter! Her chart is clear and she's a recovering addict. Now we're administering addictive medicines to people in recovery?" Owen stomped and steamed.
"Dr. Hunt," Arizona responded calmly and slowly, "I am going to look into…" Her words were interrupted by Derek entering the room after asking a nursing assistant to stay in Amelia's room for a moment.
"What in the hell happened? Why was my sister given narcotics?!" Derek fumed.
Arizona lowered her chin to one side and looked directly into Derek's eyes, "As I was just explaining, I will look into this and ensure it does not happen again."
"That's not good enough, Arizona. I want to know who screwed up. Was it Annalisa? Someone unfamiliar with Amelia's case? Who the hell wouldn't check med lists and alerts before ordering a prescription?" Derek bantered about.
Owen, putting the scenario together, stated, "It was a resident during rounds, wasn't it? Who rounded in this unit today?" Owen held his hand out for Amelia's chart.
"This is my department and I will address the matter. You, Dr. Hunt, are on leave and you, Dr. Shepherd, are not a part of the neonatology staff. I will discuss this with Dr. Webber and either he or I will be in touch. I apologize for the stress this situation has caused," Arizona stated flatly before calmly stepping out of the room.
"I'm going to…." Owen began before Derek interrupted.
"Don't say it. Let's take the girls back to daycare and go figure this out over a cup of coffee and a discussion with Richard," Derek explained.
