Thursday, October 25, 2012

Pink lemon cupcakes: The trouble with color (and a heartbreaking baby story)


My little boy turned six this week. It's hard to believe so much time has passed since those first terrifying days when he was a helpless floppy thing with a neck too weak to keep his head upright, soft spots in his skull, and an appetite I could barely keep up with. Now he's his own person, becoming more himself and more independent every day, which is great, but sometimes I miss him wanting to be with us. Other times I sigh with relief that I can just sit back and watch him be himself.


No. I must stop here. Pretending that the terror of those first days was solely because he was a helpless baby and I didn't know how to take care of helpless little babies is nowhere near the whole truth. There's more to the story. 

The Boo (nicknamed for scaring us so) was born with Persistent Pulmonary Hypertension of the Newborn (PPHN). It means his blood didn't flow the right direction, and he was at imminent risk of death from lack of oxygen from the moment he was born.

We were not prepared for trouble. My pregnancy had been just about perfect. Every test had gone well. So when the doctors and nurses lifted him over to the warming table, and I could hear him struggling and the quiet, concerned, intense murmur, I could tell something wasn't right, but I was too exhausted and torn up to understand. I was just waiting to see my boy. Instead, they whisked him away to the NICU, and I didn't get to see him at all. 

I don't remember much else about that day. I was stitched up. They tried to get me in a wheelchair to go and see the Boo in the NICU, but I passed out cold (blood loss or meds? I have no idea). Mike went back and forth between me and the NICU, watching over us both, doing his best to take care of us, understand what was happening, and translate medical speak into English for us laypeople.  

I think a day passed like this. I spent time learning how to pump milk, trying to eat well, and receiving lots of visitors, and Mike went back and forth, back and forth, relaying information, keeping us together. He brought me a picture of the Boo's ear; it was all he could see among the tubes and wires, and it was perfect.

A little over 24 hours after the Boo was born, I was finally able to sit upright in the wheelchair and make it to the NICU to see my baby. He was beautiful and heartbreaking. We weren't allowed to touch him or speak loudly around him. Any stimulation at all meant that his blood oxygen level would go down, so we had to keep our distance and pour love onto him through air and glass. 

By the second night, Mike had been awake for more than 48 hours. At two in the morning, it seemed as though the Boo was finally beginning to stabilize, so Mike lay down on the couch in my recovery room and fell asleep. Two hours later, I was still semi-awake when the doctors came in quietly to tell us that things were no longer going well. The Boo would have to be transferred to another hospital with more advanced equipment, specifically the ability to provide treatment with inhaled nitric oxide and an ECMO machine (a kind of bypass machine that takes blood out of the body, oxygenates it, and then passes it back into the body). I was wheeled down to the NICU with Mike, and we sat and watched as a team of medical personnel prepared to move our little baby into a plastic box on a gurney (a device they called the "Spaceship") and transfer him to Georgetown Hospital in Washington, DC.

I will never adequately describe the grief of sitting in that wheelchair, in that dark, night-quiet hospital corridor watching skilled, concerned, caring people preparing to take my son away. A cold, black pit had opened in my chest and would never close. I could not stop weeping. When I heard the siren as the ambulance left, I wept more. I wept every time I heard an ambulance for a few years. 

I couldn't go to Georgetown that night, but we decided Mike had to go while I stayed and prepared to leave Manassas Hospital the next day. I spent the day pumping milk, eating, and trying to get on my feet long enough to shuffle down the hall, a prerequisite for release. In late afternoon, I was released, and my parents drove me downtown.

What followed was a desperate search for food and a cold, miserable night in a guest room at Georgetown. By the time I got to the hospital, the cafeteria was closed, so we had to order Chinese to be delivered to the emergency room. We slept on a bare mattress on the floor. Mike's glasses broke during the night. The next morning, we decided this was no place for me to stay and recover and gave up the guest room. Our plan was that I would visit during the day, and my brother (who had immediately booked a ticket from Sweden on hearing of our troubles) would drive me home to rest every afternoon, while Mike stayed until late in the evening.

And so the next few weeks passed. Mike sat and watched our boy's saturation rate like a hawk for 10 days. For him, every dip in the numbers was a slash to the heart, a threat that our son would die. The one night I wasn't there because I was too sick and weak to make it, the doctors wheeled out the ECMO machine (an invasive procedure that can leave permanent scars) and then decided against it. I was dazed, in shock, and on pain medication, trying to maintain a schedule of pumping milk and stacking up bags of it in the hospital refrigerator until the day when the Boo would be able to start drinking. 

Then came a turning point. One night, while I was doing my two a.m. pump, and Mike was calling the hospital to check on our boy, the nurse told Mike that the little guy had extubated himself. (She had a hilarious way of saying this, which left us laughing in hysterics.) The boy was done. Annoyed with the stuff stuck down his throat, he just spit it right up. As my sister-in-law commented later, "Only two weeks old, and already rebellious and addicted to drugs." (To save his life, the doctors had had to administer a lot of drugs to keep him sedated and ensure his blood flowed in the right direction. We had to wean him from the addiction by administering opium for several weeks, but that's another story.)

After 29 days, we finally got to bring our boy home. Those 29 days of fear and grief were the worst of my life, and they left damage that took a long time to undo. But he survived. And now the earth has traveled around the sun six times since the day when he first arrived, so it's time for a treat.

           
This post was supposed to be about the cupcakes I made for his birthday celebration at school, but obviously, I got a little off track. My original idea was to make cupcakes that look like toadstools, a fun thing to celebrate both his birthday and Halloween. Sadly, the natural food dyes I purchased were not up to the task of turning my lemony frosting red, just pink. Even though I added ALL the dyes, red, blue, and yellow, the frosting remained stubbornly pink. It's a pretty pink, but I still feel a little funny about showing up with pink cupcakes to my boy's birthday party. At least the taste made up for it (and I gussied them up with some sprinkles, although my decorating skills are seriously lacking). 


So now, finally, here is the recipe for pink lemon cupcakes and some tips for coloring foods. This batch was enough for 24 mini cupcakes and 12 regular cupcakes, so it would probably be enough for 24 regular cupcakes or 48 minis (if you have two pans, which I didn't, thus the mixed sizes). 

Ingredients

FOR THE CUPCAKES*
  • 1 and 1/3 cup PLUS 3/4 cup all-purpose flour
  • 1 and 1/4 tsp baking powder
  • 1/2 tsp baking soda
  • 1/4 tsp salt
  • 1 and 2/3 cup sugar
  • 1/3 cup canola or other mild vegetable oil 
  • 2 large eggs
  • 1/3 cup whole milk
  • 2 teaspoons vanilla extract
  • zest from one lemon (don't forget to wash the lemon carefully)
  • 1 cup boiling water
FOR THE FROSTING**
  • 12 Tbsps (1 and 1/2 stick) unsalted butter, room temperature
  • 3 cups powdered sugar
  • 4 Tbsps lemon juice (make sure to strain out any seeds)
  • zest from one lemon
  • 1 and 1/2 tsp vanilla extract
  • red food coloring (optional)

Directions

FOR THE CUPCAKES
  1. Preheat the oven to 350 degrees Fahrenheit. Place bake cups in the wells of your cupcake pan(s). 
  2. In a large bowl (your stand mixer bowl if you have one; it will make this recipe so much easier), mix together flour, baking powder, baking soda, and lemon zest. Use the paddle attachment at low speed to mix it all together evenly. Then add the sugar and mix at low speed until evenly distributed. 
  3. Add the oil and mix at low speed until the mixture is crumbly, sort of like sand. 
  4. In a separate bowl, mix the eggs, milk, and vanilla extract until blended. Add the egg mixture to the flour-oil mixture at low speed until blended. Stop the machine and scrape down the sides if needed. 
  5. Finally, with the mixer at slow speed, add the boiling water in a slow, even flow until the batter is just mixed and smooth. Once again, scrape down the sides as needed. 
  6. Fill the bake cups about 2/3 full. Bake at 350 degrees for 35-40 minutes for regular cupcakes and 30-35 cupcakes for mini cupcakes. They should be lightly golden-brown on top when they are done. Let them cool in the cupcake pans. (Putting the pans on a rack would probably aid cooling.)
FOR THE FROSTING
  1. Sift the powdered sugar into a stand mixer bowl if it has lumps.
  2. Add the remaining ingredients (softened butter, lemon juice, lemon zest, and vanilla extract) to the bowl. Start mixing slowly with the paddle attachment until the powdered sugar is just incorporated into the butter to avoid getting a cloud of sugar. Then beat on high speed until the frosting is white and fluffy.
  3. Beat in drops of red food coloring until you get the shade of pink you want. 
After making this recipe, I asked my friend Cheryll of Decker'ated Delights who makes beautiful cakes and cookies how to get a good shade of red. She shared these tips:
  1. Don't use food coloring. 
  2. Use the paste. Apparently AmeriColor works well and doesn't leave a funny aftertaste. (Obviously, this doesn't quite fit with my real food ideals, so I will probably have to live with pinks and lavenders for now, but I wanted to pass on the information in case you want to try it.)  
  3. Tint with a light pink first for a vibrant red. (Or light brown if you want a deeper red.)
  4. Then tint with red. 
* Adapted from the Devilishly Moist Chocolate Cake recipe in Tish Boyle's The Cake Book.
** Adapted from the Creamy Frosting recipe in Williams-Sonoma's The Kid's Cookbook. 

12 comments:

  1. There are no words. Happy Birthday to your little Boo.

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    1. Thank you! He had a good one. With cupcakes. He likes pink anyway (more than I do, actually).

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  2. Happy Birthday to your son. I complained about 17 hours of labor but I feel I have nothing to complaine about after hearing your story. Thank you for sharing such a personal story.

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    1. Ugh! Seventeen hours! That's awful. I had nowhere near as long. Also, there's no competition as to who has experienced the worst thing, and I certainly wouldn't want to win that competition. Everyone has their own ups and downs. We can connect with other people by empathizing with their stories without judgment.

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  3. Tora, there´s not much I can say but Happy Birthday to your son and to you and Mike too!

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    1. Thanks so much, Paula! My boo has gotten so many wonderful birthday greetings from so many wonderful people!

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  4. Such a heartbreaking story but one with such a happy ending, I am so glad it all worked out and now you have a beautiful little boy! My mum and younger brother both nearly died when he was born - I was 10 at the time, so just old enough to understand and be terrified. I remember that cold, empty feeling as both baby brother and mother were fighting for their lives, but they both pulled through and he is now a healthy teenager(!)

    Have you thought about using beetroot juice? That mixed with some natural orange coloring might turn out red - I've never tried it, but it might work!

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    1. That sounds like a truly frightening story. I am glad it turned out well, and your brother is a healthy teenager now.

      I will probably give beetroot juice a try sometime, but so far, I am not having much luck in the natural food color department. But I will probably keep trying anyway.

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  5. Happy birthday, sweet Boo!!! He is a blessing!!!

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  6. Happy birthday Boo!

    What an amazing and triumphant story. I'd hug you both today if I could.

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  7. I'm just a passerby who was looking for ECMO blogs. My daughter was born on Nov 4 2011 after a perfect pregnancy and an ok labor. Who knew that day our world was about to come crashing down. She had PPHN (do you have any idea how your son got PPHN? I will always wonder why she developed PPHN). Our story is so similar to yours - scared, sad, lots of prayers, all those saturation numbers, blood gas levels, tubes, wires, pumping around the clock. My dear Ava ended up on the ECMO. With God's grace, she did better and we came home on day 35 with a feeding tube. She is now a naughty happy 15 month old who is the light of our lives!! Thank God for wonderful doctors and modern medicine.

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    1. Thanks so much for passing by and commenting, Keya! I have no idea how he got PPHN. When he was first born, they thought he might have had pneumonia, which filled his lungs with phlegm and thus stopped him from breathing properly, but a few days later, no one thought he had pneumonia anymore. So no, I have no idea how he got it. One of those awful random things I guess. I am sorry your Ava wound up on ECMO, but I am glad she is doing well now. My son has had no aftereffects from that time; I hope that proves to be the case for you. It is so wrenching and hard to deal with when your little one is so sick, and you feel so helpless. I am grateful for excellent doctors and modern medicine too!

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