29 February 2012

NICU Observations. :-)

Before I talk about my NICU observations, let me update you on Samuel's progress!

He is doing AWESOME with no oxygen support.  Please pray that he continues this way!  We have noticed that Sam tends to drop his oxygen saturation level just before and during a feeding.  I think he does it just before to let us know he's hungry (he also cries a little, wiggles around and thrusts his tongue). The doctor thinks he does it during because he exhibits signs of reflux.  NOT a big deal at this point.  It hasn't caused him to drop his oxygen to really low levels and he seems to be handling his food well.  This seems to be something pretty common with preemies, so it is a matter of him developing more and that should go away.  If it doesn't, well, we'll cross that bridge when it comes.  :-)

He had another head ultrasound on Monday (not because the doctors are worried, just more of a follow up check) and that came back with 2 grade zeros (referring to the intraventricular hemorrhaging that started as grades 2 and 3).  So that was good to hear that it is still nothing to really talk about.

We are looking forward to few upcoming changes.  One is to transition him to a crib.  Currently he is still in the same kind of isolette he started in, but is getting very little support from it.  It started with giving him 80% humidity to help his skin.  Well as of last weekend he has been in room air humidity.  It also was changing the temperature to help him regulate his body temperature.  So for a quite a while he had a temp probe on that would constantly tell the bed his body temperature, then the isolette would adjust its temperature according to how hot or cold Sam was.  They have since taken the probe at and set the bed at a constant temp.  Currently it is at 26.5 C or 79.7 F.  They have slowly been turning that down, which it is already closer to room air than it is average body temp.

Another change is to take him off of his caffeine.  Yes, he's on caffeine.  I'm sure I mentioned it before, but he's a refresher.  The caffeine is meant to help him to keep his heart rate up and keep him from having too many apnea spells.  Well, he's been doing pretty well awesome at both, so now it is a matter of deciding when is good to stop the caffeine (which one doctor told me, that if you increase the amount to match an adult's body weight, he receives the equivalent of 6 cups of coffee every morning).  The doctor also mentioned that it will take about 5 days after he's off the caffeine for it to fully leave his body.  So that will be exciting to see how he handles it when they do that!

Of course we are continuing with upping his milk feedings based on body weight.  He started at 3mL and is already at 30mL and taking the feedings quite well!  Between 33 and 34 weeks gestation (he'll be at 32 weeks on Saturday) is when they start figuring out the suck, swallow, breathe rhythm, which means we'll be started to try some nursing!  YAY!  That means eventually I won't have to pump as much!

Alright some observances about life in the NICU.  Currently there are around 10 babies here, but almost all of these babies are different than the ones that were here when we arrived.  They take on babies because they're early, but also if they were full-term and sick.  So the turn over rate is high.  However there are some that have been here longer than us.  We said goodbye to one on Monday.  She went home!  Which is exciting and sad at the same time.  You form bonds with the other parents of preemies that are here and when they leave it's kind of sad (besides we walk by their now empty room to get to ours, so it is a constant reminder).  Another one of those families will also probably be going home at the end of the week.  So we are starting to look like the old timers in the NICU and hopefully be able to provide the encouragement and like minded conversation that we had with those families.

Something I've also notices is how babies cry.  Samuel is in an isolette, which muffles his cry to the outer world some, and besides he isn't really loud yet either.  So he doesn't get to add to the chorus of cries you hear just outside your room.  However, we have noticed that there is one baby (and I have no idea which one, nor have I tried to figure this out) that cries like a cat meows.  When I first heard this baby, I thought there was an upset cat in the NICU, then I realized that that is silly and it is a baby.  Yet every time that baby cries I keep thinking cat!  We're just glad Sam's cry sounds like a baby and less cat like....

26 February 2012

Blood Transfusions = Red Bull for Babies

So last Thursday Samuel received a blood transfusion, which I'm sure I mentioned is very common for babies as early as Sam.  Well, it seems to be doing exactly what it was meant to do, which means it is a kind of "red bull" for babies in that it jump started his development again.  Here are some examples of what it did for Samuel:

  • It turned him back to his usual skin tone.  Before the transfusion he was looking kind of pale which translates to red for preemies.  Now he is back to his usual skin tone which definitely looks much healthier!
  • It made him a more content baby.  During the days before the transfusion Samuel was getting quite fussy, but you would be too if your body had to work really hard to pump the blood through to get oxygen everywhere!  On Friday he was about the most contented and happy that I've ever seen him.  Yesterday and today he's fussed some, but he always has a reason for the fuss ("I'm hungry," "my diaper's dirty" or "I'm tired of laying like this" for example).  So seeing that our baby is happy makes me happy!
  • He's gained some weight.  Our little baby's cheeks are definitely chubbing out and he's slowly becoming a more typical chubby baby.  He was 2# 14oz at the time of the transfusion and last night he weighed in at 3# 3oz.  Way to grow Samuel!
  • He's been keeping his stats up much better.  This means we've had much fewer A/B spells.  (Again A-apnea-breaks in breathing; B-bradycardia-drops in heart rate).  In fact he's kept his stats up so well that they decided instead of taking him off of CPAP and putting him on Vapotherm the doctors decided to just take him off of CPAP and put him on nothing!  This means that as of about noon today our son has been doing all of his breathing on his own with no assistance.  Way to go Samuel!
Those are some basic ways Samuel has improved since the transfusion, those aren't all his improvements, but some of them.  Now just because he is not on oxygen support right now does not mean he will not need oxygen support again.  He is doing well, but could definitely use some prayers that he continues to do well and improve without oxygen support.  The normal process of oxygen support starts with a ventilator (which he had for less than the first 24 hours of life), then CPAP (which he's been on ever since, with about a 5 day break on vapotherm), then vapotherm and final a nasal canula.  I guess Samuel decided he need to speed up the process and skip some of those steps!  If he can do it, then why not let him?

I am continually in awe at Samuel's progress.  Never did I imagine we'd have a month old baby already, nor did I imagine after he was born that he would progress this fast!  He is doing great.  All the nurses here love him and keep saying how cute and sweet he is and how much they love working with him.  Now this, of course, could be something they say to most parents, but I still take it as a good thing.  :-)

23 February 2012

Blood Transfusion Time

In the NICU there are a lot of procedures and equipment commonly used with babies like Samuel.  Now Samuel is a fighter and does really well over all!  In fact my neighbor has decided Sampson is an appropriate nick name because he is such a fighter!

Some examples of his amazing progress is the fact the was only on the ventilator for less than 24 hours!  Go Samuel!  Also when we started Mother's milk feedings he took them extremely rare.  He almost never had residual and that continues to be the case.  That meant we were able to take out the IV pretty quick!

Here is now yet another example about the miracle of Samuel.  Today he received a blood transfusion!  Yes, that is some what miraculous!  It is my understanding that preemies, like Samuel, tend to need blood transfusions.  Yes, I meant to write that in plural, multiple blood transfusions.  In fact, they only receive a third of a unit of blood and it isn't unusual for them to eventually receive 2 or 3 transfusions from it, using the entire unit!

The thing is generally preemies like Samuel would have already received their first transfusion.  Samuel is almost 4 weeks old (tomorrow) and is just receiving his first one.  So I consider that to be amazing.  Now he has received it.  It was a 4 hour transfusion process and it happened from about 1:30 to 5:30.

There were a few factors for why we decided to give him one.  First, his blood count has been just been hovering above the line of needing it.  Second, having more blood can give him an energy boost to do better with oxygen (maybe go back to vapotherm in the next few days and not go back to CPAP??) and weight gain.  Ever since about the 18th of February he has been staying at either 2#14oz or 2#15oz, never quite hitting 3#.  The Doctor was a little concerned about this as he was gaining and then pretty much put the brakes on that.

We are hopeful that this blood transfusion will do what it does for these preemies--give them the boost to keep moving forward.  He has been slowly but surely progressing, but that progression has definitely slowed down a little too much.  Samuel has not digressed at all, but we would like to keep seeing signs of forward motion.  Maybe over the weekend I'll be able to announce that he hit 3 pounds!  That will be wonderful!  (just remember a particular weight level is not the goal for release, just that he is showing weight gain)

Today Samuel's been really fussy, but that has a lot to do with getting stuck with a new peripheral IV, going through the usual cares, and having the blood transfusion (that actually didn't interfere with him much, except at the beginning and the end to hook it up and take it away).  Hopefully tonight as we aren't poking at him much he'll go back to being pretty well content.

19 February 2012

Sam's Breathing and Emotions

So not a whole lot has happened since I last posted.  On Friday they upped Sam's milk feedings to 25mL from 24mL because of his growth and then yesterday they upped it again to 26mL.  Four more milliliters and he'll be at an ounce!  He's been growing very nicely.

So last Tuesday they moved Samuel off of the CPAP and onto the Vapotherm as I explained in that post. I also mentioned that he had been having more A/B spells again (apnea, bradycardia).  Well, he kept having them, but generally these spells didn't drops his stats much and he practically always pulled himself out of it pretty quickly on his own.  Yesterday he actually had very few spells during the day, so that was great progress!

That is until last night.  Now before I go any farther, I just want to say these things are completely NORMAL in the NICU.  That is to say, nothing to cause alarm about.  Last night his spells were deeper and he struggled getting out of them himself, which was basically him telling us he's not ready for Vapotherm.  Thus he went back to CPAP early this morning.

Some people might think this "setback" should make me emotional and I'm sure it does make some people emotional if it happened to them.  However, please try to look at this from my perspective:

Sam was born at 27 weeks gestation, which means to go full-term, he should have stayed inside of me until about 40 weeks, which is approximately another 13 weeks.  Samuel's now just over 3 weeks old, which means he should still be inside of me for another 10 weeks or so.  Now being inside of me, I should be the one taking care of most of his essential body functions.  He's not supposed to be breathing yet!  But he's been born and now he has to.

Imagine if you moved to a foreign country that speaks a foreign language.  BUT you haven't learned the language yet.  This is going to be a rough transition at first.  Yes, some people will know English and be able to aid you, but it is still difficult.  This is kind of like Sam's situation.  He hasn't been given the full time to prepare for the experience of life out of the womb.

This takes time to adjust to and to allow time for his body to mature.  This is why they say to expect babies to be in the NICU until their due date.  Discharge is not a word we'll hear about Sam for a while yet!

When I process things emotionally I always have to look at the big picture.  Where are we going compared to where we are and how does that process look like?  What is normal?  What's not normal?  For Samuel having A/B spells, taking steps forward then backwards is completely normal.  It is normal for babies in his situation to need a blood transfusion.  It is normal to move him down on oxygen interventions then have to move him back up.  We won't know fully if he's ready until we try!

The staff is also just wonderful.  The doctors, nurses and respiratory therapists are constantly asking if we have questions and they answer any questions we as thoroughly as we ask them to.

Now what does this mean to my emotional state?  It means that I don't worry, I am relaxed and happy.  I don't worry because I know he's being well cared for.  I am relaxed because I am doing what I can and that's all I can do.  I am happy because we have a healthy, happy and active baby boy, who will one day come home.  Which is why I am not falling apart emotionally.

Why?  Because I know that God is giving us strength and the resources needed to deal with Sam's 13 week early arrival.  :-)

16 February 2012

Samuel's Progression

Right after he was first born, prepping him to go upstairs.
Our pastor here in town and my Dad getting ready to baptize little Samuel the day of his birth.

Holding his Daddy's hand.  He also had really red skin at that point!

Under special lights to help his jaundice so his skin would be more normal.

His skin was already looking better!  Check out all those cords!

Sleeping peacefully.

My favorite photo (taken on Valentine's Day).  Skin looks fantastic, he's gained some weight and he's a happy baby!

Kangaroo Time Photos

First Kangaroo Care
After the first one it became a little less awkward getting him there! 
Just staring at the miracle that our son is!
Family photo!
Much more comfy without the CPAP!

15 February 2012

Tuesday, Valentine's Day 2012

Yesterday might not have been a very mushy Valentine's Day for Ben and myself, but that's ok!  He had a very busy day at work and we had a somewhat busy day in the NICU.  That is a somewhat GOOD busy day!

So lately Samuel has been protesting the CPAP rather vehemently.  As in any time we had to readjust something on it he would start crying a little and we had to readjust things often!  Why?  Because Samuel wouldn't keep his hands off it!  He would constantly be grabbing the head gear, undoing the straps, pulling on the mask or prongs (I don't know how many times over the weekend and on Monday we would find the prongs were in his mouth and not his nose, not helpful at all in his mouth!).  So we were constantly going into his isolette to get the CPAP functioning again!

Well, to doctors and nurses had been talking about moving him off of the CPAP and onto something called Vapotherm.  Vapotherm is not as high level of oxygen intervention as CPAP, which means they only move babies off of CPAP and onto Vapotherm if it seems like they will be able to handle it.  Considering he's had a lot few A/B spells and when he does he brings his own heart rate and oxygen back up with no help, they decided to give it a go.

Overall he's been doing fine on it.  He has been having more A/B spells again, but most of the time he gets himself out still.  He has needed some extra stimulation a few times.  They are going to keep monitoring this and if they feel he needs stimulation too much, Sam's beloved CPAP will be coming back.  So please pray that his "device of torture" does not have to be replaced!  I call it that because that's what he acts like it is...  A device of torture...

This morning they took an X-Ray to make sure that the Vapotherm is keeping his lungs expanded just right.  Well, it turns out they are slightly under expanded, but the doctor didn't seem too concerned about this.  He wants to keep monitoring his spells and if things are work, back comes the torturous CPAP.

Kangaroo time was a little different yesterday.  He kept lifting his head and moving it down my breast...  We are thinking he smelled the milk, if that is the case, way to make that association!  The other thing that made it interesting is we forgot to put the call button by me...  The nurse and I both forgot.  So I am sitting there kangarooing and by the point we'd been cuddling for about an hour and a half, I started thinking that I need to pump soon, I'm hungry and soon I'll need to make a run for the restroom...

So I texted my husband to ask him how he thought I should get out of this situation.  His ideas were look for the call button and see if I could reach it and/or try to call out verbally and see if they hear me.  Well, I had been looking for the call button, but I finally found it after he texted me back.  Unfortunately it was on the floor and the cord was most definitely out of my reach.  So I tried to say our nurses name out loud to see if she'd hear, the only problem is I didn't want to actually yell, as Sam's ears are still sensitive...  No luck there....

So I texted Ben to call the NICU and tell them I'm ready to put Sam back.  Which he did.  My next step, if he was unwilling to call for me, was to unplug a cord.  I was already quietly debating which cord I could unplug briefly to get the nurses attention, but not cause too much trouble.  When our nurse came in she was extremely apologetic.  I didn't blame her, because I could have easily said something too.  With these little guys there is so much to be thinking about, that at times something like the call button slips your mind.  The important thing was that I had other resources at my fingertips, so if there was a real problem, I could have gotten help.  Our nurse yesterday was very good and I think she did a great job with Sam.  So instead of getting angry about the one slip up, we laughed about it.  :-)

Some notes to leave you with:

  • Sam is a strong little boy!  When on his belly he sometimes tries to lift up his body, I like to think he's practicing his push-ups.  He can also lift his head for short periods of time.  Not sure when most babies start lifting their heads, but he's ahead of the game I think!
  • Sam does not like people messing with him and definitely does not like diaper changes!  He hasn't realized that bending and stretching his legs CAN help it go faster, but not when he's doing the opposite of what is needed right then...  When wiping his butt, stretching the legs is much more helpful than bending them!  I've had to wipe off his little feet because of that....
  • Sam knows when it's time to eat and will let you know that he knows.  He's got a schedule and by golly, he wants to keep to it!  Time to eat, give him food!  Time to change position, move him before he gets completely tangled and himself completely out of alignment!
  • Sam detests his food line while goes through his mouth down to his stomach.  I wish our little boy would realize that pulling it out, just means he has to go through that awful process of having it shoved back down his throat again...  He can sure get upset when it is put back in!

14 February 2012

Saturday - Monday February 11-13 - Life Has a Routine

So there really isn't a whole lot to talk about for the weekend and Monday.  Which is a great thing!  Life is starting have it's own new kind of routine.  This routine is what life in the NICU means for me.  Basically it includes activities such as pumping all the time, eating as much as I can (I just can never seem to get full!), helping with the cares that Samuel goes through (changing diapers, containing him while they take his vitals or change his CPAP from mask to prongs or vice versa), kangarooing with Samuel for at least an hour, sleeping at home, and doing it all over again the next day.

I think the hardest part of this new routine is the part that it is split in between being home and being at the NICU.  When I am home and sleeping for the night I still have to wake up to pump and I don't even have Sam home with me!  So I definitely feel like a typical tired new mother, I just don't have the baby to tote around with me...  I do take naps at the NICU, if I have time (between helping with cares, pumping, eating and having visitors my time is quite short, oh and don't forget I am trying to go walking on occasion for some exercise too!).

Some positives over the last few days:
  • Samuel is taking his feedings of 24mL of milk fortified with calories very well.
  • He has had fewer A/B spells (apnea-breaks in breathing, bradycardia-drops in heartrate).
  • He had another head ultrasound today which is looking even better!  It will be repeated in a few weeks to make sure the ventricles are the correct size still (they sometimes have swelling when there had been bleeding).
  • They are talking about changing him from the CPAP (which he's been trying to wiggle out of lately) to a vapo..... which is less intrusive to babies.  We'll see if this happens this week or not, life in the NICU goes day by day!
  • He continues to be a very good pooper!  Well, he's just doing great overall!

11 February 2012

NICU Misconceptions

Ok, so I decided to depart from the usual posts that I write and write a post about things I have found that people think to be true about the NICU, but actually aren't.  Really it's just 2 main things.

  1. "So how what weight does he have to achieve to be allowed to go home?"
There is actually NO weight goal for babies in the NICU to achieve to be allowed to go home.  So if he doesn't have to gain weight, what DOES he have to do to be allowed home?

  • He has to be taking his feedings orally.  Right now he has a tube that goes straight to his stomach and that is how he gets my milk, he does not actually go through the whole intake, swallow, digest process we do at this point.  When he can do that, he is one step closer to coming home!
  • He has to be able to regulate his own body temperature.  Right now the incubator (actually called an isolette) aids him greatly in regulating his body temperature.  His has a temperature probe that gives the isolette information and when he stops to drop his temp too much or raise it too much the isolette adjusts to get his body temp back to where it should be.  When he can do that, he is one step closer to coming home!
  • He has to be able to breathe pretty much on his own.  Some babies get sent home with a little bit of oxygen, but most go home being completely independently stable.  Right now he is on the CPAP and is receiving a little bit of oxygen, when he no longer needs oxygen, he is one step closer to coming home.
  • He has to be able to keep a steady heart rate.  Currently he will drop his heart rate on occasion.  Now almost 100% of the time he brings it back up on his own with no stimulation, but we want him to not be dropping it at all.  When he can do this, he will be one step closer to coming home.
  • He also has to show weight gain.  This does not come in a specific magic goal number.  Babies used to have to reach a certain weight to leave, this is no longer the case.  Simply showing that he is gaining weight is enough.  When he does this, he is one step closer to coming home.
     2.  "I didn't think I would actually get to SEE him!" - Said when visiting me at the NICU.

Yes, if you visit me at the NICU you actually get to SEE Samuel!  In fact, at St. Luke's, all the NICU babies have their own private room that the parents have access to 24/7, complete with a couch, sheets and pillows.  This means when you visit the NICU you actually enter into the family own personal space and where I get to spend time pumping around the clock!  No, I don't have to stay at night to pump, that's why I have one at home (with the help of health insurance covering part of that cost).  As this space is the private space for each family in the NICU to have with their baby, when people come to visit a call in advance is preferred.

Think about if you were to visit someone at their house, most of the time you would let that person know in advance that you want to stop by.  Same idea here.  In fact it is almost more important here because I have to pump around the clock.  That is why if you drop by unexpectedly you will probably not be let up to the NICU, especially if I am here by myself.  When a person visits, they have to stop by the front desk down stairs and let them know who they want to visit.  They call up to the babies room and make sure that Mom or Dad is there with the baby.  Then they get a sticker with Samuel's room number on it.  Next they go into the elevator, which upon entering the lady at the front desk hits a button and you may now go upstairs to the NICU.  Without her hitting that button you are can't get to the floor that has the NICU.

Other amenities for the family of a NICU baby include free wifi, a whirlpool tub, showers, washer and dryer, refrigerator, microwave, and 3 meals a day down on the labor and delivery floor.  It is because of the 3 meals a day down there that snacks are probably more helpful to families at the St. Luke's NICU than meals.

I hope this helped clarify some misconceptions you and others might have had about the NICU.  This has been quite the learning experience for Ben and myself and through reading my blog about the experience I am sure it is for you too!

Friday, February 10 - "Bubble" Bath


When Ben and I got home Wednesday night we were both so tired that we took our time getting ready in the morning.  I got to the NICU at about 11:20 Thursday morning.  When I got there our nurse for the day asked me what my plans were for the next half an hour and I told her that Ben was going to be coming in shortly and we wanted to eat lunch.  So she said we could probably wait a little bit for Ben to get there before giving Sam a bath if we wanted to be part of that process.  One thing they do every 2 weeks is change out the incubator, so as of Thursday, Samuel is hanging out in a fresh incubator!

So I texted Ben and we slowly gathered up items and prepped Sam for the bath.  Right as I was saying we could probably begin because Ben will show up any minute now he arrived.  This was an exciting bath because this was his first bath with soap.  So it wasn't a true bubble bath, but there were some soap bubbles in it!  Once these preemies hit 2 weeks you don't have to be as worried about the skin.  The nurse said his skin now is more like that of a full-term newborn, which is still fragile!  When he was first born his skin was extremely thin and fragile.  So YAY for stronger and thicker skin!

As we were prepping him for the bath we noticed that Sam had a nice breast milk poopy diaper.  That means he's been able to work out all that nasty meconium stuff!  We keep thanking God for things like poopy diapers.  :-)

I talked to the doctor a little later that day and he said that Sam was still hovering on the border of needing a transfusion, which is a very normal thing for preemies to need.  His blood count and oxygen levels have been just high enough to not need it, but it could still very easily need to happen this weekend or early next week.  We are so thankful at how well Sam has been doing and knowing that transfusions are common place here in the NICU we are thankful for a hospital staff that is very well trained and know just what my baby needs to get strong!

After Samuel had his bath he was very alert and awake.  He was wide eyed, squirming and looking at what was around him.  Such a good sign that he is so active.  I kangarooed with him as we fed him at 3pm and that was absolutely wonderful as usual.

That evening my friend, Rachel, stopped by.  That was good to see her.  I got to explain all the NICU baby stuff to her.  It is always fun when someone new stops by because they have no idea what all the alarms mean.  When people stop by they sometimes are surprised that Ben and I don't respond to the alarms at all.  We might glance at them and comment that he's fine and continue conversation.  This is because there are many alarms that go off in Sam's room.  Some are cause for real alarm and some are just letting you know there was a change and by the time you look it is already resolved.

Sometime's there's an alarm because Sam pulled his temperature probe out (his incubator get's kind of mad when he does that).  Only occasionally does an alarm sound that we actually have to worry about.  That is when he drops heart rate and stops breathing and doesn't get it going very quickly on his own again.  Generally he bring his heart rate immediately back up or he starts breathing right away again and that isn't a big deal.  He's being a big boy and getting himself back on track!

09 February 2012

Thursday, February 9 - No More IV!!!

So today was really an extremely uneventful day when it comes to Samuel (praise God for that!), last night however was slightly more eventful (but only in good ways).  As I mentioned yesterday his peripheral IV went bad and they replaced it with a new one.  Well, that happened again last night!  Only this time they decided not to replace it.

Yesterday I wrote about how that peripheral IV was really just replaced to keep it open while they made sure that he was taking the feedings well.  Last night when the IV went bad, they decided that since he had been taking his feedings so well there was no real need to replace it, just keep going forward without it.

So today they starting fortifying my milk.  Instead of just giving it as is they added calories.  This means instead of 20 calories per ounce he is getting 24 calories per ounce.  So far he has been taking to his feedings really well.  We continue to be amazed and thankful that everything has been going so well!

This morning Samuel was being slightly fussy.  I kangarooed with him during his noon feeding and he was just so cozy and loving it!  We hardly heard him the rest of the day!

Today I got out and went the the ymca for a little while.  I did a half hour walk using the fancy new gps/activity tracker my brother gave me for my birthday.  It's really cool and I can't wait to get out and take advantage of more of the features, but all in good time I suppose.  For now I just want to get over to the ymca and do some walking several times a week.  Then if that goes well, walk longer and more frequently!

I decided after Samuel was born that it makes no sense for me to stop everything I am doing just because he is in the NICU.  This school year I have been tutoring two students once a week, so after going to the ymca, I came home, did some chores and tutored for an hour.  It was good to concentrate on something else!

This evening I have just been tired, Samuel seemed to be doing quite well, so I called it an early night and went home before 9pm!!  Not that that helped too much as I still need to pump before going to bed and it is already almost 10:20.  Alas, I am a slave to the pump!  At least I am giving Samuel the nutrition he needs and that is all that matters.  :-)

08 February 2012

Wednesday, February 8 - Kangaroo Care is AMAZING!!

So today has thankfully been yet another uneventful day.  Last night I guess was a little bit more eventful (though not in the concerning kind of way).  They have been checking and rechecking that peripheral IV with some surprise that it has been holding up.  Well, last night, it finally went bad (as it doesn't work anymore).  So they had to establish a new location, which worked and he's been doing great on the new site.

Which the new site is needed more as back up rather than out of necessity for Samuel's nutrition.  Today they upped the milk intake to 18, which means (based on some elaborate formula that includes body weight and other things) he no longer needs the supplemental nutrition through the IV.  However, they don't want to rely solely on the IV yet until they make sure he is taking the milk consistently well for a little while.  Until then they are running what is basically sugar water through the IV to keep the spot live, until they can take it out.  According to the staff here, hopefully tomorrow they can take out the IV and remove another piece of equipment from the room.  Praise God for giving Sam the strength and health he needs to make all these "baby" steps.  :-)

This morning and early afternoon Sam's been a little bit fussy, but then we kangarooed for his 3pm feeding.  We kangarooed for almost 2 whole hours.  It was amazing.  Every time we kangaroo I just sit there with amazement.  He sleeps real deep during our kangaroo care, but every once in a while he'll shift position and I can feel his little arms, legs, hands and feet move around a little bit.  I sometimes look at him when he does that and just marvel at how he is a complete person despite being born so early.  He has all the body parts we do and he can move them around, he just needs some time to make them stronger.  This is truly amazing.

The other thing that amazes me about kangaroo care is how he immediately calms down and falls asleep as soon as I get him positioned on me.  He was being somewhat fussy just before I picked him up and while I was picking him up.  Then right when I get him positioned on me (before I even sit down, while I am standing by his incubator about to move to sit down) it's like the switch gets flipped and he's asleep.  Now if it stays that easy to calm him from here forward that would probably be a miracle, but I am just loving it right now!

Really nothing else has happened, since kangarooing I've had a very peaceful baby all evening so far and hoping that this evening continues being peaceful.  :-)

07 February 2012

Tuesday, February 7 - Bath Time

Today was a good day for Sam.  But before I go into that, let me tell you about the last bit of last night.  Ben got to the NICU before Sam's 9:30 check and feeding (they check his vitals and feed him apr. every 3 hours) and one of the things we do at these checks is to change his diaper.  Since I had been changing his diaper all day, I asked Ben if he wanted to do this one.  He eagerly declined (though he had already changed one diaper and then another today, making it 2 diapers).

Well, this diaper was a perfect diaper for the Daddy to change, because it was quite full.  He got quite the poop out (and it is that stuff that full terms generally get out in one or two poops, if you've had kids, you know what I'm talking about).  It was by far the biggest diaper all day!  We were relieved that he was wearing the bigger size diaper because Samuel might have blown out his diaper otherwise!

This morning the doctor came in to tell me that Samuel's creatinine levels were a little high.  The creatinine levels indicate how well the kidney is functioning.  His kidneys are functioning pretty well we know by how wet or poopy his diapers are.  However his levels were more akin to what they should be for an adult.  That said, the medicine he was on can affect those levels.  Now that he is off the medicine they did notice a decrease in the creatinine and we are expecting for those levels to continue to go down.  If they don't Sam might have to get a renal scan to check the kidney for problems.  So we are hoping and praying that the doctor is right that the medicine is what caused it and we will continue to see those levels go down!

All morning he was breathing great!  In fact they kept turning the oxygen down until it was almost to the amount that we breathe in regular air.  At noon our nurse for the day went and collected things to give Sam a bath, he had had a sponge bath last week, but this bath was with a little plastic tub.  Preemies get bathed a little differently than full term babies (not that I would know as I never had a full term baby).  What they do is they leave the baby wrapped in a blanket and then unwrap and rewrap as they wipe down different parts of his body.

Samuel did really good through the whole bath!  During the bath I held up his arm with the peripheral IV so it wouldn't get wet.  When they were done bathing him they wrapped him in a dry blanket to dry him off.  We did this all in his incubator with the top up, that way he'd stay even warmer throughout the process.

This afternoon we had family rounds.  Most of the goals from last week we either kept and want to do even more so or they were achieved and no longer need attention.  Some goals for this week include: decreased creatinine levels, continued kangarooing with feedings, becoming stable enough to not need the CPAP, increased milk intake so he doesn't need the IV, Ben and I to continue helping contain Samuel during the different cares, and maybe a few more along those lines that I am not thinking of.  Really Sam is doing great and there were no real negatives to discuss.  :-)

06 February 2012

Monday, February 6 - Fussy Baby and Good News

Today has been a fairly uneventful day.  Samuel's been kind of fussy off and on all day.  They had switched his tube for my milk to a larger size, but as he kept fussing they switched him back and finally managed to tape it down in a way that he isn't spitting it right back out!  But he was start crying a little for every little thing today it seemed.

Then I got to kangaroo hold him.  After that he finally settled down.  We also turned him on a different side, so it could be that too, but I'd rather think he settled down because of his cuddle time with his Momma.  :-)

The exciting thing today was another head ultrasound.  I know I said they weren't going to do it until Friday, but when I came in this morning they had changed their minds about when to do it.  Apparently this morning was when they met with the neuro doctor and discuss all the babies in the NICU, when discussing Samuel they decided to run another ultrasound today just because of the big discrepancy between the first two.  They wanted to hopefully confirm the second one.  So they ordered the ultrasound to happen today after all.

They came in before lunch and did the ultrasound and as I mentioned Samuel has been a fussy baby today, so he fussed all the way through the ultrasound.  I don't blame him, they were chasing his heartbeat down with that goop they use for ultrasounds on my belly all night, I don't think I would want anyone smearing that all over my head!

Later that day the doctor who's on today came to talk to me briefly.  He said that the initial look of the ultrasound looked the same or possibly even better than the Friday ultrasound.  He said I could come and look at the ultrasound pictures with him when I want, I told him I wanted to when I was done pumping.  I got to see the pictures from last Monday and today and it is amazing the difference!  Such a miracle!  There was a doctor there that made a comment on how the blood vessels sometimes get in the way with these premies and are easily read incorrectly.  So according to him there might have never been any bleeding problems.  At any rate I consider how strong and well Sam's been doing as a miracle, regardless if that can be explained logically!

The peripheral IV they put in him has been holding up really well.  Which is great because those kinds of IV's tend to not last very long and this one has lasted since Friday.  We ask your prayers that it continues to do well!

Sunday, February 5 - I Know What I Need!

So pretty much since day one we have known that Samuel knows what he wants and he is determined to get it.  As was evident when he pulled all the stuff off of his head because he was tired of it on him.  Or his determination to take the tube out of his mouth constantly.

Today he showed a new determination.  It start with him making the nurse run back and forth because he would drop his heart rate or stop breathing, just to bring it back up or start again right before the nurse reached the room.  Occasionally we would have to encourage him some, but generally he figured out on his own that he needed to bring his heart rate up or start breathing again.

This afternoon he decided that enough was enough and he did not want to be on his belly anymore!  I was grabbing my gear for pumping when I heard him cry.  We weren't doing anything to him (normally he has just cried when he's tired of people messing with him), so I investigated.  I looked in to see him squirming all over the place trying to (what seemed to me) get off of his belly and in some other position.  So I went to go grab a nurse.  I would turn him myself, but I don't think I should until he has less wired and tubes attached to him!

When the nurse came in we were laughing because he sure knew what he wanted and made sure we know it!  Ben and I are sure going to have our hands full with this determined and strong willed child!  :-)

Other exciting happenings included Ben's Dad, Dale, stopping by after going to the early service to say goodbye.  It was good to have him here and he sure seemed to enjoy seeing little Sam (despite me often kicking the guys out to pump...).

I went to the late service at Church (my first time there since Sam was born) and got to talk to a lot of people.  I was just sad I couldn't have Sam with me to show him off, but alas, that must wait for a while longer...

When I am out and about and I see new Moms with their babies I can't help but feel a little jealous that they get to have their babies home with them and I have to visit mine in the NICU.  I know that's the best place for him right now, but that doesn't make it any easier that we didn't get the typical picture perfect have the baby then take him home a few days later when you are all discharged at the same time.

That evening we went over to a friend's house for some supper and to watch the Super Bowl.  At half time I returned to the NICU to pump and to hold my little son.  Ahh, that kangaroo care sure does us both good!

Saturday, February 4 - Breathing is Hard Work!

This morning I woke up early to pump and decided to just get ready and head over to the hospital.  I needed more sleep and figured with all the people staying at our house, I would have a better chance of sleeping more in Samuel's room than at home.  So I left the quiet house full of sleepers that were sure to soon wake up.

I got to the hospital and grabbed some more breakfast, pumped and laid down.  Sleep overtook me quickly.  I woke up to talk to the doctor and hear more about the results of the head ultrasound.  Yesterday they gave us some preliminary results and what the doctor told me was also not an official reading, but I think we can go with it pretty well.  What he told us is that this ultrasound looked like there really wasn't much for bleeding.  In fact the grade 3 now looks like a grade 1 and the grade 2 looks like a 0.  The doctor said they might have been simply over zealous in the diagnosis the first time or they might have misread it too.  He found it hard to believe that it would have gone down that much in so short a time.  They will do another head ultrasound in another week and we are hopeful that it will match or be better than the one they did today!

The doctor also said that we would probably start giving Sam more of my milk at each feeding starting today.  He has been getting 3 milliliters every 3 hours and now he should get 6 every 3 hours.  They then starting doing this too with the 12:30 feeding I believe.  He has been tolerating the upped amount great too!

This morning Samuel must have decided that breathing is just hard work!  He would stop breathing enough, which would set off an alarm that would call a nurse over to check and help him.  After doing this several times and not getting his oxygen level back up the nurse decided to give him a little bit more oxygen.  He is doing great on the amount of oxygen he is given and actually only receives a little more than what we get breathing regular air.

Ben, AJ, Dale (Ben's Dad) and Anna all started showing up a bit before noon.  A few of them were surprised that I was at the hospital they had thought I was at home sleeping until it was commented on while eating breakfast.

During the afternoon everyone decided they were finally ready for lunch (I had eaten the food at the hospital already) so we took a break and went to Jimmy John's.  Then after finding out that Ben's Dad had never been to Cold Stone, we stopped there too.

This evening has been really uneventful.  I got to kangaroo with him again, which I just always find absolutely wonderful.  They have me pick him up and put him back and I am getting much more graceful at it, which means Sam gets less fussy during transition.

Now we are just kind of relaxing and getting ready to go home.  Samuel's still doing great!  He is gaining weight back now too, he is practically back to his birth weight!

Friday, February 3 - Head Ultrasound Update

So today was a very eventful day.  As mentioned yesterday, my father-in-law made it into town late last night and after we all got up he and I headed over to the hospital together while Ben finished up doing a few things at the house.  We got there just in time to grab some breakfast and head upstairs.

Sam was doing great!  Well, he really did do great all day.  Soon Ben also arrived.  Our doctor came in and talked to us about a few things.  One was to let us know that his blood count was low, because of that they wanted to do another head ultrasound in order to see if the ventricular hemorrhage had gotten worse and that was the reason for the low blood count.

The other thing he wanted to talk about was what to do about the IV line.  Currently he receives most of his nutrition through IV and my milk only accounts for a small portion of it.  The IV line that he was given originally was through his umbilical cord.  This is a good location for a while, but then there are risks of infection, which is why our hospital tends to try to replace it either with a Peripheral IV or a PICC line.

As mentioned yesterday they attempted (but failed) in establishing a peripheral IV.  The problem with those is that they tend to go bad quickly and can be hard to establish.  PICC lines run risks of infections, but tend to be a more stable line that they could use until he no longer needs the IV.  Ben and I talked it over and decided we would be more comfortable trying the peripheral IV and going from there.

Throughout the day I would kick the boys out so I could pump and that morning as I finished pumping they brought in the ultrasound machine to run the head ultrasound.  That was good because that meant we had a better chance of finding out the results of it by the end of the day.  Since they ordered the ultrasound that morning they weren't sure when it would happen.

That afternoon I went home with the intention of grabbing my knitting and going to knit at Church with the ladies, but I was so exhausted and started crying over the silliest thing, that I decided it was better for me just to nap.

Meanwhile back at the hospital lots of things were happening.  As I wasn't there I am relaying as best as I can remember what I was told.  The nurse was checking Samuel over when she noticed that part of his umbilical cord IV was missing.  Not a good thing and she couldn't tell how long that had been the case.  That meant that we had to go from talking about what we wanted to do about the IV to doing something about it right then.

They found a lady on staff that is really good with peripheral IVs and brought her in to do one on Sam. Ben said he and his Dad said a prayer while she was working and God sure answered it.  She was able to establish one successfully on the first try!  Thanks be to God!

Right at that point I was also feeling somewhat antisocial so I kicked the boys out again.  My younger brother, AJ was also coming into town and they wanted to grab supper with him.  I decided to stay and eat the food at the hospital (which is actually pretty good) so I could keep pumping on schedule.  Thus I was able to settle into a nice relaxed evening.  So about the time that they were getting supper, I was kangarooing with Sam.  I just absolutely love that time with him!

Later that evening my cousin, Anna, stopped in for the night and we all headed back to the house.  We then spent a bunch of time talking before finally heading to bed around 12:30.  It was overall a good long day.

Thursday, February 2 - Pokes Hurt

The big thing that happened on Thursday was trying to establish a Peripheral IV.  The goal is to eventually get the IV out of his umbilical line.  The problem with peripherals is that they tend to go bad quickly and can be hard to establish.  Today was showing the hard to establish part of it.

They came in and tried their best, but it just wasn't working, as soon as they found a good line, stuck in the needle it went bad...  Poor Samuel went through at least 4 if not 5 of those pokes.  He laid quietly through most of the pokes, in fact he just kind of laid there like, alright you can play with my arm or my leg or whatever, I know crying isn't going to stop you.

Well at either the last poke or second to last poke he decided he had sat there quietly enough for long enough and just let out a nice long cry.  He cried so hard, loud and long that he exhausted his little body and fell asleep.  Ben and I sat there amazed at how loud he could cry.  He's not loud in the grand scheme of things, and I know babies can cry much louder than he did, but he still had quite the volume!

With talking about the peripheral IV and not know when that was going to happen, and I think they were playing with the CPAP mask to find the best fit, I didn't hold him during the day, by the time everything settled down, it was getting late and I was exhausted!  So Ben got to Kangaroo with him.  :-)  We took our first ever family photo that evening!

Wednesday, February 1 - No More Bili Lights!

Wednesday was a fairly uneventful day.  The big news is that they took his bili light away.  The bili lights are used to treat jaundice if you remember from my Saturday post.  Every day they took a count of how much jaundice was still in his skin.  When the number gets low enough they no longer use the bili lights.  Well, the count Wednesday morning was low enough, therefore no more bili lights for Samuel!

That was good because that meant they were now able to snuggle him in better in his little incubator.  That snuggling is god for him because it gives him something to push against.  In my womb, he had all sorts of boundaries to kick (which he did kick quite regularly), under the bili lights he had almost nothing to kick and punch, which meant he was constantly squirming!

Now that he doesn't have the bili lights anymore and they wrap him in better he has been much more calm and relaxed overall.  It's good to see that, I always wanted to do something to help him calm down, but didn't really know what I should do!

The other exciting thing was that he pooped for the first time!  So before he just had wet diapers, now he is working on pooping out that gross meconium stuff that comes in a baby's first diaper (but for him it will take him a little longer to get it pushed out).  That means the milk is doing well with him and he is doing well at pushing it through his system.  So proud of my little man being able to poop!

I got to kangaroo with him again on Wednesday.  Those are such special moments for me with my son.  It becomes easier and easier to think of him as my son, my little child that I get to care for and love with all the joys and frustrations that go with that!

Now I can't remember if this happened on Wednesday or Tuesday, but since I had less to write about for Wednesday, I'm going to say it happened Wednesday, even though I think it might have happened Tuesday instead.  I think I have mentioned that Sam is stubborn.  If I hadn't yet, well, he is.  He is stubborn and determined to get what he wants when he wants something it seems.  Ever since birth, one thing he has wanted was none of these tubes and lines stuck to him anymore.  Just let me free!

Well one evening, while under the bili lights, he really managed to free himself from a lot of his "bondage."  Ben and I were sitting in the room and I saw him really squirming quite a bit, so I went to check on him.  I get over there to find out he had undone the velcro on his bubble CPAP hat that holds the CPAP in place, he had pulled out his eye mask that he needed to protect his eyes from the bili lights AND he had pulled the tube that goes down to his stomach almost completely out!  So I wash my hands quick and I get in there and I am doing my best to put things back where they needed to be (but I didn't trust myself shoving a tube back down his throat) so while I am trying to put things back I told Ben that we needed to get a nurse to get things back to place right!

I was very impressed with Sam's ability to get all that stuff off.  He is a smart and strong little boy!

And that is the thought I will leave off at with this post.  :-)

05 February 2012

Tuesday, January 31 - Mother's Milk

As of Tuesday our little Samuel had only been receiving nutrition through IV fluids.  He had dropped some weight (pretty much every baby drops some weight, regardless if they are term or premature), but the doctor said when he starts getting my milk he will start gaining it back.  The other "fun" thing he will get to start doing is pooping!

So Tuesday, because things seemed to be going well, they decided to start Sam on my milk.  I had produced a bit of supply by now, so I was excited that all this time I have been spending pumping and kicking people out of Sam's room so I could pump was finally going to be put to use.  Besides that, by him taking my milk, I feel like I am contributing more!

Some clarification on what it means for Sam to take my milk...  He has a line that is run through his mouth into his stomach.  The milk he receives will go into this line and directly to his stomach.  That means he doesn't actually drink it and he does not need to be on the breast to get it, he simply receives it passively in his stomach.

Also by starting him on milk that does not mean he will no longer get IV fluids.  They start these premies on such a small amount and only slightly reduce the fluids.  Most of his nutrition will still come from the fluids until they up his amount of milk.  Tuesday they started out by giving him 3mL of milk a feeding (which happens every 3 hours).  Eventually 3mL will go up, but they have to make sure he is taking to the feedings well.  They do that by checking and seeing how much of the last feeding is left over before giving him a fresh one.  As long as less than half of it is in there, then he is taking them just fine.

So I got to excitedly watch an unexciting event of him taking my milk (kind of anticlimactic, because all he did was lay there while they ran the milk through a line).  Yet it still made me happy nonetheless.

Tuesday I also got to kangaroo with him again and yet again I just stared at him in amazement that he is my son and he is already here!

All the families in the NICU do something called family rounds once a week.  Our day is Tuesday for family rounds.  What this means is the whole team of people that are working together to get Samuel strong meet and discuss his progress over the previous week and the goals for the next week.  The parents are invited and encouraged to join in on the rounds as much as possible.  So Ben and I were there and ready for our first set of family rounds.

The team that is working on Samuel is quite large actually, it includes the following people: doctor, nurse, dietician, lactation consultant, family liaison, social worker, physical therapist and I think I got everyone???  Basically the outcome of the first set of rounds was pretty much what we expected.

Goals:  keep an eye on the ventricular hemorrhage, slowly up his dosage of milk.  And I am sure they were more, but most of the goals just dealt with keep an eye on how he is doing with different things and just get him through his first week of life safely.  They say he is the most fragile during the first week.

Monday, January 30 - Tears and Joy

Monday has been my most emotional day so far.  I came to the NICU as soon as I could get moving in the morning.  I was clearly very tired though, as I didn't arrive until almost 11am.  Ben started reading the Psalms to Samuel that morning.  He left to go to work shortly after I arrived.

Then the doctor came in to talk to me early that afternoon.  They had run a head ultrasound on Samuel because premies tend to have some problems with bleeding in the brain.  The doctor came in and explained (very kindly and gently) that they did see some bleeding in his brain.  This is called intraventricular hemorrhage.  Read the explanation from the link for a better explanation that what I would give.  Basically though you have 2 ventricles in the brain and with premies like Samuel the blood vessels close to these can leak blood.  The lower the grade rating the more minor it is, rated from 1-4.  Samuel had a grade 2 on the right and a grade 3 on the left.  The doctor described grades 1 and 2 like a bruise.  It will take some time to heal, but leaves no lasting impact on development.  Grade 3 and 4 however can possibly leave some lasting impact on development (mainly physical development, but in some cases mental as well).  His grade 2 was a very minor grade 2 and his grade 3 was a more major grade 3.

Let's just say, the doctor told me this and put tons of emphasis on how it might impact future development, but many babies develop normally.  Based on his activity level it was surprising that he even had such a high grade on the one side.  Despite his strong emphasis on how this could mean absolutely nothing I started bawling.  I hadn't let a single bit of emotion out the entire time (from going into labor on my birthday through that point.  All the positive news pushed me forward, the moment I was given a slight negative the tear ducts were ripped open and I let it out.

There was some positive news the doctor had given me at the same time however.  There is a valve in our hearts that is open when we are in the womb, but after we are born it naturally closes.  This doesn't just naturally occur in premies however.  Therefore they had given him a three day dose of medicine that is supposed to cause it to close.  It had worked!!  YAY!!  His heart is now good to go with that valve now closed!

Then I got to kangaroo hold Samuel for the first time.  That pretty much dried all my tears and gave me lots of joy.  The doctor said there wasn't much we could do for him at this point until we give him another head ultrasound in a week to see if it had worsened or not.  Most bleeding like this ceases within the first 7 days of life.

Kangaroo Care is something common to NICUs.  Basically what it is is holding Samuel to my skin on my chest.  This is something very calming to babies because they know their mother's heartbeat and rhythms of breathing and speaking.  It also helps them maintain body warmth, regulate heart and breathing rates, gain weight, spend more time in deep sleep, spend more time quiet and alert with less time crying, have a better chance at breast feeding.  For me doing kangaroo care has really helped me mentally and emotionally process the fact that he is here, he is my son, and I love him very much.

At St. Luke's they like you to hold your child for at least an hour.  There are lots of tubes and such hooked into him, this way you make the process of getting him out and moving him more worthwhile with the extended holding period.  I had them take a few photos of us, they gave me a mirror and I spent the next hour and a half gawking at him laying there on my chest.  The mirror helped me gawk, otherwise I couldn't see him so close to my chin!  It gave me just soo much joy to hold and love on him.  Ok, I'm not really supposed to move at all, so the loving was more just by way of the holding.  :-)  Best feeling ever!

When they put him back in his incubator, I just wanted to pull him out again and hold him and carry him.  But alas, that is for another day!

That night Ben went home before me because I stayed to pump one more time before heading home.  When I was walking to the elevator to leave I could feel the tears welling up in my eyes.  By the time I arrived home I was all out crying.  Ben asked me what was wrong and I answered, "I had to leave him there..."  I know I had to leave him there and he is better off at the NICU than at home right now, but it sure didn't make it any easier to leave him there that night.  I felt so helpless, Samuel's my baby and I felt like I could do nothing for him...

Sunday, January 29 - Family Time

That night I woke up and couldn't go back to sleep so I paid a middle of the night visit upstairs to Samuel.  He looked like he was doing great.  I just stood there for a while staring and thinking, "You are born, you are my son, I am your mother" over and over again.  Three days later I was still in shock that all this has happened.

That morning when I woke up I walked upstairs to visit Samuel again.  I hadn't been discharged from the hospital yet and I had the morning to just relax before family came by.  Once they came by though we spent most of our time in my room downstairs.  At the NICU they don't like too many people visiting in the room at a time and we had quite a few people over.  That afternoon we were supposed to be going to small group (which Ben leads currently) and due to the baby, the small group convinced him not to have it, instead they came and visited me!

We had a good time visiting with my family that came out and with any visitors that dropped by.  We would make occasional visits up to the NICU.  Samuel's status didn't really change at all either.  So we gave thanks for the fact that they were able to make him stable on the machines they had on him.

Daniel, my brother, had a lot of fun taking pictures and videos with his fancy camera.  He takes quite the photos!  He also gave Ben and I the second picture that he wanted to give us for Christmas, but hadn't arrived by the time we saw him.  He had taken a picture out at Camp Luther where we got engaged and then another one of the two of us at Ivannacone (sp.??) in Lincoln, NE.  They were printed on a canvas which we'll be hanging in our house soon.

After everyone left to go to their own homes Ben and I went upstairs to visit Samuel for a while before leaving the hospital.  When we left it all just felt very surreal.  It felt wrong going home without our baby, but Ben was with me and that strengthened me.

Saturday, January 28 - We Really Have a Son!?!?!

Last Saturday the amazement at the fact that we really have a son had not worn off yet.  Really the whole weekend is sort of a blur at this point, between the baby arriving so ridiculously early and all the visitors we had at the hospital, I don't know that I know for sure any more what all happened on Saturday, but I'll tell you what I do know and remember!

I got really great sleep that night, I remember waking up feeling quite energized--a feeling that I hadn't really had in so long (I would say about 4.5-5 months) that I was on top of the world when I woke up!  I was just hoping that Samuel felt just about as on top of the world as I did...

That morning they took him off of the ventilator and put him on a CPAP.  Yup, CPAP is what adults get put on to help them with sleep apnea.  Which apnea is something that Sam has being born so young.  Apnea basically is when you stop breathing for a little while.  When a baby is in the womb all they can do is sort of take practice breaths of amniotic fluid, but they can't actually breathe.  They do that when they are first born.  Sam being born so young has not quite mastered breathing all the time.  He seems to know he needs to breathe, but sometimes he'll stop breathing.  We have monitors in the room that show him where his oxygen is.  Normally he is able to bring it back up on his own with no problem.

Now the CPAP he is on is called a Bubble CPAP.  It attaches to his nose with a special hat and either prongs or a mask.  Since it is a bubble one, we get to hear bubbling noises in his room all the time.  If it stops bubbling that means something isn't set right, which can happen simply from Sam opening his mouth.  It can also happen that he moved or he pulled on the prongs or mask causing them not to seal properly.  What the CPAP basically does for him is it keeps his air ways open so that he can breathe easier.  This way it isn't as hard for him to get breaths.  Eventually they will take it off of him when his lungs have matured enough and he is able to get the oxygen he needs without much help.

The other big thing that happened Saturday was he was put under bili lights for his jaundice.  So that mean that a special light was set above his little incubator and they shined it on his body because that is where they could reach the most skin.  Since the idea is that he is exposed to as much of the light as possible they weren't able to wrap him in very much.  This meant Sam was free to show off all the kicks and punches he was doing to me the whole time in my womb!  I knew he liked to move around a lot and seeing him out just proved it all the more!

During the day we received word that my brother, Daniel, was planning on coming out.  He arrived pretty late and did not get to see Sam that first day.  I was still staying at the hospital because their guidelines were 2 whole days after a vaginal birth, which meant I got to get discharged on Sunday.

With all the family and drop ins from other people it was a busy day!  We were just thankful at the end of the day Samuel seemed to be doing well.

03 February 2012

January 27 - We Have a SON?!?!

My parents jumped in their car to come down as soon as they saw Ben's text that we were in labor and the baby was coming.  They just didn't see the message until 10:30 so they got here a little later than they wanted, but also just in time.

Shortly after they arrived my Dad (an LCMS pastor) and our pastor went upstairs with us to baptize little Samuel.  With him in the NICU we just wanted to make sure it happened, after all they were telling us most babies end up staying close to their due date (April 28th).  It was amazing to see him get baptized.

The rest of the day I spent just in shock that he was born, we have a son, I'm a mother, I'm no longer pregnant....  WHAT just happened????  It all happened so quickly, I just couldn't quite wrap my mind around it.  But we had family out and we had friends stopping by and that kept my mind occupied enough to not freak out that Sam was really just born.

We took the rest of the day kind of easy, I went and saw Samuel a few times.  I finally got to eat something around 4PM (the evening before I ended up having a small supper while Ben was resting, if I knew labor was really going to happen, I probably would have eaten a lot more).  One of the nurses came in and got me started on pumping.  Pumping was really awkward at first, as I really didn't have any idea of what I was doing except what the nurse said.  But I figured as long as I follow their advice I should be ok.  The advice they had been giving me up to that point seemed to be good advice.

That night after everyone left (Ben decided he wanted to sleep at home, and I was too tired to really care where he slept) I was able to pass out and sleep like I hadn't slept in months.  It felt really really good.  And maybe the next day I would begin to comprehend what just happened...

January 27 - Go Time

By 1AM they had an IV in my left hand, given me drugs through the IV to try to stop the labor and shot me with a rather large needle in my butt with steroids for the baby's lungs.  The goal was to get this labor stopped and shoot me with more steroids later.

I was not allowed to stand up, I had to use a bedpan (that is a rather awkward experience by the way and not something I really ever want to have to use again) and that is what I had to look forward to if they were successful in stopping labor.  Well, the drugs caused the contractions to slow for about 20 minutes then they came back with even more vigor, they came just as often but much harder.

I think Ben's hand started to get sore through all the clenching of it that I was doing...  Well, it did help me to concentrate on squeezing his hand.  The funny thing was we were about to start taking some of the baby classes to prep us on labor and delivery, but we got a crash course from the nurses instead.  They walked me through breathing techniques and I tried my best to use them in the midst of everything.  I tried my hardest to not push when the desire started to hit me.

One thing is for sure, it is no fun having contractions when your bladder is full and your water hasn't broken!  So after spending several hours trying to hold myself back during the contractions my water finally did break (maybe 5AM?? not real certain I was rather exhausted by then) things started feeling much much better.  In fact I barely even felt the contractions after that happened!

Now the nurses asked us about giving me an epidural--something I hadn't really decided yet if I wanted or not.  In all my exhaustion I looked at Ben and told him that I trust him and that I want him to make the decision because I cannot think clearly and do not trust myself.  After talking it over with the nurses and finding out that baby was sitting sideways and hadn't dropped (meaning possible C-Section) he told them to give it to me.  After that I was able to get some sleep (for about an hour and 20 minutes).  We had to wait for our baby to drop anyways.

On a side note, our little one was always very active inside of me and it was somewhat comical as the nurses had to keep chasing him down all night!  They would have his heart beat, then he would move just enough to make it hard to find again.  Kind of frustrating and funny all at the same time!

When I woke up they checked me over again and found that the baby had moved and was almost in position (and in the correct vertex position--head first), so we would be pushing very soon.  They got the OB doctor in, the NICU doctor, NICU nurses and who knows who all else (Ben told me there were about 8 medical staff in the room ready to welcome our baby into the world) and we started pushing.  After no more than 15 minutes our baby came out and was given to the NICU doctors to get him stable so he could be transferred to the NICU upstairs.

Another side note:  How can a woman push for hours?  That's hard work!  I could have pushed longer if needed, but seriously for hours??

In all the hubbub we were trying to find out if we just gave birth to a little boy or a little girl, finally the pronouncement was boy.  So we gave him the name we had picked out:  Samuel Benjamin.  Samuel has quite the tuff of hair on his head.  So Ben was all jealous about that.  At this point I just settled back a big on the bed and Ben kept a worried eye on the reactions of the NICU doctor and nurses.  From the first minute Samuel was not liking the idea of having tubes and lines stuck in and on him!  They then claimed him stable enough to move upstairs, rolled him over so I could look at him and off they went (with Ben following close behind).

Samuel Benjamin was born at 12:44PM weighing 2# 8oz and was just over 15" long.

January 26 - My Birthday!

As many or all of you are aware a lot has happened over the last week!  I have not had time to write down thoughts and updates on all of it in my blog.  I intend on writing a post for everyday and then trying to keep it up to date after that.  So let's go to when the chaos all start.... my birthday!

In my last post I mentioned how I had stopped teaching (and by my birthday I really was missing my students) and was thankful for the ability to get a little more rest in.  I was also looking forward to the extra time I had for exercise and getting the house ready for baby.  In fact last week I went walking at the ymca every day for at least a half hour.  It felt great!

So on the day of my birthday I had no big plans.  I told Ben that I just wanted to stay home and take it easy and so he said he would make me supper that evening after work.  That morning I walked at the ymca, then I came home to take a shower before getting some work done around the house.  During my shower I had some pain that I hadn't experienced before, so I finished up quick and then laid down trying to get the baby to move off the nerve s/he seemed to be on.  Eventually the pain stopped and I went back to work on other things.

Only now I started having a new cramping sensation.  So I researched Braxton Hicks contractions versus real labor contractions and decided they were probably Braxton Hicks, as they came at very irregular intervals and by changing my activity they would stop.  Then they stopped for several hours.  I resolved to myself to keep an eye on it and call my doctor if they started again.

During that afternoon I got a lot of laundry done, cleaned the kitchen up nicer and made cookies.  It sure felt great to bake!  Then I had a student over for an hour that I was tutoring.  About then is when the contractions started again, so I did my best to ignore them while I was with my student.  After tutoring I had a Bible study to go to and as I didn't seem to be feeling too bad I went (only to find out it must have been canceled...).  While at Church I told my husband he had to go home because he hadn't been feeling well.

We got in our cars and drove home.  Ben clearly wasn't feeling well because when we got home he threw up twice!  Yet he was determined to make me supper on my birthday.  I made him lay down instead, after all we don't have to celebrate on my birthday, he could always make me supper the next day.

While he was laying down I started paying closer and closer attention to the cramping sensation.  In my mind I wanted Ben to sleep as much as he could, as I was starting to get the idea that it could be a very long night.  We were just at 27 weeks (3 months to go to the due date) and the contractions were coming every 10 minutes and lasting about the same amount of time.  Around 10:30 I woke him up and said something like, "we need to go to the hospital, I think the baby is trying to come and the baby doesn't need to be coming yet."  And off we went.  Ben grabbed a few things to work on as he figured they would observe me for a few hours and send us home...

By 11:30 they were admitting me to the hospital as I was definitely in labor with contractions now 3-4 minutes apart.  The goal when the admitted me was to stop the contractions, give me a steroid for the baby's lungs and put me on bed rest...