Happy 6/3 Month Birthday Sam!

So today is a BIG day!  Sam turned 6 months today and he turns 3 months old tomorrow.  We are happy to also announce that we have a very healthy normal baby!  Last Tuesday (after driving back from Fort Wayne on Monday) we went in to have a post NICU developmental check.  He checked out great!  Nothing too unusual came up, which I count as a win.  The one thing we have to watch out for is how he holds his head.  He does a fantastic job at holding his head up... tilted to the left.  They found that he has some tight muscles on that side of his neck because of it, so now we get to do some stretches to help him fix that.

They weren't really worried about it though.  They said that babies that tend to favor one side like that (in Sam's case the left side) tend to also have issues turning their heads completely both directions, which is something Samuel did just fine with.  So as long as we are stretching him and encouraging him to hold his head straight, it should be something that corrects fairly quickly.  If it's not working we might have to explore different avenues to correct it.

We have not seen any rolling over as of yet and no, he's not crawling.  But that's fine!  I'm sure before we know it we'll be chasing him around the house and wishing he weren't doing any of those things!  At this point, neither of those are reasons to think he's behind developmentally, he's doing just fine, and I'm sure he'll start them both soon enough.

He has started to enjoy standing on his feet when you're holding him.  Normally he only ever did it when he's angry (what baby does when they're angry?).  Now he's starting to do it from time to time when he's not angry!

They told us Samuel will probably start squealing more and sure enough I think we've heard him squeal more this week than ever before!  It's like he was waiting for permission!  ;-)

To celebrate Samuel's birthday my Mom is coming out for a visit!  Ok, maybe she just happens to be coming now...  Regardless she's driving out here.  We're going to have someone watch Sam while we go get massages.  Something I practically never do, but there was a groupon for a really good price!

I think he's decided to nap really well today to celebrate.  He hasn't seemed to nap well in the last few weeks, but his night sleep has been fantastic!

We'll take a photo with the bunny today, then you'll really be able to see the difference!

Sam at less than a week old and at just over 6 months.  I promise you it's the same bunny!

The Finish Line

As I write this Samuel's discharge papers are getting finished up and Ben is driving home from Nebraska (with a stop in Des Moines).  When Ben gets here we'll go through the discharge papers together and bring our little boy home for the first time.

It's all kind of surreal really.  I mean all we have known about parenting has been our time in the NICU.  As frustrating as it is to be in the NICU it definitely has come with some perks.  Now we have to say goodbye to our "babysitters,"  farewell to 3 meals a day that we don't have to cook and so long to immediate medical assistance when something happens.  This will be a new transition of sorts.

We will have a transition kind of like that of regular non NICU new parents, just a little different.  Because of the traces of ROP (retinopathy of prematurity) they saw, he's back on oxygen.  Apparently there is some evidence that keeping those o2 levels high decreases the growth of ROP.  So, he's going home on oxygen (which is kind of scary!).  Then there's a positive side, we know our son pretty well already.  Most parents start getting to know their baby at the hospital, but then really get to know them at home, we have a bit of a head start on that!  Of course, they have warned us, that babies tend to change some when they get home and develop some new patterns.  So we'll still be getting to know him!

The last few days have been very uneventful and we actually probably could have gone home yesterday.  Over the weekend he was having some borderline temps and the doctor was somewhat hesitant to send him home on Sunday.  When talking he asked me what I preferred.  I told him that I honestly preferred Monday over Sunday because then Ben could be here to help get him home and set up.  So today it is and things continue to go well!

I can't speak for Ben, but I know I am sure going to miss the NICU.  I have spent more time in the NICU in 2012 than anywhere else.  The staff here have become friends and I will miss seeing them.  The doctors and nurses have been just fantastic in every way possible.  So as excited as I am to bring our baby home, I am also sad to see this chapter close for other reasons.

This year is going to be different, but as it has already proven, different isn't necessarily bad, in fact so far, different has been amazing!  This will be the first year since I studied abroad to not be involved in Holy Week and Easter services, but that's ok.  Right now, with Sam's immature immunity system and his needing to conserve some energy for eating, that is what is best for our boy.  I don't know when I will start showing up at Church with him, but you can bet when I do, he will be kept very close to me and away from everyone else (at least for a little while).  Eventually I will let others touch and hold him, but at first....

I digress...  We are going home this afternoon and I can't wait!  I think one thing I am looking forward to is him just being there and I don't have to shower before driving over to nurse him, I can shower when it's convenient because I won't be going out into public first thing in the morning!

The next post...  will be from our house and no longer from the NICU!

The Blip...

Remember how I talked about how the home stretch can mean different things?  Well, his home stretch is starting to show us what it means.

The first type of home stretch was when you're going and going and going and then suddenly there's the finish line!  -- Yeah, that's not Samuel's home stretch...

The second type I mentioned was when you see it for quite a while before you finally get to it! -- Slowly, but surely progressing?  Also not Samuel's home stretch, he's a quick little baby...

Finally one where you see the finish and then you're sent off into a different direction -- Yup, this one is Samuel's home stretch!  As of yet, who knows how many detours we'll have to make on the way to the finish line, but we just made one.

What I didn't tell you when writing that post is that we thought Samuel would be coming home today (Thursday).  Well, that didn't exactly happen, everything was going great for it until yesterday, so this was a very sudden detour indeed.

In order to fully explain I have to back up to Tuesday night.  We opted to have Samuel vaccinated and as discharge was getting closer and closer we decided to give them to him on Tuesday.  So Tuesday night, during the first cares of the night shift, we gave him some immunizations.  Of course he didn't entirely appreciate it (and by that I mean turning beat yet and crying as loud as he could with each shot), but that's to be expected.  Most people, child and adult alike, don't really like shots.

Tuesday night he was extra grunty (preemies come as a small bundle of grunts, I mean squeaks, ok, so they just makes lots and lots of special preemie sounds).  Which meant I didn't hardly sleep.  On Monday I had started sleeping in Sam's room so we can be nursing in the middle of the night as well.  Him grunting and fussing just a little all night made it mighty hard for me to sleep.

That morning he only took 20mL of his 50mL bottle, then the next feeding he nursed very lazily.  Samuel was also being very grumpy.  He seemed to calm down some so we tried to do his 90 minute car seat check (mainly to see that he keeps his oxygen up while in the car seat) and failed it within the first 10 minutes.

Then he seemed better, he ate really well at the next feedings, we managed to do the car seat check again and he passed with flying colors.  He seemed a little more content again.  Then night shift started.  The first feeding for night shift he woke up an hour late.  Now I understand flexibility in scheduling, but he was waking up like clock work up till that point, him waking up a whole hour late was unusual.

We gave him a bath, checked him over and Ben settled down to give him another bottle.  Again he only took 20mL of the 50mL, not a normal thing for Sam to do.  We put him back down in his crib, checked his temperature again and decided to bundle him up warmly.  They swaddled him in 2 more blankets with hot packs and then laid another blanket on top.  They also put a hat on him (infants temp control through their heads).

Based on when he took the bottle he was due to eat again at 1:30am, but maybe earlier as he ate so little.  He didn't wake up to eat at the next time, at 1:45 we decided to try to wake him up to eat.  We got him into position, but no matter how hard we tried, he just wouldn't.  We managed to get him to latch and swallow some milk that I squeezed out, but that was it.  The decision was made, we were going to have to put a new tube down his throat and he was going to get moved into an isolette (you know, the one that he wasn't ever in before because he went from the fancy one to the bed).

******continued writing on Friday******

With that decision I decided to go to sleep, so I laid down on the little sofa/bed thing they have the rooms and passed out almost immediately and didn't wake up until 6:30am.  It sounded like things were pretty calm while I was sleeping, Samuel took the tube feeding well, then right before I woke up the nurse managed to give him a full bottle.  So that was great to hear, that meant that he was on the rebound, eating for himself again.

So I pumped, headed to the shower, grabbed breakfast and tried to relax a little.  We dilated his eyes at 7:30 for his eye appointment (he was not happy about that, it took 2 nurses to get his eyes open enough for the drops...  At 8am (this is all Thursday morning now) the decision was made to see how he does back in the crib.

The belief was, as mentioned already, that it was a reaction to the vaccines, with that the doctors thought that if we can just help him get back to his normal place we should be able to take the supports used to do that away and he should be fine.  So out with the crib.  After he was in the crib I realized I never took a photo of him in that isolette than he only spent about 5 hours in (but he'd never been in one like it before).  Oh well...  You could say I was somewhat tired and stressed feeling at the time.

The opthamalogist then came around 8:30 to do the eye exam.  They were trying out new equipment that actually takes video of the exam from his perspective.  The tricky thing they were finding is that even though the doctor can see things just fine, if he didn't have the linse lined up just right, it didn't show up on the monitor.  He couldn't however look at the monitor to see because that would point the camera at the monitor.  Overall they seemed to like the new equipment they're trying out and that "issue" is more a matter of practice than anything else.

My hope going into the appointment was that his eyes would continue to check out as immature (which is exactly what they are still, as he isn't due for another month to be born!) and we would be told to he'd be seen in 2 weeks.  Well, that didn't exactly work out that way...  They found some beginnings of retinopathy of prematurity on the outer edges of both eyes.  It isn't much yet, so we are now on the weekly appointment schedule.  How many of you know who Stevie Wonder is?  Yeah, ROP (retinopathy of prematurity) is why he went blind.  Now with this kind of monitoring we are able to catch ROP soon and there are procedures that can be done when it is caught at the right stage that can prevent blindness.  Hence weekly appointments.  If it looks more concerning in a week, we'll be going in even more frequently.

So that wasn't exactly the news I wanted to hear from that check up.  But we have a preemie and with that comes all sorts of fun preemie things.  I know my worrying about it isn't going to help at all, so I have decided not to be worried.  Samuel is doing fantastic despite these "blips."

Yesterday (Thursday, the day after the long night), he was back to his normal Samuel self again.  He was being feisty during cares and checks (definitely did not like his diaper getting changed again), demanded food when he was hungry (which I think he was playing catch up for not eating much the shift before, he only had 2 1/2 of the 4 feedings) and was just overall a more content and happy baby.

Along with putting him back in a crib they weaned him back off of oxygen by 3pm.  So he is no longer on oxygen again!  They aren't sure if they will be able to keep him off, so they might train me on the monitors and oxygen this weekend, just in case he goes home on it.

Last night we also had some fun.  He was being fussy after his 6:30 feeding.  I had already tried to burp him and only got littles ones out of him (he can sure burp loud though, don't let his size fool you!).  I tried holding him and he didn't quiet down.  As he just ate, I didn't try feeding him because he showed me that he was clearly done already.  I tried holding him in different positions, but nothing seemed to help.  So I checked his diaper.  Sure enough he'd pooped.  I started cleaning up, had a clean one under him, had pulled out the dirty one and was just about to finish wiping when he squirted out a bunch more.  It kind of sounded like a ketchup bottle when it's almost empty and it squirts out a glob more...

Well he really squirted and got his sleeper dirty, his swaddle sack dirty and his sheet dirty...  So I took that recently fresh diaper out and put a truly fresh diaper under him, closed it up real quick and just waited while he grunted and pushed the rest out.  This was also happening at shift change, so when the night nurse came in I let her know what happened and said that this might be easier to clean up with a bath.  So that's what we did!  The little guy got 2 baths for 2 days in a row!  That normally doesn't happen, but he was a messy little pooper....

That is basically what our little blip was.  We went from being told he'll likely discharge on Thursday to being told the earliest he can discharge is Sunday (which is code for he MIGHT go home Sunday, but it easily could be after Sunday).  So we are back to not knowing how much longer we'll be here, but knowing that he is receiving excellent care and we only want to bring him home when he is truly ready to be brought home.

After all, can you imagine how much of a basket case I would have actually been in if we were home?  As it was, I was slightly emotional as this was happening in the middle of the night, but I very tired from trying to not fall asleep and just wanting to sleep, but wanting to make sure Samuel was ok.  When I woke up I was able to simply be extremely grateful that it happened before we were discharged.  I know I keep saying how the staff is here great and I truly mean that.  I know I don't have to worry about Samuel here.  Today he's still doing great and I'm doing great and we are just hanging out waiting for him to show us he's actually ready to go home.

:-)

Oh and those of you on facebook, the crib did beat him home.

The "Home Stretch"

Before you get too excited about the title of this point, I want to give you a running analogy.  For those of you who don't know, I got into running about 2 years ago and love it!  It is very addictive I think!  I need to get back out there, because I would love to run a half marathon sometime this fall.  Alright, digressing...

Anyways, different races have different kinds of home stretches.  Let's talk about 3 different kinds.

1. Some races you run and run and run, then all of a sudden the finish line is there.  You couldn't really see it coming, it just sort of pops up out of nowhere.  Then you're finished.
2. Other races you can see it for miles until you finally finish it.  Those aren't nice because you can tasted the finish, but it feels like it's being kept from you like candy on a string attached to your hat. No matter how far you go, it just never feels like it gets closer.
3. Then there's even meaner races (right now I am thinking of the San Diego Rock'n'Roll Marathon I did last summer).  In that race (while I was in a lot of pain because my knee hurt like crazy) you could see the finish around mile 22sh I believe, but then you had to run around this peninsula/island thing and you couldn't see it for a few miles.  So cruel!  It was sooo close, you could see it not that far away, then you had to run where you couldn't see it....

So, how does any of that have to do with Samuel going home (some day)?  Basically I say we are on the home stretch because we have now been given the orders to feed orally whenever he is awake (on Friday we could feed him orally twice a shift and that went very well).  Remember how one of the big things is that he has to be on 100% oral feedings with 2 days of weight gain?  Yeah, we are getting really close.

The problem is, even though we are getting really close we really don't know what close means...  Does that mean he will start eating orally and gaining weight well and we'll be home within a week?  Maybe!  Or is his energy not quite up to snuff and after eating more he will be sleepy more, thus keeping us here past Easter?  Maybe!  We just don't know at this point, it is too early to tell.

Oh and remember how I mentioned that his oxygen levels haven't been as spectacular as before?  Yeah, we got to get that more under control too.  How long will that take?  I have no idea.  Maybe within a week or maybe not until after Easter.  So, yes, we are in the home stretch and we could be going home very soon (note to self, get that car seat installed!), but we could also be here for several more weeks.

What I do know, is that we want him healthy and strong so that he can handle what life at home means.  That's a life without monitors to make sure he's breathing and has his heart rate where he needs it.  It's also a life where being too tired to eat is not an option, there will be no more tube feeding (which is not a favorite of his anyways).  We are simply thankful for the excellent progress he has made so far and we just pray that he will continue moving forward no matter how quickly.... or slowly!

Samuel means "God heard" and we surely know that God hears all our prayers, including the ones about Samuel!  We have definitely been blessed with an amazing staff at this NICU, which is one way that God has heard our prayers!

Long Time, No Post...

I know a week and a half has gone by since I last posted.  Here's a good rule of thumb, if I haven't posted recently, that means not much has happened and what has is what is expected.  As is the case since the last post.  Besides I am constantly busy doing things as well, which I will explain more in this post.

So he started nursing last week on Monday and he has taken in quite a number of full feedings since starting.  We have not been given the orders yet to do 2 attempts a shift, but he is started to do awesome at 1 attempt a shift.  They look for things like taking in a full feeding while nursing (not needing to supplement with a tube feeding), waking for all feedings and desiring to suck or nurse at all feedings.  Basically all the criteria they looked at to start him nursing, they look at all over again to add a feeding per shift.

That may seem silly at first that they use the same criteria, but it really makes a lot of sense.  Remember how the milk in the tub feeding is being fortified with extra calories?  Well, when we nurse, he isn't getting the extra calories, as there is really no way to fortify the milk as it is coming out.  Also, nursing takes a lot of energy.  What you end up with is a baby using a lot more of his energy in one shot instead of throughout the day AND he's getting less calories to draw from.  That makes for a very tired baby after nursing.  When we first started nursing it was very common for him to sleep through 2 or 3 feedings, whereas before nursing he was awake for pretty much all his feedings (sleeping through an occasional feeding very seldom).

After about a week and a half of nursing he is starting to be awake more again for his other feedings.  He is still not as awake as he was before, but he is making progress in that direction and is getting close.  As the staff here tells us, it is very common to be put in a holding pattern like this, as the baby develops, gets stronger and has more energy.

I would also like to add that he has been getting full feedings in when we try to nurse.  He knows exactly what to do and he wants it!  In fact, yesterday morning we weren't sure if we were going to nurse or not, and as we had to change out his clothes (he had peed out his diaper) I was holding him.  He was being somewhat fussy, so I was trying to hold him in different ways to find one he liked, and well, he liked being positioned to nurse.  I think he was very confused that he couldn't just nurse with my clothes in place like normal...  So we nursed and he did great!  Samuel sure knows what he wants!

The other "big" news is that he has now been back on a nasal canula since last Friday.  I don't remembered if I mentioned this or not (but guessing I did), but it is extremely common for this to happen, especially when the parameters change and they start nursing.  With all his energy being used on eating, he doesn't have as much energy to keep his oxygen up!

One of the doctor's was in looking at him 2 days ago and suggested giving Samuel some medicine that would help him get ready of the extra fluids in his body.  While it is normal for babies to be on and off and on and off of oxygen, he is needed a little more support than in the past.  Even on the CPAP that oxygen was generally set at room air or slightly above (21%), but this time he's in the 30s% for oxygen on the nasal canula.  The doctor said that if the lungs and wet it can cause them to need oxygen, then he went on to explain a condition some preemies have that have to do with the lungs and moisture.  He didn't think Samuel has been exhibiting signs of this condition because he hadn't really needed much oxygen in the past (and as I was very tired when he was telling me about it, I have no idea what it was...).  Now Samuel is getting some medicine to help him rid himself of extra fluids (his legs and feet have been kind of puffy, showing extra fluid retention), and as he has shown an ability to gain weight despite the meds, they are giving him some more.

The doctor told me that nothing he says can prepare parents for the amount of pee, that made me laugh. He's had some rather large wet diapers and we have had to change his clothes and bedding a little more frequently...  :-)

Last weekend was also the weekend of 2 baby showers.  I'm sorry if I did not invite everyone I intended to, I have been really preoccupied and tried to get everyone invited, but that doesn't always happen.  The showers were really good and we had company from out of town come.  I did leave Ben to entertain them, as I am rather busy with Sam.  Ben's Mom came out for the first time, so it was great for her to see Sam.  My Grandma was also out for the first time, which meant it was the first time we had 4 generations together (though we didn't get a picture of my Grandma, Dad, myself and Samuel together... oops!).  My Dad was born the day after my Grandma's birthday and Sam was born the day after my birthday, so that is a neat "family tradition."  Ben's cousin also came out with her 2 girls.

Let's just say, between Samuel starting to nurse (and not knowing which feeding time he is actually going to nurse) and the baby showers I got very off on my pumping.  Actually during the last 3 days I have pumped just over half of what I was pumping up till then.  So this week I have been extremely busy pumping like a crazy person to get my supply back up.  Today has already been better, but we'll have to see how the rest of pumping goes the rest of the day to be sure.  I know that Samuel is nursing and taking some of the supply himself, but he's definitely not taking half of my supply away with 2x nursing and at first it actually caused my supply to increase.  Nothing produces milk better than a nursing baby!  But considering I am just 3oz behind where I was at at supper time yesterday, today is already looking MUCH better.

That's all I have, Samuel is doing great and hopefully in the next day or 2 I'll actually update my facebook photo album as well...

Eyes, Crib, Nasal Canula

So a lot has happened since the last time I wrote, and I am sorry for not updating sooner!  Let me start with last Thursday, March 1st.

Thursday was a busy day for the little guy!  It started with a visit from a friend of mine I met on Iowa Ambassadors of Music (I went on that the summer after high school, we toured Europe as a band and a choir for about 2 weeks), so she is from Iowa but currently lives in New Mexico.  We got along really well on the trip, but this was the first time I'd seen her since then!  Well, she arrived shortly after they had dilated Samuel's eyes for his eye exam with the opthamologist.

Eye exams are pretty standard procedure in the NICU with preemies.  Preemies are at rist for something called Retinopathy of Prematurity (ROP).  Basically when this occurs the blood cells formed incorrectly.  In fact that just went crazy forming vessels and can actually cause the retina to become somewhat detached.  This is a very bad thing of course if it happens and can cause blindness.  If they catch ROP in the early stages there is a procedure they can do to try to prevent blindness.  So around 30/31 weeks gestation they get seen by an opthamologist who then sees the baby every 2 weeks until the due date (more frequently if he sees something of concern).

During his eye exam the doctor's special head gear he uses actually has mirrors on it that allowed me to see into Samuel's eye (of course I had to looking at exactly the right spot, so if he moved slightly I had to move more greatly to find Sam's eye again, but the work was worth it to see inside of Sam's eye!).  The doctor's verdict was that he has immature eyes, which is completely normal for his gestational age.  So for now, and hopefully until his due date, we'll be on the every other week routine.  We are happy to know his eyes are developing normally!

That afternoon he took a bath.  So he had a pretty busy day for a 5 week old baby who hasn't even reached his due date yet!  Ben was somewhat annoyed because on Wednesday Sam didn't seem interested in sleep all day, then he had such a busy day on Thursday, that both nights he was fast asleep by the time Ben arrived at the NICU...  Oh well, he'll see plenty wakeful moments with Sam soon enough I'm sure!

Friday he got moved into a crib!  So that was very exciting!  With him in a crib instead of the isolette, we have easier access to him and are allowed to pull him out to hold him at our discretion.  We were asked, however, to let him sleep if he is sleeping, so that he gets the maximum amount of good sleep possible.  He's been doing pretty well in the crib so far, though they heightened noise volume and amount of lights was an adjustment for him, it's not so muffled and dark as it was in the isolette!

The next big change was to his oxygen parameters.  They set the parameters for his oxygen saturation levels (which is what we look at to see his apnea spells) based on his gestational age.  So far they have pretty much been set at 85-92%.  However at 32 weeks gestation (which was Saturday) they go up to 90-95% and I was told at 34 weeks it will change one last time to 96-100%.  On Sunday we switched his parameters to the 32 week benchmark.  It's very important that they monitor this because having too much or too little oxygen can cause eye problems in the future.

Yesterday, the first day with the new oxygen parameters, he did really well.  In fact, when we kangarooed in the afternoon he seemed to want his paci, so I gave it to him.  It was during his feeding (a time when he's tended to drop his oxygen levels) and he did not drop them at all while sucking on it. Which impressed me because he was sucking on it quite vigorously for about 40 minutes!  He was sucking on it so hard the nurse could hear him on the other side of the room!

Today has been a different story with the new parameters.  In fact all day he's been up and down with his oxygen.  Every time the nurse went to grab a nasal canula to give him oxygen, he'd bring it up and keep it up for a while.  Finally this evening we put him on a nasal canula (you see adults with these in public, the clear tube that hangs on their ears and sticks in their nose).  This is very common when the parameters change.  In fact most of the time his oxygen dropped, it would have been in the perfect place for his old parameters.  It was great to see him so interested in his paci, this is a good sign for the oral feedings that will hopefully start little by little in the next 2 weeks.

We are pleased to know that Sam is progressing quite well and nothing that has happened as been out of the ordinary.  Today he's been kind of fussy, so I kept picking him up to hold him for a bit, then putting him back down to pump.  Before I'd finish pumping he'd be whining again and I would pick him up.  Welcome to parenthood, right?

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....

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.

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.  :-)

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!

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

Happy TWO WEEK BIRTHDAY Sam!!!

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!

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.  :-)

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!

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.  :-)

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.

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.

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...