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!

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!

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.