Four Weeks

So soon?

Did you notice anything different about Chloe?  That's right ... No feeding tube!!!  They've stopped her caffeine, she's taking a bottle every three hours now, and she's nursed three times!  She gets tired out very quickly, so we are nursing once a day and following the nursing with a bottle, which she's usually to sleepy to take.  She's up to 4 pounds 10 ounces now and at 34 weeks gestational age... And tomorrow she's 4 weeks old!

Our primary nurse said that Chloe may be able to come home later this week or early next week!  How scary and exciting is that?!

Sisters

 

 

 

 

Refined Palate

We think we've figured out the bottle feeding issue....  The lactation counselor and nurse noticed that Chloe's refusal of the bottle began when they started using breastmilk which had been frozen.  We tested the theory today.  I pumped immediately before her 11 am bottle and she drank it all.  No problem.  She's a picky eater already!

Chloe Update

4 pounds, 5.5 ounces today!

Chloe had been taking her bottles really well, drinking more than an ounce in about 10 minutes.  So they increased bottle feeds to four times a day.  However, she's refused her last 3 bottles and they had to use the feeding tube.  The nurse says it's nothing to worry about and she maybe just needs a bit of time.  OT will start working with Chloe a few times a week on sucking from a bottle.

Weddings and All Things Princess ... aka Damn You, Disney.

Since starting Kindergarten and deciding she loves all things princess, Cassidy's been talking about weddings.  She has weddings for her Barbie dolls, watches Cinderella over and over, and talks about who she will marry.  I blame Disney.  For a good amount of the year, she's been planning to marry a boy named Glenn Paul from her class.  She came home one day talking about him being her boyfriend.... And said that he kisses her ...  On the mouth.  

And then my head felt like it was going to explode.

She's in kindergarten!!!  

She's five!!  

We quickly had a talk about the kissing and said NO kissing on the mouth.  If he tries to kiss her, we said she could tell him to kiss her on the cheek.  Or hug.  BUT NO KISSING ON THE MOUTH!

This lasted until last week or so when one night at bedtime, she looked seroiusly at me while laying on her bed, bouncing one leg crossed over the other, and said, "I've decided not to marry Glenn Paul."  While swallowing my smile, I gave a quick mental cheer and "thank you god", I solemnly asked, "oh?  Why not?"  Cassidy said, "he's just too crazy.  A little crazy is okay, but he acts crazy all the time."  I nodded and agreed with her.  Then she said, "I'm going to marry William instead."  

Hmmmmph.  I'm now having nightmares about her sneaking out of the house as a teenager to meet boys on bourbon street.

Anyway, two of Jeff's friends from soccer got married in the French quarter this weekend and we brought Cassidy to the wedding with us even though it would be a late night.  She was entranced during the short rooftop ceremony, complete with a setting sun.  She was very excited to watch all the wedding party dances, especially the bride and grooms first dance.  She drank kiddy cocktails from the bar and danced until her feet got sore!  

And then Daddy carried barefoot Cassidy to the car for the ride home.

I'm afraid we've added to the enchantment of all things weddings and princess.  

Damn you, Disney.

Another Big Day!

We had another day of progress with Chloe!  Today she made the 4 pound mark!  And she drank her first bottle of 35 mL on the first try!  Our nurse had her doubts about half way through whether she would finish it, but after a large burp, she pushed right on through and finished it up!  Suck, swallow, breath?   No problem!!

Two Steps Forward, One Step Back.

Chloe is continuing to do well!  They had to back off on the bolus feeding after a large spit up, so she was decreased to feeding over a two hour interval with one hour off.  After a couple days of that, she's now at feeding 32mL over 1.5 hours every 3 hours, so she's making progress.  They are supplementing my breast milk to up the calorie content (they had been supplementing at 22 calories, now up to 24).

Chloe is up to 3pounds, 12 ounces today and it's been an exciting couple of days.  Within the last couple of days, she's starting sucking and rooting.  Previously when we'd try to give a pacifier, she'd either clamp her lips shut or gum it for a bit and then spit it out.  Now she's actually sucking on it, and when it falls out, she's turning her head from side to side, mouth open wide, trying to find it again!  She's also doing this and crying when her next feed time is approaching.

 

Even more exciting is that Chloe was moved to an open crib today!  The doctor said it's likely she'll have to go back to the incubator a few times and it's a matter of trial and error, so we shouldn't be discouraged if we come in to find she's back in the incubator.  But for now ....

 

The plan for next week is to start working on bottle feeding.  After she's gotten that down, we'll transition to breast feeding!!!

 

 

 

 

 

Making Progress

Chloe is growing and making progress every day.  Today puts her at 32 weeks gestational age and she weighed in at 3 pounds 7 ounces, so she's passed her birth weight.  They've changed her feedings from continuous 9.5 mL/hour to bolus feeds.  When they switched over to this, she started at 29 mL over 2 hours, every 3 hours.  Today they upped it to 30mL over 1 hour, every 3 hours.  This is the prelude to teaching her how to take a bottle.  She's not showing much interest in sucking yet, so it may take some time to make the switch from the feeding tube.  (Sucking starts around 32 weeks with the suck, swallow, breath rythem developing around 34 weeks.)  She's continuing to maintain her temperature well inside the isolette, which is now set at 27 degrees C (approaching room temperature of 20-23 degrees C, or 68-73 degrees F.)

The NICU has a camera on her at all times except when the nurses are caring for her so we can see her at any time.  Here are some photos we took using the NICU camera of her in her isolette.

Cassidy Meets Chloe

Cassidy finally got rid of her cold and cough and was able to come meet her little sister.  She was very timid and afraid to get too close to her.  I helped her touch Chloe's hair gently but she was reluctant to do much more than that at first.

After a short break when she came back again with Daddy, she was a bit more interested.  She touched Chloe's hand and was mesmerized when Chloe grabbed onto her finger with her tiny, tiny hand.  She watched Daddy change her diaper.  And then she asked if we could change Chloe's clothes ... Her very own living baby doll!

Snuggle Time with Daddy

It's hard to tell with the close ups, but Look how tiny she is!

Nana meets Chloe!

Nana finally got rid of her cold and was able to come to the NICU to meet Chloe!

Now we just need Cassidy's cough to stay away another day or two so she can meet her little sister!

Perspective.

I took some pictures in the NICU today to give you an idea of what our visits with Chloe look like.

Her isolette (the box around her) controls the air temperature and keeps her warm since her body can't do that yet.  (See the numbers on the front of the isolette, reading body temperature and air temperature). 

She has a feeding tube that runs into her nostril and down into her stomach delivering breast milk to her constantly, now at 8ml/hour (see the syringe to the left of the isolette with the yellow stuff inside).  Today they remover her IV, so she's only on breast milk now!!  She has monitors taped to her chest which watch her pulse, respiration rate, and oxygen levels at all times (see the computer screen in the upper right).

While all of this looks scary, I have to remind myself daily to keep things in perspective.  Chloe is doing really well, and just needs more time to grow.  We are extremely blessed.

Breakfast Date with Daddy

Daddy and Cassidy went on a breakfast date this morning so mommy could sleep a little more before it was time to get up and pump again.  They went to Dunkin' Doughnuts!

And the best part.... They brought mommy a jelly doughnut and doughnut holes!!

Post Partum Pleasure

Today I held Chloe for the first time.  Amazing.  Just amazing.  She's so tiny, but at the same time my first thought was, "wow, she's unexpectedly heavy!"  I didn't want to put her down.

Chloe is up to 5ml/hour continuous feeding now!  She's still doing great!  Hopefully they will be able to remove her supplemental feeding IV in the next day or two.  Then she'll be exclusively on breast milk (they do spike the breast milk with some high calorie supplement to help with weight gain).

Home, Surreal Home.

Today I came home from the hospital.  I still look very pregnant because of the fibroids, which are shrinking.  But I came home without a baby.  It's all very surreal.

I also immediately learned my lesson about still needing to rest and recover from a major abdominal surgery.  With an eventful morning in the hospital full of walking to and from the NICU, standing and talking to various nurses and doctors, walking out to the car, riding to CVS to fill prescriptions, riding home, riding back to CVS, and then to a restaurant for lunch, it was more on my feet time and upright time than I've had in almost 2 weeks.  When we sat down at the restaurant, I noticed that my ankles were burning.  I looked down to find that I no longer have ankles.  Instead, my fluid filled thighs now run into my fluid filled calves, into my fluid filled feet, ending at sausage like toes.  Hmmmph.

We pulled up an extra chair at the restaurant to put my feet up and when we got home, I settled into a chair with ottoman, with ice packs on ankles, and here I will stay for the rest of the day.

But to end on a good note, brave daddy held Chloe for the first time today!

On the Mend.

The decision.

On Monday afternoon after my membranes ruptured, Mr. Dr. M. came to see us.  He explained that for each of the complications we'd been having, waiting as long as possible to deliver was the best option.  However, when all those complications (fibroids, two episodes of major bleeds, contractions, and now ruptured membranes) were taken together, there is no textbook answer on what the right thing to do is.  Instead, it was a balancing act between risks for preemie vs. risk to mama to stay pregnant vs. desire to do c section in a planned, scheduled way vs. possibility of the need for an emergency c section putting both mama and baby at risk.  To make a long story short, he couldn't tell us what to do and asked what we wanted.  After a bit of discussion we decided the most we could realistically hope to get of a longer gestation was 2-3 days.  A consult with the NICU left us feeling pretty confident in a 30 week baby who had been treated with steroids for lung development and magnesium to protect her brain.  We decided to go ahead with the c section that evening in the interest of everyone's safety and sanity.

The surgery.

This surgery was way more traumatic andscarier than the c section with Cassidy, from preparation all the way through to the recovery room.  Part of this is that it just felt like I had so much more on the line now that we have Cassidy.  Aside from that, the docs here went in really prepared for everything to go wrong.  I had 4 IV lines put in, 2 large ones for transfusing blood.  I had a probe put directly into an artery to constantly monitor my blood pressure.  They had 5 units of both blood and plasma ready for transfusion.  Mrs. Dr. M. was assisted by another of her partners, as well as an OB oncologist who regularly operates on bodies distorted with tumors and cancers, in case we needed to do a hysterectomy.  I had a spinal block and an epidural with general anesthesia standing ready in case things got ugly.  And the NICU team was in the room ready to rush in for baby as soon as she was out.  

Things moved really slow with all the prep work that we could see starting around 5:00.  Once the surgery actually started, Chloe joined us after only a few minutes.  She came out crying and pink at 6:23pm.  They checked to make sure she was stable, with two APGAR scores of 9, brought her over for a quick introduction and then whisked her away to the NICU. A while later, the docs double checked that I still wanted my tubes tied.  When I answered yes, both of the docs' heads popped up from behind the curtain and said "I think that's a good idea".  For what seemed like forever, they pulled and pushed to get to those tubes around my giant fibroid inhabited uterus through the incision which extends upwards from the top of my belly button about 6 inches.  They finally found and finished one when I started throwing up and my blood pressure started falling.  Around that time, they started replacing the unit of blood I had lost and started talking about putting me under general anesthesia as I was starting to get very sore and uncomfortable in spite of them increasing meds in the epidural or spinal block twice.  At that point, I said I'd had enough and they should forget about finding the other tube.  They immediately started to stabilize everything and close me up.  I think I made it to the recovery room between 8 and 8:30.  During the surgery, I started shaking and shivering, which continued until about 1 and a half hours into recovery.

The Recovery.

That night we made it back to our high risk room about 11pm.  We spent a long night there with concerns about the amount of bleeding they were still seeing.  The next day after consults with the doctors, we moved over to the mother and baby area with instructions to keep monitoring the bleeding.  

Things continued pretty well Tuesday and around 3pm, I had them remove the catheter, which they like to do no later than 24 hours after it's put in.  This, of course, meant that I had to get up to pee.  By the middle of the night I was a mess.  The meds they were giving me by IV didn't seem to be helping the pain, they just made me loopy and I'd fall asleep.  I was feeling ok when I would wake up about an hour after my last dose of meds, but as soon as I tried to move, the pain was just excruciating.  Every muscle in my abdomen was cramping, my fibroids were hurting as my uterus continued to cramp down to stop the bleeding, and then throw in some gas and digestive pain also.

By Wednesday at 4 am, I was crying (while saying "don't cry. don't cry. dont cry."because guess what feels awful on an already painful abdomen?  Yep, crying.). and begging the nurse for more of the IV meds or any other medicine so I would fall asleep and not hurt for a couple of hours.  The plan was to switch to oral meds that morning, so they were getting those orders put in but still had to wait a bit because of the amounts of acetaminophen I'd had in the past 24 hours.  I also requested some simethicone for gas pains and stool softeners to help get my digestive tract running again.  I got my first dose of Vicodin and simethicone (gas ex) around 8am. Within a couple of hours, I was feeling and moving better.  Mrs. Dr. M. stopped in to check on me and also prescribed some naproxen to take in addition to the Vicodin.  By the afternoon, I was able to take a shower and remove the incision dressing as Dr. M. instructed.  By 5 pm I was out of my room for the third time walking the hallways to stimulate my digestive system!  I also started to see results from my breast pumping efforts with the first collectable amounts of colostrum.  Wednesday turned out to be a pretty fantastic day considering the way overnight Tuesday and early Wednesday went.

I love Vicodin.  It is the best medicine ever!

So that brings you up to speed on our week.  It's been a pretty emotional couple of weeks considering I was admitted to the hospital for bleeding on March 25th.  It's looking like I'll be discharged from the hospital tomorrow to continue recovery at home.  Then I guess we try to figure out how to spend time with Chloe in the NICU and me at home recovering but not able to drive for a while.  

Also I have to say a million thank yous to my mom.  During this week, mom took care of Cassidy, getting her to and from school and bringing her up to the hospital to see us so Jeff was able to stay at the hospital with me the entire time, which made things MUCH less scary for me. 

Thank you Mom!  Thank you! Thank you! Thank you! 

And thank you, Jeff.  For your support, your understanding, and your refusal to let me attempt to be self sufficient.  

Growing....

Chloe is doing fantastic!  She came out crying, and has been breathing on her own since.

The NICU docs have told us she is most likely past the window of needing breathing assistance!  She started feeding through the tube in her nose yesterday and is digesting well.  Today I got my first bit of colostrum by pumping, so she'll start getting breast milk soon.

(Holding daddy's finger)

She'll be in there NICU for a long time, probably 6-7 weeks on the low end, but they told Jeff she is already making the transition from preemie to preterm.  Her docs have described her as an "overachiever" and "feisty".