More From the Pediatrician's Office

Okay, so I was mentally running through all the things we went over at the Pediatrician, and I'm trying to decide what's necessary to say without seeming like I'm holding back, but also trying to determine what's just going to make this a much longer update than it needs to be. So, without further ado, the highlights:

• This was my first time meeting Dr. Woodhams. Lena has always taken Chloe to see her on Mondays when she's off work (saves me from having to lose a day off, though). My assessment: I likes. She was knowledgeable, no-nonsense, and honest, but also caring. Great traits for a pediatrician, and now I know that my children are in the best of hands.


• She questioned the use of the monitor, but told us that if it made us feel better, use it, and when we wanted to get rid of it, tell her and she'd write the order for it to go away.


• Children are resilient little creatures. Obviously we should watch out for anything we think is a concern and bring it up, but at this point we don't need to worry about any long-term repercussions from the ventilator or being on oxygen. One little caveat, we have to take Gavin to have his eyes checked; one result from the oxygen is retinopathy, and he'll need to have them checked out every so often. Unfortunately, since I have bad eyesight and Lena has really bad eyesight, our children are in trouble. Or not; we'll see.


• His feedings are going great. She did a calculation to see how much he should be eating, and he's clearly above the mark. That's not to say we should cut back, but he's gaining weight and eating, so let's not starve the child just because he wants more. Chloe did the same thing and caught up awful fast.

That's all I can think of off the top of my head while I wolf down lunch. I'll run over the notes later to see what I left off.

First Pediatrician Appointment

Okay, so this was yesterday, but we lost track of time, so you get it today. Gavin's first pediatrician appointment was yesterday. He was weighed in at 5 pounds, 4 ounces and measured 18.5 inches. More details to come!

The (Almost) First Twenty-Four

We're not quite at 24 hours here yet, but it's getting close. So, what, you might be wondering, have we been up to since bringing Gavin home? Well, there has been a lot of sleeping, a few family members by, some pretty good feedings, an older sister adjusting, and only a few sleep interruptions. To be fair, Gavin never woke us up last night, we were doing the waking. He's pretty chill, but we had to get him to eat so he doesn't lose weight; "failure to thrive" is what they call it, which means he'd have to return to the hospital. None of that, thank you very much. Chloe, on the other hand, woke up twice last night, and both times happened one hour before Gavin's feeding times. Strange. But, we survived.

To be quite honest, and I haven't run this by Lena so we may not be in agreement, but it seems easier this time around. Perhaps because it is so, in that we kind of know what we're doing. Or perhaps we're just used to getting up at any hour of the night and it doesn't bother us.

I'm not sure if that's good or bad.

At Home

Here are a few stats before heading to bed:

Birth Weight - 4lbs, 0.6oz
Discharge Weight - 5lbs, 1.5oz

Birth Length - 17"
Discharge Length - 18&"

And the most important fact, he's home. BOOYAH!!

We're Outta Here!

Look, Mom, No Feeding Tube!

I've told the staff that we'll be ready whenever he's discharged, and please don't mention it again before then. They aren't going to make us room in at all since I've been here so often, so it will be that they'll just say - "Ok, now's the time!"

I don't want to get too excited again. But it's awfully hard not too...

Lena

Hopes Up Again

Gavin took about 52 cc's at his last feeding. His primary doctor came by about an hour ago and wants to play it by ear, be flexible with Gavin, and see if he gains weight. If he does and continues his feeds, he might discharge tomorrow. I will believe it when we put him in the car!
Lena

Silly Head

No explanation.

Awesome neighbors

We are sending many well wishes to our neighbors as they start their journey to Dallas today for their son's surgery. We love having Rachel, Brian, and Isaiah (Baby Eyes to Chloe) as our neighbors, and they are such an important part of our support system, and we're so grateful for that.

We miss our friends the Browns that did live across the street, and we hope we'll welcome them back to the neighborhood when their Dad finishes his tour as an Army Reserve in Afghanistan (Jen - please correct my military lingo!). We're holding their stuff hostage in our basement to make sure they at least have to come see us! Awesome meals the last few weeks definitely helps! :) We met the Browns when they moved in across the street with their infant twin girls. Lila and Kelda were born at 30 weeks in Feb 2007, and we literally bonded over apnea monitors (Chloe was on one then as well).

I remembered that when Isaiah came home in July 2008 with his own apnea monitor to join the club. Rachel was already pregnant when they moved in, otherwise I would have been really worried about our neighborhood! Rachel had developed pre eclempsia, which I had with Chloe, but she also suffered a very difficult delivery and later learned that it was due to Isaiah having Apert Syndrome. The main symptoms include bones fused together such as fingers, toes, and head plates (hence the difficult delivery). After this week's surgery, Isaiah will have 10 fingers and 10 toes, and the unusual nature of his syndrome is the push behind traveling to Texas for treatment rather than some where closer.

Isaiah spent some time in the NICU, and he was scheduled for discharge and then postponed. It was during this time that we got to know our neighbors better. Josh took care of their cat, we talked to them about the NICU and having the monitor, cooked meals, and most importantly strongly suggested they start a blog to help manage the constant requests for updates during critical times.

Isaiah is such an incredibly sweet tempered kid and a lot of fun to be around, and we're pretty darn fond of his mom and dad as well. We've started spending a lot of time together this past year, and they have been central to our NICU experience management. Most nights we sneak Brian in right at 8:15pm after we get Chloe to bed so that Josh and I can spend a little time there together. I'm looking forward to just hanging out together soon with the NICU behind us!

You can follow Isaiah's story on their blog at http://isaiah717.blogspot.com/. Please especially keep them in your thoughts and prayers this week.

Thankful for good friends and neighbors, especially when they're both.

Lena

Waiting for the Doctor's Round

The primary neonatalogist is scheduled this morning. I'm anxious to find out what she thinks of our scheme of making him eat less but higher calorie.

Gavin didn't tube feed at all last night, but he also didn't take more than 32cc's. He just took 35 from a bottle from me. They have an equation they use to determine his minimum amount based on his weight, and we're basically messing with some different variables at this point.

In other news, everyone I have spoken to at the NICU today has started by saying "what are you still doing here!?!" Last night the doc on duty said "what do we have to do to get the green light?" You tell us. We're willing to try whatever you suggest to help get the light on!

Gavin is 36 weeks gestationally today. If he had been born today, he would only be one week pre-term (37 is considered term) and likely wouldn't have been in the NICU at all. He also would be a lot bigger than he is now too, though. I keep reminding myself that he was in seriously critical condition 3 weeks ago, and as frustrated as I am that he isn't home, Gavin has come a long, long way.

Lena

Change in Strategy

Okay, new plan. Today was a hard day with Gavin's feedings. He was tubed four or five feedings today; we just lost count. The issue was that the amount he had to take at each feeding went up a whopping 50% to 45ccs. He was barely making 30ccs, so to up it to 45 really irked at us. And so, every feeding since, when he didn't make the mark, he was tubed the remainder. When he didn't wake for his next feeding, he was tubed again. And again. And again.

So we went for his feeding at 8:30pm, thinking we'd watch him be tubed, only hopeful that he would be awake. A bit to our surprise, he was awake when we got there. The feeding began.

I brought up the feeding amount to Lena, who brought it up to the doctor. The doctor did some calculations and came up with a plan for the next 24 hours. The exact specifics are not known to me. Suffice it to say that the doctor has set up a plan to not use the tube for the next 24 hours. All Gavin has to do is eat a little more than 160ccs during the night shift. The other part to that equation is that he can eat whenever he wants, but still no longer than every four hours. I am unclear if that means he will be woken up to eat, or if after four hours he still hasn't woken up, they go back to tubing. I'll have to ask.

So that's where we are right now. Hopefully tomorrow morning will bring good news of a well-fed night. Please?

0 for 2

Feedings are not going well today - we're tube feeding for the second time today. Gavin started having some trouble maintaining his temperature last night. The nurses are a little worried that he might be getting sick. They are all also surprised that he's moved backward as much as he has. The only thing I can do is hold him close to me and help him sleep deeply. Hopefully a little rest, a little weight, and a little time is all he needs to pull it together.

Lena

Countdown...What Countdown?

Oh my dear Gavin. His 6am feeding did not go well. He choked, bradyed, desatted, turned blue, and took a minimum amount of 30cc's. Basically that's about everything that can be expected to possibly go wrong with a feeding, and usually not all at once.

Lena

Weigh In

This little note. Gavin weighed in on day 23 at 4lbs, 13oz. He now weighs what Chloe did when she came into the world.

Gramps Visiting Chloe

Now if only the piano had been tuned more recently than 30 years ago...

Fun visit regardless!

Gramps Visits Gavin

The Little Angel

Sound asleep and happy. Until he got woken up to be sized for his apnea monitor belt. I've never heard him cry so loud! His nurse today said it was the third time already today, which is actually a good sign.

As for being mad at mommy for the monitor - it's your own darn fault, bud! I'm actually glad he'll be on it. Especially when I remembered how sensitive the "lead disconnect" alarm is and realized that specifically will act as a Chloe alarm! If she does manage to mess with him without us seeing him, I'm hoping that one shrill and frightening alarm will deter her in the future.

I'm starting to really dig the "big sister alarm" idea, and I'm glad my brother didn't have one. Maybe Gavin knew what he was doing after all...

Lena

Car Seat Test

Passed.

Quote from doctor - "We're just waiting on him."

Yeah...I know.

Lena

No End in Sight

That's how it feels anyway. The countdown just restarted with Gavin's last bottle. He only took 15 cc's and then had to be tube fed.

Chloe has been having major breakdowns. She's sitting next to us on the couch drinking a bottle. We gave those up by her first birthday. There's an awful lot to upset her right now, so if being a baby gives her some security, I'm all for it. The massive poopy diapers from an almost potty trained kid are a bit much, though.

Lena

Some Final To-Do Items

Gavin is two for two on bottles so far today. I'm cautiously optimistic that we're getting close.

Gavin got a hearing test yesterday, which is what this picture is from. He passed, which is great and means we won't need a specialist follow up appointment. I had a meeting with his dietitian today - we'll have to do some formula supplementation, but not quite so much as Chloe because I'm not having the same milk shortage that I had with her because of the HELLP Syndrome. Sorry for too much information!

There's a discharge check list that we have to go through. Since I've only had NICU babies, I have no idea how it compares to a term baby discharge. It's things like checking off that we're trained in giving a bath and using a bulb syringe for his nose. Another is that all appointments are made, which are pediatrician and opthomologist for us - so far, no additional specialists. We've been spoken to about the dangers of RSV and what we can do to prevent infection. I have to watch a video on infant CPR and another one that I can't remember right now. Technically we can't take him home until all those items are checked off. Plus rooming in that I mentioned previously to make sure we don't panic when we have him alone. I can't imagine that most parents have so many hoops to go through to get their baby out of the hospital.

I'm waiting to see if we can do apnea monitor training today. I really don't want to get stuck here until Monday for that if Gavin is otherwise ready to go.

The last test will be a car seat test. Gavin will have to prove that he can still breathe and maintain his heartrate when he's in one. Our lovely neighbors got an extra NICU day because their son Isaiah didn't pass on the first try. Not just any infant car seat will do. We were lucky that the one we got from the folks at Dad's Garage for Chloe was (and still is) perfect. I was trying to remember the car seat measurements and came across this great article:

http://kidshealth.org/parent/pregnancy_newborn/medical_care/preemie_home.html

Ok...last item on the list...DRINK YOUR DARN BOTTLE! (but only if you're ready, my dear Gavin).

Lena

Thank You!

Thanks so much to Josh's coworkers at Children's Healthcare for throwing us a shower! I'm sorry I wasn't able to come (seemed like we were safe to schedule it at 35 weeks!), but I'm looking forward to using the gift cards to get stocked up!

Lena

Lost Our Wireless Connection

Little man has been dropping his oxygen saturations over the last day, usually just during feedings. Apparently he also dropped while sleeping...during the doctor's exam. He's so busted! As are my dreams of not having a home apnea monitor.

The peace of mind especially at night is really nice. It's just so strange to plug your child into the wall. I remember being scared and unsure what to do the first time a big thunderstorm came through after we took Chloe home. Given that our desktop computer was fried during a storm shortly before the office was converted to a nursery, and given that the same wall outlet is now the one next to the crib, I feel pretty confident in just unplugging the darn thing.

Sigh. More posts regarding apnea monitors to follow soon, I'm sure. Dealing with wires coming of your baby affects so many things that most parents don't think about, like what he wears. Zippered clothes aren't an option because there isn't a good way to get the wires out. Gowns aren't great because then the wires get wrapped around little kicking legs and can really hurt and easily cut off circulation. I have such cute gowns and zippered jammies that are gender neutral that we got with Chloe, and that neither of our monitored kids will ever wear.

Lena

Not Coming Home Tonight

We were tentatively scheduled to bring Gavin home today, and we can't because he's struggling too much with finishing his feedings. His last 3 feedings required finishing off 6, 10, and 15 cc's in the feeding tube. Not an option for a baby to get out of the NICU.

His nurse last night is also worried that his oxygen saturation level goes down when he eats. I didn't tell her, but it always does that, and none of the other nurses have expressed any concern. Josh and I have joked that patience is a virtue I don't have. That's starting to be a real challenge. Chloe has been a champ but is also starting to wear down. She woke up yesterday morning hysterical and chanting "I want Baby Brother home!" I understandably was a mess after starting my day that way. Ultimately, we all of course want what's best for Gavin. It's just hard when that's not being at home with his family.

By the way, today marks one month from my official due date. Gavin is 22 days old!

Lena

Wide Awake

This was after his 9pm bottle. Of course, he just pooped, too.

I Surrender!

Wimpy White Boy Syndrome

I've had two nurses and two doctors refer to it today, including Chloe's (and soon Gavin's) pediatrician that I adore; I ran into her on my way out of the parking garage and immediately started crying. I know Gavin will be fine, but I just want him healthy enough to come home. I also know there is virtually nothing I can do to help him get there other than just to be here to hold him, let him hear my familiar voice, and nurse him when he can.

Wimpy white boy syndrome refers to a medical stereotype that proves true for reasons unknown to me. African American girls tend to do best in the NICU followed by white girls, then African American boys followed last by white boys. I don't know where other races tend to fit in that stereotyping spectrum. In the case of twins that are boy and girl, the girl is almost always ready to go home first. At least that's what I'm told.

Gavin has been fed through the tube since midnight last night, with the exception of 20-25ccs at 6am. He's just pooped out. Apparently I'm supposed to feel consolation that it's just because he's a boy, and a white one at that.

Lena

Scrubbing In

Before you enter the NICU, you have to do a two minute scrub in following specific instructions. This was Chloe's third scrub-in of the visit...probably in a 30 minute time span. Apparently she told another family how to do it when she and Nana first arrived.

This exhibits two of Chloe's personality traits - cleanliness and bossiness. I think we'll put her on germ patrol when we take Gavin home. If you visit, prepare to be bossed.

Lena

Day 20

Included a visit with Nana and Big Sister Chloe!

Not Us

Josh works for Children's Healthcare of Atlanta Foundation, and I'm so grateful for both what they do and that we haven't benefited too extensively from their services.

I feel a wave of terror and sadness whenever I see one of these vehicles ever since the birth of Chloe.

Kennestone is actually a Level 3 NICU, which refers to the level of treatment they can provide. Since we knew we were high risk for a preemie, I did some additional research before Gavin was born. Surprisingly, Northside Hospital is also a Level 3 NICU; they're just a lot bigger. Several factors including proximity weighed in our decision on where to deliver. Remembering all the middle of the night drives to visit played a major role in wanting to be close to home.

Plus, if anything really goes wrong, Children's Healthcare is just a transport away.

Lena

Typical Preemie Behavior

That phrase is repeated over and over in the NICU as well as in my preemie book and from multiple preemie parents that I've spoken to about our kids.

Typical preemie behavior basically means that the only consistency to expect is inconsistency. Which means little man Gavin neither fed nor grew yesterday! He took half a bottle at one feeding with Josh, but otherwise he's been totally asleep. His nurse on duty is going to try to get him to take one at 6am. My consolation yesterday while I watched him being tube fed was that at least he wasn't burning calories to eat and should be putting on weight. His weight also stayed exactly the same at 4 lbs, 10.6 oz. He didn't gain a fraction of an ounce!

I'm ready for some atypical behavior already!!!

Lena

Feeders and Growers

That's what the babies are called in the intermediate nursery where Gavin is now. The babies here are almost out the door and just waiting to get bigger and eat on their own.

Gavin has done a great job in the get bigger arena since moving over here yesterday. He's up to 4 lbs 10.6 oz. The feeding is another story. He's basically just been tube fed since 3pm yesterday. Just another reminder that for Gavin to be ready to leave, we have to go 24 hours of feedings off the tube. We're actually tentatively scheduled for a Friday night room-in. But I'm not getting my hopes up too much yet as sleeping through feedings isn't a promising path to get there.

So what is a room-in? In the NICU, they don't just let you have your baby. You have to prove that you can handle it. There's literally a room set up like a home environment complete with TV and DVD player. And it's you and the baby with no monitors, alarms, or nurses. Except for the one that checks up on you to make sure you're handling things well. There are a lot of crutches in the NICU, and this is an opportunity to parent without them while still having a bit of a safety net.

Other late breaking news. I just got a call from our social worker. We're now on her radar because she's heard we won't be here much longer. According to the notes she's received, Gavin won't be on a monitor! We will however be having a home nurse visit twice a week for two weeks if insurance will pay for it. I don't know much about that, and we didn't have that with Chloe. Gavin also has more respiratory problems, so part of it may also be about assessing any changes we need to make at home. Luckily neither of us are smokers. We'll hopefully just be dealing with keeping dust and pet hair extra under control to keep him healthy.

Little man is so much closer to home!

Lena

Who is Gavin?

Just a quick note to share about what we've learned about our little guy. He is (thank goodness!!!) pretty darn laid back. He smiles a lot, and I hope that's a true personality trait and not just gas. The NICU nurses have been around so many babies, and I think they have a good intuition of the personalities that they're born with. Chloe was in the NICU for 11 days, and during that time I had 3 different nurses say that she's intense, feisty, and was always the first baby to be fed. I'd say they had her number awfully early! I hope Gavin keeps his sweet and laid back demeanor. And definitely the smiles!

Lena

Family Time!

Awesome visit! And we officially need a new camera. Ours finally broke, and otherwise we're limited to cell phone quality...

Location, Location, Location

We've moved down the block! We're out of the semi-private room that Gavin shared with one other baby and are now in the big open room known as the intermediate room. That means we're no longer in the high risk area! It also means that he's one step closer to home. With that in mind, I'll gladly trade to smaller square footage for an awesome view of a light at the end of the tunnel! I'm hoping he'll be home in 5-7 days!

Lena

Question for the Preemie Parents Out There...

Is there anything else you think people should know about preemies? I just got a suggestion of wire/lead management, and I can't believe I forgot that! Feels like this should turn into one of the "girlfriend's guide" books. "The Girlfriend's Guide to Preemies" including everything the doctors and nurses don't tell you. Just because they don't know! Like if you send us home with an apnea monitor, we'll be lugging it around for 6 months whether or not we need it. I think at least a chapter can go to managing a home apnea monitor!

Lena

Nightly Weigh-In

We feel like negligent parents for taking Chloe to the Braves/Mets game while Gavin is in the NICU. We called the night nurse on our way home to get Gavin's nightly weigh-in. He's up to 4 pounds, 8.3 ounces; that's just over 4-1/2 pounds! Woot!!!

Grieving and Reflection

I am so thankful that we're not grieving the loss of a child. Now that Gavin has turned a major corner, I do feel like I have let my guard down some and am starting to let myself experience the sadder emotions of life in the NICU.

There's the understanding and acceptance of what he went through. I've now had several nurses and doctors let me know just how serious things were. Apparently moms almost never have blood transfusions in labor recovery, especially in the middle of the night. Gavin received what one nurse described as a "last ditch effort" to help him breathe. My Doc has reiterated more than once that my coworker driving us to the hospital instead of waiting for an ambulance saved one or both of our lives. The NICU staff thought he would be sick here for several months. While they don't talk about other patients, you can't help but pick up on the health and well being of other patients. There is a baby that was born just a few days ago that weighed a few ounces over a pound. I can tell by all the activity and commotion that things aren't going smoothly - my guess is that they never do at that size. I still haven't seen 5 nurses hovered over like I walked in on with Gavin one night. And that little one pound baby is well enough to share a nurse assignment. Gavin had his own nurse for a few days - not a good sign. He was really, really sick. He couldn't breathe. He had an infection basically poisoning his blood. And he was in so much pain plus the immaturity of his nervous system that hearing our voices or touching him would cause his vital signs to tank.

Someone asked me if there are worries about Gavin getting breastmilk with I'm still on painkillers. Yes. But since he was on morphine for awhile for his own pain, what he's being exposed to is nothing in comparison. It's a little funny that I worried so about exposing him to caffeine both before and after birth. He actually was getting a shot full of caffeine in his feeding tube to help maintain his heartrate until today. If he maintains it well without the caffeine, he may not go home on a monitor after all. Josh and I need to talk more about our preference in that arena. The peace of mind it brings at night is great. Lugging it around for 6 months when he doesn't need it is annoying!

Back to grieving. Supposedly its really common with parents of preemies. Even though our child is now okay, it is about allowing ourselves to grieve the missed experiences. Never going through the movie-style water breaking, rushing to the hospital delivery. No baby on my chest right after delivery - heck, he was a week old before we could hold him. With Gavin, there weren't even any cries for what felt like forever. No rooming in at the hospital. No visitors coming to see the new baby. No being wheeled out together at discharge. And basically losing those first few days that are supposed to be celebratory and exciting to fear, absence, and a lot of unknown. Some of which may have long term implications. Even the labor recovery staff often doesn't know what to say - most of their moms have babies with them, and part of their job is helping care for the babies. I thought my mom or sister were going to punch out the tech that said "where is your baby?" when I was in my hospital room. Not only because of the way she said it, but also because she asked on two different days!

Anyway, if you see me in the next few days, I'm probably going to be a bit teary-eyed. We've been through a lot, and while I can hold my own better than most I think, my armor is getting a bit hard to carry at the moment. Writing this all out has been therapeutic for me, though. I'm almost back to being able to take on the world.

BTW - I love that I can take pictures and post to the blog all from my phone! Despite my many "smart" text typos. And especially while I'm holding my little man.

Lena

Getting That Light to Turn On

How long we stay in the NICU is up to Gavin. As Josh has said, he's got to demand food every 3-4 hours and eat via nursing or by bottle instead of the feeding tube. There's no way to teach him how; it's something that babies master as they get older - usually around 36 weeks gestational age. Little Gavin is 34 weeks tomorrow.

What we can do is introduce him to the concepts and make nursing available to him as often as possible. The nurses all refer to it as getting the light to turn on. I'm so glad to say that I saw a strong indication this morning. He nursed well for a bit before falling asleep. A challenge is that we can't tell how much he ate that way, so we're basically taking a guess and cutting his feeding tube amount in half. And now I have a conked out little boy asleep against me chest, which is also part of the learning process.

Time for a nap. Good night!

Lena

And Speaking of Unsolved Mysteries...

We got an awesome gift card today for meals...with no note about who it was from. Please let us know if it was you so we can thank you properly!

Unsolved Mysteries

So...for those of you counting, we have two kids, and both deliveries were surrounded by frightening and potentially fatal complications. How did this happen? I wish I knew. I'd settle for just the doctors knowing! As one of the more sensitive Ensemble members at Dad's Garage put it, it's a good thing I can't have more kids as my last two tried to kill me! In the moment, the comment was really funny, I promise.

If you have time, you can go back to June 2007 entries to read about Chloe's dramatic entrance into the world. With Chloe. I developed pre eclempsia and later HELLP Syndrome. Which means my liver started failing and was in danger of rupturing, my platelets got down to 48 (one doc told me they couldn't do a c section with a count under 50, but they did!), major clotting once she was born, and other generally bad things.

With Gavin, I saw a high risk doctor the whole time. HELLP survivors (as they call themselves on blogs, list serves, etc) have a high risk of getting it again. As long as you know that and are actively monitoring the pregnancy, it should be okay. The symptoms can be misleading (one doc told me it was just heartburn), so the primary danger is in being misdiagnosed or of course not getting prenatal care. There isn't any proven treatment to prevent the onset, but I was taking baby aspirin, which may or may not help.

So, I had an appointment on a Tuesday, and each appointment includes an ultrasound. Everything looked great including my placenta. I started having some cramping during the night Wednesday night/Thursday morning. It didn't feel like anything to worry about, and I had already gone to the hospital once with it, and it wasn't anything. A bit more cramping at work that morning. Bleeding. Rush to the hospital. Found out I was in active labor with signs of fetal distress (meaning Gavin's heart rate wasn't steady). Emergency c section within an hour of arriving at the hospital. Followed by emergency hysterectomy to try to stop the bleeding. I'm not super sure what the numbers mean, but my hemoglobin was 7 and my hematocrit level was 20, which apparently is really bad. I had 2 blood transfusions with 4 units total. Gavin also ended up getting 2 transfusions as well.

The medical community generally has no idea as to what causes a placental abruption. There doesn't seem to be any connection to HELLP, and my unscientific survey of other HELLP "survivors" didn't find many people that have experienced both. At my Tuesday appointment, the only thing slightly resembling a red flag was that my amniotic fluid was still low, even though I had been drinking 100+ ounces a day.

I had no physical activity really from Tuesday to Thursday. I was having mixed success at keeping my stress level down, which is a contributor for a lot of complications. Per doctor's orders, I was either sitting at my desk or laying in bed or on the couch at home. No heavy lifting. I did crack jokes about going to term along the lines of I know how to have a 4 lb baby, but a 9 or 10 lb one is terrifying to me. But I also said I was up for the challenge. My neighbor also reminded me that I had just said a few days earlier that I wasn't going back to the hospital unless I was delivering, having been embarrassed by 2 visits that found nothing (First was cramping. Second was Chloe jumping on my belly, which could cause a placental abruption, but doc says 2 weeks between incidents is too long to connect them). Josh's folks were in town 2 weeks prior for Chloe's bday, and my MIL and I joked about how Chloe was born 2 weeks after a visit from them and that if it happened again, no more pregnancy visits! For the record, I don't think there is any correlation, and in hindsight, I think the conversation was funny - Mom, I hope you do, too!!!

And I had a preemie again despite best intentions. And while I will be more aware of what I say in the future, I don't think any of those comments pushed baby Gavin from his warm home. I also was pretty well prepared for my maternity leave with our amazing staff, with the idea that if we were prepared this time, we wouldn't need to be ready 6 weeks ahead of my scheduled c section. Which is also almost 8 weeks before his due date.

I'll probably never know why both my babies were so early. But I have a "matching set" as many people put it. We have an incredible little family unit, and I'm just counting the days until we can all be home together. Which is the next mystery - it's been 16 days so far, and the doctors haven't even started talking yet about when little Gavin will be able to join us here.

Lena

It's A Small World After All, or Four Degrees

So, Gavin has been sharing a room with a little boy named Micah. Turns out, they already had a connection. I call it Four Degrees of Separation. You see, 1) Gavin is our child, 2) A woman named Carla was at our wedding in 2002 (friend of Lena's family), 3) Carla has a sister, Melinda, 4) Who is Micah's mom. Proving once again that after all, it truly is a small world. Smiles for a beautiful Saturday.

On The Rise, On The Move

Gavin's continuing his upward trend of weight gain, putting on 0.4 ounces since last night, and coming in at a whopping 4 pounds, 6.4 ounces!!! If he tolerates his feedings tonight, he'll bump up to 39ml by morning (that's the equivalent of 1-1/3 shots of your favorite liquor). And one of these mornings we'll show up and not be able to find him because they'll have moved him to the open room nursery. This is good for two reasons: 1) he'll be on "ad lib" feedings, meaning he eats when he wants and as much as he wants every four hours max; should he wake up at three hours and scream for food, he will be fed; 2) that puts him so much closer to going home!

Look Mom! No Oxygen! (The Sequel)

Flips School!

Josh and I took Chloe to gymnastics this week - trying to keep her life semi-normal. She loves gymnastics, which we call "Flips School." Came up with that when trying to explain it to her before the first class. Plus, when she says gymnastics, it sounds like "biscuits." It's 8 classes total, and it runs through the end of this month. My mom and sister took her the week prior when I was in the hospital. As Josh noted after this class, it can be more of a workout for the parents than it is for the kids. Aunt Jerilyn is coming to the rescue for the last two classes so that Chloe isn't dependent on her recovering mommy.

No News is Good News!

Nothing really to report. We're just working on the things that will get Gavin discharged - eating and growing! He gained 0.3 oz in the last day, which is great especially considering he lost 1.3 in the last two days combined. I'd like to see him putting on more, but pushing a NICU baby is the best way to get them to regress progressions.

I'm headed to bed!

Lena

Hey!

I call this, "Hey! What are you looking at?"

Things To Know About a Preemie

One of the reasons that this blog is important to me is that I think it gives an insight into life with a preemie. Luckily the last year plus with Chloe hasn't been as much about her early start at life, and I'm looking forward to Gavin growing and being well enough that the blog is just about our life with two kids, a dog, and a cat living in the suburbs.

We're not in near as much shock as we were with Chloe. Everything about the NICU was so new and scary then. Our reality is that we have 2 kids and won't have any more, and they both were born rather dramatically. As I said the very morning that Gavin was born - I know how to have a 4 lb baby; I don't know how to have a 10 lb one!

Having a good friend that had a preemie helped us so much in emotionally and logistically adjusting with Chloe. In fact, little Elizabeth's experience was more like Gavin's, so we continue to rely on our friends to help us understand what's happening and the potential long-term implications.

I'm hoping that this blog entry will help you understand more about preemies in case there is another one in your life. I'm doing this very steam of consciousness. This isn't in any particular order.

Work Schedule
Josh went back to work immediately, even though we planned on him taking time off when Gavin was born. When it looked like Gavin was going to be here 2 months or more, I actually started to figure out if I could go back sooner once I recover more from my surgery. Otherwise my maternity leave would end right as he was being released from the hospital. Especially in the first few days, there is virtually nothing a parent can do when a baby like Gavin is in critical condition. He didn't even want to be touched!

Age
The question of "how old is your baby?" is tricky with a preemie. Preemies like Gavin have two ages. His actual age, and his adjusted age. So...on September 2 (Josh's birthday), Gavin will be 2 months old with an adjusted age of 1 week because it is just 1 week after his due date. Developmental areas and general progress are measured by one or the other date depending on a few different factors. So...if you ask a preemie parent how old their baby is, that's why you may either get a hesitation first or a long explanation for what seems to be a simple enough question.

It's Okay To Ask Questions
Preemie parents may not have answers, and there might be some tears because it is an emotional roller coaster, but it's okay to ask. And that's way better than seeming uninterested or distant.

Clothes
Since folks generally don't plan to have a preemie, you don't stock up on preemie sized clothes like you do newborn or larger sizes. Most preemie sizes are up to 5 lbs, so a preemie may not even fit into them for long. It is so nice though to be able to put your child into clothes that fit when enough of the medical equipment has been taken off to allow it. Huge thanks to my sister Jerilyn, Jennifer and the rest of the Messer family, and the Warrens for setting is up with tons of preemie clothes for Gavin. We are set! Preemie clothes can also be really hard to find. If you are in the market for someone elses baby, try Babies R Us, Carter's, Gymboree, or Walmart. Target unfortunately doesn't carry any. The Children's Place is great for up to 7 lbs.

Day Care
I don't know what we'll hear regarding day care for Gavin. Often the doctors recommend keeping preemies out at least until one year of age. We know two preemie families that didn't get approval even at age two. Kids get so many colds and stuff from being in day care, and it can be a serious problem for a little one that started off life with respiratory problems.

Doctors
Lots of extra doctors appointments are required. We know we'll have to see an opthamologist. Some of the medical interventions that save lives can also contribute to other problems down the road. Gavin's respiratory treatments can cause retina damage (which apparently caused Stevie Wonder's eye damage). We may need to see a respiratory specialist. Other preemies we know also see physical therapists, specialists for digestive problems, and more that I'm not thinking of right now.

Social Workers
NICU families are all assigned a social worker during the hospital that helps with a wide range of issues. Among many things, the social worker helps set up any resources needed post hospital time. "Children 1st" is a program with the State of Georgia to identify and help at risk infants get the best start that they can. "Babies Can't Wait" is another program that works with infants that may have developmental delays. The social worker's involvement really depends on the individual family's needs. For us, they will help communicate with our utility companies. Gavin will probably go home on an apnea monitor (Chloe did, too), and the power company in particular will be notified that we have medical equipment dependent on having service. If there is an outage in the area, homes with medical equipment issues are supposed to be higher priority.

NICU Visitors
Because NICU babies are at high risk for infections, the only people allowed in the NICU are parents, siblings, and grandparents. They are really strict about that, and we appreciate it because limiting visitors for all the tiny patients means less possibility of infection. It does stink though that my sister in particular isn't allowed to see her nephew. Until he's probably a month old. Because they're hooked up to a bunch of machines, it isn't even possible to bring a NICU baby to the glass door to say hello that way.

Germ Exposure
Germs are a big deal. A really big deal.

House Arrest
Our experience with Chloe was that was she was out, the doctor didn't want her anywhere but home for the first month. We also weren't supposed to have many visitors. I remember taking an illegal trip to Babies R Us that was super exciting.

No Touching
Again, germs are really bad. Please always ask before touching a baby, preemie or not. I got into the habit of carrying purell with me. Passing a common cold can send a baby like Gavin that has respiratory problems right to the hospital. We have been lucky with Chloe that she didn't have respiratory issues, but we know plenty of other preemies that are constantly sick for years.

RSV
One of the reasons germs are bad is that there is a super common virus known as RSV. A really annoying cold for us, but it can be fatal for a preemie. Chloe actually had it, but she got treated really quickly. It stick around for about 3 weeks and required using a nebulizer with very expensive medicine, even with insurance. And speaking of expensive, a vaccine is available, but it has to be taken monthly, and it is $1500 per shot! I think it's over 6 months.

NICU Help
One big plus is that we have amazing help 24/7. With that help comes a lot of training for us as well. That was probably more helpful with Chloe since we've now been through it once, but having a trained specialist walk us through basic infant care is pretty awesome. And it is so comforting to be able to actually get some sleep at night knowing a baby in the NICU is being watched and cared for.

Umbilical Cords
Two things to mention. We don't have to worry about umbilical cord care as they tend to fall off before discharge. There is also a lot of money spent on marketing cord blood banking. With a preemie, there isn't enough cord blood to bank, plus deliveries are often done in an emergency, so banking isn't generally done. At least according to my doctor!

Breastfeeding
Here are the basics. Getting breast milk is supposedly really important, though we know plenty of kids that aren't. With a preemie, they don't know how to breastfeed until they are 36 weeks old gestationally. And then it can take awhile to figure it out fully. Which means the insurance company pays for a breast pump. Fun times. I'll save you from the rest of the details, but I will say that it is emotionally challenging, and what made a difference for me with Chloe was talking to someone else that went through it. So if you know someone that just had a preemie, get them in touch with someone that's been there!

Preemie Books
I am a perpetual student, and I didn't find a lot that was helpful when Chloe was born. I did get a book this time donated to the NICU by the Kiwanis Club. It's by Dana Wechsler Linden and others titled:

Preemies: The Essential Guide for Parents of Premature Babies.

I highly recommend it!

I think that's it. If you have questions, let me know! Assuming you made it through this novel...

Lena

Silent, But Deadly

Gavin had some seriously stinky gas this afternoon! And he let mommy change two poopy diapers in a very short time frame. But otherwise very sweet.

Chloe and Nana went to the hospital with me this afternoon, and Chloe was great about being gentle, singing to, and nicely touching Baby Brother while he was in my lap.

Other news is that his umbilical cord fell off, so he now has an adorable belly button. He's still on oxygen, but he's down to "room air" so it's just helping to remind him to breathe deeply. He got his IV taken out a couple of days ago, which I think he forgot to mention.

Only other thing to mention is that he slept a lot today, which is important for his growth. He lost an ounce Monday night to Tuesday night, so we've had to be careful about anything that burns calories, which includes holding him. It's pretty heartbreaking to not be allowed to hold your baby, but at least we've had the chance to hold him, and it now is so important for him to gain weight.

What's still keeping him here primarily is getting him off the feeding tube and eating on his own; all while demanding to be fed.

Lena

Outfit #2

Thanks to some well placed spit up!

The Outfit Revealed!

Gavin is wearing clothes, which means he is maintaining his temperature without the warmer! The nurse picked this one out for him from a full drawer in his room. It is from Aunt Jerilyn and Uncle Justin!

Lena

Step Forward!

Little man took a step backward yesterday when they put him back on the oxygen cannula. His resps and oxygen saturation were starting to falter. The chest x-ray showed some fluid in his lungs, but nothing of great concern; the x-ray was precautionary. He looked great this morning. He also threw up all over himself, but it sounds like reflux, which could cause yesterday's problems. The day nurse said that the only rason he's still in the two-patient room is because they need someone from the open room (8-10 beds, I think) to go home first. And that's just superb news!

Two Steps Forward, One Step Back

That's pretty standard in the NICU. We're back on oxygen, but just a little bit of assistance. I noticed that he is breathing hard, and they may do an x-ray shortly to make sure his lungs look ok. It could just be reflux from eating more. I'm hopeful that whatever it is resolves itself quickly.

Lena

Update

I think this picture is great to give you an idea of all the stuff we have to navigate to hold our baby. The oxygen is now gone, but that's only one tune in a tangled mess. Most of the wires are attached to check vital signs.

And for the update. Little man weighs 4 lbs, 6.7 oz! His next and almost only major hurdle will be mastering feedings. He will probably be off of the IV tomorrow, and that's the last thing still hooked up to him other than the feeding tube in his nose. Prayers and good thoughts that he figures out what's called "suck, swallow, breath." That can be super tricky for a preemie. Its what kept Chloe in the NICU a few days longer. It's hard for me to wrap my head around that he'll be 11 days old tomorrow. That's how old Chloe was when she went home! I think Gavin will be in for another 2 weeks. I'd love for it to be shorter, but even that is aggressive given what all he's gone through.

Lena

Little Froggy

Aunt Jerilyn made this adorable hat! She actually has her own company making hats at http://www.giannabyjerilyn.com/.

Lena

The Things Kids Say

Chloe is explaining to Daddy that milk for babies comes armpits.

Look Mom! No Oxygen!

Gavin is off all his breathing assistance! That's a really big deal! Yea!

Lena

Middle of the Night Update

I have to get up every few hours both to take my pain medication and to pump, which maybe I will eventually talk about more in some future posting.

One of the nice things about life in the NICU is that I can call his nurse at any time to find out how he's doing. I especially like to call in the middle of the night since it's difficult for me to be there at that time.

His nurse just told me that he is up to 19 cc's of milk and that he weighs just over 4 lbs, 5 oz. He weighed 4 lbs, 0.6 oz at birth and hasn't lost weight from his birth weight, but I think that's mostly because of the amount of IV fluids that he's been on. He was really puffy and swollen for a few days and weighed just over 4lbs, 7 oz at one point due to the extra swelling.

Chloe will be getting a bit more well deserved time and attention tomorrow. She's going to the zoo in the morning with Nana and Gramps, and then she will come home for a nap before going to our neighbor Isaiah's first birthday party in the afternoon.

We've tried to be really careful to include Chloe as much as possible and to make sure all of her needs are being met. Seems to be working so far! Mondays are a big day because she has gymnastics in the morning through the end of this month, and it has been important to figure out maintaining that routine because she loves it so much.

It feels like she has grown up a lot in the last week in terms of her understanding and thought process as well as her vocabulary and communication skills. I'm not sure if it's just that I'm more aware or if becoming a big sister really has been that transformational for her.

Back to bed for me!

Lena

Nurse Chloe

Chloe is so excited about her baby brother. We went to the NICU last night in time for his bath – his second bath ever! Awesome Nurse Susan asked Chloe to help take his temperature, listen to his heartbeat, give him a bottle, etc. The daytime Nurse Pam was sweet to find a stool for Chloe to stand on to see all the action. I think these pictures speak for themselves.

Pictures From Today

We had more good news! Gavin's billi level went down to 7.6 today from over 12 yesterday, so he's off the billi light. He is still on the high flow to help him breath, but the oxygen level is set at room level, which means that he isn't getting any extra oxygen, and his saturation looks great. He did partial feedings from a bottle 3 times yesterday, and he's been tolerating all of his feedings really well. He's up to 16 cc's and will continue to increase the amount at each feeding. That means his IV will probably come out late Sunday or early Monday.

All that means that we get to hold him more! Which also means that my hands are now full of baby instead of my cell phone to update the blog. No offense, but I'm pretty happy with holding the baby!

One of his nurses got back from vacation today - she last saw him on Sunday. We talked about the drastic changes he has gone through since then. She left a very sick baby that seemed like he would likely be in the NICU for 2 months and came back to find a vocal and fiery little guy on the road to a quick healing. I'm afraid to get my hopes up because setbacks are such a normal part of having a preemie, but the nurse said that she would expect that he'll be in the transitional nursery within a week and home within a month.

These pictures are all from today. The mirror is to help me see his little face while I'm holding him. Enjoy!

Lena

Overheard From the Backseat

Toddler chanting:
I want baby Gavin!
I want baby Gavin!
I want baby Gavin!

It made toddler car whining much more bearable!

And it was then followed by:
More crackers please!
I like crackers!

Snuggle Time!

Daddy Finally Holding Baby!