Thursday, October 22, 2009

An End in Sight

Tonight's visit to the NICU was one of the most encouraging yet. Brooklyn attempted the Haberman bottle at every feeding and took 4 or 5 entire bottles. She is now up to 5 lbs, too!! My little princess is looking so much more like a newborn and much less like a preemie, though she is still tiny. :)

One of my favorite nurses had her tonight and we chatted for the entirety of my visit to the NICU. I love that there are such caring and personable nurses taking care of my baby girl. Kara (tonight's nurse) talked to Dr. Stevens and I will get to attempt breastfeeding once a day beginning with my visit tomorrow!! I am so excited! If Brooklyn goes to total bottle feedings for 24 hours, we'll be able to go to care-by-parent!! *see bottom of page for explanation* Kara told me that she didn't want me to bank on it but there's a good chance that she could be just a week from coming home!! I am SO excited!! She will have her car seat evaluation tonight (she'll sit in the car seat for an hour while still on the monitors for signs of breathing problems to make sure she doesn't need a preemie seat). Kara is also scheduling her hearing test and started giving me instructions on what we'll need to do before Brooklyn can be released. So PLEASE pray that our little Brooklyn continues to improve so that we can have her home by the beginning of November! My mom is supposed to be here through the 6th or 7th and it would be such a blessing to have her home before Mom heads back to Texas!

*For those of you who aren't sure what care-by is, its when Paul and I stay in a room across from the NICU (picture a normal hotel room w/o windows) and take care of Brooklyn on our own for a specific period of time (ranging from 1 night to a week depending on the baby). We will take her into the NICU for her vitals and if she's gaining weight good and not having any desats while we're there, she'll get to go home.

Tuesday, October 20, 2009

Week #4 - Set Backs

This past week was a good week for Brooklyn in the way of weight improvements and periods of wakefulness. As of October 19th, Brooklyn was exactly 1 pound over her birth weight at 4 lbs 12 oz. She has also been awake and alert for more of her feedings which is a wonderful blessing.

Last night she had her first "set back" since her birth. While bottle feeding her last night, she got a bit too aggressive with sucking and forgot to breathe. Once she realized she needed air, she began breathing too fast and sucked milk into her airway. This caused her stats to drop - becoming mottled (bluish-gray in color), pulse ox dropping below 55 and respers (breathing) above 100. Normal pulse ox is above 90 and respers should be below 50. With a bit of oxygen and a lot of rest, she was back to her normal self but when she tried taking the bottle this morning, she aspirated again. The nurses say that she's trying to tell us that she's not quite ready to take on the bottle. I have to remind myself that we've got to go at her pace and at barely 35 weeks gestation (as of tomorrow), she's doing wonderfully.

When I spoke with her nurse this morning and found out that she'd aspirated again and was going to have to be backed off of the bottle a bit, I felt completely discouraged. I called my sister to ask for prayer and then called my good friend Cathy from our church Life Group and after a wonderful talk with both of them, I feel so much more at peace. I have to remember that *I* am not the one watching over her but that God is the one in control.

I am looking forward to bringing her home in the coming weeks. God-willing, we'll be able to bring her home by her due date of November 25th, if not before!

Wednesday, October 14, 2009

Turn down the heat

Just a quick update for you. Brooklyn is now 4 lbs, 5 oz (1982 grams). Her temp was high all day today so they were nudging her Isolate temp down to keep her from over heating. When I went in for her 7pm feeding, I noticed that her respers (breath rate) were REALLY high - average is around 30-40 though she was between 100 & 120. Her nurse said it was most likely from being overheated. We took her out of the Isolate and changed her, weighed her, etc. As her temperature began averaging out, her respers returned to normal. I asked when they were planning on switching her to an open-air crib since she was already passed the 1800 gram mark (4 lbs). Her nurse went and talked to the physician and they will continue to turn the heat down until she's maintaining the temp on her own which means that by tomorrow evening, she should be in an open crib!! What a praise! I cannot wait to be able to see her all swaddled up and being more like a normal newborn! :D

She looked wonderful tonight and her color was awesome (meaning she was doing GREAT with her breathing). I was able to talk to her and she stared at me for a long time during her feeding before snuggling up and falling back to sleep. I so greatly enjoy these longer periods of awake time that she has been having. She was fed twice today from a bottle and as long as she's awake, she should be fed one more time this evening! Each day she shows improvement! :)

I can't wait to see her in her crib tomorrow! Please keep praying for little Brooklyn!! Just a few more weeks and hopefully we'll be able to bring our little princess home for good! :)

Tuesday, October 13, 2009

Week #3

Oh my goodness, how crazy the past two weeks have been! Brooklyn has been doing wonderfully since her birth on the 26th. Here is a quick "overview" of her achievements to date:

11 hrs old - received 2nd dosage of surfactant; removed from oxygen & intubation.

Week 1 - Receiving breast milk via nasogastrical tube in addition to fluids by IV; increasing feedings by 1 ml per feeding. No longer needing bililight or IVs. Pick line (IV) removed. Taking the bottle when offered; taking 2-3 mls at a time. Bottle offered once a day. *by the end of the week, she thrives solely on breast milk with added calories.

Week 2 - At 34 mls per feeding (just over 1 ounce). Bottle now being offered up to 3 times a day. Taking between 18-20 mls on average per bottle feeding; remaining fed through feeding tube. Still at 34 mls per feeding. Reached the 4lb mark midweek. Has continued to gain 20-30 grams each day. Has continued to breathe on her own. Still has episodes of periodic breathing (pauses between breathing) but does not require outside stimulation to begin breathing again.

This week we are hoping to move her to an open crib (she is currently still in an Isolate). I will hopefully find out tonight at her 7pm feeding when the doctors are wanting to do that. She will bottle feed in the morning and then sleep through her next 3 feedings (approx 9 hours) so she still has a while to go and more weight to gain before she is able to stay awake through more than 2-3 bottle feedings a day. She is past the 4 lb mark and is breathing fine on her own so her last big hurdle is the bottle feeding. Once she is taking all of her feedings by mouth for a 24 hr period, they will remove her feeding tube. Then its only a matter of days before she will be able to come home. As of right now, it looks like it will be another 3-4 weeks at least before we are able to get to that point. Last night I also discussed with her nurse about breast feeding and hopefully we will be able to start attempting that once she is awake a little more for her feedings.

Her feedings are still every 3 hours - 7am, 10am, 1pm, etc. Most days I am only able to go to her 7pm feeding but I am so grateful for being able to see and hold her each day. Now that she is past the 4 lb mark, I can hold her during her "touch time" for as long as I am able. Occasionally I am able to do "kangaroo care" (skin-to-skin) and absolutely LOVE that time with her! It has been wonderful to hold her this past week without the leads connected to her and me constantly watching her monitor for signs of stress (lowered pulse-ox reading, etc). Aside from when I'm holding her, she will remain on the monitor (breathing, pulse-ox, heart rate) until
she goes to care-by-parent.

We are all so looking forward to having her home! Pumping has been a challenge for me but I have contacted the NICU Lactation RN and hopefully she will be able to help me get things more on track. Right now I'm having to pump every hour to try and build my supply back up as stress/exhaustion has seriously affected my output.

Though I have my days (most often when I have neglected to take my medicine the night before), I have been very blessed with lots of help to make it through this time. I am so thankful for such a caring church and wonderful friends who have kept us all in their prayers on a daily basis. Those prayers have made such an incredible difference.

I am needing to go pump so I will have to sign off for now. Here are Brooklyn's current stats:

As of 10/12 - she is 4 lbs 2 oz or 1873 grams
Taking 34 mls every 3 hours; being offered bottle up to 3 times per day
Currently waiting for results of TORCH test in regard to her head size (head circumference is under the 25th percentile). Results should be back tomorrow or Thursday.

Thursday, October 1, 2009

Birth Story and first update

I am sorry to take so long to post this but you can imagine how crazy things have been since Brooklyn's birth.

Saturday, September 26
I had been having contractions the previous night (not terribly painful) but they died down once I was able to sleep. On Saturday morning, the started back up again (but again, were very tolerable). At 9am, they started my NST and though some of my contractions were showing up on the monitor, most were not. We assumed that they were just "Braxton Hicks" and didn't think any more about it. By late afternoon, the contractions were becoming a bit more regular and a few began to feel crampy. They decided to put me back on the monitor to see what was happening but once again most of the contractions weren't showing up on the monitor.

The on-call doctor, Dr. Wotherspoon, decided to do an internal just to see if the contractions were doing anything but I was still at a 2 - the same that I was when I was put on hospital bedrest a week and a half prior. She decided that the contractions weren't anything to worry about but went ahead and transferred me to L&D for observation because my abdomen was tender to the touch - a possible sign of infection. This would have been about 6pm. My best friend, Krista, had come up to see me earlier and offered to take the girls for the afternoon so that Paul could be with me for a couple of hours. Paul arrived right as they were transferring me back to L&D.

For the next hour, my contractions all but disappeared. I could feel some tightening but nothing showed on the monitor and nothing was crampy or painful. Around 7:50pm, my contractions began picking up again and started to feel very much like real labor pains. However, even though they'd moved my monitor several times to see if they could pick up the contractions, most weren't showing so we were just "waiting" to see if I was in labor. My contractions continued to worsen and by 8:30pm, I was in agony. I called for my nurse (who was wonderful) and asked if there was anything they could do. I had the option of tylenol or percoset because labor had yet to be confirmed. I chose the percoset - which did absolutely nothing. Within a few minutes, I was feeling like the contractions were coming one right on top of the other. I began getting frustrated and called my nurse back in to ask her what they could do. Dr. Scarrow, the attending OB, ordered a blood draw to check for infection and an IV to start Stadol to help me rest, since the percoset did nothing. What I really wanted was an Epidural but that would have to wait until the IV was started and Elizabeth had checked my cervix to see how far (if at all) I was dilating. Keep in mind - labor had yet to be established. Elizabeth started placing the IV and drawing the vial of blood before securing it. (IVs are NOT easy to sit still for when you're having contractions.) In the middle of the blood drawn, I felt a tremendous amount of pressure and lifted my rear end off the bed. To my shock and amazement, out came Brooklyn. There was no doctor present, no labor established and I was still wearing those gorgeous hospital issue net panties.

Paul, Elizabeth and I were stunned for a few seconds and then the room went crazy. Elizabeth yanked the call light right out of the wall in hopes of getting someone's attention and then had Paul yell down the hall for help. The room became a scene of chaos. A nurse began rubbing Brooklyn with a towel to (I'm assuming) clean her off and stimulate her. She was breathing well and even let out a precious cry. Such a relief to Paul and I. As Paul and I sat there and just stared at her in amazement, the nurses scrambled to find the necessary equipment to clamp and cut the cord and get Brooklyn transferred to a warmer and the NICU. There was no warmer in the room due to lack of confirmation of labor. For the first time ever, I felt energized, rather than exhausted, after labor.

Dr. Scarrow came in to deliver the placenta (I know, TMI) and check to make sure that I was doing alright. She had to be pulled out of a C-Section in order to do this. Elizabeth cleaned me up and we waited for the NICU to stabilize Brooklyn so that we could go see her and then be transferred back to my room on the floor. Elizabeth wheeled me into the NICU a short time later and Paul & I spent a good 15 minutes just staring at our precious little one. I ached to hold her but because she had been intubated, that would have to wait. We went on back to my room and I finished getting cleaned up and had my first meal since breakfast. It was now after 11pm. Paul made himself comfy on the recliner and I climbed into bed to try to get some sleep. While sleep came quickly for Paul, I felt wired. I could not stop thinking about Brooklyn and decided that, at midnight, I would go to see her in the NICU. I spent the next 3 hours by her bedside, just watching her sleep and asking her nurse a million questions about what they were doing as far as monitoring, what to expect in the coming days/weeks, etc. At around 3:30pm, I headed back to the room to get some sleep.

September 28
By 11am the following morning, Brooklyn was given her second round of surfactant (to help open her lungs) and taken off of oxygen. Two hours later, she was taken off of the ventilator. At that time she was transferred to a normal incubator and moved from the isolation room to row 1. By Monday she was started on photo therapy (billirubin was high) and began feedings every 3 hours by stomach tube. Monday evening at her 7 o'clock vitals, Paul and I were able to hold her for the first time. She was SO tiny and so perfect.


Discharge & Status Update

Monday was very challenging for me because, though she was doing so well, I was being discharged and the thought of leaving her in the NICU and going home where I could only see her 1-2 times a day was torturous. I bawled all over Becky and Paul but pulled myself together long enough to pack everything up and head home. It was actually relieving to be home after nearly 2 weeks on hospital bedrest.

Since then, I've made a routine of going in at least once in the evening at her 7pm vitals/feeding. Born at 3 lbs 12 oz., she was down to 3 lbs 9 oz. by Tuesday night. Up until last night, her billirubin count had gone up a little each day as well. Yesterday evening, I went in to do our "skin-to-skin" where I am able to hold Brooklyn against my bare chest and really snuggle with her. (This has been a blessing for my milk supply.) I pumped after our cuddle time was over but decided to remain at her bedside until her next vitals/feeding time so that I could see how much she weighed (they weigh her every 24 hours, during the night shift). As a side note, when I arrived at the NICU at 7pm, I thought I recognized her nurse. After talking with her a little bit and going back through Raegan's pictures from birth, I realized that Kara, her nurse, was also Raegan's NICU nurse after she was born. How neat is that? Especially with over 150 NICU nurses on staff!

Anyway, back to Brooklyn. At her 10 o'clock feeding, Kara weighed her and she'd gained 2 grams! Definitely an improvement over the 4 ounces she lost in the past 4 days! Her billirubin count had dropped 1 point from the day before and she even made a concerted effort to take her pacifier again. I am so proud of how well she has done so far! The cultures that were taken when she was born have all come back negative. Yesterday they did a lumbar puncture to check for infection in her spinal fluid and that culture takes 72 hours for results. God-willing, those cultures will come back negative as well. Because of my membranes breaking a 11 days before her birth, they are still giving her antibiotics as a precautionary measure.

Her feedings have gone from 3 or 4 milliliters on Monday to 15 milliliters as of 1am this morning. That is half an ounce!! Not bad for such a tiny squirt! The fact that they are increasing her feedings so quickly is a wonderful sign! As is the fact that she no longer has to be continuously monitored as far as body temperature is concerned and they only have to check her blood pressure every 6 hours instead of every 3.

As often as is possible, I will try to post her daily stats (feeding intake, weight, etc.). It may just be a one or two line update but I will do my best to keep everyone in the loop as to her progress. God-willing, we will be able to take her home long before her due date of November 25th! Please keep your prayers coming!

Thursday, September 24, 2009

Day 9

Soon I'll be able to literally start counting DOWN the days instead of watching the days I'm here increase (i.e. the title). Dr. Williams is supposed to give me a definite date and time tomorrow and I'm excited to be able to count down the hours until I meet Brooklyn and can sleep in my own bed again.

I went to bed last night feeling a bit clammy and "odd feeling" but didn't think a whole lot of it. This morning, I awoke feeling much as I did last night except that I now also felt nauseated. I thought breakfast might help but I honestly couldn't talk myself into ordering anything. I mentioned to my nurse how I was feeling and she brought me apple juice and graham crackers to see if they would help settle my stomach. They did a little but I was still feeling a tad crummy. After my NST, I ended up falling back to sleep and slept hard until 11am! I know that its not as if I have a lot to do but I have to admit that sleeping that late makes me feel guilty. The plus though was that I was feeling much better. I ordered lunch - a yummy PBJ - and was able to eat it all plus the plate of fruit I always order.

My afternoon was spent reading and knitting. Nothing too eventful. The highlight of my day was having Morgan and Paul show up for a few minutes to see me. Paul sat next to me on the bed and just held me in his arms. I have not been able to lean into his arms since Tuesday. It was so wonderful to be in my husband's arms. After they left, I showered and came out to a freshly made bed (I'm going to get spoiled). I didn't do so hot on my fluids today - only drinking 39 ounces total. I need to do better tomorrow since that is what is keeping my amniotic fluid up. Even though I slept quite a bit this morning, I feel exhausted tonight. It is only 7pm and I'm already to snuggle in for the night. I have my evening NST yet to do however so I will have to wait a while longer before I can do that. I'm excited to be more than halfway done with the week. Each week brings us that much closer to being able to go home.

Wednesday, September 23, 2009

Day 8

Can I just say how awesome it is to have been able to sleep without noise from the roommate's television or having to vie for use of the bathroom? LOL I slept WONDERFULLY!! I had my NST last night, showered and then crawled under the covers to get some sleep. I laid there for a while and prayed and thanked God for the blessings he's given me like a healthy baby girl who is still happily in her little cocoon, wonderful nurses that helped me to get another room and even a window! :) I turned on one of my Christian radio stations on Pandora and sang myself to sleep. LOL

This morning I woke up bright and early and ordered my breakfast. I seriously have not felt so refreshed in a week. I ate breakfast and then nestled in to watch some tv (lasted about 15 minutes... blech) and then decided to read some more of my book instead. I ended up falling back to sleep and napped until it was time to do my morning NST at 10am. Sarah called me and we chatted for a long while. At one point Dr. Williams came in and I talked to him about my fears of going natural when my water was already broken (meaning labor will probably be much longer than normal for me) and he was a great encouragement and answered all of my questions. He started to walk out to go deliver a baby and turned back around to tell me that I was handling this all very well and that he was actually very proud. It made me feel so good to hear that.

Tedra came by shortly after I ordered my lunch and we had a wonderful visit long into the afternoon. We got a good giggle when the window washers worked their way down to my room. It was so odd to see a guy dangling there from a rope, washing away. Tedra waved and he looked at her like she was in the psych unit. It was too funny. It was awesome to just chat with her and to find out that she was accepted into the first nursing school she'd applied to (and the best, in my uneducated opinion. LOL). Congratulations, Tedi! Shortly before Tedra left, my nurse came in and told me that she had good news - I was getting a roommate. Ok. No problem. Then she said that because I was getting a roommate and the roommate was a handful, they had a private room for me and I could switch as soon as they finished cleaning it. PRIVATE. How cool is that?! I packed up my belongings, placed them in a chair and sat back in bed to read until they transferred me. Let me just say how AWESOME my nurses are! They wheeled me to my new room, hauled all of my stuff for me and got me all settled in to a room that is larger than my own bedroom. And the view! Instead of the courtyard (picture "The Rear Window"), I have a wonderful view of the outside - I can see trees, the main parking lot, the street running along side the hospital. After not having a window and then having a view of the 7 floors of hospital across the courtyard from me, this is awesome. I feel that much less disconnected with the outside world!

I was able to get settled in and snuggle back into bed to listen to my music and read some more until Paul and Morgan surprised me with an early evening visit. Paul and I chatted for a while and then decided that I would take advantage of that wheel chair ride that Dr. Williams had granted me earlier in the week. I climbed into the chair, wrapped in a blanket and Paul wheeled me to the elevator and down to the first floor we went. From there, he took me outside to the courtyard that I had a view of from my previous room. I was outside for the first time since last Wednesday. I cannot tell you how wonderful it felt to be out there, even though I was surrounded on all sides by 7 floors of hospital and it was starting to rain, I honestly didn't care. It was so beautiful to me out there. I don't think I will ever take fresh air for granted again. From there Morgan and Paul wheeled me in to the cafeteria and I was able to enjoy a meal with my family - a first since Tuesday night. Then it was back up to my room for a couple rounds of Kings Corners with Morgan. I cannot tell you how wonderful it was to have them here and to have the privilege of going outside, even for a short time. I am seriously on cloud 9 right now! :)

Its currently 8:30pm and I'm waiting for the nurses to come in and say that L&D called and said they are ready for my evening NST. After that, its shower and bed for me. This past weekend was quite a challenge for me as I adjusted to the idea of being here for the duration of my pregnancy with Brooklyn (albeit only 3 1/2 weeks) but God has so greatly blessed my week so far. I know that there may be some "down" days in the next 3 weeks but I am so thankful for days like today that help seriously lift my spirit.