My Turn to Hold Justin!!

Well today was my turn to hold Justin. Even though it was not chest to chest like Georgy did the other day, I still enjoyed it the same. We kicked it, talked about the upcomming football season, and just boxed a bit with my finger and his hand! Georgy kept bothering us, she wanted to see his face, read him books, but she didn't realize that none of that mattered to Justin because he was chillin' with Dad! With his permission I finally gave in and let Mom read him the three little pigs! I figured I hadn't heard it in a while so I guess it was worth a shot. Wow, I never remembered the "Big Bad Wolf" eating two of the little pigs (tear falling), oh well, such is life!! Anyway, even at 1 pound and some ounces, lil Justin got a tad bit heavy after an hour or so. I'm glad Justin responded well to hanging out with me for a while, we'll have to do this again real soon!!

Week 4 Update – Thursday, June 26, 2008

This was a pretty good week for Justin. He was even called boring by one of the nurse practitioners because he’s the most stable out of all the little ones currently in the NICU.

On Sunday Justin was switched from a high-frequency ventilator which provides tiny quantities of air at rapid rates using lower pressures to a conventional ventilator which uses high pressures to deliver breaths and maintain a relatively normal pattern of inhalation and exhalation. He has been responding pretty well to the switch with minimal desats so they have been able to decrease the amount of oxygen he’s receiving and the amount of breaths they’re providing has been decreased from 60 breaths per minute to 20. They hope to wean him off the ventilator this evening and switch him to a nasal c-pap tomorrow morning.

Breast milk feedings have been increased from 1 ml every 6 hours to 4 ml every 3 hours. Justin has been tolerating his feedings really well with very minimal residuals (meaning he is digesting his milk) so the plan is to increase feedings by .5 ml every 12 hours.

Justin was moved to the isolation pod as a result of his staph infection and will more than likely remain there until he is discharged. Additional tests will not be performed unless he shows any signs of illness. He also had a repeat head ultrasound this morning which showed the same grade 1 bleed so no more ultrasounds will be performed.

Justin’s current weight is 530 grams (1 lb 2 oz).

Highlights of the week
Holding Justin for the first time was the best feeling in the world. I can’t wait for Carl to experience it this weekend.

Justin had his first poopy diaper on Friday. I’m sure I won’t be as excited about them once he comes home and I’m changing them on a more regular basis but for now this is a huge milestone.

I finally held Justin…

and I’ve been on cloud nine all day. Yesterday when we left the hospital the nurse mentioned that we’d probably be able to hold him by the end of the day but when I walked in this morning I was surprised when she told me that we were going to kangaroo*. After 3 ½ weeks of being told by the nurses when I could or could not touch him it was a surreal feeling when they finally placed him on my chest. And it’s hard to believe since he’s just over a pound, but after an hour my arms actually started hurting. But I think it was more from me being a little nervous and trying not to move so my arms were a little stiff.

*Kangaroo care is a way of holding your baby to allow him or her to be closer to you. The baby is held naked (except for a diaper) between the mother’s breasts or next to the father’s chest. Some of the advantages for the baby are: 1) a more stable heart rate and more regular breathing, 2) improved circulation and better use of oxygen throughout the body, 3) longer periods of alertness and longer periods of sleep, and 4) more rapid weight gain.

Week 3 Update - Thursday, June 19, 2008

After the “episode” on Monday Justin was started on steroids the following day to help mature his lungs. A significant improvement was noticed in his chest x-ray taken on Wednesday and the number of desats has decreased drastically.

This week’s tracheal culture is now positive for the staph infection which Justin developed last week. Fortunately, as a result of suspicious lab results this past weekend, he was already started on antibiotics to help fight off any potential infections.

Justin’s current weight is 540 grams (1 lb 3 oz) and his length is 10.6 inches.

Highlights of the week
Breast milk feedings were resumed since there is now a noticeable amount of gas in the stomach.

Lights, Camera, Action - Part 2!

These will probably be the last pictures posted for a while since Justin is very sensitive to light, sound, and pretty much everything else, so he isn't tolerating picture taking very well.

2 Steps Forward, 3 Steps Back

The last few days have been pretty rough. I had been warned that there would be bad days, but nothing prepared me for walking in Monday morning to see Justin surrounded by nurses, nurse practitioners and respiratory therapists who were bagging him. When we visited on Sunday he was doing pretty well, but things took a turn for the worse that evening and he started to desat repeatedly. (An oxygen saturation monitor helps monitor the concentration of oxygen in Justin’s blood. At Justin’s age they like his saturation level to remain in between 85 – 92, so anything below that is considered a desat). As a result, at Monday’s rounds they decided to switch the type of ventilator he was on. I didn’t expect him to respond so drastically to the change in vents. I had an emotional breakdown and had to leave when I saw his heart rate drop to 43 and his saturation level as low as 29. After about 10 or 15 minutes one of his nurses let me know that his levels had returned to normal and he was okay. Unfortunately I know that more bad days will happen. As the nurses say in the NICU, 2 steps forward and 3 steps back.

Week 2 Update - Thursday, June 12, 2008

Test results show that Justin’s jaundice has gone away so he was taken off of the photo therapy light treatment. The head ultrasound taken on Monday showed a Grade 1 bleed which the doctor stated is of no consequence because that type of bleed is very small and will resolve itself, but another head ultrasound will be done in two weeks. His chest x-ray has improved and shows that his lungs have expanded. They are starting daily diuretics to help increase the excretion of water from the body, which will help the lungs.

Justin developed a staph infection this week. Of course I was freaked out about it but the nurses said that this is something very common for preemies and assured me that this was nothing to be highly concerned about. His infection is colonized in the nose, is not in any of his bodily fluids or blood and all tracheal cultures were negative. But they will continue to monitor and test for any changes.

Justin’s current weight is 450 grams (15.9 oz), which was down from 490 (1 lb 1.5 oz) on Wednesday. The doctor mentioned that because his growth was restricted in the womb he will more than likely have a slow growth rate. Now that he is two weeks old the goal is to focus on weight gain, so they are increasing his caloric and protein intake.

Highlights of the week
On Monday they started breast milk feedings, but suspended them the following day because the chest x-ray showed that there is no gas in the stomach and he has yet to have a bowel movement.

Carl and I were able to change his diapers, take his temperature, change the pulsox sensor, and clean his mouth.

Justin is now wearing big boy preemie diapers. Previously he was so small that they had to make his diapers out of gauze bandages.

You don't look like you just had a baby...

I’ve now heard that from several nurses in the NICU and it kind of makes me sad. Anyone who knows how difficult this pregnancy has been will probably think I’m crazy, but I actually miss being pregnant. I grew out of most of my pre-pregnancy clothes the week before I was put on bed rest and had just started wearing maternity clothes, and still have quite a few maternity items with the tags still on them. Unfortunately I can’t return them since the items were all on clearance and considered final sale. But I was actually looking forward to the big stomach and really wanted to have maternity photos taken. On a bright note, I’ve already lost my pregnancy weight, and then some. But that really isn’t saying much since I only gained 2 ½ lbs, all in the last week before being put on bed rest.

Lights, Camera, Action!

I'm definitely a boy.

I like my tummy time.

I'm already flipping off mom & dad, lol!

Week 1 Update - Thursday, June 5, 2008

Justin’s first week of life went pretty well. All lab results are moving into the normal range, his red platelet levels are good, and his white platelet levels have increased significantly so he is now able to fight off infection on his own. Within the next day or so he will be taken off of the photo therapy light treatment which was used to treat jaundice. A head ultrasound is scheduled for Monday to rule out any bleeding in the brain. He is on day 3 of a 7 day antibiotic treatment and is responding well. He does not currently have an infection but the doctors wanted to err on the side of caution and treat him proactively. His chest x-ray, which is done on a daily basis to check for proper tube placement, as well as to check the development of his lungs, was good. Justin did loose weight (2 oz.) after birth, but all babies lose weight in the first ten days or so of life. His current weight is now exactly 1 lb, but at this early stage his weight will fluctuate because preterm babies lose more water through the skin or respiratory tract than babies born at full term. The highlight of the week was when he opened his eyes. He didn’t open them completely, so I still can’t quite tell what color his eyes are, but nonetheless it melted my heart.

Happy B-Day Justin Carl - Thursday, May 29, 2008

I don’t quite remember the time but I was awakened by an excruciating, sharp shooting pain across my lower back. The nursing staff and doctors were perplexed and thought that I was possibly having contractions, but no contractions were registering on the monitor. The pain continued and worsened, my blood pressure rose above 200 and the ultrasound showed that Peanut’s heart rate had dropped to 60. The time was 12:37 a.m. when I looked up at the doctor and she said “Sweetie, we have to take him” and I immediately started hyperventilating. They were trying to get me to calm down and breathe and I remember saying, “But I’m only 24 weeks, I haven’t taken a birthing class yet, I don’t know how to breathe”. I somehow managed to call Carl, although I’m not sure if he understood me when I told him to get his butt back to the hospital ASAP because they were taking Peanut. I was immediately rushed into the operating room for an emergency c-section. There was no time for an epidural; I was put under general anesthia. Justin Carl arrived Thursday, May 29, 2008 at 12:46 a.m., weighing in at a whopping 14 ½ oz. and 10 ¼ inches.

As it turns out my placenta abrupted and I had developed a severe case of pre-eclampsia and chronic hypertension. I knew that’s what they were keeping an eye out for and thus the constant blood draws and urine samples but I was not informed that I had indeed developed it until the morning after I delivered and spoke with my doctor. FYI, my doctor was not the one to actually deliver me and I had yet to be seen by her prior to delivering. I actually didn’t see her until the day I was discharged from the hospital. She works in a women’s health services group and I was told at my first prenatal visit that I would be delivered by the doctor on call at that time.

Looking back I realize how fortunate I am that my body gave up on me in a sense and I was in the hospital when my placenta abrupted. They were able to get Justin out within 10 minutes. I hate to think about the worst case scenario had I been at home. I might not have known that Justin was in distress and he possibly could’ve died in the womb. I am truly grateful that my son is here, alive, and has a fighting chance.

Bed rest at 24 Weeks - Monday, May 26, 2008

I started having contractions around 5 o’clock Monday morning and by 6 I had already had 5 so I called labor & delivery and they told me to come in to be checked. They put Peanut on a fetal monitor to check his heart rate and a monitor to check for contractions, which by that time had calmed down significantly. They checked my cervix, which was closed and long. But because my blood pressure was elevated they started an IV with magnesium sulfate and I was admitted and put on inpatient bed rest, indefinitely. And so began the constant monitoring: continuous fetal heart monitoring, blood pressure checks every 30 minutes, blood draws every 6 hours, 24 hour urine sample, twice a day ultrasounds (one to measure Peanut’s fetal movements and another to measure the blood flow from me to Peanut). I was also given steroids to help develop Peanut’s lungs. The doctors were concerned that I was developing toxemia, aka pre-eclampsia. But my high blood pressure was the only symptom as I had no blurred vision, no headaches, and no swelling.

The doctor’s discussed with me the possibility of preterm delivery and that if the baby or I were in distress they would have to deliver me via emergency c-section. On paper I had reached the point of viability (24 weeks) just the day before, but because Peanut’s growth had been restricted as a result of lack of blood flow to the umbilical cord, he was actually only measuring approximately 22 weeks by ultrasound. Based on this we were told by my high risk doctor at my last appointment with him just the week before that his chances of survival if born at this point were very slim. The day I was admitted and put on bed rest the doctor’s from neonatology spoke with us and gave us a 50/50 chance of viability. I always figured that I was not going to make it to full term but I was hoping to be in the hospital for at least the next month or so and deliver somewhere around 30 weeks. At a minimum I wanted to get two more weeks which would hopefully get Peanut’s growth to the 24 week mark.