Day 18: Part 2

I got to hold my sweet baby girl for the first time today. Aside from her birth, it was the best moment of my life. I cannot truly describe how wonderful it was (and since I'm very tired, I'm not going to attempt to try right now).

Aerin is doing well. She did not get a transfusion today. Her hematocrit was borderline, so the doctor wants to give her a chance to resolve the anemia by herself. She's back on the Vapotherm. I'm glad about that - I didn't think she was ready to be on a regular cannula. Her feedings are now up to 17 cc's!

She was moved from NICU A to NICU B. They just needed to even up the unit and they chose to move Aerin because she is the most stable baby in NICU A.

Day 18: Kangaroo Care

Aerin is anemic, so she's getting another blood transfusion today. That is normal for preemies (full-term babies get anemic, too, but they're able to resolve it themselves without medical intervention). She's back on the Vapotherm, on a very low pressure and oxygen percentage. I had a feeling that she wasn't quite ready for a regular cannula.

Today is a very big day for us - I might get to hold her! As long as she's stable when we get to the NICU, I'll be allowed to do 30 minutes of Kangaroo Care. I am beside myself with excitement.

Two Pounds!!!

We just called the hospital to check on Aerin before going to sleep. Neither Andrew nor I can sleep until we know how she's doing. Aerin's nurse gave us some big news: Aerin weighs 2 pounds!

There's more big news. Aerin was moved down from the Vapotherm to a regular nasal cannula. This means that she is getting very little help breathing - she's getting a lower percentage of oxygen with lower pressure.

This is really astonishing progress and we're very pleased. To tell the truth, though, I'm somewhat overwhelmed - she's taking such big steps so quickly.

Day 17

Aerin's feedings and weight are both increasing. She's up to 14 cc's today and she'll go up to 16 cc's tomorrow morning. As of this morning, she weighs 1 pound, 15.7 ounces. We're so close to 2 pounds.

If she continues to tolerate her feedings as well as she has been, she won't need a PIC or a PIV line. Those are used to deliver nutrients and she's getting all she needs from my milk. Those lines can be sources of infection, so we're very pleased. Since she's getting so much milk and she's so little, she gets it over the course of an hour. She gets a binky during her feedings (if she wants it) so that she can learn to associate sucking with filling her tummy. She's very good at sucking, which bodes well for the time when she'll be able to nurse. That won't be for another month or so. Nursing involves sucking, swallowing, and breathing at the same time, which is too much for a young preemie.

She's down to 2 liters on the Vapotherm, which is extremely low. She's back on the biliblanket, but since she gets to be in a snuggli, she doesn't mind.

Sweet 16: Part 2

Aerin's PIC line has come out. She has a PIV line instead. This is because the PIC line was likely the site of the infection. They will put another PIC line in in a few days.

She has grown from her birth length of 12.75 inches to 14 inches. It looks like she'll take after her father in height (he's 6'5''). Her weight is stable at 1 pound, 15 ounces.

Once again, Aerin was very stimulated. Having one line removed and another put in was a lot of excitement for her. Once again, I had to whisper because she gets worked up when she hears my voice.

Sweet 16

Aerin is doing quite well. She was downgraded to the Vapotherm from the CPAP. All of her stats are good and she's only requiring 25% oxygen. To give you an idea of how good that is - you and I breathe 21% oxygen (referred to as "room air").

She is up to 11 cc's with her feedings and is digesting everything like a champ. She's still on the biliblanket, but she may go off it when she finishes her antibiotics.

She was very stimulated yesterday, so much so that I wasn't allowed to talk to her or keep her isolette cover open. She got a bed bath and had 2 diaper and bed changes in 3 hours. That is much, much more stimulation than a preemie her age normally gets. It had to be done, but it took her a long time to go back to sleep. Over-stimulation (from light, sound, and too much touching) can be harmful to preemies and needs to be avoided. Usually, when Aerin hears my voice, she calms down. Yesterday, she heard me and got very excited (all her numbers went up, which is not dangerous, but not helpful, either). She had her eyes wide open for almost the entire time I was there. She loves to look around, even though she can only see shadows at this point. She finally closed her eyes and drifted off when I left. She's been sleeping today, which is great. She's got to get plenty of rest so that she can get to 2 pounds this week.

Day 15: 1 Pound, 15 Ounces

Aerin continues to do well. She's up to 9 cc's with her feedings and might be bumped up to 10 later today. Her weight is up to 1 pound, 15 ounces. She's just 1 ounce away from 2 pounds! Dr. Seguira is considering taking her off the CPAP and putting her back on the Vapotherm because she's doing so well. We'll find out after he does his next assessment of her.

It turns out that I'm allergic to the scrub soap in the NICU. Dr. Rose has given me premission to scrub with another kind of soap that they have in there and gave me some A&D ointment, which worked wonders.

Two Weeks Old!

Aerin is 2 weeks old today! It's hard to believe. She had her first excellent blood gas last night and her feedings are being bumped up to 7 cc's this afternoon and 9 cc's tonight. She'll be on the biliblanket for a couple more days, at least. Dr. Seguira (who was at her birth, btw) wants to keep it on while she's receiving her antibiotics. Since it's not uncomfortable for Aerin, I don't mind in the least. It's so much more benign that the bililight.

Our family also has another, smaller milestone today: I am allowed to drive again. It's great to have my independence back and it's easier for Andrew to get his work done without having to plan around my schedule. He has been fantastic throughout my entire difficult pregnancy, the bedrest, and Aerin's birth. We've been married for almost 5 years, and I've never loved him more.

Something is up with the index and we're not sure what. It's at the very bottom of the page for some reason and we have no idea how it got there or how to fix it. Please bear with us, as we probably won't get around to fixing it for a while (or at all). We're kind of hoping it'll fix itself.

Special thanks to my friend Sarah Townsend, who hand-knitted 2 gorgeous hats for Aerin. We can't wait until she's big enough to wear them.

Day 13: More Improvement

Aerin looks great. It turns out she has a staph infection and the doctors nipped it in the bud. She's on antibiotics and will be for the next week. They restarted her feedings and she has digested everything quite well.

The big news is that Aerin gained an ounce and a half. She currently weighs in at 1 pound, 14.5 ounces.

The CPAP is held onto her face with a hat. It's very comfortable for her, which is the important thing, but it looks utterly adorable.

Day 13: Improvement

Aerin had a much better night and hasn't had any more apnea episodes since yesterday afternoon. She was taken off the Vapotherm and put on a CPAP (continuous positive airway pressure) ventilator. She's still on the biliblanket until we get the results of her latest blood gas. She slept all night long and has slept peacefully through the morning.

Day 12: Bump in the Road

Today was our first bad day. Aerin had a number of apnea episodes, one of which was accompanied by bradycardia (slow heart rate). This is not at all unusual in preemies, but since she hasn't had more than a few of these episodes since she was born, the doctors are taking some precautions. Dr. Seguira described his treatments as "prophylactic medicine," which means that he is just taking precautions, not treating anything acute.

Her hematocrit was low, so they decided to do a blood transfusion. They are also stopping her feedings for now, in case she is reacting to reflux. They'll most likely resume them on Monday. They're starting her on antibiotics, on the off chance that she has an infection. We won't get her cultures back for 48 to 72 hours. Lastly, they're starting her on Lasix. She's still on the biliblanket, but we're hopeful she'll be able to come off of it tomorrow.

Aerin slept through all of this, which is certainly a blessing. Andrew and I are somewhat worried, but we're confident in the doctors and nurses and we know that this is just a bump in the road of Aerin's recovery.

Night 1 Remembered

Over Aerin's first night in the world, I slept in the hospital room with Kira. She was recovering from the surgery, of course. We were happy to see Aerin have such a great first day, but the warnings of the neonatologist just prior to her birth were still with me. He described Aerin's road as "long and rocky." While half-asleep, I recalled Sam's words to Frodo in The Two Towers:

I know. It’s all wrong. By rights we shouldn’t even be here. But we are. It’s like in the great stories, Mr. Frodo. The ones that really mattered. Full of darkness and danger they were. And sometimes you didn’t want to know the end. Because how could the end be happy? How could the world go back to the way it was when so much bad had happened? But in the end, it’s only a passing thing, this shadow. Even darkness must pass. A new day will come. And when the sun shines, it will shine out the clearer. Those were the stories that stayed with you. That meant something, even if you were too small to understand why. But I think, Mr. Frodo, I do understand. I know now. Folk in those stories had lots of chances of turning back, only they didn’t. Because they were holding on to something.

Day 11

Aerin's umbilical stump fell off yesterday. We're not sure if she's an innie or an outie because of the umbilical lines.

She's tolerating the biliblanket fairly well. She's a bit more squirmy than usual, but that is partly because she's not in a snuggli. She is incredibly strong - she pushes herself up with her arms and arches her back so that she almost rolls over. It's really astounding, even the nurses are amazed.

Her feedings were increased again. She's up to 5 cc's every 3 hours. She gained another 1/3 of an ounce, which brings her up to 1 pound, 13.66 ounces.

Day 10

Aerin had a good day. Her Vapotherm flow is being turned down from 3 to 2 and her feedings are being increased to 4 cc's every 3 hours from 3 cc's every 3 hours. She slept all day, as usual, and it would make you feel so peaceful to see her sleeping so sweetly.

No News Is Good News

Aerin had another good night, with no changes in her condition. That is the best news we can hope for. She is tolerating her increased feedings well and has gained 10 grams (1/3 of an ounce). I'm really looking forward to the day when she reaches 2 pounds.

The Bird

My daughter decided that she was tired of having her picture taken and made us aware of this in her own special way.

Day 9: Part 2

Aerin had another good day. Dr. Rose increased her feeding schedule to 3 cc's every 3 hours. Since I pump every 3 hours. we're on a similar schedule.

Her oxygen is being turned down from 40% to 30%, since she's doing so well on the Vapotherm (a high flow, humidified nasal cannula).

Aunt Jenn is going back to Eugene, Oregon tomorrow morning. It was so great to see her, especially since she's been in Europe for the past 10 months. Aerin's Aunt Jenn (aka Jennifer Bildersee) is one of my oldest friends from college. She is a seasoned world traveller and is working toward a master's in landscape architecture.

Day 9

Aerin has finally surpassed her birth weight and, as of very early this morning, is 1 pound and 13 ounces!

She also had a head ultrasound and there are no brain bleeds!

Day 8: Part 2

Aerin was sleeping peacefully and adorably on her tummy today. I got to change her diaper again and take her temperature. She's so soft and sweet. Things that mothers of full-term babies take for granted and are probably getting tired of are so special to the mothers of preemies.

She gained 1/2 of an ounce, which brings her up to 1 pound and 11 ounces. She's just 1 ounce from her birth weight. She pulled our her feeding tube again, despite the tape holding it in place. She got a new one in time for her fourth feeding.

Aerin got a new neighbor today - a huge baby boy (at least 5 pounds). Now she's sandwiched between 2 big boys.

You can donate to the March of Dimes in Aerin's name through their bandingtogether program. The money will be used in the March of Dimes' fight against premature birth.

Day 8

Aerin had a good night and a good morning. She' s had 3 feedings so far and tolerated them well. That is to say she digested the milk without any problems. She gets 3 cc's every 6 hours. That's less than 1 tablespoon. This is a big milestone and we're extremely happy.

Her oxygen was in the high 40s during the nights and in the 30s this morning. It was in the 50s yesterday, so that's an improvement.

She sucked on a binky today! This is another first. I have mixed feelings about binkies for full-term babies and I hate to see them being used by a toddler over the age of 2, but I'm thrilled that Aerin can get some comfort and that she can suck.

Her nurse today is Karen, who I don't think I've met.

One Week Old: Part 2

Aerin's PICC line went in, but it went in too far and had to be adjusted. A second x-ray confirmed that it was just where it should be and both of her umbilical lines came out.

Today was the first time we've seen her entire face since she was born. The bililight went off and she hasn't had to be re-intubated. She is such a gorgeous baby.

She had her first feeding and I got to feed her! It was only a matter of holding the syringe and letting gravity pull the milk down her feeding tube, but it was thrilling. Her next feeding is tomorrow at 3:00 a.m. and we'll find out then how she tolerated it. This is her next big milestone, so I'm pretty nervous.

I also got to change her diaper for the first time, which was fantastic. I actually changed two, and both of them by myself (with the nurse's supervision). However, the best part of today was that I got to hold her up when the nurse changed her blankets. It's the first time I held her and it was the second best moment of my life (the first being when she was born). I'm quickly getting over being scared to touch her and I can't get enough of it.

She gained another half an ounce, which brings her up to 1 pound, 11 ounces. She's just one pound away from her birth weight. Dr. Rose, one of the neonatologists I met for the first time today, said we can expect weight gains from 10-30 grams each day. She is very pleased with Aerin's progress. Chris, Aerin's day nurse, said she is doing "remarkably well." I am trying very hard not to get ahead of myself, but I am cautiously optimistic.

One Week Old!

Big day today!

Aerin's PICC line went in her right arm. We're waiting for x-rays to see if it went in properly. Her arterial line is coming out and she's going to be fed my breast milk for the first time. It'll only be a couple of drops. I'm anxious to see how she does with the feeding. She's done so well with her breathing and her heart that I'm afraid that the other shoe will drop with her eating.

Here bilirubin count is down, so the bililight is going off. I hope it's for the final time, but we'll have to wait and see.

I was worried that all the activity would stress her out, but the nurse said that she tolerated it really well. She won't be fed until 6:00 p.m.

My friend Jenn is coming from Eugene, Oregon to see her. I'm very excited.

Day 6

Aerin was extubated today. She still has a little tube in her nose to push oxygen in and remind her to breathe at all times, but it's a lot better for her than the breathing tube. It was the first time we got to see her mouth since she was born. It is an exceptionally beautiful mouth. She's still under the bililight, but sleeping peacefully.

She's up to 1 pound 10.5 ounces, which is much closer to her birth weight of 1 pound, 12 ounces.

I read the first couple of chapters of The Secret Garden to her and she seemed to like it.

They're going to attempt to put the PICC line in again tomorrow.

Aerin Amelia 9-16-05

Day 5

Aerin's bilirubin was up today, so they turned the bililight (blue fluorescent lights (phototherapy) that help the body break down and eliminate bilirubin.) back on. I was very upset when I found out, because when it was on her during her first 2 days, she was very uncomfortable and got very little sleep. When I called to check on her, the nurse assured me that she was sleeping peacefully, and I saw this for myself when I visited her.

She had her second blood transfusion early in the morning and it went well.

Today Aerin got her Hebrew name. In Jewish tradition, after a child is born, the father is given the honor of an aliyah (an opportunity to bless the reading of the Torah) in the synagogue at the next opportunity. At that time, a blessing is recited for the health of the mother and the child. If the child is a girl, she is named at that time. Aerin's Hebrew name is Sela Shoshana bat Keren Miriam. Hebrew naming for a girl follows the following pattern: [child's name] bat [mother's name]. "Bat" means "daughter of." Sela is for Andrew's mother's sister Stephanie and Shoshana is for his paternal grandmother, Rose. She was named at Congregation Or Atid by Rabbi Merrill Shapiro. Sela means "rock" with the connotation of strength and Shoshana means "rose."

Background

This pregnancy had been difficult from the start. I got pregnant after months of fertility treatments. Our magic cocktail was Follistim, Clomid, and hCg. Before I even got a positive test back, I developed Ovarian Hyperstimulation Syndrome. This is a relatively rare disorder that can be caused by fertility treatments. The symptoms include enlarged ovaries, abdominal pain, and fluid leaks into the abdomen and chest cavity. It can also result in bloating, pressure, nausea, shortness of breath, increased abdominal measurement causing clothes to feel tight, thirst, and weight gain. I had almost all of these. It can last for up to 10 weeks, but mine only lasted for approximately two weeks. The pelvic ultrasound revealed that I was carrying triplets. Sadly, we lost one at 3 weeks and one at 10 weeks. In mid-June I had an episode of bleeding that my doctors felt was from the other sacs separating. I also had 4 raging UTIs (Urinary Tract Infections) during my second trimester. Throughout all this, the baby did just fine.

The next couple of weeks were relatively uneventful. Dr. Christmas and my OB, Dr. Davis, decided to put in a pessary to keep my cervix closed. Since I presented relatively late with an incompetent cervix, Dr. Christmas did not feel comfortable putting in a cerclage (a stitch that pulls the cervix shut, like a drawstring purse). There was a high risk of rupturing my membrane and the baby was not yet viable. The pessary was a good alternative. It is a device like a small foam ring that causes the cervix to point posteriorly as in a normal pregnancy (an incompetent cervix points anteriorly within the axis of the vagina). Direct pressure on the cervix is eliminated and premature dilation and membrane rupture may be prevented.

I didn’t have any more contractions after that first day. At one point, they were going to let me go home, but an ultrasound revealed that my cervix was funneling again. That was a disappointing day – I was thoroughly sick of being in the hospital and Andrew really wanted me home. Things were pretty stable until early Tuesday, August 30, 2005, when I started bleeding around midnight. I was uneasy, but not too upset because everything had been fine during my June episode. After an initial gush, the bleeding dwindled to nothing. Dr. Davis wasn’t excessively concerned, but she did order an ultrasound for me. It revealed that I wasn’t dilated and my membrane hadn’t ruptured. My placenta looked great, there was no blood in my uterus, and there was no previa (a condition whereby the placenta implants in the lower part of the uterus and obstructs the cervical opening to the birth canal). The doctors felt that I was probably bleeding from my cervix or it was another complication from the other sacs. I went back to my room and tried to relax. Then, at almost the exact same time on Wednesday August 31, 2005, I started bleeding again. We went through the same things and they were still unable to tell what was causing the bleeding. I was put on total bedrest, which meant that I couldn’t get out of bed for any reason. That was the end of showering, which was very hard for me. I’m somewhat obsessive-compulsive and tremendously fastidious about being clean. At that point, I was 24.5 weeks along.

The Beginning

On Monday, August 15th, I had a routine ultrasound with my perinatologist, Dr. Christmas. I was 22 weeks and 1 day pregnant. Everything was fine with the baby, but the tech thought that my cervix looked like it might be open. Dr. Christmas agreed and they decided to do a pelvic ultrasound to take a look. It was instantly apparent that my cervix had funneled about 9/10 of the way. Dr. Christmas informed us that I was going to go to the hospital immediately and be put on a monitor to see if I was having contractions. The doctor’s office is in a wing of the hospital, so we just walked over to Labor and Delivery. Needless to say, we were terrified.

We arrived at Labor and Delivery and were shown to a very nice labor room. The nurses had me change into a super stylish hospital gown and I lay down on the ridiculously uncomfortable bed. It became much more uncomfortable when they put me in the Trendelenburg position (a position in which the head is approximately one foot below the knees). They propped pillows under me so that I was tilted to one side, stuck all kinds of tubes and needles on and in me, and hooked me up to the monitor. I was indeed having contractions, so Dr. Christmas prescribed a drug called Indocin (Indomethacin) - a nonsteroidal anti-inflammatory drug. This relaxed my uterus and stopped the contractions. I also tested positive for GBS (Group B Streptococcus – not the one that causes strep throat), which may have caused an infection in my uterus, which may have caused the contractions, which may have caused the cervical incompetence. The contractions stopped after about an hour.

The nurses told me that I probably wouldn’t be going home until the baby was born and that I might be flat on my back until then. I was too anxious about the baby to give that much thought. It was a pretty rough night. I spent most of it staring at the monitor to see if I was having contractions. I could barely move and my back hurt from being in Trendelenburg. My mental state wavered between terror and exhaustion. Little did we know that this was just the beginning.