One Last Week in the ICC

Sorry for the delay. Time seems to have rearranged itself on us. The minute hand and the hour hand have switched places as the minutes seem slow and the hours seem fast.

This story starts the week before discharge day (10-26-2011)!

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Our life of routines has been replaced by Naomi time. What used to be three hours of temp taking-diaper changing-syringe feeding-tucking in for sleep has been replaced with, when I'm hungry or stinky or cold, I'll let you know.

It all started earlier this week. Mom has been working on nursing and after a few hurdles things were figured out. I tend to compare it to synchronized swimming. There's some arm waving, some breath holding, and when it all works out, it's quite the spectacle.

We were still on nurse time, so Ana would arrive around 9 AM and spend most of the day with Naomi. Cares were every three hours starting at 9 AM. However, after weeks of tummy measurements, cold stethoscopes, and bright lights at night, Naomi was letting us know that she wanted her own schedule. So sometimes Naomi would eat well and sometimes she wouldn't. Like her mom, she tends to be sleepy early in the morning and not interested in waking up to eat. I think Ana and I would both be okay with that schedule, but we also need Naomi to keep gaining weight if we want her to come home soon.

In response, after a few days of some successful nursing and some observation by the nurse practitioner, Ana was given the green light to try a twelve hour shift of feedings. They would allow Ana to feed Naomi when she showed signs of being hungry. So we shifted to Naomi time. On average, it's the same as nursing time, but her variation is much greater. Sometimes she is hungry one hour after eating and sometimes she isn't hungry for four hours. We do our best to keep her full.

Ana's first twelve hour shift was a day of two Naomi's. The first six hours was a fight to keep her awake and interested. By the time Ana called at 3 PM, she was tired and frustrated. Mom stuck with it though and the final six hours were great. Naomi was awake and eating. She was even giving us a burp or two.

Ana continued with the twelve hour shifts for a couple of days before the discussion moved on to 24-hour shifts. In addition, Naomi would get 100-mL of bottle milk with Elecare and vitamins. I quickly asked the nurse if I could give Naomi her first bottle. The nurse hesitated slightly, but agreed that I could give Naomi her first bottle. Early birds tend to choke on their first bottle feeding and you need to be very focused while feeding her. You need to listen and watch to make sure they suck, swallow, and breath. You also need to hold them so they face you and you need to hold the bottle like a dart. I was a little nervous after all of the warnings, but the nurse reassured me that Naomi was mature for her age (at least when it concerned eating).

So I showed up in my finest clothes the next evening, knowing they might be urped on. The nurse watching Naomi got the bottle ready for me, I changed Naomi's diaper and took her temperature, and after a gentle swoop of the arm, we were facing each other eye-to-eye. She gave me a look that I interpreted as: those look like nice clothes to urp on, and I tried to convince her that the milk dripping all over her face was all part of the plan.

Naomi eventually opened her mouth and the bottle feeding began. The nipple we started with was a little fast and Naomi's mouth filled quickly. The nurse told me to pull back and let Naomi breath. After two attempts, we decided to switch nipples. The new nipple reminded me of the star ship enterprise, and after a quick flight, Naomi was drinking at warp speed. She was performing great and after a couple of burp breaks, she ate a total of 53 mL. I was pretty proud of my little daughter. She not only fed well, she also burped like Booger. After worrying about all of the air in her belly a couple of weeks ago, she was doing great getting rid of it. It was a relief since early birds are not the burping type.

We decided to head home shortly after that. After a couple of 24-hour shifts by mom, the nurses encouraged her to go home and get some rest. We obliged and as soon as we got home we were pretty much ready to sleep.

After a brief rest we got ready for the weekend. The plan was to stay at Ronnie's place and to pull a 48-hour shift. We still had several things to learn before going home and this seemed the best way to accomplish them in a logical order.

So Friday evening, I showed up at Children's. Ana had been there most of the day and had reserved a room for us at Ronnie's. Feedings were going well and after dinner, we checked into our room. The rooms at Ronnie's are pretty amazing. It feels like you are staying in a luxury hotel rather than a hospital. It really has been a great space for us. We quickly settled in for sleep and Ana set her phone to alarm every three hours. She would get up and walk over to ICC in the middle of the night to nurse until about 6 AM. I took over at the 6 AM shift after grabbing a cup of coffee on the way.

As the weekend continued we began to hear the D-word more often. By Saturday evening a plan had been established. Naomi would get discharged early in the week, most likely Wednesday. Needless to say, we were pretty excited.By Sunday morning however, we were starting to get a little worried. Naomi had been off of caffeine for six days to prepare to come home, however, she was starting to have poor oxygen saturation's again as a result of inconsistent breathing. I was a little worried that this would change our discharge plan. After some discussions with the nurse practitioner, we would be giving Naomi caffeine at home. Naomi would have to go home on a monitor anyways, she'd just have to be on it three weeks longer than previously thought.

At 10 AM I was learning how to give Naomi her caffeine. She takes it straight milk right before her feedings. It consists of one part liquid caffeine and one part milk for a total of approximately 5 mL. After giving her a dose, I could cross that off of the "to learn" list.

The remaining three days were filled with tests and shots. Naomi needed to pass an apnea test while sitting in her car seat before heading home. A lot of early birds tend to have apnea spells in car seats, but Naomi seemed to take it all in stride (at least with the caffeine in her system). Next, Naomi received her shots before leaving the hospital. She was officially two months old, so she could receive her vaccines. Finally, she had one last eye exam before discharge.

Everything looked good, so Tuesday night, we reserved a room at Ronnie's and waited for Discharge Day. We awoke and Ana headed off to feed Naomi while I packed away our things. The hours ticked away fast and soon it was lunch. We quickly ate one last time at Ronnie's and headed back to Naomi's room. Everything was ready to go.

We quickly got Naomi situated in her car seat in a slow, where does this towel go, drawn out fashion. The nurse took some photos for us with Naomi in her car seat and said farewell and that was it. We headed for the door dodging germs along the way. Through all this, three trips home stick in my head: My first trip home to take a shower and get some things when Ana was still in the hospital, my second trip home with Ana after she was discharged, and this trip, our first trip together as a family.