Friday chores

Friday was reset day. With the help of Grandma Menk, we cleaned the house, picked up the Subaru from the mechanic, and made some important phone calls. As the day progressed, I kept watching the clock knowing that I was missing cares at 12 PM and 3 PM. These are always my favorite time since we get to interact with Naomi. She dislikes the temperature readings, waist measurements, and diaper changes, but she loves milk on a stick and feedings. By Friday she was working 6 mL of milk through that little body.

The doctors were still monitoring Naomi's heart murmur, but it was within what they considered normal. Her belly button though, was not looking normal. Over the past couple of days it has been red and slightly infected. After the doctor stopped by, he asked that Naomi be kept on her back for a little while to give her belly button some air. It wasn't serious enough to warrant antibiotics, but it's still tough for a dad to see. This is a very common site for infection due to the early venous line and lack of a mature immune system.

As part of Naomi's belly button recuperation plan, she was switched to wee-pee's. To save my daughter from embarrassing photos, the bison was willing to model a wee-pee. They are a low cut bikini diaper.

In case you forgot, this was the previous diaper.

Even the bison looks more comfortable.

The afternoon ended with dad's turn for kangaroo time. I was so excited I asked the nurse if we could start a little early. She did well and slept the whole time. She had a couple of alarms due to a low saturation, but that was because dad wasn't holding Naomi's head straight enough. After a little help from the nurse, we took a family nap. I kept one eye open though, being the more protective parent.

We told ourselves that we would head home after 6 PM cares, so after a diaper change, a feeding, and a temperature check, mom comforted her daughter before heading home to get some food and rest. The temperature check was important because it indicated how well she was doing during kangaroo time. Between her and dad, we need to keep her body temperature between 36.5 and 37.5 degrees Celsius.

Twenty-five hour days

Time kind of evaporated on Ana and I over the course of the week. By Thursday, lunch had slipped to 3 PM and dinner was at 9 PM. We decided at the end of the night that it was time to press the reset button and with the help of Grandma Menk, cleaned the house Friday morning and took care of all of the calls that needed to be made.

On Thursday, Naomi looked happy and comfortable. She did well through the night transitioning from CPAP to nasal cannula, so she was put on the cannula full time. Her saturation was good and she hasn't stopped breathing once! The nurses had warned us that little ones like Naomi will usually stop breathing once in a while as they transition through the various breathing machines. I like to think Naomi's still stomping along to dad's banjo in her isolette and you have to breath to dance.

It was mom's turn for kangaroo time Thursday! As little Naomi rested against her mom's chest she peered up to see mom again. I've read that Naomi can see dark and light objects six to eight inches away, so I'm guessing when mom holds her, she sees a beautiful, loving face. When dad holds her, she sees beard. Naomi fell asleep as mom rocked and hummed. It was another great night after an exhausting week.

Day 7

By Wednesday we had figured out the NICU, settled into a routine, and started to catch up on some sleep. I took care of bills in the morning and we packed up to see Naomi. She was doing well and was the last stop for the doctor on the previous day. We learned that this is a good thing since the doctor prioritizes who she sees based on their condition. Naomi's lungs were starting to look better. Earlier we were told that she had hyaline membrane disease (HMD).

HMD is common in preemies and the result of under developed lungs. Since Ana was diagnosed as having HELLP syndrome at 6:30 AM and Naomi was delivered at 2:02 PM, there wasn't enough time for steroids to help Naomi's lungs develop. She received two doses of surfactant within the first 48 hours, which, if I remember correctly, helps Naomi get a jump start on creating her own surfactant. Basically, the surfactant reduces surface tension which helps Naomi's air sacs in her lungs stay open.

We were also told that Naomi has a heart murmur and the most likely cause is patent ductus arteriosus (PDA). This is also common in preemies of Naomi's gestational age. In a normal birth, hormones released later in pregnancy tell the PDA it is time to close. Since Naomi was whisked away rear end first, I don't think the hormones showed up in time. They are monitoring her closely and so far they think everything is going well and they are waiting to see if the hole will close on it's own before ordering an echo.

Grandma and Grandpa Menk also stopped by to say hello to Naomi. Grandma Menk has rapidly surpassed Grandpa Menk when it comes to figuring out social media. She now has her own twitter account to get even more updates on Naomi.

Around 6 PM that evening, Naomi decided a CPAP wasn't for her. She'd grab and pull and pretty soon the CPAP alarm would sound. She did this a couple of times before the doctors orders finally arrived. Naomi was being switched to a nasal cannula! When we arrived in the room after dinner with the g-parents, Naomi was sleeping peacefully enjoying her new breathing machine.

Dad also taught her how to make bubbles after a whopping 3 mL of milk.

And every once in awhile, she gives us a smile when she hears our voice.

Favorite Things

Ok.  First blog post from the Mom.  I'll try not to mess it up since the Dad has been doing such a great job. 

Wow, what a week.  I can say that this past week will go down in the books as the longest and, let's say, most dynamic I've ever experienced.  While there have certainly been difficult moments, I'd like to highlight some of my favorite things about the week (yes, I will be using bullet points).

• "It's a girl": In the midst of all the stress and uncertainty surrounding the birth, it was a moment I will never forget.  We got to hear a couple sweet little cries before she went into the next room, and someone in the room said "it's a girl".  I smiled and repeated it to Jeremiah, whose eyes I was locked on the whole time.  What a wonderful surprise.
• Getting acquainted: Needless to say, the hardest thing has been the separation (not taking her home, having her in the isolette).  However, those moments of getting to know her have been all the more special.  From my first time visiting her room when I was still in a hospital bed, to the incredible experience of holding her for the first time, to finally being able to see her whole face when she switched off CPAP, I've fallen more deeply in love with her every day.
• Progress: I realize that not all weeks will be this packed with milestones, and that sometimes steps forward are followed by steps back or sideways.  But I have been absolutely astounded by how much progress has been made in one week.  As much credit goes to the staff at Children's as it does to our feisty little girl.  From the ventilator to CPAP mask to nasal cannulae, from IV nutrition only to 6mL of milk every 3 hours, and coming off of the phototherapy lights...I'm amazed.  I have a feeling this little girl is going to continue to blow me away with her accomplishments for years to come.
• Power of prayer: It is amazing to think about how many people have said they are praying for her.  The love and support reach farther than I could have imagined.  And I believe that all of those people really are praying for her, and I believe that it really is working.  We've also had a few visits from Pastor Jen, who pretty much has PhD in prayer, and I have been so touched by those moments of praying directly at her bedside, laying hands on her.  I'm learning how powerful it really is.
• Being parents: Even though she spends her days in an isolette, we still get to change diapers, take her temperature, give here milk "on a stick", etc.  And we get to find out who the extra protective parents are.  Surprisingly, Jeremiah has emerged as the ultimate germaphobe (I thought it would have been me) and he insists that anyone in the room speaks in a whisper whenever "his baby girl is trying to sleep".

That's all for now; I look forward to more highlights in the weeks to come.  Thanks so much to everyone for their support and encouragement.     

Working on a routine

Monday night when we got home, I scrambled to set up our house for Ana so she could be comfortable. After stealing furniture from other rooms, grunting and pushing the armoire to the side to get to an outlet, and running an extension cord, we closed our eyes for a couple of hours.

We awoke around 3 AM to the cell phone alarm and Ana began the routine of pumping like she was feeding Naomi at home. We've kind of built up a routine where Ana takes care of the first part and I clean, bottle, and label when she is finished. Our only problem so far is that cell phone alarms have snooze buttons whereas Naomi does not.

We arose for the day around 9 AM after some much needed rest. Our morning routine consists of completing one task for the day, packing, and heading to Naomi's around lunch. (I also want to say thank you for the many offers to help. I haven't had a chance yet to even figure out what needs to be done and I haven't taken the time yet to respond to the many emails.)

When we got to Naomi's room, she was sleeping in her isolette (Ana informed me that she is not in an incubator, her medical terminology is far superior to mine).

We've started to notice all of her different facial expressions as we get to spend more time with her. One of them reminds me of her Uncle when he was little. For now I'll keep that Unlce's name secret. She sticks out her little lower lip and occasionally throws a little tiny mini tantrum. The doctor's tell me that's good, she's showing she's a fighter.

Naomi was still under her Drager 4000 catching a tan. Her bilirubin levels were lower so they removed the light blanket that was underneath her. It was a nice change and she looked much more comfortable.

The generosity at Children's has been amazing. A nice lady stopped by to give us a taggie for Naomi when she goes home. They were donated by a woman who also had a child in the NICU at one time. From the nurses at Naomi's bedside to the volunteers at the Ronald McDonald house, the halls are filled with compassionate and caring people.

Next, was the moment I had been waiting for all day. They call it kangaroo time for obvious reasons, but Ana decided to change it to bear cub time. I got to hold Naomi for the very first time! It was the sixth day since her birth and it had been really hard on me to not be able to hold her. She snuggled on my chest as I hummed a hackensaw boys tune. It was a moment I'll never forget.

After bear cub time, we helped the nurse with Naomi's cares. Ana took a temperature and changed a diaper.

We're getting faster at slipping the tiny diaper through all of the wires. After finishing all of her cares, we comfort her for a little while before covering her isolette. The doctor said she could have a break from the Drager 4000 since her bilirubin levels were much lower.

We gave Naomi's shades to the bison since she had out grown them.