Papa makes us laugh
Feed Me!
Thursday, January 7, 2010
Friday, January 1, 2010
It's been quite a week for Finley and the Cook Family. After several days of losing weight (which all babies do, not just preemies), Finley is on the upswing and has gained weight steadily over the past three days. Her weight tonight was 3 pounds 8 ounces, so she has passed her birth weight of 3 pound 7 ounces. A gain of half an ounce to an ounce per day is considered good progress. Finley has gained 7 ounces in the past three days! She's an over achiever already!
Our days consist of driving to the hospital to feed Finley her 11:30 am feeding and then again for her 5:30 pm feeding. The unit closes several times a day to visitors for an hour at a time while nurses change shifts. We also try to limit our time with her so that she has as much time as possible to rest and conserve energy. She tends to wake up when we hold her, so we try to only hold her right before and right after a feeding. This is incredibly hard on me. I hate that she lays in her isolette for most of the day and doesn't really get any stimulation. I have to constantly remind myself that rest is what she needs and it is what's best for her, but I could sit in the rocker and hold her all day long.
The nurses and doctors seem very pleased with her progress. She needs to be at least 4 pounds 4 ounces to go home. She also has a list of other milestones she has to meet before they'll discharge her. We're thinking she'll probably be in the hospital at least 2 more weeks. Hopefully they will start weaning her tube feedings and let her breastfeed or take bottles more frequently. I'm dying to see her make more progress, but I know that we can't ask too much of her.
She seems like such a different baby from just a few days ago. She has more energy and is much more alert. She opens her eyes, kicks her legs, and cries when she's upset. Most of the time she's awake and sucking her hand and ready to eat 30 minutes or so before her feeding is due. This makes her mamma happy!
Here are a few more pictures.
Our days consist of driving to the hospital to feed Finley her 11:30 am feeding and then again for her 5:30 pm feeding. The unit closes several times a day to visitors for an hour at a time while nurses change shifts. We also try to limit our time with her so that she has as much time as possible to rest and conserve energy. She tends to wake up when we hold her, so we try to only hold her right before and right after a feeding. This is incredibly hard on me. I hate that she lays in her isolette for most of the day and doesn't really get any stimulation. I have to constantly remind myself that rest is what she needs and it is what's best for her, but I could sit in the rocker and hold her all day long.
The nurses and doctors seem very pleased with her progress. She needs to be at least 4 pounds 4 ounces to go home. She also has a list of other milestones she has to meet before they'll discharge her. We're thinking she'll probably be in the hospital at least 2 more weeks. Hopefully they will start weaning her tube feedings and let her breastfeed or take bottles more frequently. I'm dying to see her make more progress, but I know that we can't ask too much of her.
She seems like such a different baby from just a few days ago. She has more energy and is much more alert. She opens her eyes, kicks her legs, and cries when she's upset. Most of the time she's awake and sucking her hand and ready to eat 30 minutes or so before her feeding is due. This makes her mamma happy!
Here are a few more pictures.
Tuesday, December 29, 2009
Saturday, December 26, 2009
Finley is Here!
What a week! Finley decided that her stay inside mamma's belly was over and she was delivered by c-section at 4:12 pm on December 24th. She was 3 pounds 7 ounces and 15 3/4 inches long. What a wonderful Christmas present!
On Wednesday (the 23rd) Dr. Hume did an ultrasound and there was no change in my amniotic fluid levels but Finley still looked reassuring. Because I had an appointment the next day he said he would let Dr. Brickler decide about delivery. Sean and I were so disappointed that we would have to wait another day. The entire week building up to delivery had been very stressful on us because we were so worried that Finley would take a turn for the worse and we wouldn't know about it until it was too late. Dr. Brickler walked into our room, sat on the counter, and immediately started to explain that he felt like the pregnancy had reached the point that it was no longer safe and we needed to deliver that day. Even though we knew Finley would be premature we were relieved to know she would be managed outside the womb by a team of highly skilled doctors and nurses. We left the office and went straight to labor and delivery.
The c-section went off without a hitch and Finley tolerated everything well. As soon as her head was out she took a breath and let out a little cry. It was the best noise I've ever heard. She was doing well enough at delivery that the nurse and the Respiratory Therapist wrapped her up and let me see her before they took her away. Sean got to cut the cord and go with her to the NICU while they measured her and got her settled. After a few minutes she started showing signs of some minor respiratory distress and she was put on high flow oxygen through a cannula in her nose. It's not uncommon for c-section babies to have some distress because their lungs usually have a little bit of fluid in them. She responded well and was weaned down to room air by the next morning. Her breathing has been completely stable ever since. Her main issue at this point is her small size. Because she's premature, it won't be as simple as feeding her and letting her gain weight. She has to be able to eat quickly without expending too much energy. There's a good chance this whole process will be two steps forward, one step back. Once she's able to take larger amounts of milk consistently they will let me try to breast feed. Right now I am pumping breast milk for her. I am so thankful that I have not had any problems with pumping because I feel like it is something I can tangibly do for her. The nurses have been very good about letting me change her diapers, take her temperature, etc when I'm visiting. It feels good to do mommy things.
I am very confident in the NICU nurses and doctors. They are providing excellent care for Finley and they are cautiously optimistic that her stay will not be as long as originally expected. There are still some lab tests that are pending, but we've been told the tests are routine and that they will most likely be negative. My placenta was sent to a pathologist to see if we can determine why Finley developed IUGR. Dr. Brickler said I had a skinny cord, a skinny placenta and a skinny baby. Maybe she'll just be a petite little lady!
Sean and I have definitely felt your prayers and support. A very scary thing has turned into an exciting and happy time in our lives. We can't wait to get her home and be a family.
On Wednesday (the 23rd) Dr. Hume did an ultrasound and there was no change in my amniotic fluid levels but Finley still looked reassuring. Because I had an appointment the next day he said he would let Dr. Brickler decide about delivery. Sean and I were so disappointed that we would have to wait another day. The entire week building up to delivery had been very stressful on us because we were so worried that Finley would take a turn for the worse and we wouldn't know about it until it was too late. Dr. Brickler walked into our room, sat on the counter, and immediately started to explain that he felt like the pregnancy had reached the point that it was no longer safe and we needed to deliver that day. Even though we knew Finley would be premature we were relieved to know she would be managed outside the womb by a team of highly skilled doctors and nurses. We left the office and went straight to labor and delivery.
The c-section went off without a hitch and Finley tolerated everything well. As soon as her head was out she took a breath and let out a little cry. It was the best noise I've ever heard. She was doing well enough at delivery that the nurse and the Respiratory Therapist wrapped her up and let me see her before they took her away. Sean got to cut the cord and go with her to the NICU while they measured her and got her settled. After a few minutes she started showing signs of some minor respiratory distress and she was put on high flow oxygen through a cannula in her nose. It's not uncommon for c-section babies to have some distress because their lungs usually have a little bit of fluid in them. She responded well and was weaned down to room air by the next morning. Her breathing has been completely stable ever since. Her main issue at this point is her small size. Because she's premature, it won't be as simple as feeding her and letting her gain weight. She has to be able to eat quickly without expending too much energy. There's a good chance this whole process will be two steps forward, one step back. Once she's able to take larger amounts of milk consistently they will let me try to breast feed. Right now I am pumping breast milk for her. I am so thankful that I have not had any problems with pumping because I feel like it is something I can tangibly do for her. The nurses have been very good about letting me change her diapers, take her temperature, etc when I'm visiting. It feels good to do mommy things.
I am very confident in the NICU nurses and doctors. They are providing excellent care for Finley and they are cautiously optimistic that her stay will not be as long as originally expected. There are still some lab tests that are pending, but we've been told the tests are routine and that they will most likely be negative. My placenta was sent to a pathologist to see if we can determine why Finley developed IUGR. Dr. Brickler said I had a skinny cord, a skinny placenta and a skinny baby. Maybe she'll just be a petite little lady!
Sean and I have definitely felt your prayers and support. A very scary thing has turned into an exciting and happy time in our lives. We can't wait to get her home and be a family.
Thursday, December 24, 2009
Friday, December 18, 2009
Another Update
I reread my post from yesterday and realized it was kind of mangled. It was a crazy day, so I guess that's to be expected. Here's a summary of everything that's going on.
1. Finley has IUGR (Intrauterine Growth Restriction), which is a general diagnosis for small babies. This diagnosis doesn't explain why she's small, but rather just describes a set of symptoms that she meets.
2. Because her growth has been normal up until now, the most likely cause of her IUGR is a problem with the placenta. It could be small clots in the placenta or it could be that the placenta is too small to support a third trimester fetus (it could support her when she was smaller and had smaller nutritional needs, but now she requires more). We won't know what's wrong with the placenta until I deliver and the docs can take a look at it. Also, there is still the small risk that there is something wrong with Finley that is making her small, but that risk is very small and the doctors haven't really brought it up as an option.
3. Other than her small size, everything else looks completely normal, which is reassuring (and I think why they decided not to induce me yesterday). I have had two non-stress tests and both of those have been fine. Her heart rate and activity level are normal, which generally means she is not under any stress. I will have these tests twice a week from now on. Her doppler blood flow studies are also normal. She is getting limited blood flow and nutrients, but her body is making sure that the important parts (her organs) are getting the majority of the nutrients and oxygen. I will have doppler blood flow studies once a week from now on. If these studies show a change in blood flow or if she shows any signs of fetal distress they will induce my labor or perform a c-section immediately. She has always been an active baby, and she continues to be active, so that is reassuring. The doctor wants me to do fetal kick counts a couple of times a day and go to Triage if I notice a decrease in activity. So far she's letting me know she's ok by kicking me all the time.
4. I received two doses of a steroid called Betamethasone. This steroid will mature her lungs quickly so that if she is born early her adjustment to breathing outside the womb will be much easier.
5. At this point we are just waiting to see what happens. I don't have any activity or diet restrictions, so I will be working this weekend just like normal. Obviously I'll try my best to take it easy and sit as often as I can. And if I have any problems Triage and Labor and Delivery are a short walk across the hospital.
So hopefully that update was easier to understand than yesterday. I'm still a little bit in shock and I'm trying very hard to not think of worst case scenario. Being a nurse is sometimes a burden because I know just enough to worry myself sick. Our friends and family have been extremely supportive and Sean and I definitely feel loved. We've had to turn down offers to help left and right. It's been a blessing to see how God works through difficult circumstances and I know that He is in control of all of this. I just need to relax and let Him work.
We'll try our best to keep you guys updated and let you know if anything changes.
1. Finley has IUGR (Intrauterine Growth Restriction), which is a general diagnosis for small babies. This diagnosis doesn't explain why she's small, but rather just describes a set of symptoms that she meets.
2. Because her growth has been normal up until now, the most likely cause of her IUGR is a problem with the placenta. It could be small clots in the placenta or it could be that the placenta is too small to support a third trimester fetus (it could support her when she was smaller and had smaller nutritional needs, but now she requires more). We won't know what's wrong with the placenta until I deliver and the docs can take a look at it. Also, there is still the small risk that there is something wrong with Finley that is making her small, but that risk is very small and the doctors haven't really brought it up as an option.
3. Other than her small size, everything else looks completely normal, which is reassuring (and I think why they decided not to induce me yesterday). I have had two non-stress tests and both of those have been fine. Her heart rate and activity level are normal, which generally means she is not under any stress. I will have these tests twice a week from now on. Her doppler blood flow studies are also normal. She is getting limited blood flow and nutrients, but her body is making sure that the important parts (her organs) are getting the majority of the nutrients and oxygen. I will have doppler blood flow studies once a week from now on. If these studies show a change in blood flow or if she shows any signs of fetal distress they will induce my labor or perform a c-section immediately. She has always been an active baby, and she continues to be active, so that is reassuring. The doctor wants me to do fetal kick counts a couple of times a day and go to Triage if I notice a decrease in activity. So far she's letting me know she's ok by kicking me all the time.
4. I received two doses of a steroid called Betamethasone. This steroid will mature her lungs quickly so that if she is born early her adjustment to breathing outside the womb will be much easier.
5. At this point we are just waiting to see what happens. I don't have any activity or diet restrictions, so I will be working this weekend just like normal. Obviously I'll try my best to take it easy and sit as often as I can. And if I have any problems Triage and Labor and Delivery are a short walk across the hospital.
So hopefully that update was easier to understand than yesterday. I'm still a little bit in shock and I'm trying very hard to not think of worst case scenario. Being a nurse is sometimes a burden because I know just enough to worry myself sick. Our friends and family have been extremely supportive and Sean and I definitely feel loved. We've had to turn down offers to help left and right. It's been a blessing to see how God works through difficult circumstances and I know that He is in control of all of this. I just need to relax and let Him work.
We'll try our best to keep you guys updated and let you know if anything changes.
Thursday, December 17, 2009
An Eventful Day at the Hospital
It's been a heck of a day folks. This morning I went for a routine prenatal visit. They took my vital signs, weighed me, I left a urine sample...all the usual stuff. Because Finley measured small at the last visit Dr Brickler ordered another fetal weight measurement. I was hoping all the hunger I've been having these past couple of weeks meant that Finley was going through a growth spurt and was going to be bigger. Unfortunately she has not gained any weight since my last visit, which now puts her at only 7% on the growth chart (last visit she was 37%).The official name for this is IntraUterine Growth Retardation (or Restriction). Her current weight is right around 3 pounds. After the ultrasound I met with Dr. Brickler. He took one look at her measurements, said "Oh Man" and then looked at me and said he was sending me to a Maternal-Fetal Specialist immediately and then I would need to go to triage to receive steroids and have a Non-Stress Test. As soon as he said steroids I started crying. You give women steroids to mature the babies lungs when birth is imminent, and all I could think about was only being 33 weeks Finley having to stay in the NICU for weeks and all the potential long term effects of being a pre-term baby. Dr. Brickler told me it was very possible that they would induce my labor that afternoon. Obviously all of this was a huge shock and very scary.
I left Dr. Brickler's office and immediately went to see the specialist, Dr. Hume. They repeated the ultrasound and confirmed her size (they actually measured her as smaller than the ultrasound tech at Dr. Brickler's office). Because they specialize in high-risk pregnancies they were also able to do studies to measure the blood flow in her umbilical cord and blood flow to the heart and brain. For Finley, all of these studies were normal. She is basically shunting all of her blood flow, and the nutrients in it, to her heart and brain (which is a good thing, her body is protecting the vital organs first). Because of this the doctor decided not to deliver today. As of right now they are saying that there is something wrong with the placenta that is preventing her from getting adequate blood flow for growth. There is a very good chance that we will never know why this happened or if it will happen again with future pregnancies. From this point on I will see Dr. Hume once a week, Dr. Brickler once a week, and I will have non stress tests (they place the baby on the monitor and watch for contractions and monitor her heart rate and movement) twice a week. As soon as it looks like she is not doing well or her blood flow is in any way compromised they will deliver immediately. And, more than likely it will be a c-section to prevent placing undue stress on the baby during delivery. Dr. Hume said today that the target is 34 weeks, and that after 34 weeks the risk to the baby is higher in the womb than it is out of the womb. That's next week! So, the Cooks may be having a Christmas baby. Sean, the eternal optimist, has already planned to celebrate her birthday in July if she is born on Christmas. That way her birthday isn't lost in the craziness of the holidays.
I'm still trying to let all of this information sink in. My mind keeps racing with things we need to do to get ready. Should we put the car seat in the car? Do I need to go buy diapers? If she's born next week how long will she stay in the NICU? Where do I buy clothes to fit preemies? I take care of lots of sick children at work, many of whom were born early and have lingering health effects from not being term. I am more concerned about her being early than I am about her small size. Once she's born and is able to eat she will gain weight quickly and hopefully all will be well. I don't have any experience with the steroid they gave me today, but the intended effect will be to mature her lungs quickly so that she will do okay outside of the womb. I'm assuming the two doses they are giving me are sufficient enough. I also have a lot of confidence in the NICU staff and the neonatologists at TMH.
So it's been quite a day. I am ok and then I'm not and then I'm ok again. Back and forth all day. I feel helpless, like I should be doing something to make sure she's ok. My next ultrasound is on Wednesday, but I want one before then! Being small is one thing, but not having adequate blood flow to her brain or heart is a whole different set of problems. I just want our baby girl to be healthy, so it's going to be a long week waiting for the next ultrasound. Maybe work this weekend will be a good distraction.
Sean and I opened presents today, mainly as something fun to do, but also in case we are having a baby next week. We might be having Christmas at TMH. We both got each other watches. I swear sometimes we are the same person.
That's all I can think of at this point. It's been a long, scary day. I'll do my best to keep everyone updated and let you know if anything changes.
I left Dr. Brickler's office and immediately went to see the specialist, Dr. Hume. They repeated the ultrasound and confirmed her size (they actually measured her as smaller than the ultrasound tech at Dr. Brickler's office). Because they specialize in high-risk pregnancies they were also able to do studies to measure the blood flow in her umbilical cord and blood flow to the heart and brain. For Finley, all of these studies were normal. She is basically shunting all of her blood flow, and the nutrients in it, to her heart and brain (which is a good thing, her body is protecting the vital organs first). Because of this the doctor decided not to deliver today. As of right now they are saying that there is something wrong with the placenta that is preventing her from getting adequate blood flow for growth. There is a very good chance that we will never know why this happened or if it will happen again with future pregnancies. From this point on I will see Dr. Hume once a week, Dr. Brickler once a week, and I will have non stress tests (they place the baby on the monitor and watch for contractions and monitor her heart rate and movement) twice a week. As soon as it looks like she is not doing well or her blood flow is in any way compromised they will deliver immediately. And, more than likely it will be a c-section to prevent placing undue stress on the baby during delivery. Dr. Hume said today that the target is 34 weeks, and that after 34 weeks the risk to the baby is higher in the womb than it is out of the womb. That's next week! So, the Cooks may be having a Christmas baby. Sean, the eternal optimist, has already planned to celebrate her birthday in July if she is born on Christmas. That way her birthday isn't lost in the craziness of the holidays.
I'm still trying to let all of this information sink in. My mind keeps racing with things we need to do to get ready. Should we put the car seat in the car? Do I need to go buy diapers? If she's born next week how long will she stay in the NICU? Where do I buy clothes to fit preemies? I take care of lots of sick children at work, many of whom were born early and have lingering health effects from not being term. I am more concerned about her being early than I am about her small size. Once she's born and is able to eat she will gain weight quickly and hopefully all will be well. I don't have any experience with the steroid they gave me today, but the intended effect will be to mature her lungs quickly so that she will do okay outside of the womb. I'm assuming the two doses they are giving me are sufficient enough. I also have a lot of confidence in the NICU staff and the neonatologists at TMH.
So it's been quite a day. I am ok and then I'm not and then I'm ok again. Back and forth all day. I feel helpless, like I should be doing something to make sure she's ok. My next ultrasound is on Wednesday, but I want one before then! Being small is one thing, but not having adequate blood flow to her brain or heart is a whole different set of problems. I just want our baby girl to be healthy, so it's going to be a long week waiting for the next ultrasound. Maybe work this weekend will be a good distraction.
Sean and I opened presents today, mainly as something fun to do, but also in case we are having a baby next week. We might be having Christmas at TMH. We both got each other watches. I swear sometimes we are the same person.
That's all I can think of at this point. It's been a long, scary day. I'll do my best to keep everyone updated and let you know if anything changes.
Subscribe to:
Posts (Atom)
