Movin' On Up

Lily  10/29/08

Being an astute follower of the real estate market, Lily decided today was a good time to buy, so she convinced her doctor she was ready to get out of her condo (her isolette) and get herself in to a new crib (for our readers of a more advanced age, a "crib" is not only somewhere a baby sleeps, but slang for ones house or home).  One theory is that once she is out of her isolette, she may burn so much energy keeping herself warm that her growth will slow down, but the only way to find out is to test it, so this afternoon Lily's isolette was rolled out and her new crib was brought in.  Her isolette had been down to 28 celsius, so it's really not much of a stretch to be outside, and in fact, one nurse told us the room temperature in the NICU might even be warmer than 28.  They'll keep a pretty close eye on her for 24 hours or so and see how she reacts, and if she needs to go back in she will.  But for now, Lily is extremely happy to be out of the fishbowl, taking one step closer to the door, and continually reminding us we better start getting our act together at home.   Your bassinet awaits you, Lily, with bells on.  And a mobile.  

Don't Forget To Breathe

Edited 11/1/08:  The morning after Lily's first night in a crib, she had a weight gain of 2.2 oz.

Lily's new crib  10/31/08

Lily in her new crib  10/31/08

When It Rains...

With all of Lily's recent developments, I've been remiss in sharing some family news.  My sister and brother-in-law, Julie and Jeff Kowalsky, adopted a beautiful baby boy, Louis Evan Kowalsky.  Born 10/20/08, at 9lbs, 12oz, he shares his birthday with Amanda.  Julie and Jeff found out about the adoption match the afternoon of the 20th, and picked him up and brought him home on the 21st.  So my parents had two grandchildren in nine days, for a total of three now, one from myself and each of my two sisters.  Lucas Hereford, Shari's son, was born 11/9/06, so yes, the three cousins are Lucas, Lily, and Louie!

Julie, Jeff, and Louie are all doing great, and we're all looking forward to raising our kids together and having them get to know each other.  At the tender young age of 42, I was the youngest of my sibs to have my first child.  Good times.

Don't Forget To Breathe

Keeping Up With Lily

Lily's progress the past few days has been so great it's hard to keep up with her sometimes.  The other day she wanted so much to speak out for Barack Obama for president, that I didn't get a chance to mention the recent improvements in her feedings and the temperature inside her isolette.

First, let's talk about her isolette.  When Lily first came to the NICU, they were keeping her glass house (really it's lucite, but let's not nit pick) around 34 degrees celsius, regulating her body temperature to around 37 celsius.  As she grows and is able to keep herself warm, the isolette temp is gradually dropped to compensate.  After her first week or so the isolette was down to 30.5 where it stayed for about five days.  The past few days, however, they have been steadily lowering the isolette temp, and today it is at 28.0 celsius.  This is pretty significant, as 28 is about the same as the room temp outside the isolette, a sign that she may be moved to a crib any day now.  As Lily was breathing on her own since being born, being able to regulate her own temperature was one of her next big steps, and she seems to be well on her way.

Lily's isolette, 10/11/2008  34.6 degrees

Lily's isolette today, 10/28/08   28.0 degrees

Another sign of her being ready for the real world will be to take her feedings from a bottle rather than feeding tube.  It isn't until around 34 weeks or so that babies are able to mouth feed.  They have to learn to suckle, swallow and breathe at the same time, and rest when they need to.  Also, at her age and size,  just trying to do all that can burn a lot of calories (if only we could burn calories just trying to eat).  The other day at one of her scheduled feeding times, she was awake and alert, so we decided to try to give her a bottle.  With nurse Missy's assistance and guidance, I held her, and as soon as I put the bottle in her mouth, she started going at it like a pro.  She even stopped after a short time to give herself a rest, but took every last drop from the bottle.  Since then she has taken from the bottle about every other feeding during the day.  At night when we're not at the hospital they usually feed her through her tube so she can stay rested for us to give her the bottle the next day.

Daddy feeding Lily for the first time  10/26/08

Mommy feeding Lily   10/28/08

I know this is not the last time I won't be able to keep up with my little one, I just didn't expect the first time to come so soon.  I guess I better start getting in shape.

Don't Forget To Breathe.

Babies For Obama

As you know from reading this blog, it hasn't been an easy start for me.  My first 4-8 weeks will be spent in the hospital because I can't regulate my own temperature or even eat on my own yet.  I have great doctors and nurses and loving parents taking care of me, and eventually I will head home and grow up to be big and strong.  For now, though, there is one thing I ask of you:

So that my first 4-8 years may be years of hope, love, and peace,

So that I may grow up in a land where people come before corporations;

So that I may grow up in a land where civil liberties come before fear mongering;

So that I may grow up in a land where equal rights come before prejudice and bigotry;

So that I may grow up in a land where tolerance comes before hatred;

So that I may grow up in a land where education comes before bombs,

So that I may grow up in a land where love of man comes before love of money;

So that I may grow up in a land where negotiation comes before threats;

So that I may grow up in a land where all options come before war and war is not an option,

I ask that you please vote for Barack Obama and make him my first president.

Don't Forget To Breathe.

Lily Maia Rogers

A Few Firsts

Lily had her first bath Thursday.  One of her nurses, Lex, wanted to move her feeding tube, and since her PICC line had already been removed it was a rare opportunity for her to be wire-free.  She was washed in a plastic tub about the size of a shoe box, which was placed in the sink.  Amanda washed her by hand, gently massaging her with soap and warm water, and she seemed to enjoy it.  I would have helped, but I was too busy documenting the event with a video camera in one hand and my still camera in the other.

Lily's First Bath  10/23/08

"Look mom, no wires!"

Upon arriving to see her Saturday morning, I was greeted by Lily's first set of hand and foot prints, taken by the nurses some time since we left Friday.

When I have a chance, I'll re-post these with a frame of reference.

Don't forget to breathe.

Next Week: French Fries

The past few days have been business as usual for Lily.  Each morning we wake up and call the NICU to see how her night was, and each morning has been good news.  Her weight has been going up since Friday, six days in a row now.  Even after her first real poop, which I had the pleasure of changing the diaper (sorry, no pics), she went up a few grams.

Up to now Lily has been getting her nutrition in two ways, a feeding tube that goes into her nose and directly to her stomach, and a PICC line, which is essentially an IV (not a roman numeral 4) that can remain in for a longer term than a standard IV.  I would tell you what goes in the PICC line and what goes in the feeding tube, but it's only been explained to me about twenty times, so I'm not exactly sure yet, but the nourishment in the PICC line is there to fortify what she gets from the feeding tube (all you docs out there may feel free to explain by posting a comment).  The good news is, Lily has been tolerating her feedings so well that the PICC line was removed this afternoon and she is now getting all her eats directly into her belly.  Next week: french fries!

  

Additionally, for the past few days Lily has been one of a group of three babies being cared for by the same nurse, rather than one of two, another good sign of her progress that she does not require constant attention.

The last few days we have had her out of the isolette for an hour or two at a time twice a day, doing our Kangaroo Care, or skin-to-skin.  And in her 33rd week, she has already been able to take some milk from the breast, quite impressive since her tiny mouth can barely latch on to mom.  

Bottom line:  Lily is a star pupil, a rock star, a champion, and a scrappy little bugger.  I think we're going to have our hands full with this one!

Don't forget to breathe.

Lily's Growth Chart

I will try to keep this post updated with Lily's stats so you can follow her growth until she goes home.  While in the NICU she is weighed daily, and her height (why do y'all insist on calling it length?  she's not a snake) is measured weekly.  (2.6.3 is read as 2lbs, 6.3oz)  Grow Lily, Grow!!

Date Grams Lbs./Oz. Height (cm)

10/11 1087 2.6.3        36.3 (14.25 in)

10/12 1066 2.5.6

10/13 1033 2.4.4         36.0

10/14 1044 2.4.8

10/15 1036 2.4.5

10/16 1023 2.4.1

10/17 1096 2.6.7

10/18 1127 2.7.8

10/19 1183 2.9.7

10/20 1202 2.10.4       38.0

10/21 1208 2.10.6

10/22 1232 2.11.5

10/23   1265    2.12.6

10/24   1303    2.14.0

10/25   1335    2.15.1

10/26  1389   3.1.0

Date  Grams Lbs./Oz. Height (cm)

10/27    1409      3.1.7            40cm

10/28    1442      3.2.9

10/29    1496      3.4.8

10/30    1530      3.6.0

10/31    1572      3.7.5

11/1      1635      3.9.7

11/2      1697      3.11.9

11/3      1742      3.13.5            40

11/4      1758      3.14.0

11/5      1799      3.15.5

11/6   1865   4.1.8

11/7      1875       4.2.1

11/8      1914       4.3.5

Now that Lily is home and she only gets weighed at doctor appointments, I won't be updating this post, but will update her weight from time to time in newer posts.

A Womb With A View

After two weeks of stress and worry, it was nice to have a week of good news and joy.  Amanda came home Tuesday afternoon, and soon after I picked up Pearl (our dog) from our friend’s house, where she had been since Thursday.  As they say, there is no psychiatrist like a dog licking your face.  And there is no psychiatrist like your newborn daughter meeting and exceeding all expectations.  Lily has been doing exceptionally well in the NICU, taking most of her food, performing like a champ when being poked, prodded, measured, and changed, and doing her most important job she has right now: sleeping.  Some of her nurses have already described her as feisty and scrappy.  Her weight had dropped slightly over the first five days, as is expected with all newborns, but took a nice jump Friday morning to exceed her birth weight (2lbs, 6.3oz), and went up again today to 2lbs, 9.7oz.

 

Amanda and I have developed somewhat of a routine.  We try to get to the hospital in the morning and spend a few hours visiting.  Lily is in an isolette (the modern term for an incubator) most of the day, and they only like to handle her when they have to, around her feeding schedule.  When we are there for her feedings, one of us takes her temperature and changes her diaper.  Her diaper, by the way, would fit in my shirt pocket.  When the nurses are done doing whatever they have to do with her, one of us gets to do what they call Kangaroo Care.  They take her out of her isolette, unwrap her from her blankets, and lay her down on our bare chest, then cover her back up with a blanket.  Then we sleep, or at least she does.  We can do this for an hour or two, once or twice a day.  This practice was discovered by doctors in Colombia who ran out of incubators for their babies, and they found out that not only could the baby receive enough warmth from the mothers or fathers body, but there were additional benefits.  Laying skin-to-skin also helps stabilize the baby’s breathing and heartbeat.  When you can only have contact with your baby for a limited time each day, Kangaroo Care is like chicken soup for the soul, two hours goes by like five minutes.  The first time I had her on my chest and Manda asked me how it was, I believe my response was, “Better than cheesecake.”

 

We usually go home for a little while in the afternoon, rest for a few hours, and try to get back to see Lily after dinner sometime.  It’s a lot of back and forth, and can be tiresome, but we’re lucky to be relatively close to the hospital, 15-20 minutes in light traffic, or 30 minutes in heavy traffic.

 

Although I would never wish for anyone to have to deliver at 32 weeks, I have found a few silver linings the past week in the NICU.  Having your baby in an isolette, while at times scary, is a rare glimpse into the developmental process, and why I call it a Womb With A View.  She pretty much sleeps all day, but at times is very active, kicking and flailing around, yawning, making faces, staring at the walls at times, basically everything she would be doing in utero.  I consider it bonus time, since she can’t come home with us, but we still get to peek in on her.  We are getting excellent hands-on training from the nurses here, and I feel like I will be infinitely more prepared to care for her when she comes home than I would have been if she went full term. 

A Womb With A View

Lily through her "porthole"

As I sit here finishing this post, Lily is kangarooing with Amanda, and even though I’m just observing my wife and daughter lying skin-to-skin, bonding and nurturing each other, it’s still better than cheesecake. And I remind myself, don’t forget to breathe.

Lily and Mama-Roo

A Minute To Breathe

It’s Thursday, October 16, 2008…. I am sitting in the Special Care Nursery at Overlake Hospital in Bellevue, WA watching my daughter sleep comfortably on her fathers' chest completely in awe.  Lily is five days old and already I can’t imagine my life without her in it.   Was it really just seven days ago that I was admitted to the hospital for high blood pressure?  Thirteen days ago that we first learned something wasn’t quite right with the pregnancy?  Twelve weeks ago that we learned we would be having a girl?  Seven months since we found out we would be having a baby?  Wow- what a blur! 

Neal and Lily on her 5th day

I feel so blessed to have her here, now, safe and growing.  Knowing that she is exactly where she needs to be brings me a peace of mind that I haven’t felt for weeks.  I am thankful for my doctors for being so proactive in my treatment plan.  I am thankful for Lily’s nurses for nurturing her and caring for her around the clock.  I am thankful for Neal who has remained as solid as a rock throughout the last few weeks.  But mostly I am thankful for my little girl who brings a smile to my face and a joy to my soul.  

Don't forget to breathe.

Lily Maia Rogers, 5 days,  2lbs, 4.1oz

Amanda and Lily, 4 days old

There's A Plan

My how things change in a week.  The last week has been the craziest rollercoaster ride I've ever been on, and I'm pretty sure it's just the beginning.  Here is a brief timeline of events:

10/2 (Thurs) - Amanda is worried she is not feeling baby kick enough for 31 weeks of pregnancy.  She called her OB and she recommended that we go to the hospital for a non-stress test (NST), where they listen to the baby's heartbeat for 30-40 minutes to make sure it's doing what it's supposed to.  The test went fine, but the doctor on call suggested we go in the next day for an ultrasound instead of waiting another week for our scheduled appointment, mostly to ease our minds.

10/3  (Fri) - We went in for an ultrasound, one day before week 31 of pregnancy.  This is where our world was turned upside down (for now, we hope).  Our baby was measuring below the tenth percentile in size for her gestational age, and was diagnosed with Intrauterine Growth Restriction (IUGR).  She was not getting the nutrients she needed from the placenta, and would probably have to be delivered early.  How early, they weren't sure.  They want to leave her in as long as they can until we reach the point where she is better off coming out.  At this point we schedule ultrasound appointments for Monday, Wednesday, and Friday, and go home and cry.

10/4-5 (Sat-Sun) - We spend most of the weekend talking to friends and family, getting advice and support.  All of a sudden, everyone I know has had a preemie, was a preemie, or knows someone who just had a preemie.  It is the two longest days of our married lives, waiting for our Monday ultrasound.

10/6 (Mon)  - Amanda worked a half day in the morning, which was what she was scheduled for, and then we went for an afternoon ultrasound.  The dopplers we were most concerned with relating to blood flow from the placenta to the baby all look good, and we breathe a sigh of relief.  Dr. Walker tells us we are probably good for at least a week based on this, which was great news after a harrowing weekend of worry of what will be.  We decide to put Amanda on self-imposed bed rest, even though no one has told us to.  She does not work the rest of the week.

10/8 (Wed) - Another good set of tests, an ultrasound and another NST, and we are just hoping to get to 34 weeks before we have to deliver.  Amanda's blood pressure is up a little, but not alarmingly so.  The problem with the high BP is that Amanda could be developing preeclampsia, which is dangerous to both mother and baby.  Wednesday evening, Amanda's mom, Barbara, calls to let us know she has a flight the next day and will arrive around 2:30pm.

10/9 (Thurs) - We have scheduled a tour of the Neonatal Intensive Care Unit (NICU) for 11:00am.  This is where the baby will be after she is delivered, and will stay here until she comes home with us, and the tour is recommended by a few people so we have an idea what our baby will be facing, and to give us an idea of how she will be cared for.  I think we both just want to catch a glimpse of a preemie so we can see how small they are, but when you walk through the NICU they discourage "window shopping."

Our plan after the tour is to stop by our doctors office, have a quick NST to make sure everything is o.k., then pick up Barbara at the airport.  The NST went fine, but Manda's BP was high, 145/95.  It was at this point that the doctor said she wanted to admit us.  She asked us if we needed to go home, or if we were ready.  We'd been bringing our bags with us since Monday, so that was that, Manda was admitted around 3:00, and Barbara took a taxi to the hotel.

The idea was to give her medicine to get her blood pressure down, and she was given an IV with magnesium sulfate (mag).  The mag is great for lowering BP, but otherwise it's like "here, have the flu."  Manda was nauseous, hot, achy, and headachy.  Not much fun, but her blood pressure dropped to about 117/75 by the morning.  Now that we're in the hospital, they can monitor her more closely, but we are still anxious to know how long she'll be able to carry the baby before they think it's not safe.  If she was born today, her birthday would be 10/9/8.

10/10 (Fri) - In the morning Manda's BP is down to a comfortable level, so they lower the mag dosage and she begins to feel better.  Around 11:30, we have an ultrasound in the room, and again, everything looks good.  At this point, we know it's not going to get better.  The placenta does not regenerate itself, but nothing has gotten worse, so it's a good scan.  The plan is for our next scan to be Sunday, but Dr. thinks we are good until at least Monday, but probably not more than a week to ten days until we deliver.  We still want to get to 34 weeks, but I realize this is not in our control.  

That afternoon, Manda's 24 hour urine analysis comes back with a high amount of protein, another indication of preeclampsia.  Around 6:30-7:00, our nurse comes in and tells us Dr. Haynes, the doctor on call, will be in shortly to talk to us about "the plan."

"There's a plan?"

"Yes, there's a plan.  Dr. Haynes will be in soon to tell you about the plan."

"What's the plan?"

"They're going to deliver you tomorrow morning.  At 7:30"

"                  "

"Are you ok?"

Then the nurse explained what was going to happen in the morning, what I would do, where I'd go, what and when they would do throughout the procedure, a lot to take in, but we listened the best we could.  Our little girl would be delivered exactly at 32 weeks.  Then the doctor came in and went through the process and answered any questions we had, which were many.  There were so many people in and out of the room, it was hard to keep track of who was who and what they were doing and telling us.  We just kept thinking about 7:30.

10/11 (Sat) - Lily Maia Rogers was born at 8:21am, weighing 2lbs 6.3oz, 14.25 inches tall.  She was breathing on her own, which is great for 32 weeks, and hasn't needed any help yet.  She and mom both came through the c-section in great shape, although mom had a few more drugs afterwards.  After the drama of our last week, it was incredible to see Lily in person and felt like two tons off my shoulders when they told me she was o.k.  As every minute passed, I felt more and more assured that she would be fine, and when I finally got to hold her, about an hour later, it was the best feeling I could ever imagine.

Lily Maia Rogers 10/11/2008  8:29am

The rest of the day is kind of a blur for me, but I remember most of it being spent going back and forth between the nursery and Manda's room, checking in on Lily and giving Manda updates.  We wheeled Manda to the nursery around 9:00pm and for the first time, Mom, Dad, and Lily were together.

Lily Maia Rogers 10/11/2008  12:19pm

Lily will be in the NICU for a few weeks, and come home near her original due date of Dec 6, although many nurses have told us we could probably expect to bring her home anywhere from 1-3 weeks sooner.  Don't forget to breathe.

The Story Begins With A Plot Twist

I became a father on Friday, October 3, 2008.  My child has not been born yet, but that was the day our world changed.  On Friday we began worrying about our little girl for the first time, formally entering the world of parenthood, as premature as our daughter herself will be.  After 31 weeks of a pretty easy pregnancy, we were informed our baby has Intrauterine Growth Restriction (IUGR).  This means she is not getting the nutrients she needs to grow, and weighs only 1000 grams, or about 2.2 lbs.  This is the weight she should have been at at about 27 weeks, and puts her under the 10th percentile for her gestational age.  Because of this we are suddenly faced with the almost certainty of a c-section delivery anytime between now and the next three to four weeks.  Our best case scenario has us delivering at 34 weeks, which would be about 4 weeks early.  We are suddenly faced with three ultrasound appointments next week, knowing that any day they could decide to admit us and deliver the baby.  We have spent most of the past two days on the phone with friends and family, getting incredible advice and support.  Everyone seems to know someone who had a preemie, and they all have success stories.  My mom reminded me that I was born three weeks early and spent a few days in an incubator, and look at me now, I know how to type!  We are looking to find the best care we can possibly receive, and are very fortunate in Seattle to have first class perinatal care available to us.  Babies born at 31 weeks and later tend to do very well, so I am remaining pretty positive that our girl will come through this and be a happy, healthy baby.  Since we had not chosen a name yet, I thought we should call her Lil, as she is so tiny.  Then I went to this website, and we did a search for names meaning Warrior, because we want her to come out fighting, and the name at the top of the list is, and I couldn’t make this up, Abner.  So I may be referring to her as Lil Abner here until she’s born and we name her.  As Amanda was crying on the way home from the ultrasound Friday, I told her this isn’t the end of the movie, it’s just a plot twist, we’re still going to have a happy ending.  And I fully expect to.  And I had to remind her: Don't Forget To Breathe.

(Note: This was written Oct 5, 2008.  I decided not to post this until we deliver the baby and know she is healthy, so if you're reading this, she is.)