Incredible progress & precious first moments…

What a day yesterday was! I got to the hospital about 8:30am and ended up not leaving until 9:30pm. It was the most incredible whirlwind day of amazing changes for Ian.  The day began with the doctor informing me that Ian's hematocrit was a little low (38 when they like to see 40 while on a ventilator), which means he was slightly anemic, so they decided to give him a 23cc blood transfusion.  This isn't abnormal for a preemie. He was increased to 15mL per feeding every 3 hours. His weight has also increased a bit, he’s up to 3lbs 8ozs!!!  The doctor showed us Ian's chest x-ray which had no pneumothorax, and the PIE was improved to the point that you might not even know he had it if you weren't looking for it! So the decision was made to go off the high frequency ventilator in the morning and see how he did.  He tolerated that well, so they extubated in the afternoon! We were able to be there to witness it and hear his first little cries after having that tube pulled; it was such a wonderful thing to hear!  He was then placed on a CPAP, and they took a blood gas a couple hours later which came back perfect!  They even decreased the pressure on his CPAP from 6 to 5 last night. Then this morning he was moved to 4 and this afternoon he’s been weaned down to 3! He is such a strong little man!

Ian was very feisty yesterday, which the doctors say is a good thing.  Since he was tolerating the CPAP so well I got to hold him for the first time skin to skin which was about the only thing that really calmed him down yesterday.  It was the most amazing moment, he got to lay on my chest for an hour and a half and it was such an incredibly peaceful comforting time for us both. It was by far my favorite moment since his birth and I look forward to our daily “kangaroo” time together! As long as he’s not having any complications they recommend 1 ½-2hrs of skin to skin time for us every day!!!

He was moved to an isolette to help maintain his body temperature better.  This has been the plan for awhile, but they were short of isolettes initially, and then didn't want to move him with the chest tube in. He seems to really like his isolette as it’s much quieter and consistently warm as well.

Today, Ian and I are having another wonderful day together. The nurse was quite pleased to see me walk in this morning since holding momma's hand calms him down quite a bit.  He hardly lets me leave his bedside. He’s such a momma’s boy already!   This afternoon we met with a physical therapist who taught me infant massage and Ian LOVED it! It was so amazing for me to learn another physical thing that brings him comfort and calms him. Pumping has also been going so well, and thankfully, my supply has been increasing every day so we’re well ahead of what he needs in terms of quantity at this time. I’ve even gotten over 100mL in one pumping a few times. I love doing it as it’s one more physical thing I can provide for him and another step to helping him to grow stronger so that hopefully we’re able to actually breastfeed together some day soon. We’re going to head back up to the hospital tonight to enjoy some more time with our little man. Thank you all for the support, prayers, and love you’ve sent our way this past week; we are so thankful for all the progress Ian continues to make.

Remembering our Lily & thankfulness for Ian….

Nick and I had previously decided to take the day off work today to remember Lily and to focus on her. Just another plan that had to be adjusted a bit with the early arrival of her little brother Ian, but we have definitely felt Lily’s presence today as we spent the day at the hospital. It’s hard to imagine all that has happened in the past year since she came into our lives. I often feel it has been much longer as there is so much that has transpired, but I also feel our lives have become so much richer. Lily gave us so much perspective on what truly is important in this life. She has helped us to cherish those we love and to really be thankful for each precious memory that we share together. Nick & I told Ian about his big sister earlier today and it seems she really is watching over him as he has had a wonderful day, and thankfully we continue to receive good news on his condition.

We feel so blessed as the NICU team working with Ian is absolutely incredible. His oxygen needs continue to be low and he's very stable.  He had a chest x-ray this morning and his pneumothorax appears to be resolved, so they're planning to clamp the chest tube again tomorrow morning and then follow with a chest x-ray.  If everything looks good and no air reaccumulates, he may have his chest tube removed!  His PIE (pulmonary interstitial emphysema) is still present, but improves a little bit every day.  He'll stay on the high frequency ventilator until it clears up, then get back on the normal ventilator, then be weaned off that to a CPAP.

Also received more reassuring news in that Ian had the standard day 6 head ultrasound and it came back perfect.  Brain bleeds are classified from 1-4 with 4 being the worst, and he had a zero.  It's pretty rare for a 31wk baby to have one, but this is still good news and one less worry for us. Ian's also getting increased breast milk every day.  Slowly but surely, we're progressing to getting those lungs healed up.  He'll probably be in the NICU for at least another 4 wks, but could be a bit longer.

Our hearts are overfilled with love for Ian and Lily, and I can honestly say that although we feel sadness that a part of our family is missing, we have also never felt so much happiness and love as we have today. This past year has been one amazing journey, and although there have been both highs and lows, I can now look back knowing it was each step along that journey that led us to this precious child we now are so incredibly blessed to call our own, and for that I am humbled beyond belief. We love you Ian and Lily.

Dismissal and new routines…

Thank you all for your kind words and for welcoming our little Ian James into the world! These past few days have been quite the whirlwind & thankfully I’m now starting to come out of my drug induced haze and back to the land of the living. We had a great visit with our little man in the NICU this morning where I got to hold my hand on the top of his head for some skin to skin contact and read him three books. He did have to have a ventilator placed to help him breath the other day and a chest tube to get rid of air around his lungs, but the neonatologist is hopeful that if things remain stable he’ll be off the chest tube within the next couple of days. I’ve been pumping diligently every three hours since the day of his birth and we were thrilled that my milk finally started to come in last night. As those of you who have had babies in the NICU know all too well, you feel so helpless and there is so little you can do for them, so it feels wonderful to be able to provide this for him in the hopes it will help him grow stronger and keep him healthy.

Yesterday was our favorite morning yet with Ian; we got this video with him when we got to see him with his eyes open for the first time after they removed his bilirubin mask.. We spent a ton of time talking to him and loving on him the morning before the chest tube had to be placed.

Seriously, how adorable is he?!

Overall I’m doing okay, just still honestly trying to wrap my mind around the fact that I’m no longer pregnant and that little Ian really is here. It’s difficult leaving the hospital without him, but we’re trying to hold on to the knowledge that his prognosis is excellent and we simply have to be patient. I’ll be dismissing from the hospital later today, and we’ll then be attempting to develop our new routine of visiting Ian in the NICU until he gets to join us at home. My blood pressure has still been high, which I’m told is normal with severe preeclampsia patients, so my OB will be releasing me on blood pressure medications for at least the next few weeks to keep that under control. I’ll follow up with her next week to have my staples removed from the cesarean incision, and in time hopefully will start to regain my strength.

It’s been a bit eerie to be in the same hospital where I delivered Lily almost a year ago, and as we again are released home without a baby in our arms, it’s hard not to feel a bit of sadness. Although we’re trying to hold to the fact that soon we will get to take our little Ian home with us, we just can’t wait for that day to come! 

Introducing...

Hey, this is husband Nick writing for an exhausted Rebecca.  Yesterday was a whirlwind.  The Magnesium that was lowering Rebecca’s blood pressure was also causing baby’s heart to slow (the Magnesium relaxes ALL muscles).  Slowly, over the course of about 30 hours, baby’s heart rate went from a baseline of 130, to 120, to 110, and the doctors started considering doing the c-section early.  When it hovered around 100 for about 20 minutes, the doctors decided to go ahead with the c-section while everyone was still healthy and not under duress.  Waiting until the next day would provide little benefit compared to getting baby out while he was still healthy.  We were briefed on the c-section, then whisked to the OR before we could even call our families.

And so, at 2:03pm on June 21, 2011, Ian James was born to this world at 31wks, 3days gestation.  He weighed 3lbs 7oz and was 16 ¼ inches long.  Ian cried right away and started breathing on his own.  He even peed on the nurses a couple times (atta boy!).  He scored a 6 on the APGARs at 1 minute, and a 9 at 5 minutes past delivery (0 is awful and 10 is perfect).  We got to see him just briefly and take a couple pictures before I accompanied him to the NICU while Rebecca got stitched up.

They put him on a CPAP to help keep the lungs open and prevent apnea, and stuck a bunch of monitors to his tiny little body.  His stats were strong and everything looked perfect.  But… as the neonatologist commented, everything was going just a little too perfect for a 31 weeker.  We had our first little hiccup this morning when Ian’s tiny little left lung got an air pocket around it.  The doctors did a chest x-ray and removed the air pocket with a tiny needle.  They also gave him some medicine to help his lungs soften and inflate better.  They went ahead and put in a breathing tube as well.  Doctors are hoping the remaining air around his lungs will be reabsorbed into his lungs.  He’s doing great and stats holding strong and steady, and his prognosis is excellent.

Here are a few pictures of our new arrival:





Rebecca is doing well but still completely exhausted from the Magnesium.  She's been limited in her visits to the NICU, so she’s looking forward to getting off of that medication this afternoon to dote on our little miracle all day long.  Please keep Ian and Mom in your thoughts and prayers.

The best laid plans....

We know all too well that even the best laid plans don’t work out as we had hoped.  I started to experience more swelling over the weekend, and when I went to work this morning, one of the nurses took my blood pressure and it was extremely high (193/110).

Thus we started our journey to the hospital’s Labor and Delivery department where I was promptly admitted with severe preeclampsia.  They’ve given me Magnesium to treat the high blood pressure and the first steroid shot to help the baby’s lungs to develop.  My initial platelet count was also low, and they are monitoring it closely.  Believe it or not, my platelet count might actually determine when this baby joins us in this world.  If the count gets too low, our breech baby boy will need to delivered by c-section.  Now for the good news: my second platelet count came back up slightly and blood pressure is down a bit.  If the platelet count keeps steady or goes up, baby can stay in the incubator for a bit longer.  At this point they’re checking it every 6hrs. I think our big goal is to make it to Wednesday so baby can get his second steroid shot through his system, but it would be amazing if we can get even more time. I feel at ease that we are in the best possible hands. I’m convinced I’m blessed to have the absolute best OB and have complete trust in her. We’re at an amazing hospital with a Level 3 NICU so I know he’s also going to be in very good hands. We had an ultrasound earlier and baby is measuring about 3lbs 6oz and is looking very healthy, so we’re feeling positive about that as well.

Trying to take things one moment at a time and not get too overwhelmed with it all. As most of you know, Lily’s Birthday is coming up only a week from today which adds even more to the situation. Will update as often as we can & appreciate all the support, thoughts, and prayers you can send our way. I treasure your words of support and encouragement, they help to keep me positive and strong. Holding hope and faith that the One who made this pregnancy possible and brought this precious life to us will continue to carry us through & keep this baby boy strong.

"When you come to the edge of all the light you know, and are about to step off into the darkness of the unknown, faith is knowing one of two things will happen: There will be something solid to stand on or you will be taught how to fly." --Barbara J. Winter

Nursery preparations, swelling, and pediatrician suggestions…

Thoroughly excited that we’ll be hitting the 30wk mark on Saturday of this week!!! We saw the MFM Specialist last week on Tuesday and had another lovely ultrasound. Our little guy continues to look perfectly healthy, and as of that appointment last week, he was estimated to weigh 2lbs 9ozs! The specialist felt that things were going so well she wouldn’t need to see us again and we could just follow up with our OB for the last couple ultrasounds. Speaking of the OB, I had my regular 2wk check up with her today which was also completely normal and drama free! I appear to be getting good at this! Overall I’m feeling good, although with the intense heat this past week has brought, the pregnancy swelling has officially begun. My poor feet appear to be getting the worst of it. I’ve been trying to elevate them in the evenings but my shoes are getting tighter and tighter and I’m not sure what I’m going to do about work shoes soon (I’m required to wear closed toed shoes at work). My fingers are also starting to swell, so this past weekend I got a silver band at Target since I think my wedding band wearing days may be numbered for the summer. The OB said as long as my blood pressure and lab work continue to be healthy there is no reason to be concerned about the swelling; it’s just part of the fun of being pregnant in the summer. We discussed delivery a bit today. As of this last ultrasound the baby continues to be in the breech position. She said that if babies are going to move, they typically do so by 34wks, so if he hasn’t moved by the last ultrasound, we’ll have to have a discussion about trying to move him or the possibility of a c-section. She also felt that if I made it to 39wks she wouldn’t want me to go past that, so we’d likely be looking at induction if we make it that far and he’s not breech. Interestingly, with my first pregnancy I had every intention of trying for a natural childbirth, which technically I did, but now this time around I’ve really been unable to think about it much until recently, and to be honest as long as he comes into this world healthy I don’t care how it happens. I have complete faith and trust in my doctor and I learned the hard way last time that no matter how much preparation I place on the delivery, whatever is going to happen will happen, so I’m ready to just roll with it this time.

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Face and hand

Saturday we attended a breastfeeding class at the hospital where we’ll be delivering. It was very informative and we both were glad we attended as it gave us a lot of useful information that will hopefully help to make our breastfeeding experience a positive one. I was also relieved to know they have outreach services available if problems do arise after we’re home, so I’ll know where to turn for help. The instructor struck a good balance between adding some humor to the topic and getting the information across. Nick pointed out how similar she sounded to the Church Lady (Dana Carvey skit from SNL) about half way through the class which left us both enjoying even more laughs!

We had a great time this weekend starting to prepare the baby’s nursery. I had found these adorable wall decals on Etsy, and Nick put them up this weekend. As you can see, the finished product is pretty freaking adorable! It was so exciting to start making changes to the room for his arrival, but it was also mixed with some bittersweet emotions. It also meant going through some of Lily’s things and moving them out of the nursery. Another one of those moments I wasn’t sure we’d reach and filled with such mixed emotions; the sadness of her absence and the joy of his impending arrival. Talk about a rollercoaster of emotions!

Dresser/changing table, opposite wall from crib

I’ll see the OB again in two weeks for another check up and ultrasound!! We’re also starting to look into pediatricians in the area and asking around to see who friends recommend. We’ve started a list of those that have come recommended and are doing our research. To those of you who have had children recently, what did you do to find your pediatrician? Did you make an appointment to actually meet the doctor before having the baby?