After 31 days in the hospital....

Apparently I spoke too soon in Thursday's post - when I arrived at the hospital yesterday, I was the parent the nurses asked, " So, are you ready to take your baby home tomorrow?"

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

When Edwina asked that, I think I looked something like this:

 So I spent the day getting perscriptions filled and diapers purchased in between feedings at the hospital. We've packed her diaper bag and installed her carseat base, and we're heading to the nicu to pick up our baby at 9am this morning. Abigail is coming home :)

Reasons I'm frustrated:

1. Although I can nurse just fine with the lactation consultant helping, I cannot seem to do it on my own. Abigail SCREAMED every time we tried by ourselves after the LC left and I almost cried with her :(
I feel like once we get home, we'll be able to take our time and figure it out- hopefully.

2. Abigail is too small for our carseat! We even have one that is supposed to be for tiny babies, but it just swallows her :( We're bringing in another today to see if she will be able to go home in it. We need the harness straps to tighten more than they do on most.

3. The nurses won't commit to even GUESSING when she'll be going home. I sit in the nicu all day and see babies come and go - most are only there for a few days - and hear the nurses say "are you ready to take them home tomorrrow?" to the parents, and I'm just WAITING to hear that. What's so hard is that some of the babies are sent home on oxygen, or still with major apnea problems - problems much more severe than Abigail's. And now that she is gulping down her bottles (WE'RE AT ALL BOTTLES, ALL DAY!!!) I am getting so antsy to take her home.

4. My baby cries when I put her down to leave. So I hold her as much as I can - and we both LOVE it! But I just can't wait to have her home where I can hold her whenever she is upset and not have to leave her for hours on end.

5. My FMLA runs out next week, and Abigail isn't even home yet. Looks like I'll be talking to HR about a longer leave of absence, but I can't do that until the case manager writes my letter stating why Abigal needs full time care and cannot be in daycare for a year due to her immature immune system- which she can't write until I have a discharge date to give her - which none of the nurses will even speculate on! ARGH!

Reasons I'm smiling:

1. Abigail has started drinking her entire bottle! They've moved her to 3 bottles a day.
2. The nurse told us to bring in our carseat for the nicu carseat test -we're getting close to discharge!
3. The lactation consultant helped me in the nicu yesterday and Abigail actually latched on and nursed for 15 minutes! She did so well!
4. My husband is great - I can't imagine going through the last month without him. It's been amazing to see how in love he is with his child. And we've gotten even closer through the whole experience. I can't even write this without smiling :)

Nearing 4lbs!

A quick update before I head over to the nicu:

Yesterday Abigail weighed 3lbs 11.2oz and took 27ml of her 38ml feeding from a bottle! I think she was trying to show off since her daddy was the one feeding her. She always falls asleep with me during her bottles, but she stayed wide awake for him yesterday! I'm wondering if maybe she can get the whole bottle down today!
She has been keeping her temperature up while in the open crib, and latest ultrasound shows that the infammation of her left kidney has resolved itself (although the right kidney is still inflamed). I'm hoping that maybe it will resolve itself as well in the coming weeks.

I've started washing Abigail's clothes and blankets in preparation of her coming home in a few weeks. My goodness - this little girl has so many clothes! It's funny that the preemie clothes are STILL too big on her, but that means that she'll get to wear those and her newborn clothes for a few months. We've also rearranged our bedroom to accomodate her bassinet since she'll be sleeping with us for a while.

And now I'm off to snuggle!

You want me to wear WHAT?!

It's official: Abigail is now wearing CLOTHES! She also has been moved out of her isolette and into an open-air crib - we'll see how her body temperature tolerates the move! If she gets too cold, they will put her back in her control-temp islolette. She had another bottle today and finished 20 mil (as compared to the 10 mil she finished on her first bottle yesterday), so we're moving right along!

And for everyone who keeps asking: the nurses think she'll be coming home with us in 2-3 weeks (5-6 weeks after birth). We cannot wait!!

Nom nom nom...

A quick Abigail update: She had her first bottle today! She will get 1 bottle a day (in addition to her regular tube feedings) for a few days, and we will build up to more every day.  Of course, she didn't finish her bottle on the first try, but she made a valiant effort before falling fast asleep on her mommy. Good day!

Update from the Nicu: Day 21

Current Weight: 3lbs 6.4 oz!!
Gestational Age: 35 Weeks
Actual Age: 3 weeks

I can't believe Abigail is already 3 weeks old - and that we've been in the Nicu for 3 weeks now! She's doing her thing and growing. The nurses all adore her because she's so darn cute and has a bit of an attitude. Don't know WHERE she gets that from! She gets quite fussy whenever anyone disturbs her sleep.  Poor thing - I say she deserves to be as fussy as she wants after being poked and prodded for weeks.  It wasn't her choice to come so early after all!!

Abigail's definitely starting to have more wakeful periods where she looks around and just takes everything in. Today she was awake and looking around for a good 45 minutes while I held her. She especially likes it when she hears Dr. Villez walk by speaking Spanish. She also will open her eyes and peek around when her daddy reads her bedtime story each night.

Today we tried to nurse, and although we didn't get much accomplished, it was nice to sit there and snuggle for a while. She is still taking her feedings by tube, but she takes them in 1 hour instead of 2. The next move is to slowly start adding bottles and breastfeeding sessions. We will probably start on those later this week/early next week.

In other news, Matt and I got our dryer fixed! I'm so excited to finally be able to do laundry again (it broke back in August right before I was hospitalized) but completely outraged by the price to fix it! The sad part is, we kn ew exactly what was wrong - we were just too technologically intimdated to fix it ourselves! Never again!!

Update from the NICU: Day 19

Current Weight: 3 lbs 5oz
Current Length: Same (15.5 - 15.75 inches)
New Milestone: Bolis feedings

Abigail's feeding method has been changed to bolis feedings! This means that instead of continuous food being given to her through a tube that goes down into her intestines (N-J tube), now they are feeding her in 2 hour intervals with a tube that goes down to her stomach (N-G tube). So far she is doing GREAT on her new feedings, although she is experiencing a little bit of reflux and may need to be put on an acid reducer like Zantac. If she continues to tolerate the N-G tube for a few days, they will slowly start replacing her feedings with bottle feedings. It's really up to her how fast or slowly she wants to start taking a bottle. She still hasn't mastered the suck/swallow/and breathe reflex, so it may be a challenge to get her going on bottles to begin with.

Today Matt was able to bathe her - and she was not happy about getting her bath! Afterwards, though, she stopped crying and just looked up at her daddy for a while as he held her swaddled and the nurses changed her bedding. She was quite entranced!

Matt and I then went to an infant care class with some of the other couples from the NICU. It's so weird being part of this "preemie world" now that most people don't even know exists. Before August 26th, I certainly had no clue about the things preemie parents go through in the NICU or what special considerations they have to take when they bring their babies home.

Here are a few of the things I've learned in our stay at the NICU:

1. Parents of preemies feel cheated out of all of the "normal" birth experiences.  I didn't get to go to a shower and really celebrate while we prepared for Abigail (although I hear my shower was wonderful!). We are woefully unprepared with a nursery. Friends felt awkward celebrating the birth of such an early baby, so we didn't get the balloons and flowers and visitors in the hospital after her birth. We didn't get to really prepare for childbirth or use any techniques we had learned. Abigail's birth was not greeted with the excitement I had always imagined I would have - it was instead a time of high tension and fear.

2. Preemies are NOT just smaller babies! Even I did not realize this until we were put in this situation. Preemies are still supposed to be in the womb, developing - which means they look and act differently than newborns. For example, Abigail gets EASILY overstimulated and begins to panic when she is faced with sensory overload. While a newborn baby can handle being talked to, looking at their mom, and nursing all at the same time, Abigail can't handle that many senses being used together yet. She gets easily frustrated and confused and will flail her arms and stare wide-eyed until some of those stimulators are removed.  This is why we have been told not to have too many visitors in the NICU.

3. Preemies are more suceptible to infections than full-term babies - for most of their childhood! Since over 50% of preemies end up back in the NICU with infections in the first year, in the infant care class we were told that under no circumstances are we to take Abigail out around people for the first three months of her life.  This includes staying home for Thanksgiving and Christmas this year. This we have no problem with, as the last thing we want is for Abigail to get sick. We're just hoping everyone can understand why we seem so over-protective and why we're going to insist everybody who visits washes their hands. We're really nervous with cold season starting soon.

4. Preemies will probably not hit their developmental milestones on time. Preemies have both a "real age" (from their actual birthday) and an "adjusted age" (from when they SHOULD have been born). Right now Abigail's real age is 2.5 weeks, although her adjusted age is -5.5 weeks still.  Abigail may always be about 2 months behind on the usual baby milestones of crawling, walking, and talking - although it's possible that she won't be behind at all. But for this reason it is hard to go by the usual baby books as far as what an infant/toddler should be able to do by what age.

Abigail Update: Day 16

I'm so tired, so I'll make this short and sweet!

::Drum Roll::

Current Weight: 3lbs 2.7oz

We've hit three pounds!!!!!!!

Today was a good day - I got to hold Abigail for 4 hours and even gave her a bath all on my own! She wasn't too happy about that part. The nurses are letting me take over parts of her care - for example, I now take her temp and change her diaper whenever I'm there. Finally starting to feel like a mama! I've found that even doing these little things for her helps keep the blues away. They seem to creep back up during long car rides home, though...

Now off to bed!

Update from the NICU: Day 14

Current Weight: 2lbs 15.9oz - YAY! She is back up to her birth-weight (plus some!)

Abigail is doing well and so I (thankfully) have very little news to report! She's still dining on breastmilk, although they've raised her feedings to 36 ml every 4 hours. The next step is to move her tube up higher into her stomach (right now it goes all the way to her intestines) and give her larger amounts of food in shorter time periods. If she tolerates that, they will start her on BOTTLES!!

I'm working hard to keep up my supply for her, but it's really hard being tied to pumping every 3-4 hours! I hate when one of those times falls during our kangaroo session and I have to put her back in her isolette for the evening. But I keep reminding myself that the best thing I can do for her right now is supply food that is easy to digest - so I'm keeping at it!

It's also been hard to work around her schedule in order to hold her - and also having to ask to hold my own baby is humbling. Because she is woken up for measurements/diaper change at 5,9 and 1 (AM and PM), those are the times I need to be there to kangaroo. I hate when the nurses decide to do her measurments early and I arrive to find her fast asleep again...and have to wait until next time. Today I missed her bathtime because she blew out a diaper in the morning while I was at a dr's appointment, so they went ahead and cleaned her.

My 2 week post-partum follow up went well - and my blood pressure is back to normal! I asked the doctor about the possibility of having HELLP in future pregnancies, and she said it's possible - we wouldn't know for sure until I get pregnant again. However, she said that my fear of HELLP is NOT a reason to avoid getting pregnant in the future. She recommends waiting at least a year - and believe me, we will have no problem doing that! Not sure how I feel about having any more children. Luckily, we don't need to decide anything for a while.

Matt is heading over to the hospital soon to say goodnight to Abigail, as he does every night, by reading her Goodnight Moon (thanks, Mrs. Julie!) I really think he's going to be the best daddy ever. :)

Gummybear update: Day 12

Current Weight: 2lbs 14.3 oz
Weight Gain: -.7oz (but gained 3oz since last weigh-in!!)
Current length: 15.75 inches (up .75in!)
Current feeding: Still through the nose tube. They have upped her feedings from 4ml when she was born to 32ml every 4 hours! She is currently dining on breastmilk with milk fortifier to give her more calories. She appears to tolerate the breastmilk very well, so hopefully my supply can keep up!

Abigail is doing well and is GROWING! Dr. Villez calls her his "skinny little friend" but promises that she will start getting chunky soon. Every day I hold her while in the NICU - it is called kangaroo care. Basically I put her on my chest for skin to skin contact for hours. She has been attempting to nurse, but gets very tired quickly. Hopefully as she gains more weight she will continue to want to nurse. Mostly we just sit together and snuggle for hours.

She has had 2 ultrasounds on her kidneys and Dr. Villez is concerned that she has renal reflux. Basically, the tubes that connect the kidneys to the bladder are inflamed and are retaining water. He put her on an antibiotic to stave off a bladder infection and he is going to send us to Scottish Rite to have a special test done once she comes home.

This weekend Abigail graduated to the Intermediate side of the NICU! I'm so excited, although this means that she does not have her individual room anymore. The nurses are also talking about trying her on bottle feedings later this week. Every day is another day closer to bringing our angel home!!

Why Abigail had to come early: about HELLP Syndrome and IUGR

HELLP syndrome is a variant of preeclampsia/toxemia. The symptoms I showed during my hospital stay were

• extremely high blood pressure,
• high levels of protein in my urine (showing that my kidneys were starting to fail)
• elevated liver enzymes (showing that my liver was starting to fail)
• extremely low levels of platelets - that continued to drop (in fact, dr's will not allow an epidural below 100,000 platelets for fear of stroke and clotting issues. I was at 101,000 on the morning of her birth)

The decision to induce labor was not an easy one, but one that was basically made for us as my condition worsened. Luckily, Abigail is in one of the best NICU's in the south and I'm really very happy with the care she has gotten thus far.

Abigail also had some issues that influenced the decision to give her an early birthday.  The main issue was that Abigail had IUGR (Intra-uterine-growth-restriction), meaning that she had not grown since she was 29 weeks.  So Abigail is one of the shrimpiest 32 weekers they have ever seen! For some reason (probably her smaller cord) she stopped growing right before I was admitted into the hospital - so the induction saved both of our lives.

Abigail's Birth Day

*Note: Graphic sections are hidden. Highlight around astricks to read.*

When Matt left off on the last post (Weds), I was at 2cm and had just had my water broken.

*We heard a "pop" and then I felt the gush. I had barely had time to understand what was going on before he did it! Apparently the water was clear, which is a good thing, but it kept gushing out and onto the bed. I honestly can't remember how they cleaned it up with me still lying on the bed.*

That was about 4pm and I was rather frustrated since I had not progressed much at all since Tuesday morning. The nurse told me that breaking my water would "move things along" since it would mean there was no fluid to cushion the contractions. Well, it did!


I was given Nubane in my IV, which made me a bit loopy and hungry. I was able to breathe through the contractions, then I would almost fall asleep between them. Remember, we'd been at the hospital for a week by then, and if there is one thing you do NOT get at a hospital, it is rest! Around 7pm the dr checked me again and I was at 4cm. Again, I was frustrated at having been in pain for 2 days and not having that much progress. Matt and I were making bets as to when she would finally be born, and we both thought it would be around 5 or 6 the next morning.

Meanwhile, I was put back on magnesium to control seizures, since my blood pressure was so high. This meant I had to have a foley catheter inserted and I would not be able to get out of the bed or change positions during labor. So I would be flat on back to have this little girl. If there was one thing I knew from all my months of reading baby books, it was that I DIDN'T want to be flat on my back during contractions, as that would lead to back labor (contractions in the back), but I really had no choice. All my ideas about labor positions and leaning on Matt and walking around through the pain were thrown out the window.

After checking me at 7, they cranked up the pitocin (contraction inducer) and the contractions were coming at about 2 minutes apart and were soaring off the charts. I was shaking so badly and the nubane was not really helping anymore. I chose at 7:30 to go ahead and get the epidural. I'm all for women who want to experience natural childbirth, but this is how I see it: unless I get a medal for it, I will not willingly put my body through unnecessary pain. Since there is no medal for going natural in child labor, I chose drugs. The epidural was not as bad as I thought it would be - or maybe I was just in so much pain that I was glad to get it. Lets give credit where it's due, though - Matt got me through the whole thing.

*To get the epidural, I was sat up on the edge of the bed and leaned on Matt. He held me and talked to me while the anesteseoligist injected a numbing agent into my spine, and then inserted the epidural catheter into my spinal column. Not fun, but definitely not as bad as I had imagined.*

Once the epidural was in place, I noticed right away that my right side went to sleep...but my left DIDN'T. I could still feel every contraction on my left side, and they radiated down my pelvis and into my upper leg. For 3 hours. It wa also at this time that we noticed Abigail's heartrate dropping VERY low during the peak of the contractions.

Around 11pm I was in so much pain that I decided to ask the nurse to check the epidural and make sure it was working. My contractions were coming one on top of another and were not giving me a break between. I started to panic - something was wrong! They must have given me too much pitocin! When the nurse came into the room, I could barely explain to her what pain I was in. I wouldn't be able to do this all night. I was at my limit. She quickly checked me and said, "that's because you're ready to push!" Matt and I were in shock as the nurses started coming in with the special equipment they would need.

After what seemed like an eternity (but was probably only 5-10 minutes), the doctor came in. He immediately went into very serious mode. The baby's heartrate was so low, and not speeding up, since my contractions were not letting up. They had to get her out NOW. Hearing the urgency in his voice scared me to death. No "Hi, I'm dr so-and-so and we're going to have your baby now!" - straight to business, which I was all for by that point. After 2 or 3 pushes, Abigail was out. The actual pushing didn't hurt, but I am a little sad that I was unable to feel her come out due to the epidural.

Abigail was born at 11:23pm and I waited in a fog to hear her cry for what felt like an eternity. Then I heard it - and it was the most beautiful sound ever. She was breathing on her own and scored a 6.9/9 on the Apgar scale - amazing for a baby of only 2lbs 15 oz.

After checking her out and weighing her, they put her on my chest for just a second for a quick kiss. Matt was then able to hold her for a minute before they wisked her away to the NICU.

*The doctor then had to reach up into my uterus to make sure everything had come out - and I definitely felt this! It was more painful than the delivery.*

Afterwards, the nurses and doctor filed out and Matt and I were left alone and shell-shocked. Our baby was here - unexpectedly 2 months early. Everything had changed in a matter of a week.

I was wheeled into the NICU for a quick peak at the baby as they took me to the recovery room. That night I could hear the cries of newborns that were with their mothers in the rooms next door, and that was so hard. Because I was on magnesium still for 24 more hours, I was tied to the foley catheter and confined to bed. I wasn't even able to go see my baby. Matt went down to visit her throughout the night and the next day, though, and would bring me updates. Finally, about 36 hours after the birth, I was able to be wheeled downstairs to the NICU to spend some time with her. For some moments, there are not words.

Introducing Abigail Sandlin

Abigail Leontine (Lay-un-teen) Sandlin was born at 11:23pm on Weds, August 26th, 2009 after 3 days of induced labor.

She weighed a tiny 2lbs, 15oz and was 15 inches long.

She was breathing on her own and opened her eyes to look at her mommy and daddy right after birth.

Abigail was born almost exactly 2 months premature and will spend the next 4-9 weeks in the NICU gaining weight and learning to suck/swallow/regulate temperature.

She's our miracle baby and already has her daddy wrapped around her teeny-tiny finger.