Homecoming

This post is a little late in coming but I think most of the people who read it see my posts on Facebook as well. Abigail came home a week ago on June 16th at 5 lbs 15.9 oz. She came home on oxygen and 2 monitors (heart/apnea monitor and an oximeter "oxygen saturation").  Here is how things went.

On Sunday, June 14 when Travis was at the hospital after church the nurse practitioner said that she could be going home on Monday or Tuesday. When I got there after trading places with Travis, they asked me what I thought. Since our home oxygen tanks were coming sometime on Monday afternoon, I said I would be more comfortable with Tuesday so that we could make sure everything was all in order.

Tuesday morning we geared up to bring Abigail home. We did a Bella Baby photoshoot in the morning at 10 AM. I'm so glad we did it because they turned out great. (Thank you to Heather Masa for the perfect going home outfit)

Joshua did so good taking pictures. He was so excited that Abigail was coming home.

This family of 4 is all together at last!

After taking her last bottle at the hospital and having our last meal in the hospital we were ready to go. We got out the door around 1 PM.

Sadly none of our primaries were working on Tuesday to send us home, but I was so thankful to have a nurse we knew!

Thank you to Gretchen and Robin for helping us get everything ready to go.

During Abigail's last days in the hospital she started to develop some reflux (not bad). Since she was coming home on moniters anyway it was okay to elevate her bed and use a "Tucker sling" to keep her from sliding and turning in her bed.

Abigail has a oximeter (pulse ox) monitor.
A heart rate/apnea monitor.
And oxygen

Things have gone well at home.  I was very worried about her gaining weight at home. The first 3 days she gained 4 oz

We had our first doctors appointment with our pediatrician who will follow her growth from here on out. We still have appointments with Mercy feeding (occupational therapy) and physical therapy. Then at 6 months adjusted age which is December 27 (appointment Jan 4) she will have her first Mercy NICU follow-up clinic where we will see one of the Mercy Neonatologist. 

Abigail is a miracle baby and we are so thankful to God for her continued growth. She is a 23 weeker who got to come home 2 weeks before her due date.  

Please continue to pray for our family for good health for all,  for continued growth, and adjustments to once again a new normal.

Next week

Well they are talking like Abigail might come home sometime late next week! 

Aaahhhhhhh

I hope we are ready!

She continues to take her whole bottle when she nipples her feed. So far she nipples every other feed. We are going to start to try to nipple 2 out of 3 feeds.

Most likely she will come home on oxygen. We don't know how long that could be. It is possible that she could all the sudden be ready to go without it, but it is also possible that once she starts taking all her feeds that she will need to go back up to .2 on her oxygen.

I asked Joshua what he thought about holding Abigail today and he said, "that be awesome." So he got to hold her with me after she finished her bottle.

Things are going to be so different when she comes home. Right now when we play pretend, Joshua says I'm the baby and he is either the Mommy or the nurse and he will get in his car then and says he has to go and leaves me, the baby, at the hospital. I'm not sure that he quite understands that she gets to come home and won't stay at the hospital forever.

Before hitting up the hospital today, we went to the Zoo to meet the new Polar Bear, Kali. And of course we couldn't miss the carousel or the train.

Such a big girl

Well feedings have gone pretty well. Abigail starting nippling some of her feedings starting on Thursday. As of Saturday she had nippled 8 feedings and took the whole bottle each time. On Sunday they changed her orders to nipple per cues, meaning that at the feeding time if she was awake and showed cues of wanting a bottle then she would get to take a bottle or try to breastfeed. At that point Abigail decided don't rush me and she only took parts of her next several bottles offered. Over night Monday she decided she was ready again and took 2 bottles in a row and took another one at 11:30 am Tuesday. It is still important to give her breaks and gavage (feeding tube) some of her feeds so that she doesn't use too much energy feeding.

Giving a preemie a bottle: To feed Abigail we hold her in front on her side for 2 reasons.

1. She can protect her airway better on her side because the milk isn't going straight into her mouth
2. Whoever is giving her the bottle can pace her a little by tipping the bottle so that the nipple is only half full. When she takes a break in sucking then we tip the bottle down so she doesn't get extra milk.

Abigail likes her her mobile. I like it because it has the black and white designs on the circles and on different parts of the animals. (So many in the store are for the look of the nursery instead of whats appropriate for a baby) It is fun to watch her eyes lock onto one of the parts as it moves around and then see her catch another one and watch it move.

They tried her on no oxygen yesterday but she didn't make it. She is on a low flow of .1 oxygen (I don't know exactly what it means, but I do know that it is just like a little whiff) She can even handle the prongs being out of her nose as long as they are near her nose but if you take them completely off, she desaturates.

4lbs 15.6 oz!

She looks like Joshua!

One of our primary nurses is head on vacation on Wednesday and will be gone the next weekend and won't be back until the Sunday after. We are hopeful that we will get to go home before then. We love April so much and are so thankful she was part of our team. Lately our primaries schedules have seemed to overlap so we haven't seen April as much in the last 2 weeks. Thank you to 2 of our other primaries for letting April work with Abigail on Sunday and Monday. God's Blessings to you April.

Ready to Eat

Yesterday they gave us the go to start feedings by mouth! Abigail's flow was adjusted to low flow so that she can start to learn to eat.

I tried to nurse her yesterday but I had already pumped so she wasn't too interested. Instead I got to give her her first bottle.  (Sorry no picture we'll get one today)

The nurse practitioner reminded me to not get discouraged if she only took a few mL, to remember that this is the first time she is getting something in her mouth.

Well she took all 40 mLbin about a half an hour. And she did it again early this morning for the nurse.

2 feelings by mouth!!!

They adjusted her to 3 feedings a day by mouth and the rest by feeding tube. As she is learning and getting used to it they don't want her to use too many calories eating and then start losing weight.

I'll keep you updated on her progress.

New Room and more changes!

We are now in the yellow section of the NICU (growers and feeders). We moved on Wednesday late afternoon. The room is huge!

They switched Abigail to all high flow/high humidity on Friday. Then on Sunday they lowered her flow from 5 liters to 4 liters. As they continue to lower she will be able to start feeding by mouth!

Joshua loves his sister and actually sat there looking at her for 10 minutes. We had to convince him to go eat because he was being a little too loud. Every time she did something he would comment or laugh about it. "She put her tongue out," or "She opened her fingers," or "She open her eyes." The more he talked the less Abigail was able to lay peacefully.

BREASTFEEDING DETAILS

I am able to start working with Abigail on learning what to do to breastfeed. I have to make sure that my breasts are completely empty because they don't want her to really get anything since her flow of oxygen is still high. She could aspirate if she gets too much and that could cause pneumonia. The first few times I tried she really wasn't awake enough to do much but she still nuzzled and got a bit of the idea. Today when we did I made sure I was here in time to pump before her hands on time at 8:30 when she is most awake. I was so excited that she latched on and sucked for several minutes. She would pause and maintain her latch and keep sucking! All that coordination wore her out though and she was ready to sleep.

Growing up

Abigail is growing up in so many ways.

1. Respiratory: Abigail has been on CPAP for about a week and has been doing great. They started alternating her between High Flow (no pressure to keep her lungs open) and CPAP starting on Monday. She does 4 hours on high flow during the night and day shifts. With continued success she will spend more time on High flow and Less time on CPAP. Then eventually they will be able to wean the flow completely. She is getting between 23-21% oxygen (21% is room air, what we breath).

2. Feedings: They are starting to train Abigail's stomach for accepting regular feedings instead of continous. Currently she is getting 24 mL of food every 2 hours through her feeding tube but instead of it being continous for those 2 hours the feeding pump delivers it all in 1 hour. Gradually the time will be shortened to 30 minutes. Then they will start stretching her to every 3 hours. So far she has done well. During her hands on time they check how much is left in her belly using a syringe to pull back on the feeding tube. So far she has had very little to nothing left.

3. Abigail is starting to regulate her own body temperature. They are leaving the top to her bed open. Possibly by the end of the day she will be moved to an open crib!

In a crib!!

Joshua also surprised us all this weekend! We went to Travis' sister, Kimberly's wedding. We were so excited to celebraate with Kimberly and Tom, and Joshua was excited to be the ring bearer. Now those of you who know Joshua would probably place bets that he wouldn't make it down the aisle. Joshua is not really known for being out going. He is typically pretty shy and clings to Mom in social settings he is unfamiliar with. 

He walked the whole way with is shoulders up to his ears and smirk on his face!

You can see him sitting in the background.
He liked chasing the bubbles as they blew into the church.

What's new

Sorry for the delay in posting this week has kind of gotten away from me.

Last weekend started with a big change for us. When I called the NICU early Saturday morning I found out that they had moved Abigail to a new room. It is still a room on the Green side (more intensive care) but now we have a window.

Abigail is now a resident of the Butterfly pod. It is so great to have a window now and see the daylight. We were upgraded because Abigail is now ready for the extra stimulation and the sunlight will help her start to regulate her melatonin levels.

On Saturday Rose got to hold Abigail for the first time.

Daddy held her on Sunday before Mommy and Joshua got to the hospital. It was great to spend my Mothers day with my "babies"

On Monday, Abigail had some other big changes. They decided it was time to put Abigail on CPAP meaning she would no longer get a respiratory rate through her nasal cannula. The CPAP still provides the pressure to help her keep her lungs inflated but she is taking all of the breaths herself.

On Tuesday my mom got the chance to hold Abigail before going to pick up Joshua from school.

Abigail is now 34 weeks gestation and 10 weeks 3 days old. She weights 3 lb. 12 oz. She loves her pacifer and even prefers the big girl green Soothie over the purple preemie Soothie pacifier. 

Maybe the pacifier will also help put in perspective her size. I know many people say it is still hard to see how small she is in pictures because you can't tell with pictures in her bed. 

Big Brother comes to visit

The sibling ban has been lifted in the NICU. The number of flu and RSV cases in the St. Louis area dropped enough that older siblings are now allowed to visit their little siblings. We found out right Wednesday afternoon and decided to bring Joshua up to see Abigail.

I picked him up from school and told him the exciting news. He was excited to go the hospital as always but I'm not sure what he thought about going to see Abigail. We went home and cleaned up (Joshua likes to play in the rocks at school and is a little dirty when he comes home).

First stop was a haircut. I have cut it in the past but with a wedding in 10 days it was time for a professional.

He was very excited to get his sticker like Mommy and Daddy get!
And doesn't he look like a pretty awesome big brother with his shades.

Getting ready to walk down the hallway.
He's not quite sure what to think about these new people talking to him

He was definitely a little scared.

But started to warm up

 He sat on Daddy's lap for a little bit in the chair in the room but decided it was time for him to get out. We went to play with the activity tables in the hallway then took a trip upstairs to the pediatric outdoor garden. He was a big fan of the roller coaster. I think he could have rode on in for an hour. I very quickly taught him how to walk the coaster back up the hill so he could do it again all by himself.

Before leaving for the night we went back down to Abigail's room to tell her bye. He was more comfortable this time. It is going to take some time for him to get adjusted to seeing his little sister. I look forward to him developing a relationship with our nurses so that going to the hospital to see Abigail is exciting for him.

I did get him to put his hand on her head and say, "Goodnight" before we left