Palm Sunday

It was so great to attend the Zion Easter Egg Hunt yesterday wih Travis and Joshua. We got to see lots of people and had a great time with Joshua.

It is so funny to watch a 2 year old hunt eggs. For the first few moments he wasn't too sure, he would pick up an egg the walk past 10 and pick up another. It want until his basket was getting full that he got the idea to just keep picking them up. (Travis blames my use of Easter grass for holding him back). His favorite part aside from the candy was the giant balloon sword he got.

In the hospital Abigail continues to do well. The infection is gone and her lungs are clearing. They have upped her feeds and are now fortifying them to give her more calories. She is currently 720 grams  which is about 1lb 9.4oz.

She goes back and forth on her ventilation. One minute she will be at 100% saturation on her oxygen and the next she will be down to 74%. Her doctor today will be monitoring her all day and possibly extubate for her and putting her back on the CPAP to see how she does before deciding to reintubate with a larger  tube. They aren't sure if her up and down on her O2 saturation is due to her air leak (tube too small) or how she is reacting to the tube. It seems like she moves around and makes the ventilator say her airway is obstructed (by her blocking the airway) and then she will desat but come back up with our assistance within a few seconds.

Prayerfully when she is extubated she will be able to work to maintain her breaths with out getting too tired. 

We are happy that we have started to pick primary nurses so that we have familiar faces when we come in. So thankful that Mercy gives us that opportunity to make decisions about Abigail's care.

(Update)

Abigail was extubated in the evening on Sunday but had to be reintubated as she did not do great on CPAP. The larger tube was too big so she still has an air leak, hopefully after growing some more and getting stronger she will be ready to try again.

Start of a new week in the NICU

Well here we are. I was thinking over the weekend that it is hard to believe that it had been 3 weeks since we checked in on Saturday night at Mercy. Just 3 weeks ago I was praying that God would keep this little girl inside me as long as possible. Now here we are she is 2 weeks 5 days old (gestational age 26 weeks 2 days). Every day is another blessing from God.

Abigail is now 740g (1 lb 10 oz). She has out grown her snuggly (the special wrap they place her on to help cradle and swaddle her.) She is up to 5mL of breastmilk every 4 hours in her feeding tube which they just changed to a constant drop to help her stomach handle it. Eventually it will move to feedings every 2 hours.

So far the cultures from her staph infection have been clear and she will finish the antibiotic today and another culture will be taken.

She does not tolerate being messed with to well. She typically needs more oxygen support when she gets her temp, diaper change, and other routine procedures.

Sometimes she seems to be high maintenance, she will be fine until the nurse leaves to take care of the next baby, then she will desat (needing more oxygen). When the nurse walks back in she goes back up and is fine. She can't see the nurse because she spends her time being covered up in the dark to help her rest but she has some sort of sense that someone else is getting attention

She is doing much better with Kangarooing (skin to skin holding) since the staph has cleared up. The nurses can usually turn down her oxygen support by at least 8-10 percent 😃. I can't wait until she can be extubated and we can Kangaroo with a little more freedom.

I made her a new hat over the weekend the one she got the first time we Kangarooed was getting to small. I made this one myself with a little more girly detail. (This momma loves purple)

We are so thankful for all the prayers. Please continue to pray for her doctors and nurses and respiratory improvement. Also pray for our family as we settle into our new groove. Joshua is showing off his ability to be a two and a half year old ( in good and bad ways).

He did have a great time this weekend outside and with all his grandparents.

Travis and I even spent some time together this Saturday. We went out to eat at Billy G's in Kirkwood and walked around Laumeier Sculpture park. I wa exhausted Saturday night but it was good to spend time together away from home and the hospital!

Fighting Staph

Today has been a more difficult day. It actually all started yesterday evening when I got home. My mom had picked up Joshua and after supper discovered he was running a fever. Which meant no school on Wednesday and I would stay home with him instead of going to the hospital.

During the night after waking up to pump I called the hospital to check in with Abigail's nurse. She said everything was going fine.

On Wednesday morning I called again to check in with the day nurse. She let me know that over night A boy's blood pressures had dropped and they gave her an infusion of blood and that she would get another me later today. I got very worried and had a hard time not being at the hospital to find out what was going on. Thankfully Travis was able to come home and stay with Joshua, who was feeling better but not 100% yet.

At the hospital I found out that her need for extra respiratory support and blood was most likely due to her bodies response to fighting the staph infection even with the antibiotics doing their job. They started giving her medicine in a constant drip called dopamine to regulate her blood pressure and help her body pump her blood. Which will in turn help her recover as her cells get the needed oxygen. They also gave her some pain medicine to help her relax and get more rest. It was good to hear from the doctor that this is a normal response to fighting infection.

I was able to leave the hospital and spend the rest of the afternoon with Joshua so Travis could go back to work. 

By this evening they were able to stop the dopamine and reduce her respiratory support. 

We pray her body keeps fighting the infection and she gets back to her feisty self soon.

No more umbilical lines

Today Abigail's last UAC - Umbilical Artery Catheter line came out. This was her last line that she had in her umbilical cord. Up till today they were using the line to get her blood pressure reading on a constant bases and using it to draw blood for lab work.

Abby has a tendency to pull on, wrap feet, and wrap hands/fingers around things that are attached to her. Several days ago she pulled her UVC - Umbilical Vein Catheter line so shallow that they had to replace it with a PICC - Peripheral Inserted Central Catheter, which would have happened anyway.

Because she no longer has a UAC she is now ready to be held. I will get to do her first Kangaroo Care with her tomorrow (hopefully) which means I will get to hold her skin to skin for as long as I can sit!

Abigail has lots of personality and likes to show it by the ways she positions her body. Very rarely does she have all her body parts tucked into her snuggie. As you can see in the pictures below she likes to make herself comfortable.

(These pictures are before the UAC came out)

Just chillin'.
(Not the best picture because of the low lights and glare on her isolete)

Legs crossed like a little lady

First week

After Abigail's baptism it was time for me to go back to my room and assume the role of postpartum recovery. Unlike my postpartum time after Joshua was born I assumed my first Mommy duties with a machine at my bedside instead of baby swaddled close. What joy that I can still provide for by baby and do something for her.

In the morning I went to see her right away, surprised to find that she was no longer intubated instead she was breathing with a respirator. The day moved on with trips back to my room for meals and Mommy duties. Unlike most women I really felt completely fine, like I hadn't even had a baby. Nurses were surprised to find me sitting on the couch spending some quality time with Joshua instead of in my bed.

For Joshua you could start to see the toll the 5 days away from Mommy and Daddy were starting to take. No matter who he was with he missed everyone else. He did really enjoy the play table in the waiting area between my room and the NICU.

Thursday and Friday have kind blurred as far as Abby goes. She was doing great, they continued to step her down on the O2 rate and pressure. Travis and I spent most of the time figuring out what all of the monitors mean.

On Friday I was discharged and went home for the afternoon to get myself organized. I took things a little too quickly and realized that I needed to slow down because my body was still recovering. I spent my first night at the hospital which gave me the chance to just sit.

We found out that she had a murmur in her heart due to an open vessel between the heart and lungs. This vessel kept the oxygenated blood from circling through the body. After an echocardiagram the doctor decided to start her on a medicine called indocine (like ibuprofen) to shrink the vessel. During that time her feedings stopped. After 3 doses over 36 hours her next echocardiagram looked much better and they could no longer detect a murmur in her heart.

The nurses took their time to help me learn how to care for Abigail. We are able to help with what they call "the cares" - taking temperature, changing diaper, repositioning, and changing leads if needed.

On Saturday Travis spent the night at the hospital and Joshua and I had the evening to ourselves as my sister and Travis' parents went home. It was great to spend some quality time with Joshua. We made supper together and had some down time watching Disney Jr. before taking a bath and getting ready for bed.

With the different labs that are taken routinely to check lots of different things in her blood, it was time on receive her first blood transfusion as well. They cross match the blood to my type and hers.

Abigail continued to do well with her oxygen level and pressure on her respirator. She spent different days on and off of the bililight to help her body break down the bilirubin in her blood. With a little assistance she had a big bowel movement.

Through Monday and Tuesday she started to have lots of Brady and Apnea episodes where she would drop her heart rate and breathing. Sometimes she would recover on her own and other times she would need assistances. Because of her immaturity it is a normal occurrence, but the doctor decided it was time for her intubation tube to go back in to giver her more assistance breathing. 

This happened on Tuesday afternoon and was not a fun even to watch. Thankfully the doctor was able to get it done and since then she has been doing better.

Her weight at one point was down to 570g and is now up to 720g (though that number seems a little too high). 

Everything is going well. She no longer has a heart murmur, the vessel between her heart and lungs that was open causing problems has closed.

Time for a change in scenery

Well change in scenery may be a stretch because it was just a change in beds so they really look exactly the same.

I am working on a post to cover things from birth to the present but I had to share some pictures from today!

Abigail has been experiencing episodes called "brady's" her heart rate and breathing start to go way down. It is caused by two factors; first immaturity of the respiratory system and she just doesn't breath, and the second is immaturity of the nervous system sending the signal form the brain to breath. When this happens sometimes she will recover on her own and other times she needs a little rousing from the nurse to get her to snap back. As scary as it can be especially when it first started yesterday day. It is completely normal for a baby so young. It is possible that she will be re-intubated to help her get through this phase. Meaning that they will replace the respirator in her nose with a tube down her throat. The doctor told us this maybe a possibility because she came off of the tube so quickly. At this point there have been lots of other babies in our part of the NICU that have been more pressing than Abigail because we still have not seen the doctor today which is a first for us, other days she was on the top of the schedule. We know things are going better if we aren't first priority.

The real reason I wanted to share a post today was because she had a bed failure. She is in an isolete bed called a Giraffe OmniBed. The bed adjusts the temperature based on a probe attached to her skin as well as a high humidity level. The fan on the bed went out and after restarting the bed it said system failure; which meant she needed a new bed. I got to hold little Miss Abby outside of her bed while they were swapped.  (shhh don't tell Dr. Mauer) Before today I only got to pick her up to do her weight check while the bed zeroed about 6 inches above where she lays. Abigail's nurse, Kaylan took special care to ensure that all of her lines (especially her very shallow arterial line which may come out any day) were all tucked in close inside Abby's snuggie during the move.

waiting as her nurse Kaylan gets everything ready

Hi sweet girl

Making sure all the lines, wires, and tubes get back in the right places

Getting everything adjusted. She kept lifting her legs and bottom up.

Also wanted to share how Joshua is doing! His change in scenery is getting back to the normal life of school. As much as her enjoyed all the special attention he got last week from his Mama, Grandma, Papa, and Aunt Rachel, it was time for him to get back to more normal. It is so great seeing him back in his classroom having a blast with his friends and teachers. We love Zion PDO so much!

Cousins working side by side.

Dance party

Doing some work in his alphabet book.

I can't wait to ask him tonight about the birds in the Commons

New Journey - Welcome to the world Abigail

Family and Friends I hope that you will be able to use our family blog to help stay in touch with our family and to keep you updated on Abigail and the rest of the family. I will try to post often and include pictures and brief explanations of what is happening. I also hope that his blog will help me do some of my own personal journaling of what is going on before it all starts to blur together. I will give warnings before going into details that some readers way wish to overlook.

Little did we know that just a week ago that we would be checking into Mercy and having a baby in March.

I was 23 weeks along when I started experiencing bleeding and cramping. We got to Mercy at about 7 PM on Saturday, Feb 28. Joshua was with us as the snow had started to fall and we knew no one would be able to get him to bed. I was admitted to Labor and Delivery and Travis and sleeping Joshua left the hospital at about 9:30 to go home. Things were okay over night and by the morning were looking better.

Warning Details
I had a sonogram on Sunday showing that my cervical length was shorter than it should be and a check the night before showed I was about 1 cm dilated. The high risk pregnancy doctor had to give me the harsh reality that our little girl could be born soon but not necessarily.

With Joshua in Red Bud now with my mom, Travis was able to stay at the hospital with me Sunday night. Sunday the cramps got worse along with the bleeding. A resident checked me and I was now 1-2cm dilated. The decision was made to give me magnesium to slow/stop labor as well as the first steroid shot to stimulate lung development. Once again on Monday things slowed down (I was now on the mag). The magnesium made it so that I was light headed and could only have a clear liquids diet of jello, broth, and popsicles. I still had bleeding on Monday night but no cramps and I was given the second does of steroids.

On Tuesday I got another sonogram and amniocentesis to see if there was an infection causing preterm labor and if it was bacterial then our little girl would need to be born very soon. By Tuesday late afternoon I was moved to the Antepartum wing in hopes that labor had subsided and we would be moving into bedrest for a prolonged time. When the night time hit however my cramps and bleeding returned. I was put back on monitors to watch baby's heart rate and my cramps/contractions; however, when checked my cervix was unchanged which was a good sign. The resident doctor was able to start seeing contractions through the readings and right away in the morning I was moved back to Labor and Delivery. Things settled a little but but cramps and bleeding continued. I was checked again and everything was still unchanged, it was looking like maybe we would just be in this state for a while. I was preparing myself to deal with labor pains for a few days! 

Like everyday my OB/GYN stopped in to see me and we discussed how this could go on for a while. Not to much later I spoke with the resident again explaining that cramps were getting a little worse and he reminded me that we were moving into the night time mode in which contractions get worse for most women. After he left I decided to relieve some pressure by using the bathroom. The nurse helped me get everything settled with the monitors back in bed and was out of the room. Not more than 3 minutes later things changed dramatically.

All of a sudden I could feel pressure and the pain increased. We pressed my call button and shared the changed. I could really feel the pressure and told my mom and Travis that they had to get someone in the room. Quickly the nurses responded as well as another resident. Within about 2 minutes our baby girl just came out in the bag of waters. The resident carefully moved her to the isolate and the nurses started doing their jobs. Within a few seconds the first nurses from NICU were there and the Dr. was there very soon as well. My resident dr. worked with me to finish labor.
End of labor details

The doctor and nurses worked quickly to resuscitate our 23 week, 4 day, Abigail and get her stable. Once her breathing tube was in her heart responded and then they gave her medicines to help open up her lungs. It seemed like time was flying away as I watched them work. Just thinking and praying for her to be okay. Once she was stable they moved her over to my bed so that I could look at her and touch her before they took her back to the NICU to continue to help her. Travis went with her and my mom stayed with me. I had to complete the recover process that every woman completes after delivering a baby.

Travis was back in short time because they were putting in Abigail's IV lines and he really could be in the room. Travis' parents were able to come up after getting his aunt and uncle to come and stay with sleeping Joshua. Pastor Reitz was also there quickly. After some time Travis, his parents, and pastor were able to go back to NICU and my mom stayed with me as I finished up recovery. They took me to my new room to unload stuff then I finally got to see my beautiful tiny little girl.

We are so thankful to Pastor Reitz who performed a very emotional baptism and made Abigail Lydia part of God's family.

I had to get back to my room to be admitted and after prayers everyone else left for the night. I was so thankful to be able to do what many new mothers do for their babies and start providing milk for her. After taking a sleep aid I was able to get the first nights sleep in 4 days (while still doing my Mommy duties).

In the morning I got to go see my little girls on my own accords. The nurses said she was doing great!

Thank you the awesome nurses, great resident doctors, Dr. Matt and Dr. Ryan, as well as all those who helped Abby and I during delivery. Thank you also to Abigail's nurses and NICU doctor, Dr. Booth.