Monday, June 29, 2009

A Coil & Other Updates

The good news is that it has only been one week since I posted last. I thought surely it had been longer. The bad news is that when you go a whole week without posting and you used to post daily, you end up with lots to say. So get ready for information overload.

The first fun fact is that on Friday Elise was up to 9 pounds, 2 ounces! She's ginormous, I tell you. She has, however, been struggling with constipation so her weight was a little higher due to some excess baggage she was having trouble letting go of. The good news with that is that the problem seems to be clearing with a pause on her vitamins (since they have iron) and a bit of prune juice each day, and she treated grandma with a nice large present yesterday afternoon while I was out.

Speaking of grandma, things have been a bit rough around here. I didn't mention it last week, but Elise has been throwing up whole feedings 1-3 times per day most days for the past couple (maybe three) weeks. We think it's her reflux, but the doctor said on Friday that she wanted to wait until Elise's constipation has cleared and she's pooping 1-2 times per day to make sure she's not just spitting up because she's constipated. If she keeps spitting up excessively like this, we'll put her on a stronger reflux medication. I've been feeding her more smaller meals when she's not so hungry that she needs a bigger meal. I'm also stopping her many times during her feedings to burp her to ensure she doesn't spit up because of extra air.

That said, it's very difficult to watch your baby loose so much of her food each day when she only eats 5-6 times per day in the first place. And we're not talking a little spit up and needing to maybe change her clothes, we're talking 90-120 cc (3-4 ounces) of milk (and sometimes medicine and/or prune juice depending on the meal) coming in full force projectile mode. This results in needing to change her clothes, needing to change all of my clothes (because it quickly seeps through the layers of my clothing) and needing to clean the chair, the floor and anywhere else it gets. I've started feeding her with a thick towel on my lap, and she's hasn't spit up in my lap since. Last night she had a large spit up in her bouncy seat though, which also went all over the floor and my slippers that were next to her seat.

All that to say, I haven't been doing well between exhaustion, trying to breastfeed (which is going wonderfully!!), bottle feeding, pumping, keeping up with some housework, etc. I called my mom crying a couple of days in a row, but she was planning on coming Tuesday so I was trying to hold out until then. Saturday morning I knew I just couldn't do it without her. So I called her around 10:15am, and she packed her bags and was here by about 6:30pm. I'm so thankful to have her here and only wish I had asked her to come sooner!

And speaking of being out yesterday, I was able to get together with fellow blogger, Amanda, and to briefly meet her adorable daughter (who was born at 26 weeks in August of 2007 and weighed a mere 1 pound, 11 ounces - 1 whole pound less that Elise) and three of Amanda's sisters. Amanda and I had a wonderful three-hour coffee chat at Starbucks - the longest I've been away from Elise since we brought her home. I find it so refreshing to know others who have been in a similar situation to ours, and Amanda has been a huge support to me via email over these past four months. Her daughter has severe reflux issues so it also helps to have someone who understands on such a deep level how hard it has been to watch Elise lose so much of her food each day and not knowing exactly how to help her.

This morning we had an appointment with the cardiologist at 9:15am. Getting a baby to the doctor that early in the morning proved to be a bit of a challenge, and I'm headed to take a nap (thanks to my mom!!) once I finish blogging. I hadn't expected much at this appointment and thought we'd here the typical, "she still has the PDA, and is asymptomatic so we'll see her in a few weeks and hope it closes." Unfortunately, after answering various questions from the cardiologist and having an echocardiogram done, he said that because she's taking so long to heat (30-45 minutes), often having to catch her breath and is sweaty feedings and at other times and because the echocardiogram showed that her left ventrical is enlarged from pumping the extra blood, they are going to have to place a coil in the ductus to close it.

So on July 13th we'll be going to get that placed at the hospital. My mom went with me and Elise to the appointment today; Kit didn't go since we thought we were just going to get the usual spiel so now I get to show him the picture the doctor drew on and explain it to him in laymen's terms until we meet the doctor who will place the coil who can explain it better. The cardiologist showed us an ultrasound picture of what the coil will look like in the ductus as well as a little sample coil taped to a piece of paper. It's tiny and thin, maybe like a two or three pieces of normal thread wound together in thickness. And it's made of platinum and has some "fuzz" (that's what the cardiologist called it) that helps it to stay in place and keep the PDA closed. Here's a sample ultrasound picture pre and post coil placement to show kind of what it will look like. In the first picture, you can see that the blood is flowing through so it's darker on the left side. In the second picture, you can see the coil and then that the blood is no longer flowing through.

The procedure is fairly simple. The put a very small catheter (I believe) in the artery in one of her legs that they then feed up into the heart to insert the coil. She should only need to be in the hospital for a day. There is a small chance she'll need to stay overnight, but it's most likely that she'll come home the same day.

The good news in all this is that she doesn't need to have surgery! The cardiologist explained what surgery would entail since, although he recommended the coil, he said we could choose to have her have the surgery. Not sure why anyone would choose to have their child undergo a surgery that would require a fairly large incision in her back near her ribs, the deflating of her left lung, the removal of the PDA and then the putting of everything back together is beyond me. We're going with the coil. There is a small chance she might need to have another one put in six or so months from now if for some reason this doesn't keep it closed, but he said the doctor (can't remember exact specialty - maybe cardiac surgeon??) who will put in the coil is very good and does these in babies who weigh 500 grams (barely over 1 pound) so the likelihood of it not working is very slim.

My mom thought to ask about whether this will mean she has to carry something saying she has metal in her body for things like the airport and whether she could have MRIs, etc. The coil is so small that there's nothing to worry about there. He said it's made of inert matter so it doesn't hurt the body in any way to leave it in for the rest of her life.

For now, she's on another diuretic to help pump fluid from her body, which should help with her heart function until she can have the coil placed.

Well, that's way too much information and it's now actually Tuesday (though I'll leave the post date as Monday) so I'm going to go ahead and post this. More to come later.

Monday, June 22, 2009

Eight Pounds, Eight Ounces

Yes, you read the post title right: Elise is 8 pounds, 8 ounces!! Can you believe she's come so far? We have been so blessed and are so thankful that the Lord has blessed us with this beautiful (and chubby!) little girl.

I've been praying for a few days now about whether I should try getting Elise to entirely breastfeed or for peace about continuing to pump for as long as she needs me to.

With the news of her fabulous continued weight gain at her pediatrician appointment Friday (forgot to post her weight from two weeks ago but will do so once I confirm it with them since I don't actually remember the exact weight) and with my questions to the pediatrician about continued pumping (wondering how successful she's seen moms be who have exclusively pumped for their child's entire breast milk/formula feeding length), the pediatrician gave the go ahead for me to try breastfeeding as much as I want and Elise will participate in this week. This includes exclusively breastfeeding if she's able.

Our weekend was busy so I didn't get started until today. So far she's nursed 3 times today and done really well. She's needed the bottle (aka wouldn't nurse any more and was still hungry) after each feeding, but the plan is to spend as much time at home and without visitors as possible this week so as to focus on being able to nurse as much as Elise allows. It's a balancing act of having the right amount ready to go in the bottle, still getting her medications and vitamins via bottle, and knowing whether to pump or to wait because she might be hungry again in an hour. Phew! Friday we go in again for a weight check to ensure she's still gaining.

Please be praying for us this week. As any mom who has breastfed knows, it's not an easy thing to do for anyone. And given all that we've been through, most days it seems like it would be easier to just continue pumping rather than having to nurse, bottle feed and then still pump (very time consuming). But in the end, it will be so worth it if we can get to where we are only using bottles and the pump occasionally. It will most likely take a few weeks if we do transition off the bottle, and this week will be really telling as far as her weight gain as to how quickly or slowly we can make the transition. No matter what, as I said above, I'm just praying for peace with where the Lord leads.

Another thing to be praying for is Elise's reflux. Praise the Lord that the medication she's on seems to be decreasing the acid enough so that she's not seeming to be in pain with the reflux. It's the lowest level of medication, and we'd love to not have to go to a higher level as those medications have more possible side effects. Any of the medications only neutralize the acid though and don't stop the reflux from happening (i.e. excessive spitting up as well as coughing when the food only comes up part way). It's hard to see her sometimes lose entire feedings and to not know how much of her blood pressure medication or vitamins she might have lost when she spits up after bottles with those in them.

Overall though, we're doing well. Just doing all the normal stuff that parents do when they have had their baby home for four weeks like being sleepy all the time, feeding, changing poopy diapers, changing clothes that have been spit up on, cuddling, tummy time, etc.

I love my little family and am so grateful to have such a wonderful, supportive husband. And ultimately I'm so glad to know that I have been redeemed by my Savior in spite of all my shortcomings. God is good.

t4gkfmuhvq

Sunday, June 21, 2009

Happy Fathers' Day

I find picking out mothers' and fathers' day cards difficult. Most of them are filled with sweet sayings about how moms and dads were always this or that (usually a reference to nothing short of perfection). My problem with that is that always seems like an exaggeration and the cards' references to them being almost God-like just seem plain silly. Call me overly analytical (because I am) and feel free to laugh. But I don't want to lie in a card so it makes things tough.

(Note to Dad: I already mailed your card, and while I know I meant what it said, forgive me if it uses the word "always" and know that I do mean what it says...even though I can't currently remember what it says.)

As I thought through what to write in this post, especially having read others' tributes to their husbands and dads, I was having the same troubles I have in the card aisle. Neither my husband or my dad are as perfect as the cards seem to think they should be. And that's exactly why I love them both so much...

As we finished out our fourth week of having Elise at home and the fifteenth week since she was born, we're still bumbling through new parenthood like everyone else. I'm tired and cranky. Kit isn't psychic. And it means neither one of us is always a peach to be around. But one thing I know, Kit is almost always the first one to apologize and the first one to forgive - two things I struggle with immensely. And he's always willing to talk through things with me - another thing I try to avoid from time to time. Both of these traits are things that I think will make him a wonderful father. Because being a dad isn't about being right all the time. It's about loving your kids the best you can, admitting when you make mistakes and being able to forgive when your kids do the same. I'm so thankful to have Kit as the father of my little girl.

Also finishing out this fourth week of having Elise home, I grow in admiration for my own dad. He's done this more times than most (I have five sisters and three brothers). I can't imagine. He too isn't perfect, but I remember fondly a trip we took to Montana with some other members of our church youth group when I was in high school. My dad, like my hubby, isn't a super emotional guy. So you know when the tears brim his eyes, he really means it. I remember at the end of that week as the group reflected on the week, my dad crying as he expressed regret over not spending more time with me and not always expressing his deep love for me. My dad was technically my step-dad (though I've called him dad for as long as he and my mom were married) until I was twelve, which is when he adopted me. So I've always known that he must love me a whole lot to have chosen to be my dad (and not in the choosing to have a baby sense but in the choosing to be the father of a little girl who talks too much). But in that moment in Montana (or maybe we were in Idaho at that point), I knew more than ever of his love for me in his apology for not being perfect.

So while it might be more status quo to post a tribute to how perfect my husband and my dad are, today I'd like to post a tribute to their humility in their imperfection. I love you both dearly.







Wednesday, June 17, 2009

First Play Dates & More

Well, Elise has now had her first two official play dates - both with boys nonetheless. Either she's going to be a tomboy or quite the little lady. Kit hopes for the former, I'm sure.

Both gatherings involved long walks, which was very nice to get out of the house. They also both involved moms/babies we met while in the NICU, which was also very nice to both catch up and to talk through all we've been through and are going through from having preemies. Oh, and I just realized that both boys came home on the same day - one day after Elise. Elise spent her whole first play date in her sling so I don't have any photos from that one. But her second play date (today) was with her buddy Anthony (whom I've written about before; his parents have become good friends of ours and were tremendous support while Elise was in the NICU). So, of course, Susan and I pulled out the cameras after our walk and took tons of pictures. They're at the end of this post.

Last Friday I took Elise to the pediatrician after she developed a bump on her gums that grew quickly and almost looked like a tooth but was soft. Her pediatrician was booked so we saw another doctor and I really like him. He thought he knew what was going on before looking in her mouth and confirmed it when he looked at the bump (which had gone down significantly). He also showed me another bump on the roof of her mouth. Diagnosis: clogged mucous membranes. I guess it's really common for babies to get them and not anything to be concerned about. The ones on the gums are called Bohn's Nodules and the ones on the roof of the mouth are called Epstein's Pearls; however, the pediatrician said they're both the same thing, just discovered at two different times in history by two different guys who didn't know at the time what they were.

On Saturday night we were in the living room watching a movie. We rarely all sit in there because Kit and I watch most of our TV online and don't get movies very often. But I had checked out a couple of movies at the library so we sat down in there. Kit ended up finding another movie on TV so we were watching that instead. Anyway, luckily we were in the room and Kit has more powers of observation than I do because he noticed that there was bubbly water filling the family room. Someone accidentally put a wash cloth in the drop sink that our washer drains into (we're honestly not sure who because neither one of us remembers setting a wash cloth anywhere near the sink recently), and it had clogged the drain.

So at that point we had the drop sink full of water and then water all over about 1/3 the living room. Kit's dad came over with tons of junk towels because ours have been magically disappearing (again, we're not sure where they're going to because neither one of us recalls taking them anywhere). He helped Kit move the washer and dryer out of the way so that they could mop up the water underneath them. We have vinyl flooring in the kitchen and family room rather than hardwoods like the rest of the house so it was a bit easier to clean up and shouldn't be a problem for the flooring, but we ran the ceiling fan in that room all night to make sure to dry up any remaining water. While this took place, Elise slept on the couch and I sat next to her - ah, the rough life of ladies.

The other day Kit brought in a package that had been delivered with my name on it. The package was from the library, and I was very confused because I don't think I've ever used my library card because we always use Kit's. When I opened the package, I was delighted to find a hard baby book inside as well as coupons for four more books (to be obtained at four separate visits to the library) and information on early literacy. I thought this was very cool and am excited to take Elise to get her books once she gets older and her immunity is stronger; as I've gotten older, I've gradually found libraries more and more disturbing as far as the germ factor and sometimes feel weird about reading library books when they are older books that are bound to be more germ-filled. I know this is probably odd, but it's gross to me so I'm going to have to be a big girl and let my little girl go to the library when she gets older and actually touch things (for now I'll just carry her in the sling once we get the go ahead from the doctor to take her out and about).

Another fun occurrence in our household took place while Elise was sleeping. Kit made homemade chocolate ice cream while I made homemade strawberry freezer jam. Both turned out delicious, and we had a great time working together on our separate projects! His ice cream tastes much like a delicious fudgecicle. And I made two different kinds of jam; one has tons of sugar and is more like a jelly, and the other has more berries and is more like a jam.

Last week I inadvertently ruined a bunch of bottle nipples when I boiled them. We've been using the hospital ones that are technically one-time-use but that the hospital staff said we could use repeatedly as long as we washed them in hot soapy water. Soon after I ruined those, a couple more of the new ones we opened looked like they were starting to crack as well and got tossed. So I knew it was time to go to the store and actually pick out nipples.

Anyone who has gone to the store looking for bottles or nipples knows there are tons of options. It's really ridiculous. So I spent quite a bit of time walking back and forth between the different brands. I had planned to just buy some nipples and figured we could still use the hospital bottles. However, Elise was already eating more than can fit in one bottle in a sitting (which doesn't matter so much when she's getting her medicine or vitamins but is a pain when she just needs milk.) And the nipples on they're own are ridiculously expensive, especially when the NICU staff said you just have to try the various flows to see what works best since all brands are a little different. In the end, I bought the Dr. Brown's bottles. They have high promises about being good for babies with their scientific technology, and the box I got came with the most stuff for my money when compared to the value-sized boxes of the other brands. So for $49.99 I got:
  • 4 - 4 ounce bottles
  • 8 - 8 ounce bottles
  • 12 - level 1 nipples
  • 4 - level 2 nipples
  • 4 - level 3 nipples
  • 4 - level 4 nipples
Before opening the box, I got online and read lots of reviews of the bottles. Overall, everyone seemed to like them other than the occasional leaking (which sounded like user error) and the extra parts to clean (seriously takes like 10 extra seconds). So, with Kit's backing since I think I've mentioned my fear of big purchases, I opened the box. She seems to be doing well with the bottles so I've been pleased so far. And she's using the level 2 nipples. Oh, and the special subtance the bottles are made with dries quickly, which is really nice. The nipples take longer to dry, but it's an okay trade off.

Without further delay, here are the photos I've been promising...

She's been loving her tummy time and sleeps like a log once she gets settled down.


I love to just stare at her.


When I bought the bottles I happened to notice a familiar "face" hanging from a kiosk in the store. You may recognize her as a small, rattle version of Petunia, the monster Kit bought Elise while she was in the NICU. I introduce to you PJ or Pentunia Junior.


Just had to include this photo from what I consider to be my first official day as a stay at home mom (Kit went back to work on Monday). It's my relatively clean and completely empty kitchen sink!! With no husband around to put dishes in it, I managed to keep it clean and empty all day! There's something very peaceful about an empty kitchen sink.


More tummy time.


I loved how she had her feet propped up on her little toes.


So cuddly.


Last night Kit ran to the bank to deposit a couple of checks. While he was gone Coco decided he was okay with this little creature he's not allowed to lick and cuddled up with her. I, of course, ran to grab the camera to capture this first cuddle.


How adorable is that? I didn't set this up, they were intertwined like this on their own. So precious.

And here's the play date photo shoot...