We Had A Baby!

I have discussed our pregnancy issues in the following posts: The Unexpected Diagnosis – PJ's Projects (pjsprojects.com) , I Am Tired – PJ's Projects (pjsprojects.com),  Pregnancy Update – PJ's Projects (pjsprojects.com) , Pregnancy Update #2 – PJ's Projects (pjsprojects.com) , Pregnancy Update #3 – PJ's Projects (pjsprojects.com) and Pregnancy Update #4 – PJ's Projects (pjsprojects.com)

I appreciate all of the many words of encouragement and support. This post is another update. 

The entire event has been a whirlwind. Basically, the surgery went well and we avoided complications. Baby has required a NICU stay but she has improved daily. We are hopeful to be able to bring her home soon. 

I am including a more detailed description below for those that are interested. I have missed. forgotten about and inadvertently ignored many texts, messages and phone calls over the last few days. It has not been intentional. I have appreciated the concern expressed by all of them. I simply was unable to keep up and I hope that the description below will allow those that I have ignored to forgive me and provide an insight as to what may happen in these situations.

*Note that all times listed are approximations and I may have missed some details along the way. 

Pre-Op Day

The day was a bit slow as we were anticipating the meeting of our new little one. The kids were able to visit in the early evening and we had a small pizza party in the room to celebrate. We discussed some last-minute questions and thoughts. This turned out to be a really nice thing to have before delivery. I highly suggest doing this if you find yourself in a similar situation. The kids then went home with grandma and the hubby stayed in the room overnight. 

9pm: My last full hour of NST monitoring. No problems

11pm: Vital signs were obtained and recorded. 

1130pm: IV fluids were hooked up as I was no longer allowed to eat or drink anything. 

Birthday

4am: Blood draw for pre-op labs. 

5am: Shower and change into hospital gown. 

530am: Twenty-minute NST monitoring prior to delivery. No problems

6am: Met anesthesia. After discussion, it was determined that they wanted a larger IV placed in case I required a blood transfusion. Now, I have two IV lines. 

Things became a little delayed, so we waited for a while. 

730am: Wheeled into OR. Time for the party to begin!

I was prepped for surgery and an epidural was placed. The doctor walked into the room and explained that they were going to avoid the defected area of the uterus in order to limit complications, like hemorrhaging, urinary bladder repair, etc. Instead of cutting along the typical surgical line, they chose to cut above it and then make a vertical incision in the uterus. This would allow them to be able to suture their cuts in the uterus and avoid ripping any scar tissue that may have been attached to the bladder wall. Personally, I suspect that the location of the defect pressed up against the bladder wall was the physiological reason why we were able to sustain the pregnancy this long. The bladder wall sort of "stepped in and held things together". 

Next, the hubby was allowed into the OR and the surgery began. I was able to see the surgery in the reflection of the overhead light. I know it sounds weird but being able to see the process was quite comforting to me. The hubby chose to avoid looking into this reflection and appreciated the large curtain separating my head from my mid-section. We all have different ways to cope with things. By watching this reflection, I was able to see my baby being born. She presented to the world feet first, then her little booty, then finally her head. 

I got a quick glimpse of her because they had to take her away for assessments and treatments. I have had other C-sections and the baby was always evaluated in the same room as the mother. This time, they took the baby to an adjoining room. I don't know if this was intended to prevent causing me more stress since she was premature and required more interventions, but I hated it. I know that they were working hard but the not knowing was worse for me. 

Later, they let hubby see her for a few moments before they took her to the NICU. Hubby returned and told me that she was a big baby for this age at 5lbs 11 oz. He stated that the doctor was trying to see if she could clear the mucus and fix her breathing on her own but that her breathing was definitely labored. 

We had intended for the hubby to accompany the baby to the NICU while they finished my surgery but that wasn't offered when they transported her. Again, this not knowing that hubby was with her during these stressful moments was frustrating for me. We simply had to wait. 

The surgery took longer than any of my other ones. I expected this as they had more issues to consider and repair. Overall, it went very well, and we avoided several of the possible complications. 

Hubby accompanied me to the PACU (recovery room) where I had some minor trouble maintaining my temperature. It wasn't a big issue, and it was corrected with warm blankets and a bear hugger (plastic covering with warm air blown into it). The waiting for information about baby definitely tested our patience. The kind PACU nurse called because she could see that we were concerned. She was able to send hubby to the NICU. Hubby left and I continued my recovery. The nurse helped me to pump a small amount of colostrum for the baby. 

Hubby texted to let me know that baby failed the initial breathing trial. They decided to intubate her and give her surfactant. Surfactant is a medication that is administered through the breathing tube directly into the lungs of babies that may not be able to produce enough of it. I think of surfactant like the oil in a car. It is there to make sure that the parts of the lungs are able to move and work as intended. 

*before intubation

 *after intubation

1pm: I was transported to my room. I waited for what I considered patiently until I could convince the nursing staff to let me go to the NICU. I found out later that it wasn't exactly patient, but they tolerated me. With their assistance, I was bundled up in the wheelchair and taken to baby's room. I stayed in the room with her for a few hours. The respiratory therapist, doctor and nurses were in and out but overall, she was stable. Finally, I let hubby convince me that I should go back to the room. 

530pm: I returned to my room. The nurse did her assessment and vitals were recorded. They gave me Tylenol and ibuprofen for pain. I attempted to eat but was nauseous. I was more tired than hungry. I slept.

630pm: Another assessment and one of the IV's were removed. I slept. 

8pm: I pumped but didn't get much. I attempted to get up but discovered that I was in more pain than expected and felt very dizzy and nauseous. I slept. 

9pm: Foley catheter was removed. Nursing assessment was performed. Checked in with hubby and discovered that baby's vitals were stable and that she looked comfortable. He encouraged me to rest. After confirmation of her condition, I decided to take some oxycodone for the pain. Nurse informed me of the upcoming scheduled assessments and plans. Based on this timing and my slowness in getting to the NICU, I decided to stay in the room overnight. Hubby agreed to call if anything changed. 

11pm: I pumped. Still very little. Report from hubby that baby looked good, blood gases were better and that she was resting. 

1130pm: Vital signs, nursing assessment was performed, Tylenol and ibuprofen were given to me. I slept. 

Day #2

3am: I had to prove to the nurse that I didn't have any urinary difficulties after the removal of the catheter. I discovered that the trip the bathroom was brutal. I was in pain and very nauseous. I asked for more oxycodone. I verified with hubby that things were still going well in the NICU. I pumped. I slept.

630am: The resident stopped in to check on me. I messaged hubby and he verified that things were stable. Rumor was that baby was doing so well that she may be extubated (breathing tube removed) soon. 

7am: I pumped. This was getting ridiculous. I was hooking myself to this machine for a considerable amount of time and getting NOTHING. I know that it takes a while for a mother's milk to come in, but this time I felt more pressure to provide the milk for my baby in the NICU.  

8am: I became very lightheaded and nauseous after a short trip to the bathroom. This surgery was kicking my butt.

9am: Nurse completed her assessment and gave me medication for nausea.  I felt that I was dehydrated and asked the nurse if I could have some IV fluids. She agreed to discuss it with the doctor. The tech pushed me to the NICU in a wheelchair. Baby passed her breathing test and was extubated. 

   *I'm sure that she was happy to have the breathing tube removed but she looked ready to put up a fight!

~9am to 1pm: I visited with hubby and baby in NICU. It was discussed that anything that I pumped would be given to baby in the OG (oral gastric tube). I was in more pain and weaker than expected. Hubby insisted that I return to the room to rest. I felt guilty that he was taking on this huge burden all by himself, but I relented. They removed the arterial line and after lying flat for a few hours, we were told that we may get to hold her around 5-530pm.

1pm: I returned to the room. I pumped. The nurse was my advocate and convinced the doctors that I could benefit from some IV fluids. She started them for me. I slept.

2pm: I had a variety of visitors. It was great to see them and show off pictures of the baby. 

3pm: I slept. 

4pm: I pumped.

5pm: Hubby came to the room to wheel me to the NICU. I wanted him to see some of the kind gifts that were dropped off for the baby. We returned to the NICU. 

6pm: I was able to hold my baby for the first time!

8pm: Baby was weighed again and was 5lbs 9oz.

10pm: I returned to my room. I pumped. I ate a little bit. The nurse completed her assessment. I took more medicine for pain. Hubby reported that baby was doing well but wide awake. He stayed up with her and I slept.

Day #3

430am: I pumped. I felt much better than the day before. Maybe it was the rest, the IV fluids or the continued positive milestones that the baby was making, but I didn't care. I was ready to go! I took a shower and changed.

7am: I ate breakfast. After speaking with the resident and my nurse, I was ready to see my baby again!

Events of the day:

   - Hubby changed baby's diapers. 

   - Baby started tube feedings of 5mls every 3 hours. We set up a schedule as is typical for the NICU. I was told by the physician that if I didn't start producing enough milk that we would be forced to start baby on formula for her feedings. 

    - The CPAP (green tube forcing air into baby's lungs with oxygen) was decreased from 6 to 5. 

     - We did some skin-to-skin interactions. Luckily for me, this kicked in my mommy hormones and my milk came in. 

     - Introduced the pacifier. She liked it. 

     - Feedings were increased to 10mls every 3 hours and were starting to give them by bottle.  

     - The umbilical venous line was removed. It kept getting pulled and wasn't in the desired location so it was removed and an IV line started in the hand. 

    - The OG tube (oral gastric tube) was replaced with the NG tube (nasogastric tube) to allow her to feed better but still have access to administer feedings directly to the stomach if she couldn't do it through regular feeding. 

    - The antibiotics were stopped. We were told that due to her premature age, antibiotics were preemptively started until the culture results were considered negative after 48hours. She had shown no signs of infection, so I was glad to see these medications stopped. 

   - Weight =  4lbs 9oz. We believe that this may be off. The bed that she was in was sending out false alarm messages and it was replaced. The new weight was obtained from the new bed. 

    - Baby wore a hair bow for the first time.

    - Daddy held baby for the first time. 

Day #4 - Mommy Discharge Day

Events of the day:

    - I was discharged from the hospital. It was a great feeling! It took some creative packing and loading on the hubby's part to get all of the stuff from the room to our vehicle. I spent the morning talking with new friends that I had made during my admission. They were very supportive and kind. I will miss them, not the hospital, but some of the people. After I was officially discharged, I returned to the NICU. 

    - Baby appeared to be having some gas pains, so she tried some tummy time. She loved it!

  *Note the new swaddle given to us by a kind friend. 

    - The CPAP was weaned off for a trial run. She did well and it was officially removed and has not been replaced. The green tube is gone! 

   *She really likes tummy-time!

     - Feeding was increased to 20mls every 3 hours. 

     - Weight = 5lbs 2 oz

     - Bilirubin was elevated but light therapy not needed at this time. 

      - After my discharge, the hubby went home to rest and spend time with the kids. He returned to the hospital around 7pm to stay with the baby overnight. I left to spend my first night at home in almost three months. It was great! The kids had cleaned the house, made and posted welcome home signs and were very attentive. I was tired and sore so we made it an easy night with a little TV, pizza and early bedtime. I spent some time talking with the kids about the events of the last few days. I spent a little one-on-one time with one kid discussing the feelings and events of the past few months. I realized that these kids were working hard to be brave for mommy and daddy over these last few months. They had a lot of worries and concerns in addition to their lives being turned sideways. This was just the start of many conversations that we need to have to move forward, but at least we are at the stage of being able to have these talks. As I explained to them, we are on the upswing! 

Day #5

Events of the day:

    - She pooped. She was squirmy and wiggly all day yesterday and really needed a good poopy diaper. Lucky for me, she did this on the hubby's shift!

    - Hubby informed me that baby pulled out her NG tube in the early morning. They replaced it, taped it securely and placed mittens on baby's hands. Somehow, she managed to pull it out again. They decided to leave the NG tube out and would only replace it if baby didn't complete a feeding by bottle. Her face was free of all tubes and tape!

   *She has a very pretty face, even if I am a bit biased!

   - Our NICU wing welcomed three new babies overnight. A couple of them required several interventions and the hospital staff was very busy. We didn't get a lot of information in the rushed physician meeting, but we were grateful that we didn't need a lot and wished them all the best in their work with the other babies. Hubby and I sat together and discussed how thankful we are for how things have turned out for us. We really couldn't have asked for a better outcome. I hope that the couple across the hall will be able to say the same thing in a few days. 

   - Baby's bilirubin increased overnight and just passed the threshold of needing light therapy. She put on her mask and looked like a superhero. 

    - Feedings were increased to 30mls every 3 hours. 

    - The lipid portion of the TPN was stopped as she is getting closer to her weight-based feeding goal. 

     - Hubby returned home for some much-needed rest and I will remain in the NICU with our little munchkin. Hubby will return in the morning to be with me as the physicians make their rounds and we discuss the therapy plans. Then, I will return home. We plan to change out like this for a couple of days and reassess our plans as needed. 

There it is. We are in the upswing of a crazy time in our lives. We still have work to do and things to address but I can't stop smiling. We have survived this struggle and are looking forward to more adventures (albeit slightly less dramatic ones) in our future. 

I think this is a great stopping point for the pregnancy series. Don't worry, we will continue to share important events, homeschooling activities and homesteading adventures so don't run away.

Thank you for reading my blog, praying for us, the supportive words, gifts and overall encouragement during the ups and downs of the last few months. It has meant a lot to me and my family.