Pins and Needles

Atty comes home today!! In about two hours, as a matter of fact. We just need to wait until James gets off work, and we're heading up to get our boy. It's quite a surreal feeling--excited and thrilled and terrified and skeptical at the same time. Much how I felt the morning James and I got married--is this really going to happen? My whole world is going to change in a matter of hours, and everything looks and feels just a little different.

I'll post more about his homecoming tomorrow. Until then, enjoy this collection of photos and a video clip from the last few days. The video's a little choppy--we don't know how to fix that on our camera. But at least you get some motion and voice. I love those little hands.

Day 3 and Counting

Atty has gone three days without an A&B! AND he's been without oxygen for two days now. What a little wonderboy!

He's still working on the eating thing. He gets too tired drinking from a bottle, so he still gets some of his food through the tube. He seems to eat better when I feed him (she says with motherly pride), so I might take some time off next week so I can spend more time with him at the hospital and feed him more often.

I'm trying not to get my hopes up TOO high, but if things continue to go this well, he could come home next Wednesday. We'll survive if he needs to stay a little longer, but it would be so nice to have him home next week.

On a semi-related note, our combined hospital costs are now close to $150,000. One statement for Atty's care alone was $103,000. We don't have to pay that much, of course, and there's no way insurance is paying that much, either. It's like they have to charge twice as much so they get what they really want. But it's still heart-stopping to realize the costs of health care. I'm so grateful for insurance.

We don't spend ALL our time at the hospital...

Last night James and I went to the ballet. It was a collection of four short performances, each with a very different flavor. Kind of like a ballet sampler. The first was "Serenade" (pictured above) by George Balanchine. I'm not super familiar with ballet, but this was the one and only Balanchine piece I've heard of, and it was absolutely lovely. Classic, elegant, and with a little drama. It made me want to get one of those skirts and leap around my living room.

Next was a dramatic pas de deux, Hamlet and Ophelia. Then there was an all-male piece that was supposed to be very masculine, but in my humble opinion, it wasn't. I've seen some very powerful, masculine dance, and this just wasn't it. The costumes didn't help: puffy peach shirts and tights don't scream manliness to me. But it was still well done.

The headlining piece was "Nine Sinatra Songs" by Twyla Tharp. (James pointed out that it should really be called "Eight Sinatra Songs," since they used "My Way" twice. Sure, they were different versions, but still....) The choreography and costumes were much more modern, though still definitely ballet. It was interesting to recognize it as ballet even though it was more ballroom-style.

I'm not a huge Sinatra fan, but I really liked this piece. My only complaint is that we were sitting a little too close to a speaker, so those final notes of "My Way" were a bit intense. I shouldn't complain, though, because our seats were great--3rd row orchestra.

This isn't the kind of thing I'd normally search out, but James got free tickets through SLUG, so we went. I'm really glad we did. I miss going to things like this. Susan and I had season tickets to the opera for two years, and I don't think I've been to the opera since. I haven't been to the symphony since Margaret moved to Boston, and I haven't seen a play for a couple years. Maybe I need to look into upcoming events more closely.

Speaking of which, James and I are really excited for an art exhibit opening at the UMFA next month: Monet to Picasso, from the Cleveland Museum of Art. All you Utah people should come check it out. There will be pieces from some of our favorite artists, including Van Gogh and Modigliani. We're thinking of becoming museum members so we can get invited to the preview social and get free tickets. Yes, it would be cheaper to just buy two tickets after it opens, but this way we'll stay informed about upcoming events. I've missed a few that I really wanted to see just because I wasn't paying enough attention. (I shudder to think of how much of life I've missed simply because I wasn't paying attention.)

Art: It does a body good.

Let the countdown begin...kind of

Yesterday we got our first semi-solid estimate on when Atty might be able to come home.

Short answer: the very SOONEST he could come home would be 30 April, or a week from Wednesday.

Long answer: He has to be off caffeine for 14 days, then have no A&B's for 7 days after that. (Don't know what an A&B is? See sidebar on right for link to more info.) This Wednesday will be his 14th day without caffeine, and the 30th is 7 days after that. He was taking caffeine because it stimulates the part of his brain that reminds him to breathe, but he has now reached the age where it doesn't have as much an effect, so they stopped it.

Please note that this is NOT a guarantee that he will be ready to come home on the 30th. Right now it seems very unlikely that he could go 7 days without an A&B. He's been having them every day until now, and with his acid reflux and mild constipation, it's likely to continue like that for a while. (His A&B's are usually connected to one of the two experiences.)

He's still eating like a champ, and although he still has oxygen, it won't keep him from coming home. Let's keep our fingers crossed and take lots of deep breaths for little Atty.

Spring just makes me happy.

I know we're expecting thunderstorms this weekend, but I just have to say that these sunny days and warm breezes have done wonders for my soul. I love hearing the birds in the morning and seeing buds on the trees (even the stinky ones). I love seeing the bulbs coming up and being able to go for walks in the sun. I love the smell of hyacinths. It reminds me of one of my favorite poems:

If of thy mortal goods thou art bereft,
And of thy slender store two loaves alone are left,
Sell one
And with the dole,
Buy hyacinths to feed thy soul.

Atty's first bath

Last night was pretty eventful for the little guy. First, we replaced the tape holding his oxygen and feeding tubes in place, so we got to see his naked face for the first time.

It's not the best picture, and we didn't have the chance to take many more because we didn't want to leave him without oxygen for very long. He's doing his John McCain face again. We'll have to work on his Obama impression... ;-)

Second, he got his very first bath. We weren't sure how he would react to the water. I kept reminding him he's a Pisces, so he should like the water. For preemies they do what's called a "swaddle bath," where you keep him swaddled in a blanket in the water so they don't feel too exposed and vulnerable. And it helps with keeping a grip on that slippery little body. Here he is going into the water:

Oooooh yeah, he liked that a lot. He was still all squirmy and fussy from getting his tape removed, but as soon as we put him in that warm water, he got really mellow really fast. The pacifier didn't hurt, either.
(Yes, I'm wearing the same shirt I wore Sunday. Forgive me for not being more creative on a Monday morning.) With me is Atty's nurse Emily. We really like Emily. She's one of his primary care nurses, so we see her a lot.

Still mellow and content...

He didn't like getting out of the water one bit. He wailed, but he calmed down pretty quickly once he got all wrapped up and snuggly.

Then we had to get him diapered and dressed and put his feeding tube back in, which he didn't like at all. But here he is all warm and clothed and snuggly and getting fed (you can see the formula tube from the pump in the lower right corner). He's up to 42 ml per feeding, and he's just over 5 lbs now. He still fits into his preemie clothes, and everything else is still too big. Probably not for long, though.

So that's how Atty spent his first (month) birthday. Emily said she put a little cake in his formula to celebrate. :) We are so proud of our little man.

One month old

Today is Atty's one-month birthday. He now weighs just under 5 lbs, and he's still doing really well. James and I had a nice long visit with him yesterday.
Here's a video of his fantastic drinking skills. We try to help him pace his eating, so we have this back-and-forth thing going: give him a little milk, then tip so the milk drains out of the nipple to let him breathe, then tip a little more milk in. Eventually he'll do it for himself, but now he needs a little help. You can't see his face very well in the video, so I've added a "bottle's-eye view" of him drinking. This is what he looks like pretty much the whole time he eats, unless his eyes are closed. Such concentration...

He gets his first bath tonight. We'll take pictures and post those tomorrow.

Photo Tag

Susan tagged me. This was fun. Here’s what you do: Search for a picture on Google (or Yahoo!) Images in each category. Post an image from the first page of results.

Age on my next birthday:
Yikes.

A place I'd like to visit:
Machu Picchu (Peru)

A favorite place:
La Jolla Cove, San Diego. The fam used to come here on Thanksgiving, and sometimes we'd have picnics on the grass above the beach. This is one of the places I have to visit anytime I'm in town.

One of my favorite things:
Babies. Especially my baby.

One of my favorite foods:
French filet beans, or haricots verts. Love love love these! I could eat these every day, and I hope to later this summer: they're going in my garden this year.

My favorite flower:
It's impossible to choose just one favorite flower, but I'm awfully fond of ranunculus. It's a horrible name for a beautiful flower. They come in all sorts of colors, and they're just lovely.

My favorite color:
Spring green. I loved it even before it was trendy. (Isn't that what they all say?)

City I live in:
Salt Lake City

Name of a past pet:
I had a hamster named Camilla. I named her after Camilla Kimball, wife of Pres. Spencer W. Kimball. I was hoping for a photo of the flower, but of course politics and sex scandals are more popular than lovely flowers. Oh well.

A nickname I've had:
Pookie Bear

My college major:
English

My first job:
I made the best biscuits. Now they come frozen, and they just aren't the same.

A hope for 2008:
President Obama. I have lots of hopes: Atticus home and healthy, sanity in motherhood, a bountiful garden and plenty of water, peace and prosperity for everyone. But those are hard to find in Google Images. So Obama's my man.

I now tag Kathryn, Natalie, and Tammy. You're it. :)

Reality Check

As thrilled as we were that Atty drank his first bottle like a champ, we have since learned that it is highly unusual for a baby his age to do so well consistently. Apparently the suck-spit trick he was doing the other night was normal.

So we're taking a step back and working on developing good skills before we focus on volume. Last night he took about 15 ml really well, and when he started spitting, we stopped the bottle feeding. I told the nurse that we were disappointed with the step back because we wanted him to be above average, and she said we could focus on that once he reaches 40 weeks. (We were joking, of course.)

So he's right on schedule and doing great. I'm still a little worried about the desaturations, but he did much better last night, and he's not showing any other signs of sickness, so we're not getting too concerned yet.

Here's a short video James took the other night. Atty doesn't do much, but I think it's cute that he's holding onto my shirt. And you can hear the infernal dinging of his saturation monitor. It sounds the same whether he's high (like he was in this video) or low.

One step forward, half step back

Atty has officially moved to an open crib, which is a big step in the right direction. But now he's having a hard time maintaining his oxygen saturation, which means he's not breathing as well as he has before.

It's not lung problems, more that he's forgetting to breathe or just breathing shallowly. He's supposed to stay at a saturation between 85 and 95 percent. If he drops into the 70s or lower it's a desaturation, and if his heart rate drops it's an "A & B," meaning apnea and brachycardia. (For more info on these terms/conditions, click here.) They rate As &Bs by how long they last and quickly he rebounds. If he corrects it himself, it's a 0. If he needs some help (change of position, stimulation, etc.) and it doesn't last very long, it's a 1. And so forth.

Yesterday he was desaturating all over the place. He'd be up at 97, then drop down into the 50s, then bounce right back up into the 80s. His heart rate never dropped, so it wasn't too much of a concern, but certainly something to watch.

Then last night he wasn't as alert as he had been the previous couple nights, and he didn't take his bottle as well. He'd suck suck suck, then spit most of it out the sides of his mouth. I'm sure he swallowed some of it, but a lot ended up on the burp cloth. We tried several things to help him out, but he just wasn't as interested. So we gave up and fed him the rest through the tube. Funny note: he burped through the tube and blew bubbles in his formula. It scared me at first because I couldn't figure out what that noise was, but then I saw the bubbles and had to laugh.

Then he kept desaturating and had a level 1 A&B. And that was about all I could take. I knew it wasn't an uncommon thing, and I knew they'd warned us that moving him to an open crib might throw him for a while, so I tried not to be too concerned. But a higher occurrence of As & Bs was one of the signs he was getting sick last time, so I couldn't help but worry.

I just talked to his nurse this morning (the really experienced nurse who knows Atty well), and she said that he hasn't had any other signs of getting sick, but she's going to watch his saturation like a hawk. He'd just had another small A&B right before I called. She thought it might be because he was pooping, and that the previous ones were because his nose was congested (they suctioned a lot of gunk out last night and this morning).

So it could be nothing, but it could also be something. I was going to lament my fate, but then I realized that even when he comes home and is just like every other child, it's always going to be the same. Children get sick, and parents worry about them. Most of the time it's nothing too serious. That's just how life goes.

Maybe I'm a little over-sensitive, but still...

In the last month or so I've heard a couple people use the term "full-time mother" to refer to women who do not work outside of the home. And though I know that in both cases the speakers meant nothing more than this, it just didn't sit right with me. I mean, what does that make me, a "part-time mother"? Ick.

Every mother is a full-time mother. My baby is in the hospital and I see him only a few hours a day, but I am constantly thinking about him, planning for him, praying for him, missing him. Like many mothers, I will continue to work in some capacity while he is young, and I imagine I will feel very much the same way.

It's true that "stay-at-home mom" is inaccurate as well, so maybe we should just drop all the titles and define ourselves by what we are and always will be first and foremost: mothers.

Thanks. Just had to get that off my chest.

Atticus the Magnificent!

Last night was a great night. First of all, we caught him while he was alert and looking around. So now you can see his beautiful eyes. Here are a few more photos:

Little naked Atty. This picture reminds me of the National Geographic photos of little monkey babies on their mothers' chests, with the big eyes and the hand to his mouth. I guess that makes me the mama monkey. I'm ok with that. :)

Here he's doing his best John McCain impression. I love that little chin!

This is kind of a goofy picture, but I have to add it anyway. It almost looks like he's trying to explain something to me.

Second, HE DRANK HIS FIRST BOTTLE!! They didn't build up to it like I thought they would, but he did a fantastic job. He didn't know what to think of it at first, wrinkling up his forehead and drooling a lot. He eventually caught on, though, and he drank the whole 34 ml. It took him 45 minutes, and he was wiped out afterward. Such hard work. But we cheered him on the whole time, telling him how fantastically he was doing and how proud we were of him. And we were--I wanted to throw a party, I was so excited.

So here's the feeding plan: They give him one bottle per 12-hour shift for two days. (They continue feeding him through the tube for his other feedings.) If he drinks at least 75% of each bottle for those two days, they go up to two bottles per shift. If he does well on those bottles for another two days, they move to "on demand" or "ad lib" feeding: as much as he wants whenever he wants. If he's getting enough food that way, they remove the feeding tube and continue the on-demand feedings, slowly training him onto a 4-hour schedule. Then, once he maintains that for a certain amount of time (I can't remember what it is right now), he's ready to come home. Assuming he hasn't had any apnea episodes for 7 days. So he's making great progress.

They're weaning him off the heat of his incubator, so we hope to see him in an open crib today or tomorrow. He's about too big for that incubator anyway, so this will be a good move. The nurse warned us that he might not eat as well for a couple days after the move, since he'll be adjusting to the change. Any kind of change throws little babies off for a bit, so we'll see how he does.

Here's one more picture, just in case anyone wondered if James ever gets a turn to hold his son:

This was Atty's last day of antibiotics, so he still had the IV in his hand. He knows and loves his daddy.

Oh, one last thing: Atty now weighs 4 lbs. 5 oz., and he seems so much bigger to us that it's hard to realize just how little he still is. Until we compare him to his newest neighbor, who was born full-term and weighs 8 lbs. That girl is HUGE! I just had to laugh whenever I looked at her, thinking, "Oh, so THAT'S what a newborn is supposed to look like!" We're not supposed to ask about other babies, so I don't know why she's in there (they keep her under bright lights so I assume she has jaundice). I can't imagine she'll be there for long.

Anyway, that's the latest. We are so proud of our little boy. He is strong and healthy and sweet tempered. We hope to have him home by the end of the month, but we're willing to wait as long as it takes.

Milestones

Atticus is now over 4 lbs!! This is a big step in a great direction. We actually got to put clothes on him last night. He wasn't sure what to think of it, and the little onesie was all baggy at the shoulders, but he looked so good in it. He still needs the warmth of the incubator for now, but they're thinking he could move to an open crib in the next few days.

He's back up to 28 ml of formula at each feeding (he was at 29 ml before he got sick), and he's been digesting them really well. This means he can stop the IV fluids when he finishes his round of antibiotics tonight. Yea!!

The next step is teaching him how to drink from a bottle. He's got the sucking thing down, and he does really well with a pacifier, but now he needs to learn how to coordinate that with swallowing and breathing. They start really slow, maybe putting some formula on the pacifier or squirting in a few drops while he's sucking on the pacifier so he can make the association between sucking and food. We've already been giving him the pacifier during his tube feedings so he can associate sucking with a full tummy, but having something to swallow is another thing entirely. It can take some time to get it all down. So we'll see how he does.

I've had a personal milestone as well: I'm wearing a shirt today that I bought over a year ago but have never worn. It just never looked good on me, but today it fit. I have dropped 20 lbs below my pre-pregnancy weight, and I hope to keep dropping. I look and feel better than I have in a really long time, and I want to keep the momentum going.

Atty and I will surely encounter more bumps in the road as we progress, but hopefully they will be small bumps and easily surmountable.