Saturday, March 29, 2014

Here He Comes: The Birth

Disclaimer : this is a long post! I finally wrote everything down that happened the day Eli was born - I won't blame you if you don't read the whole thing :)

Christmas Day was a crazy day to say the least. But really all of the festivities started on Christmas Eve. Jason's family came to the hospital to bring us a nice dinner. The hospital food was ok, but it paled in comparison to the steak dinner they brought us—thank you! As we were enjoying our meal I was steadily having more and more pain. The nurses strapped me on to the monitors to see what was going on. After a few minutes it was clear I was having large and more frequent contractions. As the pain got worse, Jason's family left so I could rest. It seemed like the doctors always had solutions to stopping contractions. I had been on this medication called procardia while I was on bed rest that slows contractions. When these larger and more painful contractions began, the doctor prescribed a round of shots (can't remember the name) that also slow contractions. After two of these shots, my contractions really slowed down. I went to sleep feeling like we dodged a bullet and I was going to be fine.

On Christmas Day, Jason and I woke up at around 8:30 AM and started opening up our gifts. We were FaceTiming Jason's family while we opened our presents. They would have come to the hospital but Jason's brother, Brandon, is currently serving a mission in Argentina and they were unsure of when he was going to call home, so they stayed to make sure they didn't miss it. I was feeling some light contractions, but I had not taken my procardia yet so I figured it was because it had worn off. I opened up all of my presents, and took a quick bathroom break. When I stood up, I felt a strange pressure. I went to the bathroom, looked down and saw this bluish purple colored something starting to bulge out of me. My first thought was that the umbilical cord was coming out, but then I thought no, that's impossible because my water hasn't broken. I started to panic and yelled out for Jason. He abruptly hung up on his parents and also saw what was bulging out of me, and the look on his face confirmed to me that whatever was happening wasn't normal. He ran out to the hallway to find someone and I pulled the emergency switch in the bathroom. In about 5 seconds, 4 nurses came running in and quickly got me back to bed. After laying back down whatever was bulging went back inside and the nurses didn't get a look at it. I guess we looked pretty worried because the nurses tried to downplay what happened telling us that it was probably a hemorrhoid. They couldn't see anything, but just to be sure they called the doctor. She was in an emergency c-section and wouldn't be able to come down for at least another 20 minutes. I was hooked up to monitors once again and they found the baby's heart beat and also my larger contractions.

I hoped when the doctor came everything would be fine and I could continue being on bed rest. She came in, took a quick look and said I was fully dilated and that whatever had been bulging out of me was the bag of water. She told me I would be having an emergency c-section and my baby would be delivered immediately. So much emotion came over me in this moment. I was extremely nervous for the baby and hoped that the week I stayed on bed rest was enough for him to make it. I called my parents to let them know what was going on. They told me everything was going to be ok and I was strong and could make it through this.

I was wheeled over to Labor and Delivery and saw some of the nurses that took care of me when I was first admitted. When they heard I was coming to L&D, they said a prayer together for me. Jason also gave me a blessing - the nurse even tried to join in :) The doctor doing the c-section (who unfortunately wasn't my OBGYN - she was on vacation) wanted to do a loading dose of Magnesium to slow my contractions during surgery. This time was different than the first time I had Mag. Since the nurses were rushing to get me ready for the OR, they let the IV drip the Mag into me as fast as it could go - it took about 5 minutes. The next 15 minutes were the worst minutes of the entire delivery. Right as the IV finished I started to feel the effects of the Mag. My whole body felt like it was on fire. My mouth, nose and eyes were dry and hot. Jason got cold cloths to put on my head and chest to try and cool me down but at this point there wasn't anything anyone could do. I felt delirious and started getting really nauseous. My whole body ached and I felt like I couldn't move. The nurses started wheeling me down to the OR and that's when I lost it. I felt my water break and with Mag in my system it burned. I'm sure I freaked out the other women who were in L&D. Jason said people were opening their room doors to see who was making all the noise. Unfortunately, they made Jason stay back in L&D until I was prepped for the c-section so the last thing he saw was me writhing in pain. Poor guy.

About 5 minutes after arriving to the OR I felt much better. I felt bad that I was at my very worst when Jason last saw me. The epidural was a breeze after Mag. It is such a strange sensation to be completely numb from the waist down. The anesthesiologist kept pinching me to make sure I couldn't feel anything. After I was all prepped, a bunch of people came in - the OB with her nurses, the neonatologist with his nurses and other people that were doing something I don't know what. There had to be at least 15 people there. All of these people for one little baby.



The doctor started the c-section. I didn't realize it took so long for them to get to the baby. I was used to watching a baby story and having it only take 30 seconds to pull a baby out. I asked Jason to look over the screen and see what was going on. He didn't want to, but he did for me (after studying cadavers I've always been curious to see what I look like on the inside—weird, I know.) His eyes got really big and all he said was "whoa." During this first part of the surgery, the doctors were talking about Christmas and movies. I didn't understand how they could be so calm. 15 minutes later, the neonatology team started to move in and the doctors stopped making small talk. The anesthesiologist started giving me a play by play: "I see a little foot! Oh, and there's his hand he's a fiesty one! He just peed all over you!"All of a sudden I see the neonatologist holding the teeniest baby I have ever seen. He was quickly surrounded by the team of nurses and they started working on him. Before he was intubated, Jason and I heard him give out a small little cry. I kept looking over trying to get a look at our little boy. Someone moved out of the way and I saw that our baby was inside a plastic bag. I remember the neonatologist told us that they would be putting him inside a bag because his skin was too immature to maintain his own temperature and the bag would act as a second skin to keep him warm until they got him to the isolette. After he was stable and all wrapped up, the neonatologist brought him over to us so we could see him and take our first picture together.



I remember wanting to touch him and hold him, but being scared because he look so tiny and fragile. Everyone kept asking us what his name was, but Jason and I were still deciding. We thought we had 14 more weeks to figure it out! So for now he was known as baby boy.


After a few minutes, Eli needed to go down to the NICU. Jason met up with his dad outside the OR and walked down with Eli while I waited to get stapled back together (such a weird feeling!) Afterwards, I went back to labor and delivery for an hour or so to make sure I was stable. They started me on an IV of pitocin to help my uterus contract down in size—definitely not the best feeling, felt like cramps on steroids. Jason's family came in a few minutes later and all of them had this dazed look on their face like, "what just happened?" The last update they got was a text from Jason saying I was going in for an emergency c-section. It was pretty amazing how fast it all happened. From the time my bag was bulging to the time Eli was born was about an hour.

Before I was taken back to antepartum ward, the nurses wheeled me down in my bed to the NICU to see the baby since I was going to be confined to bed for the next 24 hours. I was nervous to see him again because it seemed impossible for a baby so small to live. Jason was there with me. Eli looked so teeny in his isolette, weighing in at only 2 lbs 7.4 ounces. He was long and skinny and his skin was all wrinkled. He looked like a little old man and had tubes and wires all over him.



A few hours after arriving to antepartum, a lactation consultant came to help me start pumping. Breast milk is so important for these premature babies. Doctors consider it part of their medicine because it is full of so many good things that cannot be replicated. Eli had to have some donor milk for his first few feedings until my milk came in. I'm grateful to those women who donated their breast milk and I plan on donating as well.

Jason and I had a hard time picking out his name. We both had names we really liked but neither of them seemed to really fit. We went back over our original list of names and read each one while we looked at a picture of him. I think we finally decided on Eli the day after he was born.


Thinking back now, it seems surreal that all of this ever happened. I'm so grateful that Jason's parents were here to support us and that my parents were able to drive down right after he was born to be with us too. We have such great family and friends and know that without your faith and prayers, Eli would not be where he is now.


In both pictures, Eli is holding Jason's wedding ring. Left - first week. Right - 3 months old. 



Friday, March 28, 2014

Almost Homeward Bound

Ever since Eli started nasal cannula he has been progressing very quickly! Here are the big milestones he's achieved in the past 2 weeks:

Breastfeeding - Eli can breastfeed like a champ! He has always loved his pacifier and that seemed to help him transition well into breastfeeding. Since it's hard to know exactly how much he's eating, the nurses weigh him before and after he eats. The first time we weighed him he took in 90mL! That's a lot of milk for him because he is usually tube fed 63mL every 3 hours. We thought it was a fluke so we tried again the next day and he took 70mL! We are so happy that he can successfully breastfeed. Almost all premature babies are unable to get enough volume from the breast because they have to work so hard to get it. It doesn't seem to be a problem for Eli! He does, however, have a harder time taking milk from a bottle. The occupational therapists have been trying to find a bottle with a flow that works best for him. In order to come home, Eli needs to take all 8 of his feedings in a 24 hour period by either breast or bottle. He is well on his way!



Breathing - just today, Eli was switched from a high flow cannula to low flow. On the high flow cannula, Eli started at 30% oxygen at 3 liters per minute and was weened down to 30% oxygen at 1 liter per minute. With low flow, he receives 100% oxygen at .2 liters per minute. He is doing so much better on this setting and is able to keep his oxygen saturation high! We anticipate that Eli will be on oxygen for a little while after he comes home. Ideally, the doctors want the settings to be 100% oxygen at .1 liter per minute, so we are almost there!


Grandma took this cute picture while looking in on his webcam. 




Bath - with his central line removed and being on nasal cannula, Eli was able to have his first swaddle bath from us! It was probably the cutest thing I've ever seen. He didn't cry at all but just seemed happy to be there in the warm water. Watch the video below to see his reaction:



Update: Here's another video of Eli getting a bath. It's our favorite thing to do! :)





Tuesday, March 11, 2014

Grandparent Love

Eli has been showered with lots of grandparent love this week! 

Grandma Orme held him the first time – Grandpa Orme will hold him as soon as he gets back from his trip!


My parents came into town this last week. The nurses took the CPAP off so they could snap a quick picture all together. 


Typically, the NICU won't let anyone but parents hold when the baby is on the ventilator or CPAP. They want the baby to be more stable and on nasal cannula before letting other family members hold. Luckily, the nurses made an exception and let my parents hold Eli since they were only going to be in town for a few days and we didn't know when Eli would be put back on nasal cannula.  



Today, Eli was put back on nasal cannula! So far he is doing well and we hope he won't get tired out from losing the pressure of CPAP. Also, Eli's broviac was removed on Sunday! It is so nice that there isn't anything invasive going into Eli. He is starting to look and act more like a real baby.


Thank you, as always, for all of your prayers and support. Eli is truly our miracle baby and we are so blessed to have him as our son. 

Monday, March 3, 2014

Nasal Cannula... Almost

Eli was taken off of CPAP Monday and moved on to the nasal cannula. It is so nice to be able to see his full head, he looks like a completely different baby!

Before they put the cannula on him we got to see his face with nothing on it!

Holding is so much easier without the huge CPAP. 



Tuesday I went in to hold again and the doctor said that we could start nuzzling! Nuzzling is basically breast feeding practice, I pump all of my milk out before so he's not actually eating anything. He sort of got it, but mostly just looked up at me like, "what am I supposed to do with this thing?" and then fell asleep. I held him for a little while after but then noticed that his breathing was getting faster and more labored. I was concerned and the nurse decided it would be best to put him back to bed. His blood oxygen saturation was decreasing and the nurse had to turn up the oxygen to over 40%. At that point, the nurse made the call to put him back on CPAP. He just got too tired and needed more assistance. We were bummed, but knew it could happen. Since then, Eli has been doing great on CPAP and the doctors are going to try nasal cannula again sometime next week. 

Eli has been doing phenomenol with eating. His intestines have been working well and he is pooping again! The nurses all cheered for his first poopy diaper. He has been eating the proper amount of milk for his age and they've been giving him less and less fluids through the broviac. Today, the doctor said that he called the surgeon to take out the broviac! That will happen sometime this weekend and we are so happy he won't have anything invasive going into his body. 

Eli weighs 6 pounds 8 ounces now and he is starting to outgrow his preemie clothes. It's hard to believe he has been in the NICU for 75 days - hopefully it won't be too much longer! 

Sunday, March 2, 2014

Surgery #3: Reanastomosis

Eli went under for his 3rd (and hopefully final!) surgery on Monday. We were actually looking forward to this one! The procedure—called a reanastomosis—is done by stitching his two stomas that have been sticking out of his tummy back together and placing them back inside the abdomen. Overcoming this surgery is another big step towards coming home! Jason and I got to the hospital a few hours before the surgery. They let me hold Eli right up until the surgeon arrived so I could have some last snuggles. He was so cute and happy; it made up for not being able to hold him for the rest of the week.

When the surgeon came in, he gave us his little spiel of all the risks that could happen with surgery. We were feeling very confident until the surgeon started explaining there's a 50% chance of him having to do a different procedure. Since Eli's intestines have been split in two basically his whole life, it is possible they are not the same size. If that is the case, the two pieces would not be reconnected. The stoma that is coming off of the stomach would be reconnected at the colon. The other stoma would stay on the surface and he would continue to have an ostomy bag. At nine months, he would go back in for surgery to completely reconnect. This was a huge bummer to hear, especially right before surgery! We left praying and hoping that the stomas matched up so we could officially be done with ostomy bags. Our nurse that day was really sweet and said she would call us from the OR and let us know if the stomas matched or not so we wouldn't have to wait and worry for long. About 30 minutes into surgery we got the call—everything matched and Eli was in one piece! We felt so relieved and happy. Everyone said Eli did excellent during surgery. The surgeon came to speak with us and said the stomas differed in size by only 1mm, which was fine for reconnection. It took about 50 stitches just to connect the intestines. Eli's scar is pretty long and gnarly.

He was pretty out of it for the next 48 hours… poor guy.

It's gotten a lot better, but it's still a pretty crazy battle wound. 

Eli had to be reintubated for the surgery since the pain medication sedated him so much he couldn't breathe on his own. We knew this was going to set him back a little, but once the initial pain medication wore off he, has recovered better than we could have imagined. He is entirely off pain medication and his scar is healing really well. Yesterday, they extubated him and placed him back on CPAP! His blood gases have been amazing, and the doctors predict he will be on a high flow nasal cannula next week! This is a HUGE step and we are so excited for our little guy. On nasal cannula, he can start breastfeeding, get baths, and the grandmas can finally hold him!

He is so done with this CPAP. (I just realized that CPAP looks like CRAP, ha ha)

Today, Eli will start to be fed orally again. Ever since surgery he has been getting nutrition through an IV. We hope that his intestines function properly and that a stricture has not formed where the intestines were stitched together. A stricture is formed by excess scar tissue and it decreases the diameter of the intestine at the surgery site. The surgeon explained it to us as a highway being closed down to one lane during rush hour. If a stricture occurs, surgery will need to be performed again and we will basically be back to square one with stomas and ostomy bags. So far there have been no indications that a stricture exists, and we keep praying it stays that way!

This has been a huge week for Eli and he has made more progress than we could have hoped! Next step: learning how to eat. 

By the way, he's over 6 lbs!