Week 34
Hello to everyone.
On the calendar, today begins Xavier's 34th week, but on the NICU calendar it begins his 33rd week. The NICU backs things up a week. I asked why, but have forgotten the answer. It does, however, work in Xavier's favor.
Xavier is doing much better today than his last couple of days. The staph infection is gone from his body. The type of staph was a "benign" kind which lives on everyone's skin; he may have gotten it into his blood through a scratch or through the PICC line. One antibiotic regimen was stopped because it has no effect on the type of staph Xavier contracted. The other antibiotic has pretty much gone nuclear on the infection, but Xavier will still be on antibiotics another four days. Since his PICC line is being used to both administer his antibiotics and feed him, it will be left in another four days as well.
He started on oral food again this evening, 2 ml of mom's finest every four hours. That is nice to see.
He had a routine ultrasound of his brain today where the doctors look for malformations and hemorrhages. The techs aren't allowed to comment, so we must wait until tomorrow to learn the results. However, from what I saw, everything looks good.
He is also scheduled for an ultrasound of his heart tomorrow. He picked up a heart murmur today and they want to check it out. Though that may sound alarming, it is apparently common with preemies. It may correct itself (high probability), or there is an oral medication that will correct it. If that does not work, then a light-weight medical procedure will definitively correct the problem. We are praying it corrects itself.
Xavier also has developed a hydrocele testis, his recent bout with staph and how his body responded may be the cause. The hydrocele, though not concerning at this time to the doctors, does have a possibility of leading to a hernia. The hernia, if it occurs, may self-correct, or require surgery later, after he leaves the NICU. Of course, we are praying no hernia and for the hydrocele to go away.
The IV the doctors put in him last week was removed today. Also, his OG tube was replaced with a smaller one (went from size 6, the biggest, to size 5, the medium). He is still on high-flow air at 2 l/min. He has reached a weight of 1 pound, 15 ounces! Hallelujah!
Always, thank you for your prayers.
A Bump in the Road
Hello to you all.
We have had a busy time these last few days, much has been going on. I will hit on some of the more significant items in this post.
Though Xavier is doing well, he has had a little set back. The low-flow air was not enough for him. Though the air and oxygen are not a problem, he still needs the added pressure of the high-flow air to help stimulate his breathing. Less than a day after transitioning to low-flow, he was returned to high-flow at a 2 liter/minute level. It is unclear at this time whether his need to return to the high-flow is due to Xavier's underdeveloped neurological system or coincidental with the onset of a low grade infection.
On Thursday a purple color showed across his belly, starting out as a large spot above his belly button and below his rib cage. He grew quiet and lethargic (which led to raising his high-flow from 1 liter/minute to the current 2 l/m) over the next day. The doctors took blood, urine and some cerebral-spinal fluid (through a procedure called a lumbar puncture) and ran several tests, including some cultures. Though most of the labs are returning negative, there is a low-grade bacterial infection in his blood. We will not know about his CSF cultures until Monday or Tuesday, but we expect them to come back negative, so meningitis is not likely.
Xavier is off his milk feed and back on his IV drip via his PICC line. The PICC line is also being used to deliver antibiotics. It was expected his PICC line would be removed in the next few days with antibiotic treatments continuing orally. It was scheduled to come out Friday evening or Saturday morning, but that did not happen because of all this goings on. Because the PICC line feeds close to Xavier's heart, it makes the tubing an easy highway for bacteria to spread through his little body very quickly. It was ruled out this morning that the PICC line was a a source of colonization for bacteria. The line stays in for the next few days, perhaps to the end of his antibiotic treatments.
The antibiotics have helped his strength return a little and he is doing better. Still another issue has come up. He needed a blood transfusion (about 15 ml). The reason for this is all of the extra blood draws for his recent labs trying to diagnose his illness has left him anemic, his red cell count at 26%. His infection has also contributed to this. Normal counts for babies his size should be in the 32% to 52% range. This is impacting Xavier's ability to carry oxygen efficiently and hampering his nutrient supply and his ability to fight off the infection.
This low count is hampering him from good oxygen flow in his body. The antibiotic regimen will eventually stave the problem of the infection, but the primary anemic issue is most probably due to the increased blood draws (he needs one every day so long as he is on the drip feed because they doctors need to tailor every day's drip concoction with what his body needs, which changes day by day).
Some positive news:
- His weight is 845 grams (1 pound 13.8 ounces). He put on 55 grams in one day, and since yesterday another 45 grams. Some of this weight will be water retention, but still a good trend.
- He has (or was just going to) achieve a full 8 ml of milk every two hours, which is exactly what he should be ingesting. To be fully at 8 ml in his feed will mean stopping of the IV feed and removal of the PICC line. Because of his infection, however, he is still getting his food via the PICC line. The doctors may start him with 1 ml of milk orally later tonight.
- He has grown 3 mm in length last week, bringing him to 33.8 cm in overall length. His birth length was 33.5 cm.
Always, thank you for your prayers. They will lift Xavier up on wings, like eagles!
A self-portrait of mom with nestled baby.
A happy Dad holding little sleeping Xavier. Little does the little tyke know, but he will get a blood transfusion twelve hours from this time.
Inspecting his son, Dad obsesses over the fit of Xavier's newly-changed diaper, but most importantly, Dad lovingly admires his boy!
Dad holding Xavier after a diaper change. He's a little cranky at the end of his care times. The nurses measure, and jostle and listen to his internals, change his bedding and swaddle. What's a little man got to do to get some sleep around here?
Hello Low-Flow!
Hello to you all.
Rebecca and Xavier are doing very well. Rebecca is recovering nicely from her c-section. She is still a little sore at times, but has been pain med free for three days now. Praise God!
Rebecca's milk is coming in slowly, but we have seen several times with better than 20 ml! We've been able to "bank" a good amount, but Xavier is fast approaching a point when he will drain the bank. Rebecca is persevering and we are seeing some increase on a daily basis.
Xavier is doing extraordinary and everyone is well-pleased with his development. Yesterday he was moved from 3 ml milk every two hours to 4 ml milk every two hours. His weight today was 755 grams, a new record! He gained 25 grams in a day. This afternoon, he was moved to 5 ml milk every two hours. He is keeping his food down (mostly) and he is digesting it all within the two hour window (we know this because the nurse will pull back the plunger on the syringe connected to his feeding tube--an OG--and nothing is pulled from the stomach). I am proud to report Xavier had a good sized bowel movement into his diaper which, I hear, was very messy because of another temporary piece of equipment connected to his "front side" at the time. Way to go Xavier! (it was a goal for him to have such a movement)
He has had a couple of bouts of burping up some milk. Today's nurse, Allison, and I discussed his history some and she thinks he just needs to be fed a little slower--not all the milk at once. Although both feedings we gave today (at 4 ml) did not come back up. Feeding is done via a gravity feed; the warmed milk is placed into the syringe, the syringe connected to his OG and then gravity gets it into his stomach. (No, he is not practicing for his college years!)
He was dropped from 1.5 liters/minute in his high-flow oxygen to 1 liter/minute yesterday. Today, his high-flow was replaced with a low-flow line. This is a slower feed, no moisture added. The flow was started at 0.03 liters/minute then dropped to 0.02 liters/minute about two hours later. The high-flow was not so much about him breathing in air (at that volume he did not get much air from the flow), but to help coach him to breathe on his own. The low-flow has slightly higher oxygen, but he gets more since it's low-flow. By next week some time he may be free of his nasal tubes!
Also exciting, the doctors are thinking within the next week to ten days Xavier will be completely on a milk diet and off both his drip feeds. That means his PICC line will come out! He will still be wired with heart, blood and temperature monitors for as long as he is in the NICU, however.
The general formula for babies is 700 ml of milk a day for every 1000 grams. Xavier is currently at 60 ml day, so he has not worked up to the full amount. He has started accelerating toward that however, which is why we are praying for Rebecca's milk to fully come in!
Xavier started physical therapy yesterday. There is a balance between him spending calories on moving and spending calories on growth, so his sessions are light and last less than thirty minutes. All his therapy is designed to simulate his in-utero environment. He gets moved around (his little bed moved back and forth to simulate movement in the womb); he gets little resistance exercises to simulate his cramped fetal position and resistance of the uterus when he stretches or explores; he even gets a little massage to help relieve any stress.
Mom got to kangaroo with Xavier again today, but so did dad! Dad got him for more than an hour and a half. He slept so peacefully on both mom's and dad's chests, but complained when we woke him up as we returned him to his pod.
Always, and with sincerity, we thank you for your prayers.
Xavier unbound (almost). Taken Monday, by Wednesday the high-flow tubing (shown here) was replaced with smaller, low-flow tubing.
Mom kangarooing Xavier. Today he is tucked in under mom's shirt, covered with two warming blankets and finally covered with a fleece blanket. His head radiates so much heat, he gets to wear a little hat outside the pod.
A Champion and a Superstar
Greetings and hello to everyone.
Xavier had a good day today as he approaches his first full week of life outside mom's womb. (Only a week? It seems months ago!) He had his first BM today (we strongly encouraged him to make this goal yesterday and he did not disappoint). It was only a small amount, but a great milestone. It means his bowels are kicking in. His high-flow air amount was dropped to 1.5 liters/minute; that's a drop of 1.5 liters/min over the last three days! Xavier lost 5 grams since yesterday, but he is still 10 grams heavier than his birth weight. His up and down weight is to be expected for his first two weeks. However, his weight drop was a good thing as it precipitated his food intake (mom's milk) to go from 2 ml every three hours to 3 ml every two hours.
I spoke with one of the doctors who helped deliver Xavier this morning, Jess, who came over to re-introduced herself. She is following Xavier's progress and will be until (at least) he leaves the NICU. She gave a glowing report of his progress. She called him a champion and a superstar; she was very happy with his progress.
I picked Rebecca up this afternoon and drove her to the NICU so she could visit our son. She kangarooed Xavier for ninety minutes and he was as quiet during his movement from pod to mom as he has ever been. When the time came to return him to his pod, Rebecca wept deeply; it gets harder every day to leave him for the day. Today was especially difficult because Xavier was so alert, looking around, wrinkling his brow, tugging at the pads which hold his nasal tubes in place.
We continue to pray for Xavier's growth and development. We are saying he will suffer none of the developmental issues the doctors have suggested he may have--he will continue to prove the doctors wrong! It's a great tag line for him. We are also praying for Rebecca to produce more milk; the lactation coaches continue to encourage us that it takes as much as 10 to 14 days and we (where "we" means Rebecca) have only been at it a little over five days.
Thank you all for your support and your prayers. As Rebecca noted yesterday as we considered Xavier while he slept. He is the embodiment of many answers to those prayers.
Let's Do the Kangaroo
Rebecca is doing well. She is growing a little more mobile. Still a little sore in the belly, especially if she eats too much (which amounts to not that much at all), or as she stands up.
Xavier is also doing well. His air flow has been reduced from 3 liters/minute to 2 liters/minute in the last two days. Today his photo therapy was discontinued. His skin color is much improved.
Yesterday, Rebecca got to "kangaroo" with Xavier for more than thirty minutes. The skin-to-skin contact is very important for Xavier's development and it helps stimulate milk production in mom. I got to "kangaroo" with Xavier for nearly two hours today. For Xavier, it matters that he has skin-to-skin with either parent.
We learned today that Xavier's sense of smell is his strongest sense at the moment, so it helps him bond with his parents to kangaroo.
The last two days he has been very relaxed, not so fussy when being moved around. He is keeping his food down (he was given a nose tube in place of his mouth tube; this makes it more difficult--but not impossible as he has proved--to pull the tube out) which allows him to keep his food down better. He added 5 grams to his weight since yesterday!
Always, Thank you for your prayers.
Two Tubes Less
Hello to you all.
Rebecca came home from the hospital today. It's great to have her back! Before leaving, we said our goodbyes to the nurses who have been a part of our lives these last few weeks. Many of the nurses asked if they can check on Xavier in the NICU (none of them have seen him yet).
Rebecca and I spent nearly an hour with Xavier this afternoon. He did little but sleep (picture below).
Xavier had two more tubes removed today! His IV is out of his right hand and what we have been calling his "club arm" (the one wrapped with cotton to protect his IV; the first picture below shows his wrapped arm) is now free of encumbrance. His CPAP has been replaced with a slower feed oxygen tube. We can see his face now! Also, because he keeps pulling it out, his stomach tube was threaded through his nose. This should help him keep his food down.
Rebecca was up most of the night, so she spent much of her time in the NICU. She got to hold Xavier again for his :30 skin-to-skin session. Even with a warmed blanket, he still dropped a degree in temperature like he did yesterday. Xavier sleeps with a little towel that the nurses gave Rebecca to keep on her body a couple of days. The towel picks up her scent and Xavier learns mom's scent as he sleeps.
One of the things Rebecca witnessed today was Xavier experience a "Brady", which is when the heart rate drops drops very low very quickly. His skin turns deep purple nearly instantly. When this occurs while in his pod, alarms go off all over the place and nurses appear out of nowhere to check on him. It's usual for this to happen very occasionally for babies Xavier's size and developmental level. If it grows more concerning, the solution is to add a little caffeine to his drip. This helps the brain to create a more stable wiring to regulate his breathing. What is really scary, Rebecca says, is when he had a Brady while laying against her chest!
Xavier freed of his head gear, holds mom's hand
A great scale shot, Rebecca rests her hand on her son's head.
A very focused Rebecca changes Xavier's diaper. The diapers are weighed before they are thrown out. They doctors measure how much fluid goes in and how much comes out. this helps the doctors understand how Xavier is doing with his liquid intake.
Xavier's pod opened up, a rarely seen sight.
Xavier sleeping on his tummy. This, the nurses told us, is his best position for growth and development and metabolizing his meals. The light is keeping him from jaundice and the giant foam sunglasses protect his eyes from too much bright light.
Xavier Meets Mama
Greetings and hello to everyone.
Good news: Rebecca's lab results are still trending down and nearing normal. She checks out of the hospital tomorrow (Friday afternoon). Xavier is getting a steady supply of ever-larger quantities of mom's breast milk, he just hasn't figured out what to do with it yet.
Today was a special day. At Xavier's final handling interval, the nurse opened his pod and disconnected him from the monitors (though he still had his CPAP in place and his IV drips). For thirty minutes, mom got to hold her son, skin to skin against her chest! How cool is that?! The long-term skin to skin touch is important for the baby's development, plus skin to skin helps keep his body at the right temperature.
He was a little fussy at first, but he eventually relaxed (his heart monitors were still attached so you could watch him drop off to sleep and have the heart monitor data to know he wasn't faking it).
Xavier has two goals written on his new (little) whiteboard:
- eat his 2 mm of mama's milk at every feeding (and keep it down). The milk is given to him through a drip feed via the tiny tube going to his stomach through his mouth.
- sleep and grow
Xavier also had another minor "surgery" today. OK, not really a surgery, more of a procedure. The line to his umbilical artery was removed. It did not take long at all. That's two tubes removed in two days! His belly button can now take shape (there is not much umbilical left to fall off). It looks like it might be an innie.
The doctors have reduced the pressure on his CPAP machine. There is a little knob with graduated ticks 0 to 10. Xavier was dropped from 5 to 4! This means he is breathing on his own much better.
Xavier (and by extension apparently his parents also) has volunteered in a research project being run by Children's Hospital just across the campus. They are researching why some premie babies develop serious lung disorders while others do not. For this, Xavier has to give up a little blood at 2 7 and 21 days old, the total amount being 3/5 of a teaspoon. His parents have to spit into a cup (for genetic comparison tests), and we get to fill out some surveys. We did draw the line at the final test were they wanted to take a swipe of his lungs. Most of the data the researchers need they will get from many of Xavier's usual tests (we signed his HIPPA release today so the researchers can get the information they need). Already, he's a world-changer!
On a personal note, I, just today, purchased the paint for the nursery; I have been trying to do that since Monday! Finally, I can get on with my life.
Thank you all for your prayers and your support. It has knit around us all a sea of tranquility.
We got to see Xavier for the first time without anything on his head. This is rare at the moment because he needs his little hat to help keep him warm and regulate his temperature and he needs his CPAP a while longer until his body has fully learned to breathe on its own.
Rebecca's Tale
Greetings to you all.
Since yesterday's blog entry was all about Xavier's entrance into the world, I thought I would tell Rebecca's side.
Picking up the tale after the insertion of the IV about 4:30 PM, another sterile drip was introduced. The anesthesiologist drew blood, one tube for a blood typing reference and the other vials Gwen, our nurse, thought the doctors would request. Rebecca was told not to eat or drink anything until the doctors got back to her.
As time went on, the pain in Rebecca's belly grew worse; it came in waves with its intensity. After a few hours, Rebecca had withdrawn so deeply within herself, I was unable to draw her out. This greatly concerned me, but so much else was happening I was attributing it to the confluence of all that was happening.
I found Gwen and asked if we could compare Xavier's NST from Friday (the 29 hour one) with his currently running NST. She pulled up the records and we examined the graphs. Truly, Monday's looked so much better than Friday. About 8:00 PM I decided to leave the hospital to go and at least get the trim painted in the nursery. Rebecca was quiet and withdrawn; she had no more sweat outbreaks, just the soreness in her belly which was not getting better. Nothing about Xavier's charts were concerning, and I was thinking Rebecca's stomach problem was some form of colic. She and I even discussed that at one point.
Before leaving, I asked if she would like me to read some Bible stories to her and Xavier. She said she would like that. I chose Elijah, starting from his Mount Carmel encounter with the prophets of Baal. We got up to just before Elijah crossed the Jordan with Elisha when the resident doctor entered the room with a nurse in tow.
This was about 8:30. With a stern air she told us "I think we need to deliver you tonight." After some further discussion, part of which was explaining why we couldn't wait another day, the doctor mentioned Rebecca had reached severe pre-eclampsia.
That stopped me in my tracks. I was dumbfounded at the speed this occurred. I think it also sobered Rebecca, who was already concerned there was something wrong with Xavier. What more could we say? It was like a kick in the gut, and this to Rebecca literally.
Soon, nurses filled the room. Antibiotic drips were added to the IV, a magnesium sulfide drip was added to the IV to help combat the destructive nature of the raising liver enzymes, and a whole host other drugs to prep Rebecca for the c-section. We were visited by two anesthesiologists to explain the procedures, check and double check Rebecca's allergies, previous surgeries, physical responses, etc.
We were scheduled for either the next slot in the OR or the third slot (there was already a c-section going on in the OR). During this time, the pain and discomfort in Rebecca's gut continued to increase; she was in dire pain and growing worse.
Rebecca was wheeled into the OR just before 11:00 PM. I dressed fully into my scrubs and would be allowed in after they prepped Rebecca and created the sterile field. I stood outside the OR door watching through a window. I watched as the anesthesiologist scrubbed and disinfected Rebecca's back and then inserted a needle into a spinal pocket just below mid-back. After several injections through the "tap", the needle was removed and Rebecca was laid down and her tummy scrubbed and disinfected.
About this time a doctor came out and I thought he was inviting me in. He told me it would be another :10 to :15 minutes and I could have a seat "over there." (what he nicely was telling me was to get myself behind the red line until they brought me in). When I was brought in, I sat at Rebecca's head. There was a blue drape drawn across her chest so neither she or I could see the surgery going on. The anesthetic was tested to ensure it took full effect and the doctors went to work.
About ten NICU doctors and nurses waiting for Xavier stood behind the operating table. Behind them a work station prepped to dry Xavier, keep him warm and keep him breathing. Meanwhile, Rebecca nearly fell asleep twice; at one point she could feel the doctors shifting her organs around, but no pain. Behind us stood one of the anesthesiologists. At 11:40, he told me to stand up and watch.
What an awesome sight; my vocabulary is woefully weak and no words I know can express what I witnessed! Watching my son be lifted from Rebecca's womb. I scanned Xavier as fast as I could, checking for his wholeness. Tears of indescribable joy flooded my eyes and wet my beard mask.
Rebecca and I had decided before the surgery that I would follow Xavier into the NICU while she was wheeling into a recovery room. As they brought Xavier through the room, they stopped so mom could see her son for the first time. Xavier opened his eyes for mommy! Rebecca recovered nicely, and quickly, though the mag sulfide still dripping into her veins had her a little loopy. She recovered in time to be rolled into the NICU before Xavier's pod was sealed.
The next morning, the high-risk doctor visited. She praised Rebecca for doing everything right for so long. Xavier is functioning perfectly like a 32 weeker, even though he looks like a 26 weaker. She said we carried the baby up to the last possible moment. We also learned Rebecca's pre-exclampsia was extremely severe, and approached a level called Hellp Syndrome (yes, two els), which is deadly. This is yet another miracle to praise our great God for, that Rebecca was in the hospital. Had she not been there, things may have gone badly and she may not have lived another day.
Rebecca's mag sulfide drip continued through Tuesday to help control her liver enzymes. More blood was drawn for labs, another IV catheter was put in, more blood drawn. Over the next 48 hours her concerning liver enzymes trended down and her kidney's settled down to normal.
Prayers are the conduits of God's power and the tide-changers of history. Thank you all for your labors before Heaven's Throne.
Happy Birthday, Xavier Michael!
Hello to you all. Rejoice with us in welcoming Xavier Michael into the world!
Today (or almost today; late last night actually) is the long-anticipated day! Here are some of his stats:
- born at 11:41 PM May 13, 2013 (sorry to those I texted the wrong time to)
- weight: 1 pound, 9 ounces (the ultrasound estimate was 4 ounces over)
- length of 33.5 cm or 13.2 inches
- what little hair he has, when it dried, is blonde like mom's
Xavier is strong and breathing on his own (though he has a CPAP in place for the next few days. His need for oxygen is minimal; his last adjustment was nearly down to 21%.
He cried (more of a complaint) strongly right out of the womb.
He has all of his parts, he looks well-formed all over (He's already had a physical and everyone is well-pleased). Ten fingers, ten toes, fingernails, toenails, little ears, little nipples (it was part of his exam to look for and at them)
Rebecca is doing well. She came through like a trooper. The surgery was uncomplicated; they were able to let her see Xavier before he was taken to the NICU. Later, they wheeled her bed in so she could see and touch her son.
The numbness of the spinal is wearing off and she has a magnesium sulfide drip going. We will learn later today if there will be any lingering effects of the pre-eclampsia (she was in a lot of pain the last few hours before delivery). We are also testing frequently for pneumonia symptoms (don't want that!)
Thank you all so much for your prayers, especially these last hours before and during Xavier's birth. What a miracle! I have spent nearly four hours in the NICU watching our son, not wanting to leave.
I will close today's entry by chronicling one of the many miracles we've seen. I mentioned previously that your prayers are conduits for miracles and you all have had a big part in Xavier's life already.
Yesterday afternoon, when Rebecca was still feeling colicky and before we knew or even considered pre-eclampsia, Gwen, our day nurse, came in to draw blood. She told me as we walked down the hall together that she was going to draw an extra vial because she knew the doctors would order it anyway. I thought nothing more of this, as it seemed a reasonable assumption to make, and Gwen is quite a competent nurse.
About 8:30 PM the resident doctor walked in to announce the need to deliver Xavier because Rebecca had gone severe pre-eclampsic. It was what she said next I think exposed the miracle. She said "it's a good thing you decided to have that extra blood drawn." The meaning was the doctors may not have ordered the tests for pre-eclampsia except Gwen had already drawn the blood for labs.
Many of you wrote or told us you were praying for the doctors and staff that they would be on their game. God definitely hears and answers our requests. Glory to God! Thank you, Jesus!
After getting Xavier out of the womb, the NICU team goes to work cleaning him up and getting him warm and stable.
Xavier Michael at about one minute old outside Mommy's womb. It doesn't look like it, but he likes the freedom.
Daddy gets a closeup of his son after his clean up. Daddy was so awestruck when they drew him from the womb tears wet his beard mask.
Now in his room in the NICU, Xavier is breathing well on his own, but the CPAP is still necessary for a few days because of his size and developmental stage. Little does he suspect what other gadgets he must endure before everyone leaves him alone to sleep! You can see his umbilical cord; it has another purpose to serve.
This is about an hour and a half later, after his little surgery to insert really tiny tubes into his umbilical, one in the vein and one in an artery. With these in place, blood draws can be done without poking him, some meds and food can be administered. These two tubes are now Xavier's umbilical to his pod.
The nurse is siphoning off some blood for another glucose test. He was a little low, so a tiny drip bag was set up to feed him some of the good stuff. The drip is through an IV in his right hand.
Everything is done and Xavier is set to have his pod closed. He has his heat lamp, humidifier and all his wires, tubes and little hat. He is snugged in to his little sleeper and has two soft pillows to keep him from rolling around. All of his gadgets are hooked up and beeping. "Can I get some sleep now?" he was complaining during all this or perhaps, "Dudes! Give it a rest!"
It was surreal, a scene from some sci-fi film. The sides of the pod were raised, then the top began to descend. As it began its slow drop, the doors around the heat lamp closed, and the humidifier kicked in. After about 20 seconds, the dome locked into place.
A view of Xavier's room for the next two months. No dinosaurs here, and no pastel yellows and greens. The wall behind has a whimsical "Twinkle, twinkle little star" sentence surrounded by little smiley stars. I thought this fun because the mobile we bought plays "Twinkle, Twinkle Little Star."
This was a wonderful grace. Rebecca had recovered enough and they wheeled her bed into the NICU. She got to see him and interact with him a little before they fitted him into his sleeping snuggy.
Rebecca pets Xavier. His body still has some of its lanugo, especially his arms.
This is a diaper like the one Xavier wears in the picture above. His first diaper was too big, so they found a smaller size. Even it is too big at the moment. Just before the dome sealed the pod, I got to change Xavier's diaper. It was my first and not as easy as it looks. As I snugged up one side, Xavier felt the need to create more amniotic fluid; we didn't change him again, however. :)
May Be Nearer Than We First Expected
Hello to everyone.
Today began with Xavier's NST. It went so well, they only monitored him for thirty minutes instead of the scheduled hour. His Dopplers looked good as well; I don't know if there were any lack of absences today, but definitely no reversals. Thank you, Jesus.
Rebecca's IV was removed this morning because it would no longer back flush. A new one will be put in later in the week, or that was the plan at this time; it changed later on in the day.
Also this morning, the doctors laid out their plan for the moment. If Xavier continues to do well this week (allow me to translate doctorese: if he is not delivered this week), then they will schedule his delivery sometime in his 34th week. That will be the last week of May or the first days of June. Week 34 is a good week for the baby, most of his important development will be complete or nearly so. The driving reason for this date, we are told, is to minimize the risk of a stillbirth. It is likely a C-section will be the means of delivery.
That is the plan as we understand it and as of this morning. However, in thinking over our history, things change, and they change frequently. Also, I have learned that a turnover of doctors may also mean a change in the plan. That, too, has been our history over the past weeks.
Xavier's afternoon's NST did not have the clean results of this morning. It is on-going and will be the rest of the evening and probably into tomorrow. (it's 6:30 as I write this and the NST began about 2:30). He has had many decels during this run. Nothing as troubling as Friday evening, but still several frequent and deep decels, enough to concern the doctors. Currently, he is doing well, but there are still some decels in his recent tracings.
At 3:00 this afternoon, Rebecca called me and asked when I would be coming in. When I said I planned on leaving about 3:30, she mentioned she hoped it would be sooner. Still learning my wife, I asked for clarification "Do I need to be there sooner?" She answered "Yes."
Rebecca has been feeling colicky since yesterday and this afternoon about the time the NST began she broke out in a couple of sweats. This, in combination with the frequency of the decels, had her thinking there is something wrong and Xavier would need to be delivered today.
Shortly after I arrived, a nurse came in to insert an IV catheter. She spent a good :15 minutes examining veins, then chose one on Rebecca's left arm. Sadly, that tap failed, resulting only in staining the bed sheets with some blood.
Later, James, the same anesthesiologist who tapped Rebecca Friday, came in. He uses a local nerve-blocker so the insertion of the catheter isn't painful, Rebecca only feels pressure. It took James four tries to get a good insertion (his first was good for two vials of blood, however). Rebecca is once more on a sterile water drip. Though she has not had any sweats since I arrived, her stomach is still achy.
I had planned to have dinner with my wife, then begin painting the nursery. The nursery may have to wait a day or two.
Always, thank you for your prayers; they are the conduits of miracles. God is with us and He is walking us through.
Rebecca's First Mother's Day
Hello to you all and Happy Mother's Day to all you moms!
Xavier has been very well-behaved today; he even brought his mommy flowers and a cute card. His gifts, strangely, matched with the colors of his nursery, which Rebecca and I only decided upon yesterday.
Let me back up a bit, because I don't want you to miss some of the exciting news (at least I hope you will find it exciting). Rebecca had difficulty getting to sleep yesterday. Whenever she would doze off, Xavier would escape his monitor or the monitor would slip. The rhythmic drum of his 140ish bpm heart beat would go silent and Rebecca would wake up. Her "Mother's Hearing" has started!
The exciting news I mentioned is this: late last night, the doctors decided Xavier was doing well enough he only needed to be monitored the standard three times a day. All of the wires and gizmos attached to Rebecca's tummy were removed. Praise God! Xavier's marathon NST of 29 hours ended and he crossed the finish line like a champion! All the chaos which began Friday night has settled down as the doctors grow more comfortable. For that, we also praise God!
With the monitors quiet, Rebecca could sleep without distraction. Also, the results of Rebecca's 24-hour urine came back negative. This is the test looking for pre-eclampsia protein markers. Further, the blood tests done on Friday's blood draw all returned negative.
Xavier has had two of his three hour-long NSTs today. Both of them look really good. I can't speak for the morning run, but his afternoon's run only showed one variable decel. Nothing to get concerned over.
His Doppler exam today was interesting. What we noticed was one of his two umbilical arteries did not have any absences about 70 percent of the time. This was not the case yesterday; both arteries showed consistent absences. We asked about this and the doctor agreed with what we were seeing. She stated he did not show that yesterday. The lack of absences in his Doppler means Xavier is not having to work as hard against the placenta, at least in one of his umbilical arteries, as he was working yesterday. We will be looking closely to see if those absences remain absent (and we pray that they will!). No reverse flow observed, also wonderful to see and hear. Xavier was doing well.
After reading Xavier's goal list from yesterday, so many people wrote to us or spoke with us to tell us they are pulling for Xavier to go full term! Thank you all for your encouragement and faith! That would be the ultimate "your baby continues to prove me wrong" action.
Always, we thank you for your prayers.
Mom's flowers. The yellow vase came from Xavier. He chose the colors to match with his nursery color scheme. The purples and reds were a gift from a friend who stopped by to visit. Behind, Rebecca glows on the day set aside for her honor (actually, she is being gracious as I take a photo for which she was unprepared)
Day 61
Hello to you all.
As I titled today's entry, I found it somewhat ironic that this is day 61 of our hospital saga. Our first visit to the hospital prior to this was just after we learned we were pregnant. That morning, a Friday, Rebecca was spotting. Being new to all of this, and terrified by the Internet reports, we went to the emergency room at PVH. There we saw our child for the first time and he was then 61 days old.
To continue from yesterday's entry, after yesterday's ultrasound, Dr. Yong had Rebecca admitted to the hospital. We asked if we could check in later in the day. I'm thinking "We drove here in two cars. I need to get to work." and several other thoughts. Rebecca had thoughts of her own. Based on the good results of our scheduled NST (which followed the ultrasound), we were allowed to check in later. Xavier did well on the NST.
I headed to work and Rebecca headed home to pack, find a place with a patio to enjoy a lunch, then get a pedicure. At 3:30 I packed the car and drove Rebecca to University Hospital.
Upon arrival Rebecca was beset by nurses and hooked up to monitors, oxygen, blood pressure cuff; the doctors even (after much persuasion) tapped her with an IV (the persuasive reason that the sterile water drip would help hydrate her and help Xavier with his decels (explained later)). At one time we had no less than six medical staff in the room, two doctors, an anesthesiologist, and various nurses. During the hooking up of monitors, blood pressure cups, and a host of other circus attractions, we were briefed on C-section procedures and probabilities (all this while the anesthesiologist was fitting Rebecca with a catheter in her hand). We also got the low-down on all the anesthetic possibilities. If you haven't realized it, the doctors, based on the NST graphs pumping out over the past hour, were thinking a C-section last night was a high probability (one doctor turned to me and said, "I wouldn't go home any time soon if I were you"). Around 6:00, Rebecca was given a steroid injection to help "jump start" Xavier in the event he needed to be delivered. (this is what they did as we transferred from PVH so many weeks ago). Rebecca had blood drawn through another "poke" and started a 24-hour urine collection (to test for pre-eclampsia markers).
We sat for many hours watching Xavier's NST chart thrash. We learned new terminology like "decel" and "variable" or "variable decel". These refer to deep drops in Xavier's heart rate which persisted for twenty or thirty seconds. These decels were the center of concern for the doctors and the nurses. Every time Xavier demonstrated a decel, a nurse instantly showed up in the room. We were living literally hour by hour, and the "hour-long" NST is still on-going as I type (25 hours now). Rebecca was not allowed to have any dinner because a delivery of Xavier was so close; she was not allowed to even drink water (though she did have a sterile water drip bag draining into her arm). She regrets her 1:00 lunch choice was a couple of Lamar's cake donuts.
We made it through the night, and Xavier's NST graph grew more stable (the nurses kept coming in to have Rebecca change position to see if that would help. It did, once we found the magic positioning). I left the hospital about 10:30 PM to go home and let the dog in the house, feed her, and find something to eat for myself. I returned to the hospital about 12:30. Rebecca was asleep and Jenny, our night nurse, was working to get Xavier back on the monitor (he has been very good about slipping under the radar). Through the night Xavier's NST graph maintained a good, steady, healthy rhythm, though I got little sleep because the drip-feed alarms kept going off for various reasons.
About 10:00 this morning, we met with the team of doctors who came in at the same time as we were getting Xavier's daily Doppler test. Dr. Rick, whom we have seen several times already, once again mentioned how little Xavier continues to prove him wrong. (to which I say, "Go, Xavier, go! Keep it up!"). Today's dopplers look the same as yesterdays, which is good. Dr. Rick checked another artery in Xavier, and one we have not seen checked before. It is the artery connecting the liver to the heart (I have forgotten what they called it, so much information was flying around the room one could not catch it with a butterfly net!). It looked really good, a healthy, strong flow. As a sign of the doctors' comfort, Rebecca was allowed clear liquids.
With Xavier looking good on his Dopplers and his NST graph putting the doctors' nerves at ease, Rebecca and I visited with Father Mark, who drove down to give Rebecca communion, then Rebecca returned some of the phone calls which came in during all of this. I left to let the dog out into the yard for her "business" and to feed her. I also needed (quite desperately) to mow the Southern Outpost's lawn before it started eating people.
I returned in the late afternoon to find Rebecca watching "The Jungle Book 2" and Xavier's NST graph looking good. I spoke with the nurse (Bethany) on my way in to ask her how "my girl and my boy are doing." She gave a glowing report. Xavier has continued to show some variable decels, but nothing alarming.
Currently, Rebecca is doing well. We made another goal tonight. Twenty-four hours after yesterday's steroid injection, Rebecca got the second one (it takes two doses to jump-start things, although one is better than none). The "jump start" is good for two weeks, but is best served if Xavier has another 24 hours to absorb the dose. That is our next goal. After that, our goal is always one more day and one more ounce. We really want to make it to June, and that is not out of reach, but it will be day by day and NST/Doppler by NST/Doppler. I have written on the room's white board Xavier's longer-term goals of 7 ounces and 3 weeks. Rebecca really wants him to make 2 pounds (which is another 3 ounces away) and another 10 days.
Rebecca was allowed solid food and wasted no time ordering an omelet. She requested, and was granted, time away from the monitors and all the hoses and wires to shower and clean up. We are awaiting pizza, broccoli and chocolate cake from the kitchen. One of our friends who wrote back to us this morning cited a wonderful scripture, one I thought was Spirit-led, timely and right on the money: Now all glory to God, who is able, through his mighty power at work within us, to accomplish infinitely more than we might ask or think. Ephesians 3:20
Great is our God! Today (and yesterday) have been a ride, though not like the "Space Mountain" of last week. His hand has walked us through it. We even saw a miracle: Rebecca let an anesthesiologist insert a catheter!
Back in the Hospital Again
Hello to you all and always, thank you for your prayers.
Sorry to those who follow the blog for your daily updates; I did not have an opportunity to update things in a timely way. Everyone was expecting the growth news and today was a big day. As it turns out, this day offered even more excitement. This blog entry will be split into two parts, this and the one which follows because that's kinda how today has gone: it's been one big blur across two days.
Rebecca and I arrived at the hospital in separate cars. The plan was that I would attend the ultrasound, schedule the June ultrasounds, then head off for work (which is a mere :15 minutes down I-225). Rebecca would head off to Xavier's NST and call me with the results. That was the plan. Here is what actually happened:
Rebecca and I arrived at the hospital in separate cars; I parked in a nearby lot, she used the valet service. Our sonographer was Jean, a petite RN with three and a half to four years experience. Reading the orders, she told us this morning was just a Doppler checkup. "Oh no it's not!" thought I. I'm quite sure Rebecca was thinking similar thoughts. We told Jean that was not correct, so she called the doctor to clear things up.
Coming back, she was not given the go-ahead to do the growth exam (which does extensive probing) and only did the Doppler.
I know I have mentioned the Doppler frequently as it is a vital measurement for the baby's health. I will describe it in more detail. The Doppler is a measure of the blood flow in the two umbilical arteries and the blood flow out through the umbilical vien. Each of the three cords comprising the umbilical are measured. The arteries have a pulsating flow like a pulse, and the vien a more even drain. The arterial measurements are graphically displayed on the machine and appear like a sawtooth wave something like: /\_/\_/\_/\_/. Notice that there is no part of this curve dropping below the "baseline"; dropping below the baseline is not a good thing. A ratio is taken between the peak value and the trough value and that is called the Resistance Index or RI. Xavier's placenta is resisting blood flow when his heart rests (the beat which does not pump blood). An RI ratio approaching 1 means the placenta resistance (which is abnormal in a pregnancy) is strong enough to stop the baby's blood flowing back to the placenta on the "rest" beat. At some point after an RI of 1, blood flow will be in reverse, as if the placenta becomes a competing heart. In essence this means the placenta can no longer deliver to Xavier effectively and at some point further becomes dangerous to him.
Xavier's RI this morning was 0.99. There is no reverse flow yet, but there are what are called absences. In the graph above, that is the flat bottom line. I will note at this point that the absences can persist for days or weeks before any reverse begins; there is no guarantee of this longevity, however. At this point, it is necessary to watch Xavier much closer, with daily Doppler tests and frequent NSTs. That, of course, cannot be done at home. So, the doctor, Dr. Joyce Yong whom we first met at the Platte Parenatal and who sent us to the hospital originally, sent us to the hospital once more. We have been expecting the re-admittance to the hospital because the weekly Dopplers have been trending this way, but we hoped to make it into June.
Dr Yong amended the orders and we did get our growth exam. Here is a summary of this morning's growth exam:
- weight: 1 lb, 13 oz. This is not the 2-2 1/2 we were hoping for, but still Xavier averaged a little more than 2 ounces a week, which has been his growth curve since his 23rd week
- Percentile: 2%. He is still growing at a consistent rate, just behind the curve. He is still on the curve, I will point out!
- S/D blood pressure ratio: 85%
- Amnio fluid: 7.4 cm (had to use the 4 quad method today). This is a little lower than last week; the lower fluid levels made some of the ultrasound measurements difficult, fuzzy or not possible today, but this is no cause for alarm.
- organs: all looking good, heart pumping proudly at 139 bpm; bladder partly full, brain good; stomach OK.
I will continue today's events on tomorrow's entry. To be candid, we feel we are still living one, very long day
Here is today's profile shot from the ultrasound.
Out monographer, Jean, took this 2D of Xavier's face; there was not enough fluid today to get a 3D image. His eyes are to the left.
The Night Before...
...the Growth Exam
Hello to everyone.
Thank you for your prayers and support.
Today was a quiet day for us. Rebecca got good sleep last night, and Xavier has been moving around with (at least) the frequency desired.
Tomorrow is our week 31 doppler exam as well as the long-awaited growth check. I am excited to learn what the measurements will tell us! The exam is in the morning. If you hear shouting so loud it shakes the earth, you will know before I post it that Xavier made or exceeded three pounds!
We will leave the house early to have breakfast, pick up a large OJ and a mocha. We need that to get Xavier going for his NST, which is after the ultrasound. It worked so well Tuesday, we figure why mess with success.
Today marks the anniversary of my sister's birth. She celebrated by buying her first house. In a suburb just west of Phoenix, it has a guest bedroom for us to stay in when we bring Xavier down to visit and let his paternal aunt have the pleasure of changing a diaper or two :)
A Simple Day
Greetings to you all.
It's a rainy day here in Denver. Rebecca got wonderful sleep last night (Ambien and we opened a window :) ), waking up about 9:00 AM. In the afternoon, she began to feel the stir and drove out to a mall to walk around. We planned on a movie tonight, but the traffic today was horrific and completely cratered our schedule.
Xavier has been active today, but not like yesterday. No giant OJ and mocha chaser today.
That is all there is to report today. Simple days are just as wonderful as exciting days such as yesterday.
Always, we thank you for your prayers and support.
Week 31 Begins With...
...Wonderful News!
Greetings to you all.
Take out a handkerchief, wave it around and yell "Hallelujah!"
Today began with neither Rebecca nor me getting a decent night's sleep; neither of us could get the correct sleeping temperature. it's the time of season where you want the furnace on at times and the house fan at others. About 2:00 AM Rebecca got up, took half her normal dose of Ambien, then headed to the cooler part of the house. Neither of us thought to open a window.
I was concerned Rebecca was too drugged to drive to her 9:00 AM NST but she assured me she would do well. Leaving Rebecca to sleep another hour, and after setting an alarm to ensure she did not sleep through her appointment, I left for work.
Rebecca, adamant she would not spend another five or more hours in the L&D ward today, armed herself for bear! She guzzled down a large glass of orange juice, then chased that with a small mocha. Little Xavier would be awake this morning for his NST! Also, Rebecca determined last Friday that she feels Xavier move better when she lays flatter on her back. All of her NSTs to date she has been sitting upright. This morning, she lay back and leaned to her left.
Hopped up and sweets, Xavier was active, and he kicked it into high gear. He had his best NST to date (and by far!). He baselined at 140 bpm, he had wonderfully perfect accelerations reaching 150 bpm and he moved, moved, moved!
Dr. Donnelley, Rebecca's OBGYN today and one we have worked with since Rebecca was admitted to University Hospital, was happy with the results. I am disappointed at not being there because Dr. Donnelley's excitement is infectious! She told Rebecca she was excited to see her still pregnant; she confessed she did not think Rebecca would carry Xavier this far.
Rebecca asked about her sugar-loading this morning, wanting to know if that was cheating the test (this test, after all, does not tell us anything if we pass by cheating). Dr. Donnelley explained that if Xavier was having problems, he would respond to orange juice, or sugar bombs very little or not at all. The doctor wrote Rebecca an oral prescription for orange juice and a mocha before all her NSTs!
One of the things Dr. Donnelley learned this morning, because Rebecca pressed about being sent to L&D twice last week, was that Rebecca has been taking Ambien (10mg) every night. As both Rebecca and I suspected, Ambien does affect the baby. Dr. Donnelley said "I wish I had known you were taking it;" she would not have sent us to L&D last week (that would have saved us at least one trip there). Ambien does no harm to the baby and the doctor said it is better Rebecca be getting good sleep.
While reading the diagnosis details on the paperwork we got last Friday, I noted one of the items listed was obesity interfering with delivery. We had not heard that from any of the doctors. Rebecca asked about this today. Dr. Donnelley laughed and said not to mind that. The computer system automatically lists that for all women beyond a certain indiscriminate weight. The doctor also explained one of the abbreviated terms on the diagnosis meant elderly mother, then told us of a 48 year old woman who was told she could never get pregnant, but she (at 48) got pregnant naturally, surprising everyone.
Rebecca said Xavier only slipped away from his heart monitor twice this morning, and that is something unusual. He often manages to move in such ways as to lose the monitor for a few seconds. Dr. Donnelley's explanation was that Xavier may have grown enough that he has less room to move around. This is also something Diana (the midwife we met Friday) mentioned we should expect.
I should mention that Rebecca's BP this morning was 128/77. Dr. Donnelley also told Rebecca she did not need the OBGYN exam every week, but every other until week 34. We are keeping the weekly appointments because we have them scheduled already and they are difficult to come by as the doctors are busy with so many.
Great and mighty is our God, and above all He is good! Today we got a wonderful glimpse of his awesome hand. I am excited for Friday's growth exam! I'm pulling for two and a half pounds, but (not-so-secretly) hoping for three.
Always, thank you for your prayers. They make days like today possible!
A Day Apart
Hello to you all.
I started my contract today, so left Rebecca to sleep. Rebecca was a little more tired than she thought (perhaps this past week catching up with her) and she slept in to 11:00. Later, she shopped some super markets and a local Starbucks. I arrived home to a aromatic home and sat down to a delicious dinner where we broke in our new pasta bowls.
Rebecca got up just before I left. She was concerned she could not feel Xavier moving, so she downed a large glass of orange juice. Soon after, Xavier started moving. Xavier does not, in general, move much in the morning. Though the doctors say the Ambien has no harmful effects on the fetus, we are beginning to wonder if the medication leaves Xavier with a "hangover" like it does mom. After feeling him move some, Rebecca felt comfortable enough to return to bed.
We thank you all for your prayers. They support us even in times like this morning.
Pascha (Eastern Easter)
Hello to you all! Christ is Risen!
Nothing out of the ordinary to report today. Rebecca and I celebrated Eastern Easter this weekend. We were able to make it to the liturgy portion of the midnight service and we were able to spend a few hours at the afternoon feast. Needless to write, Rebecca is a little spent; she got a few hours sleep this morning and a long nap this afternoon. Now, she is sacked out on the day bed.
Xavier's activity today has been normal for him. Rebecca reported that when the choir sang during liturgy he moved around more frequently. Hallelujah! He's praising God already (we have been praying over him that he would be filled with the Holy Spirit even in the womb; it worked for John and he leapt for joy!)
Tomorrow I start my new contract. It will be the first time in weeks I have not been around Rebecca all day. Neither of us knows what we will do, though I think I will have more to keep me busy than she (the first week or so on a new site is usually very slow)
Tuesday will be the first NST exam and OBGYN exam I have missed in several weeks. I don't mind so much missing the NSTs, but I do like to be there when the (OBGYN) doctor discusses things things with Rebecca. I may have to conference in for that! I will, of course, make the ultrasound exam this Friday.
Always, thank you for your prayers. We have only eight more weeks to go!
A Lapse in Updating
Hello and greetings to you all.
Today was an uneventful day. Rebecca slept well. Xavier has been active today.
Because there was so little to report today, I thought not to update this blog. However, I learned several hours after making that decision that people are expecting a daily entry. I should have realized this. I will maintain a daily entry in the blog, even if there is nothing out of the ordinary to report.
I was also informed that reader comments aren't showing up in the blog. This surprised me as I configured the software to accept them (except for the first few weeks of entries). After looking into it, I discovered I have the software configured so that I have to approve comments before they show up. I will see if that configuration parameter can be tweaked a bit. Thank you, those who have posted comments; I have approved them all.
Always, thank you all for your concern, support and prayers. We definitely appreciate it all. So many have written to say how they appreciate the daily updates.
Friday at the Hospital or Let's Make a Day of It!
Hello and Good (Eastern) Friday to you all. Always, thank you for your prayers.
Rebecca had another decent night of sleep, waking up at 9:00ish today thanks to our Ambien connection. Feeling antsy, we left for our 11:40 appointment early because Rebecca needed to be some place not home (cooped-up fever). We stopped at Lamar's Donuts and enjoyed them while sitting on the sunny side of the patio.
We arrived for our appointment right on time, but had a twenty minute wait. The NST is supposed to last 20 minutes, 30 if the baby is a little uncooperative. We were there over an hour! The reason was Xavier was really not cooperating. His heart rate was strong and stayed around the mid 140s at the beginning, but he did not move around. His heart rate dropped around the mid 130s for a while, then up to 140 for a while, then down to the low 130s for a while. Well, you get the picture.
I used the time to schedule more ultrasound and NST appointments and to coordinate them so Rebecca did not have to spend the whole day in the hospital to get through her tests. This involved running back and forth between two wings as the departments cannot coordinate or communicate well in the scheduling area. I managed to get a good cluster of appointments set up through the end of May. I felt I accomplished a good task: Rebecca did not have to walk back and forth between wings and I got the schedule tight enough she would not have to be at the hospital longer than two hours on any day. It would be when I returned to the room the NST was being done in that I would learn either the irony or the futility of my efforts.
While I was away, Xavier began moving around a bit, which made things all the more interesting for the nurses trying to figure him out. The goal of the NST is to catch him moving (Rebecca presses a button and the ticker tape gets a mark showing the baby moved), then to see his heart rate rise (accelerate) by 10 bpm for 10 seconds, then return to its baseline. Xavier's chart today never gave a decent baseline for the nurses to look at, hence the hour-long test.
Not being able to baseline him got us sent over to L&D again where we got to undergo another three and a half hours of monitoring. (the area of L&D we were in is considered an emergency area, btw). Xavier's heart rate ranged from the low 130s to 150 and he moved around frequently. Rebecca did not have a button this time; we weren't recording his movement activity.
The ward was extremely busy today. One of the monitors in our room had a little pop-up message to the nurses encouraging them to be as speedy as possible in discharging patients. Rebecca and I hoped that would mean we would get out of there faster. Alas, no. After seven feet of chart cranked out of the monitor, we looked it over and saw nothing too different from two days ago when we had the privilege of being monitored in L&D. When, at last, the nurse came in and took the paper chart to examine with the resident doctor, we started packing to leave.
The nurse returned (her name is Diana and is one of the midwives at the hospital; an older woman with 20 years experience). The doctor found something in the chart that warranted further monitoring, another two hours of it. The issue was two or three decelerations (where the heart rate slows down significantly). We had several of these on Tuesday; in fact, they are what got us sent to L&D on Tuesday.
After that two hour stint, Diana rolled in a portable ultrasound station so she could measure the amnio levels. When she walked in, the monitoring machine hooked up to Rebecca was not emitting any paper tape (Diana purposefully turned it off two hours prior). She began fussing about it not having a paper record and made statements that suggested we might have to start over. I thought I was going to have to hold Rebecca down, perhaps hit her with a lithium dart. She was not happy about the idea of another two hours! Can't say I blame her. The monitoring is all recorded electronically, so the paper tape is only a backup device. We did not have to submit to another two hour monitoring period.
To measure Xavier's fluid, Diana chose the same four quadrant method that Pam, the mid wife nurse who saw us on Tuesday, had used. The results: Xavier's fluid level was about 9.2 cm, very close to Tuesday's measurement.
After further discussion with the resident doctor about the fluid measurements, we were released. Xavier is doing fine. On the way home through rush-hour traffic, we stopped off at a local eatery to sate a pregnancy need.
Xavier's face on May 3rd, 2013. His chin is to the left, top of his head to the right. Even though this image has him laying on his side, he really is upside down in the womb (head-down)
Week 30 Doppler Exam
Hello to you all.
Good news for Rebecca, she has gotten two nights of descent sleep thanks to her little Ambien helpers.
This afternoon we had our doppler exam. I am bummed this was not a growth exam; somewhere between last week and this week they changed the interval and failed to mention it to us (or we heard it and it went in one ear and out the other). As it stands now, growth exams are every three weeks, so next week's exam will be more comprehensive. I asked Tianne, our sonographer (whom we've had once before) if she would do a quick growth check anyway, but she did not. I even bribed her with a dollar. (if she would have done the measurement, I would gladly have negotiated a higher price :) ).
Tianne did cursory checks of the heart, the cranial arteries, the bladder and a few other items. She slipped the sensor a little and got a peak at mom's bladder today also :)
Xavier's heart rate was 149, which Tianne said was a good heart rate. His bladder was full (always good to see that!), but his amnio was lower than Tuesday. Though still a nice sized amount, most of his fluid was between his face and belly today.
His dopplers were a little worse than last Thursday, Dr Wheeler, a Partner at the hospital and someone we've not met before, came in to discuss the results. An older woman, her manner reminded me of a crusty country doctor who had seen it all. Sitting down, she told us the ratio might be OK for now, or we would be checking Rebecca in to the At-Risk Mothers ward, or we would be checking Rebecca in to the Labor and Delivery for delivery.
She wanted to see the amnio amounts for herself before deciding, but it seemed to me she was of the mind Rebecca needed to be checked in to the hospital for more frequent observation. She was surprised we were not having two NST appointments a week.
After measuring the fluid again and probing around, she did not like the high doppler measurements and low fluid level. I countered some of her thoughts, saying his amnio measures more today than last week(3.3 cm today!). Rebecca mentioned that his amnio has been much lower. She left the room and returned several minutes later. She went to study in greater detail Xavier's history.
When she returned, she was more comfortable seeing that Xavier has had a long history of low amnio. She did have us schedule NSTs twice a week and we have one tomorrow morning.
We got a few more pictures of Xavier, one of his face, and three others I can't remember what they are (one is of his arm), but none of these three are very recognizable. If we are interpreting the scale on the face image correctly, and if a baby at his developmental age maintains the same proportions as a new-born, then we estimate Xavier's length to be ten or eleven inches!
Of course, I will let you all know what tomorrow's NST results are. Thank you for your prayers. They have kept Rebecca from returning to the In-patient floor. Also, Rebecca and I think Xavier may have hit a growth spurt. Wouldn't that be something! Since we have another week to wait for growth measurements, we are encouraging Xavier to put on at least another three to four ounces, an impressive, but obtainable goal given his current growth rate.
Winter Storm Achilles
Hello to you all.
With a significant snow storm across the Denver-Metro area, we enjoyed a relaxing, non-eventful day. After yesterday's fun, today was a good day to rest. Rebecca felt good today, and experienced only slight swollenness.
Xavier has been active most of the day. Rebecca baked chocolate chip cookies this afternoon. After eating a couple, Xavier moved around quite a lot. The cookies were tasty.
We have a doppler and growth exam tomorrow. Rebecca's belly seems like it has grown notably larger over the last few days, and we are expecting to learn Xavier has grown faster than his past rate. Rebecca is pulling for 200 grams, which will put him at 824 grams or about 1 lb, 12 oz. I'm pulling for a full two pounds.
Always, thank you for your prayers.