Friday, December 25, 2009
Thursday, December 24, 2009
Christmas (Baby Please Come Home)
Advance to Boardwalk
Here's a pic from yesterday (Tuesday), when the MVP was moved into an open crib for the first time, and had his IV removed. You can see that they kept the incubator right next to it in case they have to move him back. It's still there. They're continuing to monitor his temperature and weight to ensure neither drops.
So far, so good, and The MVP is at 6lbs, 9.5oz tonight -- comfortably past his birth weight.
We had a false alarm yesterday... The docs thought they might discharge The MVP today. We frantically started making our final preps, and called in my folks from San Diego. However, he had some trouble eating last night and they ended up having to use the feeding tube. Since we don't have one of those at home, they'll need to see a couple days of good eating, which effectively ends any notion of a pre-Christmas homecoming.
Today, however, The MVP seems newly determined. He's as alert as we've ever seen him. And though the nurses decided to leave his feeding tube in today, like Cortes scuttling his ships in after landing in Veracruz, The MVP let us all know he had no intention of retreating by ripping out his feeding tube for what we hope will be the final time.
Monday, December 21, 2009
...if only in my dreams.
I'm reluctant to get too optimistic because, though The MVP continues to make daily progress, he seems to be approaching his release asymptotically (thanks to Suelika for the phrase, which is math-speak for making constant progress but never actually reaching your goal). And this Sunday the sad realization set in that, given how far he had to go, The MVP almost certainly wouldn't be home for Christmas.
But hold the phone - some big moves in the last two days and a Christmas homecoming, though far from assured, may be back on the table. Here's what's happened so far since Saturday night:
- after generally doing much better with bottle-feeding, they've stopped using the feeding tube all together (though they haven't yet removed it, just in case)
- The MVP's weight, which had dropped below 5 lbs 11 oz at one point, has made a rapid comeback and just reached his birth weight of 6 lbs 7 oz
- From the last time we posted, the MVP's feeding amount has been thrice raised, to 35, 40, and just now 45ccs per feeding
- The IV rate has now been reduced to a very low amount and --knock on wood with both fists and stomp on your hardwood floor-- could conceivably come out as early as tomorrow
His main issue now has to do with stamina while feeding. We practically have to torture the little guy to keep him awake while he eats (more on this in a future post) - but eat he must if he is to leave the din of the ICU for the comforts of home, and meet the rest of his family.
Sunday, December 20, 2009
The World's Most Expensive Babysitting
Katsu-ya isn't exactly an unknown gem but, trendy or not, it has some of the very best sushi creations Southern California. Their Spicy Tuna on Crispy Rice and Baked Crab Rolls are mandatory ordering every time. We also ordered roasted shishito peppers, super toro, yellowtail sashimi with jalepenos, and sundry sushi items.
It was nice to have a "date night", though we decided dinner and a movie would be too much. The sushi was nearly as much of a treat for me as for V, because for the last nine months I'd been boycotting Katsu-ya out of solidarity to her plight.
Saturday, December 19, 2009
A Sucker's Born Every Minute
Because I'm a shy bird, there are no photos to accompany this blog post. However instead, I'll post a couple of favorites of my boys.
PS
Jemifus couldn't decide if my nursing post should be titled "A Sucker's Born Every Minute" or "Suck Like a Champion." I thought that "Suck Like a Champion" would only reach a narrow target audience and therefore decided to use something I thought would appeal to a broader audience. Thoughts?
Wednesday, December 16, 2009
Sweet Sixteen
And to top that off, we got to see MVP without any velcro, tape or wires on his face! Here's my fave one from the hundred or so pics we took of him with naked face because, after seeing our excitement, the nurse quickly warned us that it was temporary and that she'd be inserting his feeding tube again. He's pulled it out about 6 times already.
The many faces of The MVP
Today is the MVP's one-week birthday, and I'm completely amazed that every day brings new things. He now has an entire range of facial expressions that did not exist three days ago. Here are some pictures from the last 24 hours that aptly demonstrate this fact:
I previously mentioned that one key "milestone" is that he needs to attack the nipple with gusto. Progress?
Recognizing the Trojan "victory" symbol is an extra milestone that V-Train decided to add to the list.
Tuesday, December 15, 2009
Freshman 15
MVP has been consistently eating 10 CC per feeding so the doc bumped him to 15 CC today! Now the question is: will his little gut digest it? Please keep your fingers crossed because the doc indicated MVP would have to be at 60 CC per feeding before he'll give MVP his graduation diploma. So actually please keep your fingers, toes and whatever other body parts that can be crossed crossed.
The other day I held MVP twice after his feedings in a cradle position because I can't help myself; I love looking at him. Really he should be held in an upright position afterwards per our therapist. But anyway, like most of the male species, he lets out a lot of gas after his feedings and the faux smiles got going. It was soooo cute I can't even describe it. He was all kinds of smiles. Now I understand how parents can get excited about things that seem really strange to non-parents...believe me, a week ago, I would never think that I'd be not just thrilled but actually writing about my son's farting facial expressions. That's something called TMI right? I'd post a picture to show you I'm not crazy (uh okay those of you who know me know that I am crazy but whatever!). Unfortunately, I was on the solo dayshift so I couldn't capture that Kodak moment. So you'll just have to settle for a couple of my favorite pics from yesterday instead...
Here's MVP getting burped by the nurse. He was fooling around a lot and flirting with the nurse during this feeding. Keep in mind the nurse was probably 60 years old. I heard her say to him "Even with all that stuff on your face, you're so cute!" Between his outrageous flirting and his already growing NICU reputation for having a temper, do I have trouble on my hands?
Monday, December 14, 2009
Today was a good day
We're going to look back on this not long in the future, when The MVP is cruising around the house laughing while he knocks over things we thought were securely attached and think "what the hell happened to the little guy who needed help breathing?" Anyway, today shaped up much better - I don't even know where to start.
First off, Momma cooked a breakfast with no hog.
V-Train and I have worked out a routine for NICU visits. We go first thing in the morning after shift change and spend time as a family, then she takes the afternoon while I drive to the pad and hit the showers, and then I take the evening until midnight or so. This way we cover as much time with him as we can. So I was on duty last night, and The MVP was really agitated. For hours, I couldn't get him to calm down for long. After his feeding I held him and he stayed awake and fussed which is very unusual (or as unusual as anything can be for a four day old baby). After trying a number of things, the nurse finally decided that he really just seemed hungry, so she called the doctor at home at 11pm, who agreed to increase his feeding to 10cc immediately. As of this afternoon, he's been handling that well and still acting hungry, so another increase may be imminent.
The MVP is also seeing an occupational therapist. When I found out, I said "Great!", because it's never too early to start career planning. But she's actually a feeding expert who is training him to eat from a bottle. Eating requires a fairly high level of coordination -- cheeks, tongue, lips, swallow, and breath all have to work together in just the right sequence. Today, he took down his first bottle like it was a fraternity dare -- less than two minutes for 10cc. As a point of reference, it took him 12 minutes last night. So after he went all Kobayashi on the milk, the OT decided to move him back to a bottle every other feeding.
After he ate, V got to hold him for nearly an hour, during which he slept and drooled. He only woke when the velcro that holds on his Kanye glasses got stuck to the burp-cloth.
Finally, they asked us to leave so they could run the PICC line, so I returned him to the incubator. I'm going to briefly describe the procedure used to accomplish this: the incubator has a drop-top and, if you hit the switch, you can make the ass drop. I am not making this up.
They kicked us out for the PICC line procedure, but we're told it went great. His PICC runs deep, so deep that they are now able to take the splint off his hand that was holding the IV steady. By the time the procedure was over, the bilirubin results were back and they were able to take him out from the lights, and finally remove that stupid velcro.
One thing about the bili lights I wanted to mention. The lights work by casting at a wavelength that breaks down bilirubin under the skin, allowing it to be disposed as waste by the body. Since bilirubin is what causes the jaundice, the jaundice first disappears where the light hits. You get one guess what that means. Right -- baby tan lines! I wasn't able to capture this phenomenon photographically, but trust me that it is every bit as amusing as it sounds.
Anyway, things are progressing nicely. No lights, no velcro, no splint, full stomach, and lots of holding = happy baby.
Oh... and I didn't even have to use my AK.
Sunday, December 13, 2009
One step forward... two steps back
They also told us they want to run a PICC line, which is more invasive than an IV, but should only have to be put in once vs. his IV which keeps getting knocked loose. The doctors were pretty confident it was the right thing to do to decrease the chance of infection from multiple IV pokings, but it was still a tough decision because it sounds like a fairly uncomfortable procedure for him and they won't allow us to be there when it's being done. Also, the fact that they are running a PICC line means they definitely expect him to be there longer than another week.
In other news, they ran him under the bilirubin lights all night last night. His bili levels have dropped a bit, but they continued to run the lights today. In the middle of the night he ripped his Kanye glasses off, which is really not an easy task since it's taped and velcroed on. Add this to the several times he's yanked out his feeding tube or knocked off his IV, and he's giving the nurses a heap of trouble with his unnatural MVP strength.
Here's a picture from yesterday -- you can kind of see where he's looking jaundiced.
Saturday, December 12, 2009
Just a day at the beach.
The MVP is a little jaundiced, so they decided to put him in a tanning bed. I assume there is something to it other than the aesthetic benefits...
We Are Being Watched
In other news, they upped his feedings today to 15ccs from 10 yesterday. He took the full 15 from the bottle, and did it much better and quicker than we've seen in previous feedings -- this is definite progress, since his feeding style has been described as "disorganized".
He was also moved to an incubator, which is nice for him because it's a little quieter and a little better protected from the lights and drafts in the room. The big milestone will come when he's moved to an open crib, which will happen when he doesn't need external temperature control.
Introducing: The MVP
There was a little drama the night before he was born, as I implied in an earlier post. During labor, they track the baby's vitals through sensors, monitoring how he reacts to the contractions. Our doctor, who we chose in part because she is not at all alarmist, described his charts as "not at all reassuring" -- apparently, his heartrate would decelerate at odd times relative to the contractions. By morning, he seemed to have stabilized, but the doctor told us that if it started happening again she'd order an emergency C-section. Fortunately, The MVP played out the rest of the day like the champ he is. There was also a little bit of health drama for mom, though nothing too dangerous and everyone pulled through for an on-time arrival, au natural.
The NICU team was on hand "just in case", due to the premature date. When The MVP first showed his face, he immediately let out a hearty cry and, based on that and his pink color, the NICU team started packing up to leave. However after his initial maturity assessment, which put him at 35 weeks, he began "grunting" and his oxygen saturation levels started dropping. They initially told us they were bringing him to the NICU as a precaution and that he might just be there overnight. However, after further assessment they identified further issues and decided to hang onto him for what looks like may be one to two weeks (though they refuse to even estimate). Those issues initially included labored breathing and low oxygen saturation, some fluid in the lungs, grunting, jerky and jittery movements.
Since Wednesday night, he's made pretty steady progress. By Thursday night his supplemental oxygen was basically just air, they fed him actual food through a gavage tube that goes down into his stomach (rather than just using an IV), and they let us hold him for the first time since right after he was born. Today they ramped up the feedings to every three hours, two of which were from a bottle, took out his oxygen tube completely, and we were permitted to hold him for maybe a combined 7 hours. He's been taking really well to being held, exhibiting less of the "frantic" behavior that he's had on his own, when he does things like rip out his gavage. He's been a lot calmer and more alert today.
The big milestones they are looking for before they release him are around eating. He needs to be able to regularly eat from a bottle, in an amount sufficient that an IV isn't necessary. We're a ways off from that still, but he's been making great progress. He's doing 10cc per feeding and needs to get to 30. He's doing three bottle feeds per day and needs to get to 8. He also needs to really attack the nipple like Berkeley grad students going after the only vegetarian pizza.
Leaving the hospital without our baby was a big bummer for us, but maybe nobody is more bummed than the grandparents, who have not been able to meet The MVP due to swine-flu precautions in the NICU. We've been whetting their appetite with pictures and videos shown on camera LCD screens, and they are very anxious to meet him.
Wednesday, December 09, 2009
Brief update
expected. Best guess is that we'll meet dj late today.
--
Sent from my mobile device
Tuesday, December 08, 2009
It's Time
A couple weeks ago, V-Train started experiencing intense itching at night on her arms and legs. We assumed it was just one of those fun things that accompanies pregnancy but, when we told the doctor to see if there was something she could give us to make the itching go away, she was a little concerned. She tested us for a very rare condition called Intrahepatic Cholestasis of Pregnancy, in which the bile produced by the liver doesn't get shuttled away fast enough, and builds up in the blood. This condition is strictly related to pregnancy (goes away after) and carries no risk for the mother. However, it carries some risk for the baby which increases over time.
The diagnostic test (for liver bile levels) came back negative... but with some additional weirdness in the bloodwork. But since ICP is so rare and the diagnostic test came back negative, the docs dismissed that and started looking for other causes. However, while we were waiting for the test results, I did a lot of research on ICP. And the more I read about it, the more it seemed to describe V's symptoms to a tee.
At our last visit, on Friday, we talked with the doctor and shared our concerns, and she agreed to retest the liver bile levels (which is not a standard test). Today the doctor called me at work. She'd been trying to reach V-Train (who was having lunch with one of her company's execs and thus had her phone off). I knew it was serious when the doctor gave me her personal mobile number and told she needed me to track down the wife so she could talk to her immediately. When V finally talked to the doctor, it turned out that the retest showed extremely elevated liver bile - a conclusive diagnostic for ICP.
The doc told her to go into the hospital now -- she was going to induce tonight. That's because at 36 weeks, there is very little "prematurity risk" to the baby. And after 36 weeks, the risk of ICP to the baby increases quickly. So the safest thing to do is to deliver now.
After we both had panic attacks we went home and did our best to prepare for our hospital stay. We thought we had a few more weeks, so we're definitely not quite ready. We have wonderful friends and family who have graciously stepped up and are helping us cross off the last items on our to-do lists.
The doctors are doing what's called a "slow induction", which can take anywhere from 5 or 6 to 40 or so hours, with the best guess being a little over 24 hours. Mom's doing great, resting in bed waiting for the first contractions to kick in.
Monday, December 07, 2009
DJ's last USC home game in utero (35.5 wks)
However judging by his swift kicking, he did quite enjoy the halftime show - George Lopez as conductor, WAR as the musical act, and the USC marching band as back-up. For those of you who don't know, WAR is an old-school Chicano band. Think "Low Rider" and "Why Can't We Be Friends."
Sunday, December 06, 2009
It must be true love...
I hope the sacrificial container goes to a good home...Goodwill, please don't let me down.
Thursday, November 26, 2009
Giving Us Our Due
To determine the due date, they use something called "Naegele's rule", which basically sets your due date 280 days after the beginning of your last menstrual period (LMP). Presumably, this is because the best science mankind has to offer has determined that human gestation lasts 266 days on average, and the best estimate of the commencement of gestation is 14 days after the beginning of the last menstrual period -- bing bam boom, 280 days. Of course, they tell you up front that few women give birth on their due date but, short of having a fortune teller at your baby shower, it's the best intel you've got.
Science has had a long time to work on this problem. Undoubtedly, one assumes, scientists have conducted extensive empirical research and observed that the median pregnancy lasts 280 days. That is, of the women who don't give birth on the exact date, 50% would be earlier and 50% later than that. There should be something like a normal bell curve around that date, but maybe leaned to the earlier side (since there should be more babies born 3 weeks early than 3 weeks late).
Have you guessed where I'm going with this? Let's check in with Wikipedia and see what they have to say about good ol' Naegele's rule:
Franz Karl Naegele was born July 12, 1778, in Düsseldorf, Germany. In 1806 Naegele became ordinary professor and director of the lying-in hospital in Heidelberg. His "Lehrbuch der Geburtshilfe," published in 1830 for midwives, enjoyed a successful 14 editions.
What the what? The best estimation technique medical science has to offer was developed two hundred years ago? Perhaps this is because it is so accurate that it just never needed to be updated? Nope, that's not it.
Studies of uncomplicated spontaneous-labor pregnancies have shown that this assumption leads to due dates that are premature, relative to the median.
It turns out that the method in common use is kind of bogus, like using the Farmer's Almanac to choose a date for your outdoor wedding. Given how easy it would be to study human gestation length, and how relevant it is to, you know, humans, you'd think there would be extensive data available. There isn't. In fact, there have been very few studies, and these studies produce different results based on time, place, race of the mother, and other factors.
What we do know is that the best data available does not suggest that your due date is 280 days from LMP. 288 days is more likely to be the median for the first time mom in an uncomplicated pregnancy.
It gets worse. Remember that they estimate the date of conception based on your LMP, but that in itself introduces a lot of room for error. Very early ultrasounds may be even more accurate at placing gestational age than LMP, but doctors don't usually bother using the ultrasound to set the due date if it's within a week in either direction of the LMP version. But based on our early ultrasound and the 276 day gestation implied by scientific knowledge obtained in the last 200 years, we should be expecting the baby not on January 5, but on January 18th.
That's a pretty big freaking difference.
Fortunately, V-Train and I do have an alternate method with nearly as much scientific rigor as Naegele's rule: the fortune teller predicted that baby DJ will arrive in the wee hours of January 8, measuring a slight 17 inches long but weighing a healthy 6 lbs, 2 oz. And that, my friends, is as good a guess as any.
Friday, November 20, 2009
Twilight: Babymoon
My heavy work travel schedule isn't exactly fun for either of us, but one major perk is that we were able to use all of the accumulated points and miles to fly there and stay at some pretty swanky hotels for the very reasonable price of nearly free. On our last night in Rome, we got stuck in the lobby of our hotel for a while as bagpipes announced the arrival of the motorcade of President Napolitano with King Abdullah of Jordan. For reals, y'all.
Tuesday, November 17, 2009
Baby Myths Dispelled
Myth: Babies always land on their feet.
Reality: An infant's vestibular system is insufficiently developed for it to right itself in the air. Babies land on their feet at a rate no greater than that predicted by chance.
Myth: If you don't feed a baby, it will stay small and cute forever.
Reality: While this myth is at least partially based in fact, such an approach is likely to cause significant side effects and should never be attempted.
Myth: You should never approach a baby when it is eating or playing with a favorite toy, as the baby may become aggressive.
Reality: This myth has no basis in fact, at least for domesticated babies. It likely originated as an overly broad interpretation of wild animal behavior.
Myth: You cannot get pregnant when you are already pregnant.
Fun fact: Yes, you can.
Myth: Teach a baby to fish, and you feed him for a lifetime.
Reality: Even basic survival skills such as fishing, hunting, foraging, and opening cans are too advanced for an infant to accomplish with meaningful consistency. A baby must be supplied with food, water, shelter, and heat for a minimum of three years, and often even longer.
Myth: Babies born in December are doomed to hockey mediocrity.
Reality: This one's actually true.
I'm sure there are others I'm forgetting - I'll be sure to share any surprises or interesting tidbits as my knowledge base continues to expand.
Monday, November 16, 2009
Should I be worried?
So Jemifus and I are at the Rome airport, going through security to return back to the States. We are well-rested and have plenty of time before our flight boards. We're through security and putting on our shoes. Jemifus says to me "Where's my backpack?" Me: 'Uhhhh, why would I know where your backpack is?' This of course is the backpack with our fancy camera and some other important stuff. It turns out Jemifus never even put the backpack on the conveyor belt. Oy vey! We were lucky enough that security had just picked it up and we caught them in time before they shipped it off to the mysterious land of unclaimed suspicious bags.
So, should I be worried for baby DJ?
Friday, November 13, 2009
Get Used To It, For the Rest of Your Life.
A couple days ago, I hadn't felt DJ move in 16 hours. I tried prodding him with 2 cups of ice-cold water but nothing. So the doctor told me to come in and get checked out, which consisted of a NST (non stress test) and ultrasound. Of course, the minute I get on the examining table (not sure what else to call it), DJ is moving like noone's business. Seriously, really? I passed the NST and ultrasound with flying colors; per the doc, I got a 10/10. I couldn't help thinking, 'Boy, DJ is such an a-hole...scaring the heck out of Jemifus and me like that.' Is it wrong to already think your 1st unborn is a booger? I recounted this story to my friend, ENSV, who has 2 young boys of her own and sure enough, she said 'Get used to it...for the rest of your life.'
PS
At least we got an ultrasound and learned that in fact, DJ is still a boy and if I keep it up, he'll be 7lbs at birth. Woo hoo!
PPS
DJ is moving quite a bit as I'm writing this post. Perhaps he can sense I'm talking ill of him. Well, if that's what it takes to get him moving...
Thursday, November 05, 2009
Kicking off
We've got a lot of catching up to do. For now, I'll start out with one of our first big critical milestones: