The Great Escape

Christmas (Baby Please Come Home)

We just got off the phone with the doctor.  Assuming The MVP has a good night tonight, they expect to discharge him tomorrow, Dec 25th.  Let us all collectively cross our fingers.

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.

...if only in my dreams.

No pics today, as I haven't had time to download from my camera, but I wanted to post a quick update.

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.

The World's Most Expensive Babysitting

Just to clarify, V, my post would have been titled "Suck Like a Champion Today", a clear homage to Notre Dame. Upon reflection, however, that title now seems inappropriate. The MVP's sucking much more closely resembles the 2009 USC Trojan football team, which is to say that sometimes he sucks really hard, but sometimes he barely sucks at all and it's generally impossible to predict which one is going to happen at any given time.

So V covered the big news that The MVP now has a third delivery option for his eight daily feedings (the others being bottle and gavage tube). More good news is that, since he can now nurse or eat from a bottle, the therapist suggested that we continue to mix it up after he gets home. That means I or the grandparents will get to feed him once per day to keep him flexible and keep mom from having all the fun.

Another big piece of news is that The MVP's crib has been upgraded again. His palatial new digs are quieter and more private in the corner suite next to a window, and his incubator has a more accessible top that can be raised or lowered to your arm level. Now, this could just be coincidence, but just three days ago we brought Viet Grandma's famous Pecan Tassies and Rum Cake for all the nurses. Yesterday, fancy incubator with hydraulic height adjustment AND a mountain view. You draw your own conclusions. All I'm saying is that greasing the nurses certainly can't hurt.

Ill gotten gains.

V and I have settled into our routine a bit more. We've scaled back the amount of time we cover in the ICU from about 15 hours per day, which was unsustainable, to about 8 or 9 timed around when we know he's going to be awake. The first week we were here, the nurses kept telling us to go home and sleep. They told us we should take advantage of the world's most expensive babysitting and go catch a movie or something. Yesterday, it occurred to us that that made a lot of sense, so we did something we haven't been able to do for the last 9 months, and may not be able to do for the next 9: dinner at our very favorite sushi restaurant.

Aw, yeah. It's about to go down.

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.

This stuff is the shishito.

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.

Get in my belly.

Today, we are much rejuvenated as we return to the hospital.  By request, here are some pics of the "munchkin" from yesterday.

A Sucker's Born Every Minute

Sorry we haven't blogged in a few days. Besides Jemifus resuming work this past week, our routine also got a little more complex recently, in a good way. The doctor gave me the thumbs up to begin nursing twice a day! At the risk of TMI again, MVP latched on like a pro the first time. Our therapist gave MVP rave reviews for his performance. Now that was Friday afternoon with plenty of expert assistance. I've been sans therapist this weekend and have had mixed results. Jemifus has been a fabulous partner in crime but even with both of us prodding and poking MVP, we still have had a pretty tough time keeping him awake during the nursings. The best is when he falls into a deep sleep during the nursing but is eyes wide open when he's put back into his incubator. The nurse called him naughty today! So needless to say, I'm looking forward to Monday when the therapist is back in the building. But it's still been an awesome experience so far and we are very excited about this new development. Also other exciting news, MVP is up to 28 CCs and our nurse told us she was going to recommend to the doctor that the volume go up tomorrow. (Can't remember if we've mentioned this or not before, but the doctor told us a few days ago that MVP would need to be at 60 CCs plus a couple other milestones before he'd be able to come home).

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?

Sweet Sixteen

Today is sweet for a few reasons. On December 16th at 17:35, MVP turned 1 week old! And...drum roll please...MVP was bumped to 16 CC this afternoon with doc's orders to bump him up 1 CC every 6 hrs til he gets to 20 CC, contingent upon him digesting all his milk. (All his milk consists of 1/2 an ounce. He has a little belly).

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.

His super rosy cheeks are from the tape that was just ripped off.

The many faces of The MVP

Quick update with some photos, though I've got some more to talk about later - maybe tonight.  I should find some wood to knock on, but the 15ccs are going well so far.  We're heading back to the hospital now for an appointment with the therapist, and there is a chance, a chance, that they may have upped him again.

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.

The "farting" face that V-Train mentioned yesterday.  We knew you weren't crazy, V!

The Thinker, for those reflective moments.

What?  WHAT.

We get the warhead and hold the world ransom for

one MILLION dollars!

No, Mr. Bond.  I expect you to die.

Freshman 15

This is my 1st blog post since MVP's arrival and I apologize in advance if I don't sound quite like myself and of course, for not being as witty as Jemifus' posts. He has a gift with words.

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?

Today was a good day

Sorry if yesterday I sounded a little downbeat.  Some days have been better than others, but if you really take a step back, things are going great.  When I think about the kinds of things our friends have handled with strength, grace and positive attitudes, this ain't nothin'.  For goodness sake, we're agonizing about a stupid PICC line, but 75% of the NICU babies get them.  By the way, at over 6 lbs and with strength that defies velcro, The MVP is The Beast of the NICU.

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.

Happiness is having your stomach filled.  Or filling a diaper.  I can't yet interpret his facial expressions.

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. 

The MVP is literally stuck on mom.

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.

One step forward... two steps back

A little bit of a disappointing day.  I mentioned last post that they bumped The MVP's feedings by 50% to 15cc, and had a standing order to increase to 18 if he handled it well.  Unfortunately, the amount he was digesting actually went down.  Thinking that he's just been overtaxed, they've taken him down to 5cc, which means he's gettin about 85% of his nutrition through the IV.  Our favorite nurse keeps reminding us that anything his digestive system does right now is 100% more than he should be doing, since he should really still be getting his nutrition through the umbilical cord.

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.

Family portrait #2

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.

...and Dad needs a manicure.

And this one is from today:

Resting up for another step forward.

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

The MVP had a new nurse at the ICU today.  This is not unusual -- he's now been there for six nursing shifts and has had five different nurses with only one repeat.  Anyway, after talking with us for a few minutes this new nurse says "Wow, you guys really are nice, just like it said in the report."  This was both flattering and extremely disturbing.  Apparently, they do track parents demeanor because it helps the next nurse interact with the the parents more productively.  I have noticed that they've started being more free with information lately, and I can't help but wonder if there's a sentence in a report that says "parents are extremely persistent -- nurses are advised to provide detailed information immediately when asked to so that they may tend to other responsibilities unmolested."

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".

The MVP takes most of his feedings like this, which is the baby equivalent of having grapes placed in your mouth while you lay on the beach.

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.

The MVP's fancy new home as of yesterday evening.  It's like Park Place...

...but this is Boardwalk.

They also think he's looking a little jaundiced.  To test this, they took what seemed like a half gallon of blood out of his heel, but he managed not to cry at all, probably just to spite the nurse who said "I don't want to lie to you... he's definitely going to cry on this one.   Here are some pictures from yesterday.  Didn't get many today but he's looking good.

Getting some quality time with Mom.

 

Introducing: The MVP

I know that last post (or double post, since I haven't figured out the mobile phone thing yet) left you all hanging.  Sorry about that -- I've been a little busy.  The MVP (a.k.a. the artist formerly known as DJ) arrived on Wednesday, 12/9 at 5:35 pm.    I'm posting this from the NICU, where he will be spending an some time getting a little extra help.

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 first family portrait.

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.

Some quality time with mom.

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.

 Chillin' like Bob Dylan.

These photos are a day old.  I got some really great ones today that I really think show the progress, and I'll try to post them when I can.

Brief update:
Little bit of a rough night but things are more or less progressing as planned. Best guess is we'll meet DJ later this evening.

Brief update

Little bit of a rough night but things are more or less progressing as
expected. Best guess is that we'll meet dj late today.

--
Sent from my mobile device

It's Time

So forget all that stuff I said about how the best available science says we're really most likely to have the baby January 18th.  I'm posting this from the hospital, where the best laid plans of parents and doctors have gone askew.  We expect to meet our baby boy sometime in the next 36 hours - which is about 36 weeks and a day.

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.

DJ's last USC home game in utero (35.5 wks)

Thank goodness he wasn't able to actually visually witness the disastrous outcome.
















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."

It must be true love...

But per the husband, how can you love someone you haven't met? At least that's his reason for saying he doesn't love baby DJ whereas I clearly love DJ. I have done a lot of things in the past 8 months that I don't think I would have ever gotten around to had it not been for this preggers status. And now I've submitted to one of the biggest sacrifices that it makes me want to cry. Yes I know you will mock me but I don't care. On the eve of 12/3/09, I went from having 2 giftwrap storage containers to only 1, so that my baby (that would be DJ, not Jemifus) could have closet space for all his crappola. I did take a picture of the sacrificial storage container so that I could at least have some physical memory of the time when I had 1 container for just Christmas wrap and 1 container for all-purpose wrap.



I hope the sacrificial container goes to a good home...Goodwill, please don't let me down.