Sunday, September 26, 2010

Approaching 35 week

Casey turns 35 weeks old gestation in the next few days. Most preemies go home at 35 or 36 weeks old. But Casey is not most preemies. She's a micro-preemie. So at 35 weeks gestation, we see huge steps forward in development but her journey is just longer than the babies next to her.

8 weeks 4 days
almost 35 weeks gestation (8.75 months pregnant equivalent)
4 lb 9 oz (birth weight 2 lb 4 oz)
60 days spent in the hospital

This week we had a sweet surprise waiting for us. Somehow our nurse Leila saw us parking our car from Casey's NICU room and was waiting for us. She had Scott cover my eyes as we walked in and we saw a big girl crib. Well, a NICU 'big girl crib" which is really just a plastic bin with an open top that our baby now calls home. No longer is she in the plastic isolette cave.' She's hanging out with the big boys now. In fact, her two roommates are two baby boys about the same size as her. This means no more heated bed, it is now up to Casey and being swaddled with two blankets to keep herself warm. We were told to not be surprised if she had to move back to her isolette but she's been giving off heat waves and has remained in her new bed.

Today, Casey had a not so nice surprise waiting for her. She turned 60 days old so it was time for vaccinations...3 different shots in her thighs. When we were approached with the consent forms, I was told that all babies have this option once they hit two months. I asked "yah, but she's not a real 2 month old. She's not even at full-term yet." But, no, my little 4 lb 2 month old has to contend with babies twice her size. We wanted to be there to comfort her although Scott was concerned that she would associate his presence with the pain. It fell to Nurse Laura and Nurse Maya to do the dirty deed. Another nurse, Alex, just happened to walk away but backed out when she saw it was shot time. She told me that when she has to administer it, she would put on a mask to disguise herself so the baby wouldn't know it was her doing the mean thing. We were all apprehensive. And Casey did cry...a heart-wrenching round of maybe 5 cries...and then she was pau and she konked out. I think we and the nurses took it harder than she did.

I was telling a friend that she nippled or bottle fed once a day and he asked "so she just gets all her food once a day in a big bottle?" So, let me clarify. She gets fed every 3 hrs = 8 x a day. They're all delivered into her stomach via a feeding tube. Once a day, Casey drinks one of those meals by bottle. She did so well, that they have moved her to two meals a day by bottle. I actually got sick this past week and so I had to mask up and not hold her for most of the week. It was torture, I just miss holding her so much. So it was up to Scott to take over learning to feed her by bottle. We're still having to work with her, trying to get her to pace herself...if you let her go, she'll suck and gulp until she turns blue. She gets so determined that she forgets to take breaks for breathing...I'm not kidding.

It's a learning process for us. It's vital that we monitor her to force her to take breaks.

First. The struggle to get the nipple in her mouth. She loves her pacifier, she loves to yawn. As soon as you put the bottle to her mouth...bam...her lips are pressed tightly closed. Denied.

2nd. You get the nipple in but you have to make sure that her tongue is under the nipple so she gets suction. You try to angle the bottle to get a good look to check... and the bottle pops out and you're back at step 1 again.

3rd. Now the nipple is in place. Nothing. She's now playing possum. Is she even awake?

4th. She starts to suck and bam...milk is now disappearing from the bottle. Hmm, she should take a breath soon. The nurses taught us to kind of count to 5 or 6 and tip the bottle if she doesn't breathe. It takes any milk out of the nipple to stop the flow of milk. Doesn't really faze her, she keeps sucking. This continues for forever until she finally stops and you see her take a few breaths.

5th. Now you have to determine when she's taken enough breaths (if she has at all) to sustain her for another round of drinking. She's hooked up to a machine that tells us her blood oxygen levels. Unfortunately, the nurses tell us we have to learn to "watch our baby." They're trying to teach us what she looks like when she starts turning blue.

So now, Scott and I are playing a guessing game. "Hey, I think she's blue...she's blue!!!" Look up...oh, the monitor says she's sailing at 100%. After these four or five of these false alarms, the nurses point out that the NICU walls are painted blue so we may be dealing with some color interference.

But occasionally, her oxygen levels do drop drastically, or her heart rate plummets to half it's normal rate, or she starts to gag or choke. And then the fear grips you as you tip her forward to clear her airway and wait anxious seconds. Still reeling from holding her sisters who passed away in our arms, my heart feels absolutely frozen as I watch her little chest rise and fall as she struggles to catch her breath. And then she's back to good and she continues devouring her meal like nothing happened. I am a complete backseat driver when it is Scott's turn to feed her, but it is sometimes a huge relief when he does it. He's so laidback and confident, he is way better at it than me.

Scott coaching Casey through her meal. By the way, Scott has a blog today giving tribute to one of Casey's awesome nurses.

I so wanted our girls to have Scott's mouth. I'm not fond of mine. My upper lip disappears when I smile. I don't know why, but this whole time I thought Casey had my mouth. Now that she's spending half the day on the cannula and we can see more of her face...she totally has Scott's mouth!!! Yah, want the proof? Here's her frowning with a perfect, upside-down crescent.

Okay, Scott...let's see the frown. Perfect match.
I had to borrow pictures from Aunty Crissy since I didn't really take any pics this week. Here's Casey in her big girl crib.

She seems to be having a stare contest with Uncle Todd. Who's winning?

Here we girls are having a great time. We've kind of given up on kangaroo-ing for now. She gets squirmy and likes to be swaddled.

One of my fave pics. Uncle Jasen and Uncle Dural came to visit. I love the matching outfits.

Praise Reports:
-the diuretics seem to be working. Her oxygen requirements are now usually around 21-22% during rest and 30% when we're bottle feeding her.
-she's now on the CPAP half the day and the cannula half the day
-they've lowered her CPAP pressure to 3 (it started at 5)
-she's doing two bottle feedings a day and she may move up to three a day
-she survived her 2 month vaccinations with surprisingly little fuss
-she's been keeping warm with the help of clothes and blankets
Prayer Requests:
-that she's able to keep up with more bottles during the day.
-that she needs less oxygen support when she's feeding
-protection over our family from any sickness or germs


  1. I LOVE LOVE LOVE seeing Casey grow up and to know that she's in a "big girl crib" is so awesome! You guys are doing such a great job feeding her - I'm sure it's so hard to tell what's right/not, that's really funny about the NICU walls being blue too. She totally has Scott's mouth but I think she looks like the both of you!

    I'll be praying for her to guzzle more bottles & that she gets stronger and stronger each day. Can't wait to see her again.

    miss you three!
    her favorite aunty! Tricia

  2. Thank you for the updates, tears of joy...yep, you are right, she has daddy's motth! I will continue to pray for all of you. Keep it up, slugger! Love and hugs..Aunty Connie