Homecoming! Friday December 30, 2011

We took Alex home today!!!



Nurse Mary cutting off Alex's Hugs tag.  This tag is an RFID security system.  If a baby with the tag gets too close to an exit, alarms will sound, the doors all lock, and security comes running.  Its one of the last things to be taken off before a baby leaves the hospital.   





I'm excited to go home!!!




I am 6 lbs 3 oz.  This outfit is supposed to fit babies up to 7 lbs.  Its huge!




Arriving at home.  Its so good to have him here.



Wednesday December 28, 2011 - A great day!

Today when I got tot he nursery, Alex's nurse said he had no tube feedings overnight.  All bottle feedings.  His last tube feeding was almost 24 hours earlier on Tuesday afternoon.  That means that his tube can come out!  And we can take him home within a few days!  Friday will be our homecoming day.
 

Tuesday December 27, 2011 - 25 days old

When can he come home?
That is the $1,000,000 question.

My guess on Saturday that we were a few days from coming home may have been overly optimistic.  He had a high percentage of his feeds Saturday orally - but then he also showed some signs of being tired by the end of the day.  Alex's heart rate, respiration and oxygen saturation are constantly monitored.  Its not that uncommon for babies - especially preterm babies - to have "spells" where their heart rate drops or breathing slows/stops and their oxygen saturation levels drop.  Its a concern if they can't pull out of it without assistance.  Alex has these periodically (as do all babies, even full term babies) and he always pulls himself out of them without assistance.  He had more of them on Saturday - which is a sign that he was tired and we needed to let him have more rest.  Since then we've taken a more careful and consistent approach.  He's progressing each day and I would guess we are now around 50%.

But he can't come home until he is 1) at 100% eating on his own, 2) for 24 hours, and 3) gaining weight all at the same time.  I tell Alex he must be his father's baby, because he cannot be rushed!  He has to do things on his own time.  He will get there.

Sunday December 25, 2011 - 23 days old

Merry Christmas!  (forgot to publish this at the time - oops)

Last night Alex pulled out his feeding tube.  He's so fast!  In one quick movement it was out.  We took the opportunity to get a few pictures. 

Saturday December 24, 2011 - 22 days old

A Week of Ups and Downs 

The good stuff:  Alex continues to progress developmentally just as he should.  We worked on nursing and early this week he got the mechanics of it down.  He and I both seem to know better what to do.  That was encouraging.  He is also gaining weight steadily.  On Wednesday night he was up to 5 lbs 8 oz.  As of last night he was 5 lbs 12.1 oz!  This picture was taken today.



Alex 12-24-2011  22 days old

On Wednesday in rounds his care team said its time to introduce bottle feeding.  Alex is ready to really tackle oral feedings and my supply is just not keeping up.  So we will give him as much breast milk as I have and supplement the rest with formula.  After all of the unexpected events - early delivery, cesarean, and leaving our baby here in the hospital for 3 weeks - nursing was the thing I was hanging on to, hoping to be able to do as planned.  Wednesday and Thursday were a couple of really tough days for me. 

When its time to eat or when he shows signs of being hungry and he is awake, we first offer the option to eat orally - either nursing or by bottle.  If he's too tired or just plain sleeping he is fed through his feeding tube.  The goal is that each day he will progress to fewer and fewer tube feedings.  When he is eating 100% by mouth and gaining weight, he can go home.

The first day he had 16% oral feedings.
The second day he was up to 35%. 
We are now working on the 3rd day (24 hrs) and he seems to be taking off. 

We are likely just a few days from going home!!!

Friday December 23, 2011 - 21 days (3 weeks today!)

The Day of the Very Big Poop

Whew, time to change me Dad - I've been working on this one for a while. Hope you have fun with that - it's coming out all over!  It's a double-diaper-doosy!  (And don't post any evidence - I'll be watching you...)

Tuesday December 20, 2011 - 18 Days Old

What goes in, must come out.

In addition to taking care of Alex, the job of the nurses of the ISCN is to train Mom and Dad to take care of him.  We do more and more of his care all the time - such as baths, diaper changes, etc...

Tonight we decided to dress him in a super cute sleeper from Auntie Beth with monkeys on it.  We managed to change a huge dirty diaper without getting the sleeper dirty.  But just as we were buttoning it up, he spit up all over it - and sleeper #1 came off.  This is a picture of sleeper #2, which he wore for a few hours before spitting up on in it as well.  He's pretty much outgrown these tiny sleepers already. 

Monday December 19, 2011 - 17 days old

Alex loves to be held.

Auntie Amy got to meet Alex for the first time today.  She just arrived from Virginia for Christmas.  Alex loves to be held.  The nurses are going to try to hold him more at night during his feedings too.  They say this is one of the perks of the job they like the best! 

Sunday 2011-12-18 - 16 days old

Its been a few days of ups and downs.

I'd been feeling pretty discouraged about nursing.  We'd been working on it 1-2 times per day and Alex would latch a little, but would get tired and frustrated after a few minutes.  As his nurse put it this weekend "He just hasn't figured out how to organize it all yet."  And my milk supply hasn't really stepped up to the plate either - despite pumping 10 times a day.  (I'm totally serious).  I've visited with the lactation consultant several times and we are going to try a supplement that may help.  The staff here also introduced the idea that we may need to be open to formula/bottle feeding if he figures out how to eat and my supply hasn't kicked in.  So I have been worried that this may be something that also despite our best attempts will not go as planned - and ultimately something that we end up abandoning.  I was pretty teary the last couple of days.  



And then today, he had a great nursing session this morning.  Thanks to some help from nurse Lori (have we mentioned how awesome the staff are here at the ISCN?), he latched on properly and nursed for 40 minutes!!!!  Definitely a confidence booster for both of us.   This takes a lot of energy for him, so he will sleep for a good chunk of the day.  If he is awake later, we may try again, but tomorrow is another opportunity.

Bath time again!  This time he got a heater above him to warm any little body parts exposed above the water line.  Mike's hair nearly caught fire instead though!

Alex gets a spa treatment, and Dad gets a sunburn!

Mmm, yes, I think I enjoy my bath...

(Thanks Auntie Beth for coming and holding me!  I get a little bored with just my parents holding me all the time)

Thanks Auntie Beth for the cuddles!

And I'm spent!

Saturday 2011-12-17 - 15 days old

Alex is gaining weight like a champ.  He passed the 5 lb mark at his weighing tonight.  Yesterday I was looking at him and I realized that his cheeks are filling out.  Dr. Johnson, the neonatologist, said first its the belly, then the cheeks, and double chin.  After that his arms will fill out.  Finally his legs and butt will get chubbier. He's on his way!

Thursday 2011-12-15 - 13 days old

Today we are reminded how lucky we are that Alex is so healthy. 

Caroline was Alex's neighbor in the next room at the ISCN when he arrived here.  I know Caroline's story because Caroline's mom, Jill, and I have known each other for quite some time.  We first met 8-10 years ago playing women's and co-ed soccer and worked in neighboring buildings.  With job changes and team changes we hadn't seen each other in several years, but were reconnected a few months ago.  In mid-September we both joined a Healthy Pregnancy Program offered through the Mayo fitness center and discovered that our babies were due just days apart.  I saw Jill 1-2 times per week from mid-September through Thanksgiving.  Being at the same stage of pregnancy as Jill was nice.  We'd compare notes - "How are you feeling"  "Can you feel the baby move yet?"  To have had our babies just a day apart, both early, and then to be roomed next door to each other in the ISCN - what are the chances?

Caroline and Alex were born just a day apart and both in week 34.  Caroline was a little smaller than Alex and had struggled a little with jaundice.  The last I talked to Jill (Sat or Sun), things seemed to be going well.  Her bilirubin levels were on the decline, she had also transitioned out of the incubator, and they were also going to start nursing.  But on Tuesday when we arrived here, Caroline's room was empty.  I didn't think she had been discharged to home yet, so I emailed Jill. Caroline had been transfered to the Neonatal Intensive Care Unit at St Marys with hydrocephaly (fluid on the brain).  Lots of tests later, it sounds like they have found the root cause and will watch her closely.  This condition can cause developmental delays.  They are optimistic that this will be minor for Caroline, but even so they will monitor her progress very closely. I think she will stay at the NICU for a while, maybe even until she goes home. 

It was nice to have Jill here.  I've missed having another mom on the floor to talk to.  The nice thing about the ISCN is how private it is.  But on the other hand, it can be a little isolating.  Jill and I would check in with each other every couple days to see how the other was doing.  "How are you holding up?"  "How are you feeling"  "Is Caroline/Alex doing okay?"  I miss her.  Of course we hope for the best for Caroline.

Because the rooms are all private, I don't know anything about the other babies here.  But its still pretty obvious that some struggle more than others.  The billi lights for jaundice treatment make a whole room glow.  You see the call lights and hear the alarms.  You can see people coming in with blood draw carts or portable ultrasound machines - and you know that they don't order those tests for preemies without good reason.  We are so blessed that Alex is so healthy.

Bath number three today.  Alex likes his bath.  Mike did this one and it went great. 

Grandma and Grandpa Bruzek bought him some preemie clothes.  This is the first time he wore one of them.  He fills it out pretty well.  At 4 lbs 15.6 oz, he may not be able to wear it too many times.

Cuddling with Dad. 

2011-12-13 Tuesday, 11 days old

Alex's big task now is eating orally.  We have had 3 days now with a couple successful attempts at nursing.  This is just introducing him to it.  He is still getting all of his nutrition through the feeding tube.  Its a lot of work for him and he gets tired pretty quickly.  But each day I have seen improvement - in how long he is awake, how long he latches, and how often he latches.  (Don't worry, we won't post any pictures of this process).

We've also noticed that Alex is also awake for longer periods.  Often after changing him he will be awake for 20 minutes or so, wide eyed and looking around.  This is a sign that he is maturing too.   The first few days we hardly saw his eyes open, now its a pretty regular occurrence.  Even so - he still sleeps a lot.  Growing and learning to nurse take a lot of energy so he needs A LOT of sleep.

He's also noisier.  He grunts and sighs more.  And I think his cry has gotten louder.  Although we don't hear it all that often.  (I know, we should enjoy it while it lasts!)

Tiny feet - the sensor on his foot measures his oxygen saturation levels

 .

Awake, changed and ready to eat. 

It looks like a lot of wires, but really, its not that scary.  The sensors on his chest are to monitor his heart rate and respiratory rate. They stick like a band aid.  The one on his foot is similar and measures his oxygen saturation levels.  Then he has the feeding tube through his nose, which doesn't seem to bother him.  He does however manage to pull it out every few days.  He likes to have his hands up by his face and will occassionally get a finger under the tube.  One quick movement and its out!  Other than that, he wears a couple of ID bracelets and an RFID tag.  The RFID tag will set off alarms if he gets too close to a exit.  

2011-12-11 Sunday - 9 days old

Today Alex had a lot of visitors.  Grandma and Grandpa Meiners stopped in again before heading home to Iowa.  Auntie Beth and Uncle Cory came from La Crosse.  And Grandma and Grandpa Bruzek came later in the afternoon.  Even with all of the activity he did pretty well.

He also had his second bath which went MUCH better than the first.  There was a lot less crying!  They do a swaddle bath here under a warmer so he stayed nice and warm.  I did this one myself (Laura).  Next time its Dad's turn.

Mike also succeeded in setting up a web cam in Alex's room so we are able to check in on him at home.  I am amazed that Mayo allowed him to do it.  He's amazed that he is apparently the first person to ask whether he could do it.  It was a fair amount of work, but it is nice to be able to see him when we are at home.

Some signs went up around Alex's room to "Please be aware that I am on camera".  Apparently there is some concern that conversations and people in the room might be picked up unsuspectingly on the camera.

2011- 12-10 Saturday - 8 days old

Today was a busy day.  Alex is showing some signs of hunger before feedings.  We tried nursing today and it went great.  He latched on a couple times with help from the nurse before getting tired.  It was a success!  We'll try again tomorrow 1 - 2 more times.  Baby steps.

Grandma and Grandpa Meiners came to visit.  They can't believe how tiny he is.  Grandma thinks he has the Heithoff forehead.  We've struggled to decide whether he looks like either of us.  Apparently there is some of his dad in him.

We skipped the second bath today and will try tomorrow.  There was a lot going on and he was tuckered out.

Forgot the power cable for the camera - will have to wait until Sunday.

2011-12-09, Friday - 7 days old

One week old!
Hard to imagine it has been that long (for Mike anyway, the days seem to fly by and blur together.  Laura says it feels like a month, and she gets the good drugs! :-)

Alex is spending more time awake.  I think he's up to 1 hour a day!

The Curse of the Uncooperative Web Cam
Mike had an adventure setting up a security camera in the nursery room at the hospital.  Along the wall behind the baby's bassinet are a dozen or so electrical outlets, the vital signs monitor, and a computer for the room.  I (Mike) figured I could unplug the network cable from the jack on the wall, and using a switch, plug in both the room's computer and the IP camera.  I thought the Chart+ app to monitor vitals might go down for a few seconds, but it should be right back up.  Either I accidentally plugged in a cross-over ethernet cable, or plugged a regular patch cable into the switch using the uplink port, but either way it killed the network jack in the room.  Panicking, I called up the Mayo Help Desk and asked if they could re-activate the jack.  The guy on the other end replied "We may be able to send someone out on Tuesday".  "This is in the clinical setting in one of the baby nursery rooms", I stressed, "is there anyway it could be done tonight?".  "We have a technician out right now, I'll check if he's available", he said.  Luckily, Chuck, who was finishing up another job in another building said he could stop up after his break.  Anxiously I waited for him to appear on the floor.  Meanwhile, I tried a few different things to see if I could get the jack to reset, but to no avail.  And, not only did it stop the app, but little did I realize that Alex's vitals monitor was connected to that computer directly, and that was the system that uploaded the vitals to the central database.  So, for the whole time of the network outage, none of the vitals could be uploaded.  Luckily the nurses stations outside the door could be used to manually enter the stats every 15 minutes.

When Chuck arrived, I told him what had happened, and he said "let's go take a look in the wiring closet".  In the closet was a well organized, though scary array of thousands of colored wires connecting the jacks in the rooms to connectors on the wall to 48-port switches on a rack.  Following the numbered jack from its connector to the switch, he identified that it was on switch GCF, port 18, and the light was dead.  Initially I thought I had fried the port on the switch, but no, he said a tech can connect to the switch and reset an individual port.  He rewired the rooms connector to a different switch and port, and when we checked back at the room, the light was blinking, so all was well again.  "I'll activate the other jack, so in case you want to hook up to that one it won't bring down the systems in the room", he said.  I thanked him profusely and attempted to setup the camera on the other jack.  Three hours of downtime, and sweating during all of it.

The camera has a neat feature in that the power and video are both sent through the electrical lines.  The only problem with that is that each of the electrical plugs in the room seem to have their own circuit breaker or surge suppressor.  Even when the transmitter and receiver were plugged into the same box, the signal would not go through.  So, it had to wait until the next day when I could bring a power strip in from home.

2011-12-07, Wednesday - 5 days old

A few major events happened today.  Overnight, Alex's nurse took the top off his isolette to see how he did at maintaining his own body temp.  So when we arrived he was dressed in a sleeper and blanket with the top up on his bed.  He did great all day, so tonight they wheeled out the fancy giraffe bed and wheeled in a regular bassinet (or large tupper-ware container).  He's doing great at maintaining his own body temperature.

Alex in is giraffe bed with the top up.  Next step bassinet.

Today was also his first bath.  He did not like it.  Mostly this was because the nurse had to try to get some very sticky tape out of his hair and it did not feel good.  The tape was from the IV which had been removed the day before.

Mostly we spent the day taking turns cuddling him.  We love it.

Happy 53 month anniversary to us!  (didn't notice until we were home and it was after midnight, so missed it really).  Historical note:  70th anniversary of the bombing of Pearl Harbor today.  I'm sure the History Channel was covering it in great detail.

A couple was waiting in the family room just down the hall for their daughter to have her baby.  She had been in labor since Sunday, and was worn out.  A week and a day overdue.  Finally, sometime around 10pm she delivered a baby girl.  Hope she gets some rest!

2011-12-06, Tuesday - 4 days old

Today Baby Alex is 4 days old (or -38 days if going by his planned birthdate). He is getting some "kangaroo care" time with mommy.

























Here is a picture of his door at the ISCN (Intermediate Special Care Nursery) at Methodist Hospital. For a couple days he didn't have a name on his door since we didn't have one for him yet! Such a big name for such a little guy!



Later in the day he got his IV out of his forehead. Now he doesn't look like a little pharaoh with his headpiece!

Poor little guy had a breathing spell in the afternoon (resp rate and heartrate dropped), which was very scary, but he self-corrected within about a minute.

The nurse manager had checked about putting an internet camera in the room - she said they could do it, but legal was concerned that it not stay on recording all the time in case employees don't know they are being monitored. Should get one that has a display so you can see what it is recording, and the nurses can know where the camera is pointing.

2011-12-05, Monday - 3 days old

We were discharged from hospital today after a week.  Unfortunately no more baby channel :-(   Hard to leave him at the hospital and go home, but good to get some sleep in a quiet room.  Mike talked with the nurses about setting up an IP camera in baby's nursery room to watch remotely.  They said they hadn't done that before, and no one had asked but that they'd look into it.

Laura's mom came to visit, and helped us pack up all of the items from the room to bring home.  Funny how you can amass so much stuff over just a week!  Everyone was loaded up like pack mules, plus pushing a cart down the hall heaped with stuff.  Wheeled Laura out on a wheelchair - have to take it easy for the first few days after the c-section.  Baby steps....

2011-12-04, Sunday - 2 days old

Baby has his first poops!

Poor little dude had the IV come partially out of the vein and the fluids were just pooling under the skin in his hand. Several nurses came in to try their luck at moving the IV, first to his other hand, then both his feet. None were successful, though since his poor little veins are just too fragile and blew out when the IV fluids were administered again. Finally the charge nurse was called in and she commented that "he has some nice veins in his head", so that's where it went! He looks a little worse for wear, but I think that will be more comfortable than his big club arm which was making him upset and causing him to swing it around all the time. There's a few pieces of tape and gauze to hold it in place, which is going to be a little painful to remove from his hair!

We finally decided on name! Alexander Thomas! Nothing like a deadline to force the issue! Nurses said we needed to have it by the time we were discharged, or it's a much larger hassle to assign it later. Took us a while - we had pretty much agreed on Alex for the first name, but couldn't decide on the middle. Choices: Thomas vs Paul (Paul means "little one" which seemed fitting, but Mike liked Thomas better for the middle name, and what Mike says goes (obviously this is Mike writing right now, but I'm sure Laura would agree :-). Besides, then the option for calling him "Tommy Boy" is still open. Good timing on the email, Mr Tom Scanlan when you said "welcome Tom Meiners (hint, hint)" - with the only suggestion, you win the middle name game! :-) Sorry to the cousins Paul and Paul.

2011-12-02, Friday - Baby is born!

Laura had a little bleeding and contractions started up again, which had us worried, and unfortunately hinted to a placental abruption, where the placenta starts to tear away.  This can be dangerous to both baby and mother.  Mike was at work for the day, but Laura called and asked him to come back down.  Within a short timespan, the doctors had decided that a c-section was the safest way to proceed, especially since baby was in a breach position with head up.  Trying to turn baby for a regular birth could also be dangerous.

A swarm of doctors and nurses came in to greet us in the delivery room and introduced themselves, saying they would be helping with the surgery.  "We'll take Laura over, prep her for surgery, and call you in in 15 minutes".  Mike was given some scrubs to wear in the OR, put them on, and sure enough, 15 minutes later, was escorted to the OR, where the surgery was already underway.  He was allowed to watch and take pictures during the procedure and delivery, and got to announce the birth of a tiny baby boy!  Baby boy was whisked away to the adjoining room to get him breathing and cleaned up while Laura was stitched up.  The little guy had the typical breach legs - spread eagle - straight out to the sides, and a flattened head, instead of the conical heads typical of regular births.

Laura got to hold baby for about 15 minutes before she was taken back to a delivery room and baby was wheeled to a nursery room and put in an incubator to keep him warm until he could regulate his own body temp. He was doing well for being born 6 weeks early.

Laura was a little cold and not reacting well to the drugs, so we piled on some warm blankets.  However, this made her too warm and nauseous, so off came the blankets again.  We called our parents and Laura some of her sibs, and settled in for a mostly restless night (with nurses coming in and out every 15 minutes or so, and Laura trying to keep up with the pain killers).