Tessa is eating again

The doctors decided that Tessa's stomach is doing well enough that she can start eating again. They've started feeding her 6 mL (0.02 cups) of milk every 4 hours, which might not sound like a lot. However, she only weighs 1660 grams and 6 mL is 6 grams of liquid. That's like a 180 pound (81,000 g) person drinking 300 mL (1/3 of a liter). In addition, they're giving her almost 120 mL of IV fluids every day. So, she's actually getting a decent amount of food.

Every four hours someone has to take Tessa's temperature and change her diaper. If we show up during one of those times, then we get to do those tasks. Also, they try to only bother her during the changing times, so if we don't screw up the diaper change, then the nurses reward us by letting us play with her a little after changing her diaper. Tonight after changing the diaper we weighed her and the respiratory therapist changed the tape that is holding her CPAP mask on. Then we fed her (through a feeding tube). After feeding, the nurse let me keep my hands in the incubator for a few minutes before we turned on the blue light. This is a video I shot of Tessa's little feet. At the end of the video you can see her tongue coming out of her mouth licking her lips, which I think she is doing because she's looking for more food. Either that or she's going to try to take Gene Simmons' job.

You also get a good feeling for what it sounds like in the NICU - there is a lot of beeping and a lot of noise. More on that in another post.

Little hand

Tessa's hand is so small that she can't even reach entirely around my finger with it. I held her hand tonight while she was falling asleep and I snapped some shots with my other hand.

No kangaroo tonight. Baby needs her blue photons. Still a nice visit. Tessa was not fussy and went right to sleep after diaper change.

Just finished a two hour kangaroo session. Tessa was sleeping soundly when I left.

Birthday Hug

Here's a picture that I took of Robbie and Tessa last night. She was fussy all day, but she went right to sleep when Robbie was holding her and she slept for an hour and a half just like this. They've done a couple more x-rays of her stomach and everything looks normal. They're concerned because she's been so irritable and is having trouble getting her stomach working, so they are continuing to assess her. It may just be that she wants to be swaddled, which they can't do until she comes out from under the UV lights. Our wonderful night nurse also said that she might just be a fussy baby. I'll take fussy and healthy any day! We'll keep you posted.

My birthday visit

I'm headed in to visit Tessa in an hour. I talked to the doctor today and it sounds like her lungs are doing great, but now they've noticed that she's regurgitating quite a bit of bile. She's also been very fussy today. There are several things that can cause this stomach issue and it could be something not serious, but they are checking into it. They've already done an x-ray to see if they can see swelling and her intestines were "unremarkable" (in a good way). They're doing some blood work and should have an answer by the time I get there.

I've never been someone to worry, but I find myself worrying a lot. I'm amazed by how quickly and how thoroughly she's become a part of me. And it's not just because she makes a rocking birthday card.

Tessa's first gift to me

I had to stay home to work today, but Megan went in to visit Tessa at noon. She said Tessa is still doing great with the CPAP, but she doesn't really love it. Megan asked about some milestones for getting off CPAP and they said that they have to lower it from setting seven to setting five before they can take her off of it. It's on six right now, so we're getting closer. Apparently, she doesn't really love the CPAP or the UV lights, because Megan said she was crying quite a bit today. She does love sucking on her binky, though (see below).

Also, the best part was that Tessa and her totally awesome night nurse made me a birthday card. Megan brought it home for me and I scanned it in.

My turn to kangaroo

Here is Tessa - sound asleep on my chest. I can't even explain how amazing it was to have her that close to me. She totally conked out and was really asleep. I had to hold her binky in her mouth because the CPAP works best when her mouth is closed. She likes to sleep with her mouth open, so putting a binky in it keeps the positive pressure instead of letting it all out through her mouth.

We just finished visiting Tessa. She is still on CPAP and doing great. Tonight i got to kangaroo with her. So amazing. Will post pictures later.

De-intibation

When we visited Tessa today they told us that they thought that they thought she was doing well enough to take the breathing tube out.Apparently her heart murmur is much harder to hear (a sign the PDA is closing) and her blood oxygen levels are going up every time they test them. They decided that it was worth it to let her start breathing with a less invasive machine, so they pulled the tube and put her on CPAP. The CPAP is just a positive airflow system. It doesn't do any breathing for her (unlike the ventilator). It keeps a positive pressure in her lungs and trachea so that the passages stay open and she can breathe on her own. They had tried this two days ago, but it didn't work and that was when she went back on the ventilator and they did the test for the PDA.

Time for a suntan

To keep Tessa from getting jaundiced, they've starting putting her under the UV lamp while she sleeps. When we showed up last night, she was still under the light. It provides a really cool blue hue for the photos. These are some of my favorites.

Tessa checking us out

After our diaper changing episode, Tessa opened her eyes the widest that I have seen them yet. Luckily she kept them open long enough for me to snap a shot. In case you're wondering, those are her UV sunglasses on her head.

First diaper as parents

We got to change Tessa's diaper today during our 11:30 visit. The nurses say this is good because it gets you in contact with your baby, which the babies like. Megan took the first round, and did a great job. You could certainly argue that it's easier to change a preemie's diaper because there just isn't that much of a mess, which is partially true. However, they are so small that you have to roll the diaper up about 4 times at the top to keep it from going up to their heads. Also, you are working with your hands in the preemie box and the baby is hooked up to wires and tubes, so you can't always get the best angle.

With all those handicaps, I still think Megan did a great job!One of the interesting things that they do with the diapers is that they have to weigh them every time. This helps them know how much the preemies are peeing and provides another data point for their health status.

Trying to do the skedaddle

We checked out of our room at the hospital this morning. Insurance will only pay for moms to stay at the hospital for two midnights after the birth. Since Tessa was born at 2:26 AM, we got to stay for what amounted to be an extra night, but today was our day to leave. They weren't in too much of a rush to get us out, since Tessa is in the NICU, but we were getting antsy. We needed to get home to our own bed, food, and to a place where someone wasn't barging in every 30 minutes to take Megan's temperature and bloodpressure.

We got our discharge papers, signed everything and got ready to leave. I took the first load of stuff down and then came back up to call for the "escort" to take us out (which is what our nurse said we had to do). When I asked the nursing station to call for the escort, they said they'd call our nurse and then she would call the escort. I told this to Megan and she decided she'd rather just get out than wait for somebody to call somebody to call somebody else. So, we grabbed our stuff and started walking out (and Megan was carrying stuff). We got a couple of funny looks, which I couldn't understand until we walked by the nursing station on the way to the elevator and the nurse yelled out for us to stop. We looked at her and said we were leaving and she explained that Megan wasn't allowed to walk out on her own. This comment, of course, was greeted with a look of scorn and a scoff as Megan continued to walk right over to the elevator with all her stuff. This totally freaked the nurse out and she got up and started to come over. I wasn't sure that wrestling Megan to the ground was actually in the spirit of the "all mothers must be safely escorted out of the hospital rule", but I also wasn't sure that either of them were going to back down, so I calmed down the nurse and convinced Megan that we could wait for the escort to take us out.

When he finally showed up, he had this huge ridiculous cart that he made Megan sit in while he wheeled her out to the front door. This is the picture of her in the cart. She's only smiling because she thinks it's hilarious, not because she's happy about the policy.

The best part is that when we got down to the front door, they had to call the car around for us. While we were waiting, Megan got up, grabbed all our stuff and walked out the front door, which amazed the people at the front door. They pointed it out to me, saying, "Hey, there goes your wife with all your stuff. What is she doing? Most moms can't even walk at this stage." I just smiled at them and told them it wasn't worth it to try to stop her.

Flowers!

Thanks for all the flowers! We got seven bouquets of flowers while we were at the hospital and they were all amazing. We had so many that it took us two trips to get them all to the car and now they are making our entire condo look and smell amazing. Thanks for the flowers and thanks for all your support.

More foot stamps

Those feet are so small!

The incubator

I realized I hadn't posted a picture of the amazing preemie incubator that they use at B&W. Here is a picture from 4-26 of Tessa in the incubator and Megan looking in. It's an awesome machine. The top part of it is connected to a motor and can completely detach from the sides and bottom and slides right up so that you can reach the baby. The whole thing is climate controlled (temperature and humidity). The temperature controller is actually connected to the baby's body temp. So, all they have to do is set Tessa's temperature to whatever they want it to be and the incubator adjusts the temperature until she is at that temp. They are also able to monitor her heart rate, her respiration rate and the amount of oxygen in her blood (important for preemies who have trouble with lung development). There are hand holes on both sides (you can see on of them on the left side of the picture) where you can reach in to touch the baby (or change a diaper, etc.) without having to remove the top. If you do that, then a wall of warm, sterile air blows across the hand holes so that you don't get outside air coming in with your hands.

You might also notice that there is a pink blanket on top of the incubator. They cover the incubators with these blankets when they're not working with the babies so that they can sleep in the dark. The respiratory therapist told us that they used to leave the babies in the light all the time and that they couldn't sleep in the dark when they finally went home.

Visiting hours

One of the great things about B&W NICU is that parents can visit any time that they want for as long as they want. We've been visiting Tessa 4-5 times a day for 15-60 minutes each time. The nurses have schedules for each of the preemies and we've tried to calibrate our visits so that we get to see Tessa just after they've finished changing her and doing her bloodwork. That way she is already awake and our visits don't disturb her too much. It's really important for preemies to get as much rest as possible, so we don't want to be down there talking to her and touching her when she's in the middle of a nice long nap. We've been visiting her at 9 AM, 1 PM, 5 PM and 9 PM, but this morning we went down at 8 AM. She was just getting her blood drawn and the doctors were doing rounds on her. She's getting a little jaundiced, so they have her under a UV lamp now. We got to help put on the UV visor after the blood work was finished and then turn on the lamp. We're going back at 11:30 to talk to the doctors about the plan for the day and to help change a diaper.

Time for some ibuprofen

We talked to the doctor tonight and Tessa is still having some problems with her breathing. The suspected that this might be related to a problem with her heart that is common for preemies. The heart problem is a PDA and it is a valve that is open between her heart and her lungs that babies use when they are in utero but that is not necessary after they're born. It can make it more difficult for the heart and lungs to work well together once they're breathing oxygen. They had just gotten the ECG back and it turned out that the PDA was still there. This happens with 25-33% of preemies at her age and the treatment is to give her some ibuprofen. The ibuprofen course is three doses over a 72 hour period and it often solves the problem. So, we have plan of action and they are getting started tonight. Hopefully it works!

We went down to visit Tessa one more time before bed. They had the top off the incubator tonight because they are getting ready to put a catheter into her umbilical cord so that they have a better IV for her. I got to put my hands on her a little. It is so cool to have her grab onto my pinky (which is almost too big for her) and to have her push her foot against my other hand.

Kangaroo Care

Preemies who get skin-to-skin contact with their parents develop and grow much better than preemies that don't. This activity is called kangaroo care and B&W really encourages it. We were so excited today when Megan got to do her first round of it. Tessa immediately fell asleep on her chest and slept there for over an hour.

Tessa's feet

I love this picture of Megan feeding Tessa with the stamps of her footprints in the foreground. Her little feet are so cute!

 

Tessa's first meal

One of the things that preemies can't do is suck and swallow and breathe at the same time. Since breastfeeding is one of the most important things for a preemie, we can feed Tessa by soaking a cotton swab in breast milk and then putting it just in her mouth. She really likes doing this, as you can tell in this video when she starts sucking on the swab and then licking it!

Holding hands

Megan and Robbie got to visit Tessa just a few hours after she was born. Here is a picture of Megan and Tessa holding hands (or hand to finger, at least).

Preemie visor

Since the lights are always on in the NICU (newborn intensive care unit), the babies get little blankets over their faces that block out the light when they're sleeping. This is a picture of Tessa curled up in the fetal position with the blanket on her face.