A great day!

Emily weighed in at exactly 4 pounds tonight! I am amazed how big she is getting! It won't be long now and she will have doubled her birth weight.

I also have something AWESOME to show everyone. Last week I had a photographer come and take Emily's portraits. They turned out amazing. Here is the link to see the pictures - they will only be online for 2 weeks.

http://www.iowafunphotos.com/
Click on "View & Order"
Select "E Vollbeer Newborn portraits"

I am so grateful to this photographer, Ben Shirk, for capturing this very special time in our lives. Not only is he very talented, he is also a very generous person - he did Emily's session free of charge! He offered his services as a member of ACPCG, which is a volunteer organization of child photographers that are willing to donate their time to critically ill or extremely premature newborns. If anyone is in need of photography in the Eastern Iowa region, I strongly recommend him!

32 weeks, 3 days

32 weeks and 3 days. That's Emily's "gestational age", how far along I would be in my pregnancy if she were still growing inside of me. Its hard to believe I should still have 8 more weeks of pregnancy to endure!

On Thursday, Emily had her blood transfusion and it went just fine. And the great news is it seems to have helped her spells! She has had several great days since the transfusion.

On Saturday, I had my baby shower and Troy hung out with Emily all day. He got to give her a bath!

Sunday night, my mom came up and visited and spent the night with me at Rossi. I'm so glad she was here, because Emily had quite a big day on Monday! First of all, she was moved to Bay 5 of the NICU, the area where the most stable NICU babies go. This is a step up for her, and it's great that the doctors consider her stable enough to be in Bay 5! Her room in bay 5 has a couch, TV, and a bathroom with a shower, so it's also a step up for me and Troy! A picture of her new room...

On Monday, Emily also got to wear clothes for the first time! Although, she didn't leave them on long because she got too warm. We are trying to get her isolette to a good temperature for her, but it's taking a little trial and error. She has been in and out of clothes for the past couple days.

Yesterday they took Emily off the high-flow nasal cannula and put her on regular cannula. This is a positive step :) They also moved her feeding tube from her mouth to her nose. That will make bottle and breast feeding easier for her.

Last night, we gave Emily her first big tub bath. Before that, she had only had sponge baths and one bath in a small tub. She really liked her bath, she was calm the entire time - even when I washed her hair!

Mom and Dad couldn't be happier with the progress our little girl is making, and we pray that she continues to be the Rock Star she has been so far!

Milestones...

Miss Emily has had an exciting week. On Tuesday, she turned ONE MONTH old! The same day she also hit another awesome milestone - 3 pounds!! Yes, our little piggy continues to eat everything we give her and she is steadily gaining weight. As of last night, she weighed 3 pounds and 3 ounces. I can hardly believe she has gained almost a whole pound since she was born. I can't quite figure out where is hiding the extra pound. But I can tell that she is filling out her skin better, her face is bigger, and I don't think I can see her ribs through her chest anymore! Here are a couple pictures I took on her one month birthday.

On Wednesday, Emily had her first eye exam. The results from the first test were normal, but they will continue to check them every two weeks until her eyes are fully developed.

We had a little bit of a scare Wednesday night, when Emily had a cluster of bad spells (where she stops breathing and her heartrate drops) that required the "bag" to bring her back up. The spells are normal for a preemie, but they get concerned when they come in a cluster or the frequency increases. I am so impressed by the NICU staff's quick reaction whenever there is ANY concern about Emily's health. The on-call resident came within 5 minutes of being paged, and within 15 minutes of the resident's visit, we had bloodwork drawn and the chest x-ray was ordered. Within an hour, we had most of the results. Luckily, the results showed nothing of concern, and the rest of Emily's night went well. Whew!

Today, the doctors discussed Emily's spells and the fact that her hemoglobin and hematocrit levels were right at the level where they consider a blood transfusion. Low levels can contribute to spells. They did decide to do a transfusion, and they started that this afternoon. It takes about 4 hours. (Transfusions are also very normal for preemies. Their bodies haven't started producing enough red blood cells to keep up, so their hemoglobin and hematocrit levels drop, and a transfusion is needed to "perk them up" until their bodies kick in and help out. The nurses have all said it's amazing Emily hasn't needed one until now)

I've been rambling on long enough, it's probably time for a couple more pictures :)

So, all in all, things are going well here. Last night I talked with a group of other moms with babies in the NICU, and I am so humbled by their stories. Over and over, I am reminded how blessed we are that Emily is doing as well as she is. We could be facing far worse - FAR, FAR worse!

In a few days, when she hits 1500 grams (she's 1440 or so now), she will be able to wear clothes! And in the next week or so, she should be able to start bottle feeding. They will only bottle feed her once a day, because it's very exhausting for her to actually do all the work of sucking and swallowing, rather than getting fed through a tube.

I guess that's it for now - thanks for taking the time to read the latest on Emily!

Progress!

We have had a good couple of days! The rain has put a stop to Troy's field work for now, so he has been able to be here all day for a couple of days. Yesterday, they took Emily off the SIMV for her breathing, skipped right over the CPAP, and went to a high flow nasal cannula. We are SO happy about this, because the SIMV and CPAP both require a tube that goes 4 cm up her nose, and she has lots of problems with the tube getting clogged and irritation in Emily's nose. She is loving having that nasty thing out of her nose! She slept so soundly almost all day Friday and today.

We have also been able to hold Emily more frequently - a couple of times a day, which we are just loving! Here is one of Troy holding Emily yesterday morning as she got her breakfast!


The nurses are so sweet, today we went home for the day and when we got back, the nurse (Michelle) had taken pictures of Emily and had a little picture collage hanging on the wall in her room. Also, her night nurse last night (Alison) put a little bow in her hair. Well actually, it's glued to her head! Here's a picture.

Emily continues to grow and do all the things she's supposed to be doing - eating well, sleeping lots, peeing and pooping regularly, and just being downright precious! Last night her weight was 2 lb 13.8 ounces - I have a feeling we will be having a 3 pound party this week!!

Our home away from home

Thought you might like to see a few pictures of our home away from home. We have a room at the Helen Rossi Guest House, which is inside the hospital (although a decent walk from the NICU). As you can see, it's much like a hotel room! Sorry we didn't make the beds before we took pictures :)

And, a few pictures of Emily's home....well, at least this room was her home until yesterday, because we FINALLY got a room with a door. Wahoo!! Her new room is bigger, but basically has the same set-up, just with a glass sliding door.

Mother's Day weekend

Yesterday was my first Mother's Day as a Mom! I had a wonderful weekend - my Mom and Joey, and Jenny, Craig and the kids came to Iowa City for the weekend. The kids swam, we visited Emily, some of us shopped, we made baby shower invitations, and today we all had brunch at Iowa River Power Company. I really appreciate everyone being so flexible and accomodating of the fact that we are here in Iowa City.

My mom and her kids :)

Me and my brother Joey

My sister and her family

Things have been going better at the hospital since my last post, when I was feeling pretty frustrated. Saturday, I got to give Emily a sponge bath, and then I got the best Mother's Day gift ever - I got to "kangaroo" her. This is where they lay Emily, in just a diaper, on my bare chest and we get to snuggle for a while. It was so great for both of us, I was so happy to have her close to me, and her vital signs were just amazing as she snoozed on my chest. They say I should be able to do this every day, as long as Emily is feeling healthy! And I'm not going to be afraid to ask!

Washing Emily's hair

Drying her off
"kangaroo care"


Emily is still on CPAP, they reduced the rate today which is one step closer to getting back to the nasal cannula...but it will probably still be several days before we get there. Her weight is now up to 2 lb 9.9 oz, and she is being fed 23 cc's of milk every 3 hours (about 2/3 of an ounce). These are all good things - slow, steady progress is what we want!

Oh, and also...

I've given up on knitting!!!

Annoyed

First of all, let me say that Emily has had a great couple of days. Yesterday, they took her off the ventilator and put her on CPAP, which is slightly less support than the ventilator. So this is a good thing! Her feeds continue to go well, she is slowly gaining weight, and it's awesome to see her eyes wide open looking at us. I am so grateful for the progress she is making.

(Warning: I am about to let out a major vent!)

BUT, I am slightly annoyed about a few things. First of all, the nurse practitioner we had the first part of the week recommended they try to move Emily to a room with a door on it. She thought it would be a better, more restful environment for her. Right now, we have our own room but it just has a curtain.

Looking into Emily's room from the hallway

Which means more noise. And we happen to be located right across from the staff bathroom, the linen closet, the dirty laundry closet, and a staff exit door. Which means even more noise.

Down the hall - a room with a door!

Anyway, yesterday I asked what the status was, because I knew there was a room with a door open just 2 rooms down from Emily. The nurse said "well we will just see what happens." 3 hours later, they brought a new baby into that room. Grrrr.

I'm also annoyed that the nurses we've had the past few days are LOUD! They are in the hall right outside our room, cackling and yelling back and forth. Um HELLO, babies are trying to sleep in here! Grrrr.

ALSO, there have been a lot of full term babies coming in and out of here the past couple days. Why do they insist in putting those babies in the same areas as those of us who are here for a LONG time? When full term babies come to the NICU, its usually because they have a minor problem, and it resolves itself within a few hours or a few days, and then the parents happily take their babies home. They have a constant stream of (noisy, happy, laughing) visitors, and they don't seem to have any sensitivity to the rest of us. Grrrr.

ALSO, why are the nurses not offering to let us hold Emily? When I held her for the first (and only) time almost 2 weeks ago, they told us we should be able to hold her every day for 10 minutes at first, then more frequently if she tolerated it well. This week we were supposed to start "kangaroo care" according to all the documentation I've read, but I've only had ONE nurse mention it to me and it was 10:30 at night and Troy and I were exhausted. Grrrr.

Vent over. Sorry this was such a negative post, but I can't be happy all the time! :)

Knitting - and Blanket Safety

Yesterday, I took a knitting class, which was organized by the NICU Moms Support Group. A group of ladies from a wonderful organization called The Preemie Project came and attempted to teach us to knit. I will have to keep you posted on the progress of my baby blanket, because there isn't much to show right now! Based on how long it took me to do 3 rows of knitting on the blanket yesterday, I'm thinking I should be finished with it around the time Emily graduates from High School :)

We also talked about blanket safety and the Back to Sleep program. You will notice that in a lot of the pictures I post of Emily from here in the NICU, she will be swaddled in blankets and maybe have a hat on. She also may be positioned sleeping on her side or tummy. At first, this really bothered me, because I know to reduce the risk of SIDS, babies are not to be kept too warm and are not to have any blankets, pillows, crib bumpers, or other soft items in the bed with them. They also should always be placed on their backs to sleep. However, preemies have some different needs while in the NICU. Because their bodies and heads are still developing, the nurses must change the position of the babies a few times a day so that they develop nice, round heads and bodies. The swaddling and/or other items in the bed are to help maintain the babies temperature, something they can't do on their own, and also provide them "boundaries" which makes them feel secure, like they were in the womb.
The NICU staff does participate in the Back to Sleep program. A week or so before babies are discharged, nurses begin dressing them sleep sacs and putting them to sleep on their backs.
It was reassuring to know that the staff is aware of how to decrease the risk of SIDS, and to understand why they have to bundle the babies as they do - at least in the beginning.

Eyes Wide Open!

I took this picture this morning, Emily was wide awake and staring at me for about 30 minutes. It was so fun smiling at her and telling her how much I loved her! If you are wondering what that pink thing is smooshed up against her, it's called a Zaky. It a bean bag filled thing that they tuck around babies because they feel more secure when they have "boundaries", like they did in the womb. Her nurse today keeps smooshing it against her head, which drives me nuts....but she has been sleeping soundly, so she must know what she's doing.

Also, yes, that is a scab across her nose. It's from them having to change the tape on her CPAP all the time :( Poor thing, I hope it doesn't scar!

Emily got her PICC line out today! Check out this pic - I think it's hilarious that she seems to be pointing at her leg, where the PICC line was until today. It's like she's saying, "Look! It's gone!"

The rest of Emily's bloodwork came back and showed no signs of infection! So, they stopped antibiotics and were able to remove the PICC line because she doesn't need it for nutrition anymore. She is now up to 19 cc's of breast milk every 3 hours - for reference, 1 oz = 30 cc's.

Today they also turned down the breathing rate on the ventilator, they are trying to slowly wean her off of it. Hopefully in a few days she will be ready to step down to the CPAP.

I'd say it was a good day for Miss Emily! Thanks to everyone for their thoughts and prayers for our little girl.

FAQ :)

Many people have asked questions such as how long we expect to be in the hospital, so I figured I could do a Frequently Asked Questions post!

Q: When do the doctors think you will be able to take Emily home?
A: The general rule of thumb they give parents is that premature babies will go home around their original due date. So if this is the case, we won't be taking Emily home until mid-July. Of course, if she does extremely well, it could be a couple weeks earlier. Or if there are complications, it could be later.

Q: Can you have Emily transferred to a local hospital (Genesis) when she is a little bigger?
A: This is a possibility, if we asked for a transfer. Probably not for another month or two, and at that point we just will have to see how we feel about the risks and benefits of transferring her. I have a feeling our level of trust and dependence on the doctors and nurses here at UIHC will be so high that moving her to a different facility will be a tough decision to make. We will just have to see how Emily is doing and how Troy and I are coping with our lives being in upheaval.

Q: Can we come visit you and Emily?
A: Now that we have a few weeks under our belt here, and I'm settling in to a bit more of a routine during the day, I have a better idea when visits would work out best. Early afternoon (12-2 p.m.) or early evening (5-7 p.m.) is probably best. Anyone is welcome to visit me and Troy, but for another couple weeks, we'd like to keep Emily's visitors to immediate and extended family. We are so anxious for everyone to meet our little girl, but I'm sure you can understand our needs to "protect" her from a rush of visitors for a little longer.

Q: Is there anything that we can do to help?
A: Right now, all we ask is that you continue to pray for Emily to grow and develop into a healthy, happy baby. We are so thankful for all the well wishes, cards, emails, and flowers we have received - oh, and I can't forget all the Facebook posts people have left for us :) You have no idea how much it means to know how many people are thinking of us and praying for us. And we are grateful that so far, all our prayers are being answered!

Emily - 2 weeks old!

I have been trying to get this blog up and running since Emily arrived, but trying to describe the events and emotions of the last 2 weeks has been too overwhelming of a task....so, I decided to just start with where we are at today!

Two weeks ago tonight, Emily Grace arrived! Her first photo, compliments of Aunt Jenny, who was in the surgery with Troy and I (and about 20 doctors and nurses):

Her birth weight was 2 lb 4 oz, and she was 14 inches long!

As all newborn babies do, she lost some weight to start with. I think she was about 1 lb 14 oz at her lowest. Here are a couple favorite pics from last week:

Here is Miss Emily today, 2 lb 8.8 oz:

Overall, she has done quite well since her birth. She has had no major complications, and until recently she was doing very well with her breathing as well. She was only on the ventilator for about 24 hours after birth, then on the CPAP for a couple days, and then she was put on the lowest level of support - the nasal cannula. The doctors and nurses were amazed that a baby so tiny was only needing the cannula.

A couple days ago, she started having an increased number of spells where she stopped breathing. This is very common for premature babies, since their central nervous system is not developed enough to "remember" to breathe all the time while still maintaining all the other bodily functions! So, Emily was stepped up to the CPAP to try to stop the spells, but they continued, so she is now back on the ventilator. While we are sad that this seems like a setback, we are so thankful for how well she is doing otherwise, and we are trying hard to remember that this is normal for a baby as tiny as she is.

The good news - feedings are going well, she's gaining weight, her blood work looks great, we got to hold her a few times last week, and she is just beautiful! She will have her first bath in the next couple of days, and we should be able to hold her a little more frequently this week.