Sunday, August 26, 2018

Silas: 5 Months Old II An Update + Missing our NICU Family

5 Months Old
6 Weeks Adjusted
9 lbs 2 oz.
Cute as can be. 

Buddy, welcome home. We packed up all 8 lbz 7 oz of you on Tuesday, August 14th, and brought your sweet little butt home. What a whirlwind it's been. 

Before we busted out of the NICU, you had your G Tube surgery. That was definitely tougher on mama than you, you handled it like a champ, recovering super quickly. We've taken a crash course in what it takes to be in-home nurses, learning to feed you on our own via bottle, gavage, and feeding tube. You're on 4x bottles a day, nippling as much as possible (typically 40%) and gavaging the rest. Then on a continuously pumped milk drip at night over 10 hours. It's medical, it's lots of tubes and wires and cleaning, but it's our new reality. And you're home, so it's OK. The goal is for you to take your 4 bottles by nipple 100%, and then we'll start weaning you off the night pump. You're doing OK, but I can tell we're a ways off from getting to a point of no medical interventions, and that's just fine. The biggest thing we want to avoid is an oral aversion as that could have serious long-term consequences, so that's our North Star.

You love being home. Surprisingly you actually prefer to be out in the living room where all the action is. You like the noise and light, counter to your NICU experience where everything is quiet and controlled. You're cool in your nursery at night but during the day you pretty much sleep in your rock and play with music playing in the background or the TV on. You like all the input, just like your brother did when he was little. Crazy. 

We have a gazillion follow-up doctors appts every day but you've handled it with ease. It's a lot of coming and going, and exposure to germs which FREAKS your mama out so hard, but trust that I've got that hospital grade ava-gard (sanitizer) and I spray it on every passing bystander.

You smiled yesterday. Like for real smiled. OMG dude, my heart completely exploded, I cried. It was too much. Pics below.

Leaving the NICU was bittersweet. It was equal parts exciting and so, so sad. I truly didn't realize how much everyone there had become a part of our family until we got home and were left without their tender loving care and company. So I can't just pickup the phone and call to see how someone's day is going? It's weird.  

Ruby, our NICU BFF, took your assignment on our discharge day so she could see us out. She knew that was what we would want.  Ruby really only takes care of the tiny babies, so when it came to going through your discharge, let's just say she got in some good practice (but nailed it, as per usual). When we arrived that morning around 9a, she was snuggling you so hard and did not want to put you down. Through her hardass unemotional front, I could tell she was sad to see you go (but also obviously so happy for our family). Ruby was instrumental in getting us through those 128 days in the NICU. She nursed you back to health more times than I can count, when you were really, really sick. She comforted your mama in a way that very few can, at my weakest points she just got me. I didn't need a hug or a pat on the back, I craved the facts, the realities, someone to give it to me straight and then give me my space to collect myself and take it all in. While she looked over me and my messy emotional state, she meticulously cared for you. Everything was fine-tuned, every tiny detail accounted for. Your leads, your NG tube, your sensitive skin, your positioning, all of it was catered to from day 1. She had your chart memorized and was your biggest advocate in the unit, butting into issues she had no business being in but she knew what was best for you and was willing to be the bad guy if it meant you getting what you needed. Simply the best, for you, for me, for our family. She walked us out that day and I really thought I was going to be able to hold it together. We loaded up the car, your daddy hopped in the drivers seat, and there she was. Through my heavily medicated zanax haze, tears began to well up as I hugged her. She cried too. Ruby doesn't have emotions, she's a badass with a tough exterior, but I saw a few tears stream down her face that morning and I knew, we got her. It's been a long, hard road for us and we couldn't have gotten through it without her. I would not be standing here today without her. Thank you, Ruby. 

Ruby and all of the other nurses, RTs, PTs, OTs, NNPs in the NICU, took such amazing care of you and we will forever be grateful for them and supportive of their causes. Rose, who I don't think was ever actually on your assignment but offered me candy, jokes, comfort and reassurance on the tough days.  Toni, the sweetest, who could for some reason make me cry even when I didn't feel like crying because her heart is just two sizes too big and always makes you want to just cuddle up and let her snuggle you. Angie was hilarious - another 'not messing around' kind of nurse, it's no wonder she and Ruby are buds. She's one of us. Also she turned me on to an amazing Pho spot called Pho King Good. Yep. Sherry, the quiet, sweet caring one who will tell you about her grandkids in an instant and gave me my space when I needed it most, but was always just right out in the hall if I needed her. Also she dyed her curly hair pink at one point so you know I love her. Nikki, so meticulous and detail-oriented. She was on our assignment in the early days, she didn't know me but she entered the room and asked me how I like it (hah). She gave me all the details, explained all of the things, machines, procedures (my kinda gal), was so on it and I loved her. Day Melissa was always my comic relief. She laughed at my jokes and always kept it free and easy for me and for you. She kept the mood light but cared for you hard. Night Melissa came into the unit and trained with Lee in the early days. She's got wild Jeep and motorcycle stories to tell and cared for us in our final nights in the NICU.  Megan came on in the final weeks with her brightest smile, sweetest energy, caring so hard for all of her babies and mamas and families. Pulled us through the final stretch and lord were we grateful. Saying goodbye to Megan was a MESS. Barb is what we want to be when we grow up. She goes to a kids summer camp for a week at a time during the summer, off and on. The sweetest, most loving eyes and she cares for all of her babies there in the NICU so much.  Lee, the only dude nurse (God bless him). One of my favorite memories of our entire time in the NICU was with him, and I don't think he even knows it. You were 3 days old, it was 3am, I was upstairs in the maternity ward recovering and felt the draw to come see you. I asked the nurse to wheel me to the NICU one floor down, thinking I would just take a 20 minute visit and then head back to my room. Lee was taking care of you and you were his only assignment for the night (as your condition was critical). I didn't know what to say or how to act or what to ask, so Lee just sat with us, for 2 hours, TWO HOURS, explaining every single thing: what each machine was for, what was happening with your tiny 1 lb body, what to expect in the coming days, weeks, months. I cried, he nonchalantly offered tissues and kept on talking, explaining, giving me the information and education I craved but didn't know how to ask for. That night was paramount, he empowered me and reassured me that everything would be OK. Thank you, Lee. And to all of the other caregivers I haven't mentioned, there are too many to count. I see you, and we thank you and love you all so hard. Our most sincere gratitude goes out to you, we could not have made it through this without your patience, support and loving care. Thank you.

Sweet Silas, it is with all of my love that we welcome you home. It's damn good to have you here.


Ruby snuggling you up on your last day





Our very first visitor - Dee!


First at-home bath, handled like a champ


A cape, naturally

Brothers





Love for Uncle Cam





Sunday, August 5, 2018

Silas Update II 119 Days II He's COMING HOME SOON!

43 Weeks Gestation
3 Weeks Adjusted. <so weird>
17 Weeks old.
8 lbs 4 oz.
3740 Grams.

Boy oh boy, if you would’ve told me in those first few week that the 2nd HARDEST weeks would be those just before we were to be discharged, I would have told you you’re crazy. We’ve been through some hellish stuff in here, NICU life is a serious roller coaster but damn, these past few weeks are really putting us through the ringer. You’re so close, dude! SO SO close. You’re basically off monitors, we have no respiratory concerns for you but dude, you gotta learn to eat! You’re taking roughly 45% of your feedings through bottle, the rest through your NG tube (nasogastric intubation). We need you to be at 100% before they’ll let you leave. So the big debate was born this past week…and you better believe mama turned to statistics, research and data to inform what we did next. I taught the nurses how to export your feeding/volume data from the archaic system they chart in over to excel, and then how to filter and make a bar chart. We looked at your daily/hourly feeds for bottle vs. gavage (NG tube), and could pretty quickly see that you’ve been doing great consistently but only at 45%, with minor improvements week over week. PS I’m a NICU nurses worst nightmare. GIVE ME ALL THE DATA! Sorry, ladies.

So, we had a few options moving forward….
1. Wait another 2-3 weeks to see if you suddenly just get it and start taking 100% of your milk via bottle.
2. Go home with an NG tube (nasal tube to supplement feeding, basically what you’re on right now)
3. Have surgery for a G tube - this is a feeding tube surgically placed into your belly, which we’d use to supplement your feedings as we are currently with your NG tube.

After much deliberation on the pros and cons of each option, we’ve landed on scenario #3. We won’t go on about the reasons why (see our pros/cons worksheet below), but this is the best option for our family. So we’re staring down the barrel of yet another surgery, but it’s OK. Your mama has learned about her PTSD triggers and I’ll be honest, ‘surgery’ is one of them, which weighed heavily on our decision whether to go through with this or not. But guess what? This isn't about me, it's about you. So in my heart of hearts, I believe this is the best decision for you, for us, and for your development and growth. Mama is gonna hunker down and have a tough day that involves surgery, leaning on zanax as a reliable assistant (and plenty of pumping and dumping for the 24 hrs that follow, stop judging me! hehe).

So that’s where we’re at.
Um, also, you want to hear more news that proves that you are a freaking MIRACLE?!? Let’s talk about your brain for a second. As a reminder, you coded at 5 days old and blew a puncture in your lung (you have such a flare for the dramatic, come on dude!), this caused you to have an IVH (intraventricular hemorrhage) grade 3 on the right ventricle, grade 2 on the left. This, as we know, is an early indicator of worst case scenario: Cerebral Palsy. But, who knows, you’ve just gotta wait it out. You had a brain scan recently, and I’ll-be-fucking-damned, your scan came back normal. NORMAL. Wait what? So it appears your brain has healed itself, which is medically kind of impossible, but as we read your brain scan results amongst all of the docs and nurses at rounds today, everyone was just as surprised, and impressed. They actually laughed in disbelief, it was one of my happiest moments to surprise the doctors and blow them away. Dude, you are unbelievable. Diabolical. You are insane. I can’t even believe it.

So that's where we sit right now. 
You are incredible. 
I am working on getting us out of here. 
Our precious NICU family will guide us along the way. 


Aunt Allie Crushing that Auntie game



Esther, being adorable with you

This is what your G tube will look like.

Ovaries bursting, definitely want to have 18 more babies. 

So I have 2 boys. Dang I'm lucky.