Saturday, May 31, 2008

Home Sweet Home

We've spent a whole week (and a couple of days) home with Kai, and it's been great. In the last week, I've only left the house three times -- to go to the grocery store, BabiesRUs, and the doctor. Previously, I was not someone who necessarily enjoyed sitting at home day in and day out. I've always really liked working and having places to go and things to do. But, this year has taken that out of me a bit and the last week of nesting has been very therapeutic after 5 months of chaos with our jobs and house projects (and, of course, particularly after the last 5 weeks of the NICU). So - the last week has been great. Better than great - because we're here together, Kai is home, and the kitchen is (mostly) complete.

Since this was previously a kitchen blog as much as anything - let me just say that the new kitchen is incredible. It's better than I ever anticipated, and hard to imagine how we lived with it in its prior state for as long as we did. And, it was so wise to get the kitchen remodeled before Kailey arrived (even though it seemed like a completely insane thing to do at numerous points over the last three months - particularly starting around April 17th!) But, having a functional kitchen with a dishwasher, disposal and big(ger) refrigerator has proven to be essential. OK, maybe not essential. Plenty of people have babies without having these things -- but, it has made our lives infinitely easier and more comfortable. And, the kitchen is just beautiful.

I really don't have much to write - as I said, I haven't done much this last week. Kai is doing fantastic. She has gained about an ounce a day since being home. When we were at the doctor this week, she weighed 5 lbs, 3 oz. She seems to be a very easy baby - although, I am well aware of the fact that it could just be that she is still not supposed to have been born yet, and so she may still be coming into her own. But, at the moment, she does little more than wake for about an hour to get changed and fed, before going back to sleep. In the last few days, she's begun to be a little more interactive -- staying awake for a bit after eating in order to look around, which has been fun. But, it's also great to just snuggle with her on the couch watching movies (or updating this blog).

I do think one silver lining to the NICU is that it gave us some perspective on what is difficult. We aren't getting a lot of sleep these days and, of course, we're not accomplishing as much as we normally would in the course of the day - but we really don't mind. We're just so happy to be home with Kai, that the sleep deprivation and other stressors of being home with a new baby have not bothered us much. I suppose that could change, as the NICU fades from our memory (although, I don't think that will happen any time soon).

Apparently it's taken me an hour to write this and Kai is now doing push-ups on my chest and letting me know it's time for her next feeding.

Type more later. A few mor pics:

Wednesday, May 28, 2008

Kailey Time

We've been on Kailey time for a week now - and it's great. The days do just seem to slip away from us, but I really don't mind. I am keeping up on email and world news - and catching up on my trashy tv viewing time. I expected to feel more angst to get things done - but I think the 5 weeks in the NICU took away any desire to be productive right out of the gate. I will start working again a few hours a week in July and then ramp back up to full-time from there, but for the moment, I'm not trying to do much other than read emails, and I've really been enjoying having nothing to do other than hang out with Kailey.

Kai is doing great - she's been consistently gaining weight since coming home. I was worried that she would lose weight because we'd be doing more breastfeeding (making it harder for her to get as many calories just because she expends more energy eating when she breastfeeds). But, we've had two visits from the home health nurse and both times she had gained. She is gaining at about an ounce a day -- and now weighs 5 lbs, 2 oz.

I keep getting emails about how my pregnancy is progressing from those online services that I signed up for when I found out I was pregnant. I can't figure out how to tell them that I am no longer pregnant -- it would be nice if they could transfer me into the "how your preemie is progressing" updates (ha ha). Today I was told that "Your baby weighs about 6.5 to 7 pounds and is approximately 19.5 inches in length. You have been full term for a week now, so you might want to start addressing those birth announcement envelopes while you still have your hands free!" To that I say wrong (5.2 pounds) and wrong and hmm... birth announcements. I guess I should do that. Although, I will say - this notion that you can't get anything done once the baby arrives is sort of silly. I'm doing laundry and running the dishwasher at this moment. Eric just finished a conference call. I just sent out a bunch of emails - and now I'm updating this blog. She sleeps - and she's small. You can hold her with one hand and do things with the other. I would imagine that if we wait another 6 months to try to send out birth announcements - we might feel a little more strapped for time.

Not to say that we're being as productive as we were before she was born - but, then again, we aren't trying to be. We're on leave - and on Kailey time. It's nice to poke along for a change. But, I think I can handle birth announcements. Might even be kinda fun.

Updated to include my original design for the birth announcement - which couldn't be produced because the production people thought the pics were too grainy. I like how they turned out in the end, but these are my favorite pictures:

Saturday, May 24, 2008

Home at Last

On Thursday, May 22nd, Kai turned 5 weeks old and came home!! We arrived at the hospital at about 8:00 AM and the doctors did their last rounds for Kailey - declaring her fit to go home. I breastfed her one last time in the hospital and then we removed the monitors, packed up all her stuff (we ended up with about 7 bags of stuff -- it's amazing how much a little baby can accumulate in 5 weeks. Of course, 2 full bags were full of frozen breast milk - which is now taking up most of the space in our freezer. 41 bottles worth of milk!), put her in the carseat and headed downstairs. I was so nervous walking by the nurse who was carrying her out -- I kept expecting her to turn blue at any moment. She seemed so tiny in the carseat. Of course, she just slept the whole time.

Once at home, she continued to sleep despite all the activity around her -- Oscar was so curious about the new addition to our pack. He kept running over to her and sniffing her. He was pretty nervous - although, two days into it, he has really gotten used to her. He still gets quite concerned when she cries. One time, Kai was in her co-sleeper and Eric was preparing a bottle for her in the kitchen. Kai started fussing, so Oscar ran into the bedroom and peered in at her and then ran back into the kitchen to get Eric. It was so cute -- you could tell Oscar was saying, "hey - that thing you brought in here is upset!" Eric gave him a treat for keeping us informed.

We are so happy to be home. I haven't felt so much peace in a long time. Everything has finally come together. The kitchen is beautiful and fully functional. Kai is here with us and seems to be doing really well. We are able to attend to Oscar and Abby's needs for the first time in over a month - and they are both calming down a bit (Oscar has been a bit on edge the last 5 weeks). All is right.

We have spent the last two days just resting, cuddling with our baby, and relishing in the fact that we have nowhere to go and nothing that has to get done. Eric has been continuing to finish up some of the detail work on the house. I got caught up on the news for the first time in over a month.

This morning, the home health nurse is coming by to weigh Kailey and see how she is doing. I have to say - we have gotten such excellent care over the last 5 weeks. Kai's doctors and nurses were all top notch. The nurse that is coming this morning is the same person who conducted our discharge class. We really like her - and it will be good to see her and check in on how Kai is doing. I continue to be obsessed with her numbers... (I created a chart - of course! I know I said I was done with charting, but I couldn't resist). We have been tracking how much she eats, pees, poops, and her temperatures... but, we don't have the ability to weigh her anymore (which was the most critical number the last 5 weeks!) and so I am really glad that we will get to add that number to our chart this morning. I hope she has gained some since she's been home with us.

I'll update again soon. Hope you are all well.

Sunday, May 18, 2008

Reflections on the last month in the NICU

Hello, from the NICU!

We've been spending our days (and nights) at Kaiser for a little over a month now -- time flies and crawls. I can't believe we're a month into this - mostly, because I can't believe I've already used a month of my leave. But, at the same time, it feels so much longer -- it seems like this has been going on for years and it will never end. No one should have to spend a month (or more) in the NICU.

The NICU is an almost impossible place to get to know your baby. You're basically tethered to the bed, surrounded by other babies and worried parents and beeping monitors. You're there for an hour or two at a strecth -- trying to feed your baby as many calories as possible as quickly as possible before getting her back to her isolette so she can sleep again for a long stretch, all in the hopes of her gaining another ounce. We're obsessed with her numbers - heartrate, respiration, saturation, red blood cell count, weight, jaundice, etc. We're constantly pressed for time -- making mad dashes to the hospital so that we can feed her and then mad dashes back to the house so that we can try to do something productive at the house to prepare for Kai's homecoming. It sucks, quite frankly. It's not how you want to spend your child's first month of life.

With all that said -- Kai is really doing great and has been incredibly strong this whole month. In the last week, she really mastered breast and bottle feeding (I am still pumping all the time -- every three hours, including after every breastfeeding session... it is easier for her to get the necessary calories from the bottle, so I only breastfeed every other feeding. Again, not what I had planned - but, it is working for her...) and has been steadily gaining weight all week. This morning she weighed 4lbs, 11 oz. As an aside, I've noticed over the last month that people seem completely fascinated by small babies -- as though the tininess is so incredibly adorable and precious (I'm sure I'll notice this even more when we finally have her home and are taking her out in the world). I have to say, the fascination is quite annoying given that we spend every day hoping that she just gains weight and gets BIGGER. Her smallness is something we're trying to overcome - not relish in. But, luckily, she is getting bigger - she may even be 5 lbs by the time she comes home.

In terms of her homecoming, we are really just waiting for her to quit having so many bradys. The doctors are not too concerned about the bradys that she has while eating, as long as she doesn't have too many and as long as they are self-resolving. For most of last week, all of her bradys were feeding bradys and were self-resolving -- so the docs started talking about sending her home on Monday (the 19th). But, yesterday she had one that required a bit of stimulation, so the docs want to keep her in the NICU for a little longer. Hopefully she'll come home this week - but, nothing is every certain in the NICU.

I can't wait to be done with the NICU -- but I also don't want to leave too soon. We want to make sure that Kai is really OK and that she will be successful once she comes home. I feel like I have such an odd relationship with the NICU -- I mostly hate it. I hate the constant "loop" that has taken over our lives - running between the hospital and the remodel project (and, for Eric, the office). But, at the same time, I love the NICU because it's comforting. I know she has good care and the monitors are reassuring -- they'll catch problems and let us know exactly how she is doing second by second. Once we come home, it's just us. And, given that the monitors still go off with some frequency -- it's a bit unnerving to think about going at it without them providing us back up. So, we keep at it -- doing the loop and waiting for the day when she is big and strong enough to come home. Eric is doing a good job of juggling the chaos that our lives have become. I am not as on top of things -- although, I am improving by the day. I have to keep reminding myself that it's only been a month -- I feel like I've been out of it for so much longer.

Last week - I had my follow up doctor appointments. Both of them were scheduled as pre-natal appointments, which was funny (sort of). The receptionist, both times, asked - "how many weeks are you?" and I responded "I'm not pregnant anymore, this is a post-partum appointment." Both times I got the once over and a skeptical look -- I guess my belly hasn't yet shrunk enough yet to be able to convincingly state that I am not pregnant. Also, I don't know why they scheduled two appointments for me in the same week. At the first, they just checked my blood pressure. I had been doing this every day at home and calling in the numbers to Kaiser -- so it seemed like a total waste of time to go to the doctor's office and have them use the same machine to record the same numbers I had been calling in for two weeks. But, whatever. The other appointment was with my OB - but was really just a check-in. I have my official post-partum appointment with her this week. The good news from these appointments is that my blood pressure has normalized - and they took me off the meds.

OK - that is a long enough ramble. Here are some more pictures:

Thursday, May 1, 2008

Welcome to the World

Reading over my previous posts it is clear that I was destined to have this baby in April - and by constantly stating that I wanted anything other than to have a baby in April, I more or less guaranteed that I would have a baby in April.

Kailey Eleanor Schwartz Wesselman was born on April 17th. It turns out the high blood pressure was a big deal. Starting on Monday, April 14th, I had this extremely annoying pain in my shoulder. And, as the day progressed, it went from annoying to excurciating. By Monday evening, I was in a lot of pain, and no amount of massaging my shoulder seemed to help, which was weird because usually a massage at least temporairly relieves my back pain. As the night progressed (I was up all night, the pain was so bad that I couldn't sleep) I started realizing that the pain was really not like any kind of back pain I had previously experienced (and I have a lot of experience in the area of back pain). By Tuesday morning, I was concerned that something was wrong and as Eric was driving me to work I mentioned that the pain had me a bit nervous. Although, I cannot rememeber exactly what I said that provoked Eric's next comment, I'll never forget that in the course of the conversation Eric said, "at least it's not dire" to which I replied "define dire" and he said, "hospitalization." Well, it was about to get dire.

When I got to work, I googled "right shoulder pain and pregnancy." Go ahead, try it. I'll wait. The first site that comes up has this passage:

Stomach and/or Right Shoulder Pain

"This type of stomach pain, called epigastric pain by the medical profession, is usually under the right-side ribs. It can be confused with heartburn, gallbladder problems, flu, indigestion or pain from the baby kicking. Shoulder pain is often called referral pain because it radiates from the liver under the right ribs. Lower back pain is different from muscle strain common to pregnancy. It is usually more acute and specific. All may be a sign of HELLP Syndrome or a related problem in the liver. Shoulder pain can feel like someone is deeply pinching you along the bra strap, or it can be painful to lie on your right side.

What you can do...

Pain in this area should be taken very seriously; do not dismiss it and go to bed. Call your health professional immediately."

I noticed a few things right off about the passage -- first, it described my shoulder pain to a tee. It totally felt like someone was deeply pinching me along the bra strap. And, what had I done the previous evening? Dismissed it and gone to bed. As I read over the rest of the symptoms on the website (all symptoms of people with preeclampsia) I got a bit more worried. High blood pressure - that's what they were worried about at the last appointment. Swelling in hands and face - check (and increasing by the day). Protein in urine - check (they had found some at the last doctor appointment). Headaches - check (although, I think reading the website was giving me a headache). Nausea and vomiting - check (I was nauseous that AM and had done a bit of the vomiting the night before).

I knew at that moment that I had preeclampsia, but I also was in denial. I called Eric. He was on his way to Modesto and didn't answer, so I called Sarah. I was almost in tears at that point -- because I think I knew that what I had was serious. I told her what I had just read and she urged me to call the doctor, which I had been planning on doing -- but I just wanted someone else to confirm that this was, indeed, a bit of an emergency. When I finally got ahold of the advice nurse at Kaiser, I insisted a bit on being seen and they scheduled me for an appointment for an hour later. I called Eric again and told him I was going to the doctor and to keep his phone on him.

It's all a blur from that point on. Deb took me to the doctor and after spending a bit of time in the waiting room, I finally got called in. They took a urine sample and then the nurse took my blood pressure and turned to me and said, "wow. That's really high. You should be seeing a doctor, not the nurse practitioner. If you feel like you aren't being taken seriously, just tell me and I'll make sure you see a doctor." I didn't know I was seeing a nurse practitioner -- but, I got a bit more nervous at that point. About 5 minutes later the nurse practitioner walked in and took my blood pressure again and turned to me and said, "you need to go up to labor and delivery." I think I must have looked completley panicked and asked what I should tell my husband and she said, "tell your husband you're very sick and that you are probably going to be admitted and that he should come here soon."

Once at labor and delivery - it all started to go even faster. They took my blood pressure a few more times, took some more labs and then started the process of admitting me. The next thing I knew, I was in a hospital room and then, moments later, moved to an even larger room that was "right next to the operating room" according to one of the doctors that was buzzing around me. I think this was supposed to be reassuring - but my brain wasn't functioning. I was hooked up to a machine that took my blood pressure every five minutes and then the doctor came in and said, "You have severe preeclampsia. You aren't going to be leaving this hospital without having a baby." She said a lot of other things -- all I could think was, "when is Eric going to be here?" A few minutes later, Eric walked in and I started crying.

I think it took the doctor saying to me a few more times that I was going to be having a baby soon before I really understood that she did, indeed, mean that I was going to have a baby in April. Initially I readjusted my thinking to be about May 30th - but then realized that she meant a bit sooner than that. They started me on some drugs to bring my blood pressure down and we seemed to go from high alert to moderate alert. They moved me back to the smaller room and they gave me a steroid shot to develop the baby's lungs. They told me they wanted to get two shots in and then let the shots work for 48 hours. They kept me hooked up to blood pressure monitors and a monitor that was tracking the baby's heartbeat. We passed the point where we were going to have to deliver her that day.

The next morning (Wednesday), they moved me upstairs - to the wing where women go after they have delivered. Because of the steroids, all my numbers on my labs and my blood pressure got waaayyyy better. I started to relax, even though the doctors said explicitly that the improvement was caused by the steroids and that, in reality, the numbers were probably no better than before. But, we knew we weren't going to have to deliver her that day either -- and I relaxed a little more. Although, the steady stream of people that came by to talk to us continued to be disconcerting -- the high risk doctor, the NICU doctors, a social worker, nurses, lab people, ultrasound people (we got another ultrasound... they estimated her at 4lbs. They were wrong)... I was never alone for more than 30 minutes.

That night, the monitoring of the baby got more disconcerting. She was no longer moving around as much -- her heartbeat was strong, but she was no longer kicking. In the morning, the nurse came in and told me to eat a big breakfast to try to get her jumpstarted and told me they would hook me up to the monitor again after I had eaten. I was starving, so I dug in... but after downing the first sausage, the nurse came running back in and said, "stop eating. The doctors are really concerned about the readings from last night and it looks like today is a birthday." A few minutes later, four doctors walked into my room and told me that it was their strong opinion that I needed to get this baby out and that they wanted to do a c-section that afternoon. I have to say - despite all the labs and repeated visits from doctors and high risk doctors telling me that I was going to have to have a baby SOON, I wasn't prepared for this meeting. We asked to be left alone to talk about it -- but, really, there were no options. As the high risk doc put it "your liver pain is something we're not used to and if your liver ruptured, that would be shitty."

So, we got ready to have a baby 8 weeks early. Kailey was born at 3:38 PM via c-section. She was 3 lbs, 1 ounce. The next 48 hours were pretty rough. The first 12 hours after the c-section were excurciating. They put Kailey on my chest for a minute in the operating room right after she was born -- and I didn't see her again until 5 AM the next morning. I tried to get into a wheelchair and go visit her at 1 in the morning, but that resulted in a lot of puking.

I remained in the hospital until Tuesday, April 22nd, and Kailey is still there in the NICU. My blood pressure is still high -- but apparently it doesn't go down right away. I'm on blood pressure meds and doing daily monitoring of my BP level.

It is the weirdest and hardest thing to leave your new baby in the hospital while you go home. But, Kailey is doing well and has exceeded all expectations in her the last two weeks in the NICU. She was able to breathe on her own from the beginning and today - her 2 week anniversary (it feels longer than that) - she has gained 12 ounces. The doctors think she'll be there for a total of 6 weeks; although, they say she acts older than her gestational age. She is practicing breastfeeding (they call it "recreational breastfeeding" but it isn't very recreational...) Kai is figuring it out though. Everyone was amazed she could even latch on. But, she is so tiny that she doesn't really have the power necessary to breastfeed exclusively, so they still feed her through a tube through her nose. Which means pumping every three hours for me to make sure she has enough milk to actually get the nourishment she needs. She's making great progress and is already doing a lot of things she has to do to be able to come home. The doctors call her "strong", "fiesty", and "mighty". But she was born really small, even for her gestational age (she's in the 10th percentile for 32 weekers) and she has to get bigger before she can come home.

We've had so much help from friends and family the last two weeks -- it's been really incredible and I honestly don't know how we would have gotten through this last week without everyone pitching in on our behalf. We've had help finding contractors to finish a lot of the kitchen work, cleaning up the debris in the backyard, doing laundry, cleaning Kailey's room, painting and priming, buying flowers and plants for the front yard and turning the big dirt pile that we left in the front yard last fall (before we took on the kitchen we were doing some extreme yardwork... which included a lot of wall building and dirt hauling... we're talking hundreds of gallons of dirt... and then we found out I was pregnant and sort of left the yard and turned our attention to the kitchen). But now, the front yard is really something beautiful. So, we are continuing to make progress on the house -- Eric is putting in the floors as I type this.

Our lives aren't going to seem normal again until Kailey is home -- but, in the meantime, we are doing everything we can to bond with her and also continue to get ready for her even though she is already here.

OK -- I'm off to the hospital.

Here are a few pictures: