72 Hours of Exhaustion

I spent this past weekend at the hospital for the 72 hour breast feeding lesson with Maxim. Ok, so I didn't exactly do the full 72 hours, but it was close enough.  The hospital suggested I stay there and "imprint" on Max as I try and breast feed him at his feedings every three hours.  This meant that I had to stay over night in the sudo-hotel room they have set up down the hall from Maxim's pod.  I did not stay Friday night because I was so tired from the work week and just wanted a good night sleep.  I did get there early on Saturday and stayed until Sunday night.  I figured this would also give me a glimpse of what it would be like when he comes home. Boy, was I exhausted.  Here is how the weekend went.
1. Do Maxim's cares (change diaper and check his temperature)
2. Breast feed, but not actually breast feed because he is still learning how to feed
3. Rock the big man back to sleep
4. Walk down the hall to my room and pump since the big man did not actually feed
5. Walk back down to his pod to hand in my milk to the nurse
6. Walk back down the hall to my room to try and get some sleep
7. Sleep for about an hour
8. Repeat the above steps

It went on like this all weekend.  I was SOOOOO EXHAUSTED.  I felt it wouldn't have been so bad if I didn't have to pump, clean the pieces and hand in my milk.  If I could have just breast fed and called it a success and went back to bed then maybe I wouldn't have been so tired.  Plus, it was even more rough getting out of bed on Monday morning to head into work. Since I am working until Max comes home I am teaching him how to breast feed at night after work while the nurses give him a bottle during the day and in the middle of the night.  He is doing well, but it's a slow process.  If he is up to it he will take up to 35 ml of breast milk from the bottle.  His full feeds are 50ml, so he still has a bit to go.  He will latch on to me, but doesn't get much as he falls asleep fast, so we are working on that with him.

After a full belly!

I believe he just needs to learn how to feed on his own without the tube and then he can come home.  One nurse suggested this could take 10 days, so I am hoping we have a fast learner on our hands.  I am so excited for him to come home and have my bonding time with him that does not include the hospital and a lot of nurses.

Here he is smiling.  He smiles a lot when we hold him.  He has even laughed a couple times.  Too cute!

Maxim is currently 5 pounds and 10 ounces.  He is a growing little boy who is starting to look HUGE to his mommy.

One Month Old

Today Maxim is one month old.  I can't believe I survived a full month of him being in the NICU...ok, let's be honest, I barely survived.  This is not how I pictured spending the first month of his life with him.  Peeking through a plastic box, monitoring his temperatures, celebrating poops, crying a lot because I miss him and spending two hours a night on week nights with him.  That is definitely not how I pictured the first month going.  I also did not envision the first month photo to be taken in the hospital.  It kills me that this is how it is.  I have done the best that I can to find silver linings in all of this, but it's been difficult.  The positive about today is that I am able to take a picture of him and he is healthy.  Today he weighs it at 5 pounds 4 ounces. When I looked at him today I thought he was huge.

Maxim, your first month in this world has been a rough one on both you and mommy and daddy.  You entered way earlier than expected, but for someone 10 weeks early you are extremely strong and doing very well.  You should have been on oxygen assistance when you were born, but you did not need it.  Your lungs were strong and you were breathing on your own.  You weighed a whopping 3lb 6oz and were a long 16 inches.  You came out looking exactly like your daddy.  Some days I can see myself in you and your grandpa Jeff, but 90% of the time it is all your father.  I am assuming you are going to be tall just like your daddy as your limbs go on forever.  When you were born you were quite crabby and did not want to be touched at all.  If anybody tried to move you or change your diaper you screamed.  I thought your little screams were so cute.  Once you started to get your belly full of food you turned into a very mellow baby.  Just like your mommy and daddy.  You did get a minor infection this month, but after a week of antibiotics you were all cleared up.  You have turned into a feed and grow baby this month and we are just waiting for you to learn some basics, that you would have learned in the womb, before you can come home.

This was discharge day...the hardest day of my life!

In your isolette before you got moved to a big boy crib.

When you do get upset your pacifier calms you down and if that does not do it the nurse will give you a little sucrose...yes, sugar.  You love that and it calms you in a second.  Now that you are a much bigger boy you do not get the sucrose like you did when you were first born since you have been able to manage your temper.  You do love the pacifier though and you love to hold it in your mouth.

You love the pacifier.

Since we don't get a lot of time with you I do cherish the time we do have together.  I don't mind diaper changes as I actually enjoy doing it.  It's just one small thing that makes me feel like your mother.  Your dad and I got to give you two swaddle baths this month and you just loved them.  It must have reminded you of the womb.  As scared as I was to give your tiny self a bath, I enjoyed every second of bath time.  My favorite thing to do with you is the kangaroo hold.  I could do that for hours and every time we do it you fall asleep instantly.  Sometimes you are so zonked out that your monitor goes off because you forget to breathe.  Early on in the month this happened quite a bit that I would have to put you back to bed.

You fit snug as a bug in a rug in my tank top.

Your first swaddle bath.

For such a teeny tiny baby you sure can fart loud and produce a LOT of poop.  Your farts crack me up as they are so loud and you like to make faces while you do it.  I have been shocked at how much you poop.  I have had two blow outs from you after your week on antibiotics and let me tell you, it was both gross and funny at the same time. 

You like to grunt a lot.  You grunt all the time in your sleep and when you are awake.  The nurses say this is you talking.  This is how babies talk by grunting.  If that is the case you are going to be one chatty cathy when you get older as you nonstop grunt when we are there.

You do not like your arms tucked in when you sleep.  You like your arms out and above your head.  If the nurse swaddles you with your arms tucked in you will grunt and wiggle them out and put them above your head.  This is too funny as this is how I sleep at night and daddy has always made fun of me.  The nurses think it's a little weird too, but I don't as I understand you.

Sleeping like mommy.

You started to smile about a week and a half ago.  You like to smile when I am holding you and when I talk to you.  That makes me happy as I feel like you know I am your mommy and that I am there to see you.  Sometimes it's hard and I wonder if you know who your mommy and daddy is, but since you smile when we talk to you I am pretty confident that you know who your parents are.

Such a little smiler.

During your last week this month we have been teaching you how to suck, swallow and breath so you can start eating on your own instead of via a tube through your nose.  This is a big activity that will allow you to come home so I get pretty excited as I see you progress.  The first time we gave you the nipple you made faces and were unsure of what to do. As you are slowly progressing you are starting to figure it out. I look forward to the day when you can take a full feed from a nipple.  We are working on both bottle and breast feeding as that is what it will be like for you when you get home. 

Learning how to suck on a nipple.

This first month with you has been an emotional roller coaster and definitely not how I envisioned our first month together.  I am just truly happy to have you and I enjoy the time we do get to spend together.  I cannot wait until the day you get to come home.

Love your mommy!

Update on Maxim

Last week was a rough week as Maxim was moved to the C pod and was back with an IV getting fluids and antibiotics.  He also was not given food for a few days which was rough on me.  He was obviously hungry, but there was nothing I could do.  That was tough.

Here is the update on that bacterial infection
So good news, it doesn’t look like it is anything to do with his digestive system (NEC). However, his blood culture did come back with a small bacterial infection – they figured out what specific organism it was and treated it with a specific antibiotic that targets that organism.  They didn't expect him to get any worse since he had been on antibiotics since Sunday. He was on antibiotics for a week and was taken off them at 11pm on Saturday night and it is likely that completely wiped out the bacterial infection.  The doctor said if he were to get any infection this is the one to get since it's so minimal.  To ensure it was not meningitis they did a spinal tap last Monday to ensure the infection isn’t in his spinal fluid and that came back negative...phew!  He looked good all last week and was active and he wanted to eat, which are all great signs! The blood that showed up in his stool last Sunday was a “tiny tiny” drop with nothing since. They will start feedings again this weekend...probably Saturday.

They started feedings again late on Wednesday last week.  It was like starting over as they started with 5ml and increased his feedings every 12 hours or so.  This was to watch his stools to see how he does to make sure there is no more blood.  He is now up to 45ml of fortified breast milk which is his max on feedings.  This caused him not to poop for quite a few days.  The nurses and doctors were not worried about it so I was not either.  This would take some time for him to get back on track. He finally had a tiny poop on Saturday so I was pretty happy about that. 

I got to experience my first blow out from him on Sunday night. It was crazy!  This tiny little boy had the loudest fart I have ever heard followed by a ton of poop...twice!  I changed him and got him all cleaned up and then I did it again. I couldn't help but laugh at him and the situation.  I was not grossed out at all, but instead I thought it was HI-larious!

As of yesterday, he is 34 weeks gestational age and tomorrow will mark 4 weeks of him being in the NICU.  I can't believe I have survived 4 weeks of him being in the NICU...of course with plenty of tears along the way though. 

Mamma's big guy!



Getting fluids and antibiotics with the IV in my head.



IV is out and I sleep like mommy with my arms above my head.  I am back in my crib as long as I can maintain my temperature on my own like a big boy.

33 Week Gestational Age

Maxim has had some high points lately, but we ended the week on a low that caused me to break down in tears.

Positive
We ended the week at 4 pounds 1 ounce and that is something to celebrate.  It's great that he continues to feed and grow.  I feel when I look at him now that he is much bigger than even a week ago.  He definitely looks longer.

Last week he started showing signs of wanting a nipple so on Friday night the nurse suggested we do a non-nutritional breast feed while he gets fed through a tube so he can associate breast feeding with eating.  For a non-nutritional breast feed I had to pump completely empty and then position him up to the nipple and let him do what he wants to do.  If he was ready he would go for the nipple, but if not that's ok too as it can take a few tries.  Mr. Maxim latched on immediately.  I was super excited for this progress that I didn't even care that it hurt like hell.  The nurse informed me that this could happen since he was figuring things out and doesn't know the breast is for feeding.  Once he actually eats then she said it won't be painful. Either way I was just so happy I didn't even care.

On Saturday it was time for Mr. Maxim to get a swaddle bath and Andy and I got to give it to him since we watched the hospital's instructional video.  I was pretty excited to do this.  The usual fussy little guy actual didn't mind the swaddle bath.  Since this was our first one the nurse helped me and Andy took photos.  This bath time was special and I felt like it was another little success that I was celebrating inside.

On Saturday morning Andy got to the hospital and found out that Maxim was able to regulate his temperature enough that they moved him from the isolette to a crib.  I was so excited I couldn't wait to get to the hospital to see this and celebrate another little step forward. 

Slight Set Back
One thing you are told from day one in the NICU is that all babies take two steps forward and one step back.  From the first time I heard this I thought no way my baby will be like that. He will only take steps forward because he is so strong.  I felt my first real set back today and it was extremely difficult.  I know I just have to remind myself of all the positives and it's just one step back that all babies do.

He had quite a few of apnea and brady episodes on Saturday night that they called us at 10pm to inform us Maxim will be put on oxygen for 24 hours to see if this helps.  If it does they will wean him off.  Today I got to the hospital for his 2pm cares and I was so excited to see him and hold him.  Minutes after I arrived this very excited mom was completely let down as Maxim started up the "A's and B's" again.  The nurse said he had been great all day and was surprised he was starting this again.  I changed his diaper and there was also a tinge of blood in it, so of course the hospital takes all precautions going forward to make sure he is ok and not sick.  He has all the tests done to find out that everything is clear.  Once again the infection or virus could be so early that it's not showing up.  They are going to put him on antibiotics again for 48 hours.  Since everything came back negative they said he could be allergic to milk protein so they stopped all of his food for 48 hours and put him on an IV of fluids.  When they start his food back up in 48 hours and he has problems again then it's an allergic reaction.  The nurse said it could also be a fissure in his rectum, but there is no way to find out if that's the case.  They have to try everything else and a fissure is a process of elimination.  Great! Due to this they moved him from the crib to a bed with a heater above since they didn't want him dressed so they could watch his stomach.  At this point I am handling this well.  I am thinking it's just a bump in the road and everything will be ok. I go to pump and while pumping Andy informs me they are moving him from Pod B to Pod C.  I immediately lost it.  One of the nurses previously told us the pods are ranked and the higher to Pod A they better your baby is.  I felt like this was a HUGE step back that we were dropping down the line.  Andy said it's for the better because there are two nurses in Pod C so he will get more attention than he is in Pod B.  Andy is much stronger than I because that is so not how I took it.

Max in is new bed with a heat lamp above him and his oxygen to his nose.

I am really trying to find the silver lining in all of this, but it's just so hard.  Especially since we were knocked down on the room of pods.  I know we will only go back up and will not get knocked down the line further than Pod C.  Here's to another week in the NICU and another week closer to going home. 

What Happened?

I had a pregnancy by the book, my weight and numbers for everything was by the book.  I was not a happy pregnant lady, but I was happy that at least I could have a perfect pregnancy.  I was looking forward to my upcoming baby showers, my maternity photo shoot and starting to get his room ready for his arrival. So, how could such a perfect pregnancy turn into a nightmare where I end up going into labor 10 weeks early and have to leave my precious baby boy in the NICU for 6-8 weeks?  I really don't understand what went wrong, but I may never know as these things tend to happen all the time.  My doctor might have an explanation for me.  She feels it's one of two reasons that caused my preterm labor and she is having tests done to determine if either happened.

Bacteria
My doctor thought bacteria might have made it's way up in my uterus to cause early contractions.  If it was bacteria no drugs were going to stop the contractions as it was a way of my body saying Max's home is not safe for him anymore and he needs to get out.  How does bacteria get in my uterus?  Who knows?  My doctor said it's a fluke thing where natural bacteria from the vagina can get up in the uterus.  Max was tested when he came out of the womb and he tested negative for bacteria, but bacteria can be in the uterus without getting to the baby.  My fluids were sent off for testing to see if this is the case.  If bacteria is to blame it's just a fluke thing that happened and nothing can be done in the future if I was to get pregnant again.

Placenta Abruptia
When my placenta was delivered my doctor thought it looked like it abrupted from the wall early.  She wasn't 100% positive so my placenta was sent off for testing too. If this happened then again the drugs were not going to stop the contractions as my body was saying the baby has to get out because his home is no longer safe.  If this is the case then at least something can be done in the future if there ever is another pregnancy.  If I am not too traumatized by this incident and we do get pregnant again my doctor would start giving me a shot of steroids at 16 weeks along to help keep my placenta attached to the wall.  With the regular steroid shots I should be able to carry to full term.  Plus, I will be monitored more closely to ensure this doesn't happen again.

I will find out at my six week appointment with my doctor if any of the above reasons caused me to go into labor early.  Until then I will just focus on Max growing and developing so he can come home.

In a food coma sleeping on mommy's chest.

Sleep tight sweet Maxim.

32 Weeks Gestational Age

Today's post should be me standing sideways in front of a wall holding my sign that says 32 Weeks in pink and blue, but instead I am going to give you an update on Maxim.

Weight
Today marks his 32 week gestational age and he weighs 3 pounds 11 ounces.  That is really good.  He started at 3 pounds 6 ounces and went down to 3 pounds because that is what babies do.  When we went to the hospital today we were happy to find out his weight increased more since yesterday.  I am celebrating the small weight gains.

Apnea and Brady Episodes
He had a rough day yesterday as he kept having apnea and brady episodes.  This is where he holds his breath or just forgets to breath and his brain isn't mature enough to get him breathing again.  This is completely normal for premie babies.  He did this15 times in one evening which is a lot, so the doctor and nurses were a little concerned.  One thing that can cause this is infection, so they put him through a bunch of tests to find out if he has an infection.  The episodes kept happening so they put him on antibiotics and did not wait for the tests to come back.  This was a precautionary method because you don't want to mess around with a premie getting an infection.  This morning we found out that all the tests came back negative, but the antibiotics helped him as he had a great night.  The doctor said that since these episodes were different from his usual behavior they were going to keep him on antibiotics for the next 24 hours to ensure there was no infection.  He could have a small infection that was in the early stages and therefore not showing up in the tests. I learned that UTI's are common in premie males, so we are more than ok with continuing the antibiotics.  Yesterday was also a rough day for me because I was unable to hold him all day and I had to see him go through these episodes where he wouldn't breathe.  It was very tough on this mommy.  Today was a better day and I got to kangaroo hold and that makes me happy.

Personality
He has definitely calmed down on the temper and takes his "cares" very well.  He doesn't mind a diaper change anymore as he pretty much just lays there or sleeps through his cares.  He is starting to scoot himself around in his isolette.  I am not sure how he does it because the nurses usually have him wrapped up pretty tight in the fetal position.  The last two nights we found him horizontal and out of his tightly wrapped bundle.  The nurses said they definitely did not do that to him.  Somehow he manages to escape from his position.  The reason they wrap him up so tight is to help him with his development.  Apparently he doesn't think he needs to develop, or he is trying to escape his isolette.  Either way it's too cute, but he needs to rest and not be moving around so much that he burns calories.

Video of Maxim

I would like to share what makes me happy when I am not at the hospital.  I took this video a few days ago while I just stared at him in the incubator.  He was just going to town waving his arms about. It is so adorable that I watch it all the time when I can't be with him.  Warning: You are about to see the cutest baby ever!

Maxim has gained a little weight back.  He was born at 3 pounds 6 ounces and then he lost weight and was down to 3 pounds, but he is up to 3 pounds 4 ounces.  I am so proud of him.  The nurse also told me yesterday that he pooped the biggest poop she has ever seen for someone his size.  That is another great sign of him growing.  Another little celebration.  His temper has gone down quite a bit.  He does not freak out anymore when he is moved or having his diaper changed.  He has been pretty laid back and calm just like his mommy and daddy.  I was asked again last night if I think my due date might have been off, but I assured them again that I know the date I got pregnant.  He is just mature for his age and that makes me very happy.

Maxim and Mommy Update

We get asked how Maxim and I are doing so I figured I would keep people posted via the blog.  I will do my best to get photos up and do regular posts.

Maxim
He is a trooper.  It has been a week since his delivery date and he is doing great.  He has been able to breathe on his own without any assistance, which is huge for a 10 week premature baby.  He has been taking my breast milk like a champ.  He feeds every two hours via a tube through his nose.  He will be able to move to a nipple about 34 weeks along. Until then, he will get fed through the tube.  He is a very active little guy as he likes to pull out his tube quite a bit and the nurses have to keep putting it back in.  He is starting to recognize when it's feeding time as he starts to get restless at the two hour mark.  The nurse said yesterday "Oh, he is right on schedule.  Look, he knows it's time to fill his belly."  That is another great sign of his maturity level.

He had quite the temper the first few days.  If you tried to even move him he freaked out.  He did not want to be moved whatsoever!  His little temper tantrums were funny because he is screaming at the top of his lungs, but not much comes out.  I know that will be short lived as his screams will surely get much louder than that.  The past day and a half he has really learned to cope with people moving him and changing his diaper.  He doesn't freak out so much at all.  It seems as if he gave in to the fact he is not going to be put back in the womb and he just has to deal with it.

The nurses keep saying his is quite mature for his age.  Last night a nurse asked me if the due date could have been off because he seems to be an 8 week premie and not a 10 week premie.  I said no because I know the exact date I got pregnant.  That is a big plus because him being discharged depends on his weight and his maturity level.  That made this mamma proud!

The first couple days the nurses kept commenting on the fact he hadn't pooped yet.  They are only able to up his food dosage as long as he poops and everything is working on the inside.  I started to get worried after the second time I heard this.  I was rooting for him to poop and when he finally did we were there to see it and change his diaper.  Of course it was the "tar poop" but I didn't care.  I was just so happy he pooped that I was celebrating.  It's the small things right now.

Mommy
Maxim is doing wonderful, but I am not so much.  This is much harder on me than on him.  He seems to be living the dream at times in his incubator while I stand outside just a wreck.  I have been on an extreme roller coaster this past week.  I have gone through every emotion from guilt to sad to happy.  I find the only time I am happy and myself is when I am at the hospital holding Max.  I struggle the rest of the time.  I find myself crying a lot and just taking it day by day.

I did talk to another couple in the NICU who has a baby with no esophagus.  The mom seemed to have it all together and talking to her made me feel a little better.  She told me that it will get better and I will turn a corner eventually.  Until then, I will just have to take it one day at a time.  I have also been told this has to do with the hormones going crazy as well as the sadness of not bringing Maxim home.

I miss him all the time and it just makes me cry.  This emotional roller coaster is turning my stomach all the time so I know it's not good for me, but I can't help it.  It's the hardest thing to do to give birth and then go home without him.  I feel like I am grieving, but I am not because I have not lost him.  I am just sad and in a fog when I am not at the hospital.   Andy has been such a trooper helping me through this.  I couldn't have married a better man.

I look forward to the day we can bring him home.  Until then, I will keep everyone posted on his progress and I will work on turning that corner.