Here Comes the Snot, Do Do Do Do

To the tune of the Beatles classic......

Jackson has green snot.  For most parents, the first indication of illness is a nerve-wracking experience.  For us, it is amplified by the fact Jackson is a preemie.  The sound of snot rattling around in his throat/nose is terrifying.

In the words of George Takei, "Oh Myyy!"

Can he breathe?  Well, he is not blue.

Is he uncomfortable/in pain?  Well, he is still his sweet self.

He does not have a temperature, he is hungry as ever, and he is acting himself.  The nurse says no need to worry.  Saline drops and a nasal aspirator are prescribed.  Certainly something we can handle, right?  Fortunately, his little nose was messed with so much in the NICU he takes minor drowning (aka: saline drops down his throat) and a vacuum stuck in his nose like a champ!

Our primary problem is the internet.  If you Google "green mucus in infants" it is gloom and doom.  It could be a cold, flu, sinus infection, allergies, or even a side effect of reflux.  Nowhere does it say "your baby may just have some snot".  Thanks Google.  I am trying to keep my blood pressure down.

A secondary problem is that when you have a preemie, you are warned about RSV upon discharge from the NICU.  You get a cold, baby gets RSV.  Jackson had lung issues, so the last thing he needs is a viral infection in his lungs.  Worse case scenario, we are back in the hospital.  This is what is in the back of our mind.  Jackson was not premature enough to qualify for an RSV vaccination, so all we can do is hope we don't get colds OR expose him to anyone carrying the rhinovirus.

Ironically, the doctor told us Jackson should not be a "Lysol Baby".  Sure, we need to avoid overexposure.  However, he should not be handled by people who we do not trust to tell us that they have been sick or have someone sick in their home.  He certainly should not be handled by school-age kids, especially with the recent pertussis outbreak in Bend.  So, we are trying to live our lives as we had planned.  Jackson was supposed to join the family and be included in our activities, not keep us quarantined in our home for fear of germs.

Green snot has been our wake up call.  We think we have been taking the proper precautions, but have we done too much too soon?  We have avoided taking him to grocery stores, particularly WalMart (for more information Google "People of WalMart).  He goes to restaurants with us but remains covered in his car seat or held by us.  We have been washing our hands constantly; my hands are so dry you would think I am 90 years old looking at just my skin.  Finally, we have only allowed close friends and family an opportunity to hold Jackson.  Maybe we have done too much, but we can't take it back now.

All we can do it rejoice in the fact he seems to just have some annoying snot.

Note to Google: Just having annoying snot is apparently a possibility.  How about adding some websites for that search that present this as an option?  Thanks for your consideration.

Not my pretty nose sucking face

Time Flies......

when you have a baby.

You thought I was going to say "when you're having fun", right?  Well, I am extremely happy and content, does that count?

Remember when you were a kid and time seemed to stand still?  My theory is that kids are always waiting on a birthday or Christmas because they will hopefully receive presents.  Waiting for something to happen that you are looking forward to makes time creep by.  I experience that sometimes, such as when we have a vacation booked.  Other than that, since I have been an adult (not sure when that transition happened exactly) time seems to fly.

The phrase time flies has changed dramatically for us over the past few days.  I have realized that time really flies once you have a kid in your life.  Since we got home on Sunday I have been so busy the days have completely slipped out of my hands.  One minute I am waking up (from my last few hours of sporadic sleep), and the next minute it is time to attempt to head upstairs to bed.  Between those times I am constantly doing something.

Nursing, changing a diaper, bottle feeding, holding Jackson upright (to prevent reflux), pumping milk every three hours, logging baby care events on our handy iPhone app, washing and sterilizing bottles and pumping accessories, doing dishes, laundry, picking up the house, organizing gobs of baby clothes and other accessories....

Rinse and repeat.

Heaven forbid I eat a meal, drink some water, take a shower, and get dressed for the day.  Oh, and I am pretty sure I have some bills and insurance business to handle and some appointments to make and keep.  I am sure I will get around to taking care of that soon.....

Fortunately, Colin has had the luxury of taking this week off so we can figure this transition out together.  As I mentioned in a previous post, I don't know how single moms do this alone.  At least at first.  The logistics are insane.  There are so many new things in your life you have to use to function.  I am dealing with bottles, a fancy breast pump and accessories, bottle and breast pump parts sterilizer, bottle warmers, diapers, butt paste, wipes, pacifiers, onesies, sleepers, beanies, blankets, bibs, assorted sheets and covers, packing a diaper bag, stroller, car seat, swing, vibrating chairs, the list goes on.

Keep in mind, I am trying to function with all these new things as a part of my routine on very little sleep.  In essence, I am a moron.

That's another thing, I am not very smart anymore.  I won't go into further detail about new mommy brain because most of you know it firsthand, some of you warned me, and the rest of you can take my word for it.  Lack of sleep combined with taking care of a baby zaps your brain cells quickly.

Despite my dim-witted condition, I have had one important realization.  I have figured out how women manage to lose weight postpartum when they are not physically allowed to exercise yet.  In my case I have two reasons.

1. No time to feed myself - this is likely the primary method of losing weight for most new mommies: involuntary anorexia.
2. Every time I go downstairs or upstairs, I have left one of the many new things I need to function (remember, I am an idiot) so I am constantly climbing my stairs and running around like a chicken with my head cut off in my house.

Those women who have a single level home probably lose weight a little slower, but they are most likely scurrying from room to room trying to get it together most of the day.  So there it is, the bright side.  At least I am starting to lose weight again.  I had plateaued while Jackson was in the NICU.  I lost 20 lbs. within the first two weeks postpartum and I have stayed at that weight for the past three since.  Rather than get discouraged I have kept in mind that I am eating whatever I want and considering our situation it has been a lot of eating out and takeout food.  

Another advantage of nursing your child besides the fact it is the best thing for them and free: eating an extra 500 calories a day.

They say time flies when you're having fun.  I agree.  However, time really flies when you have a baby.  Before I know it, Jackson will have a girlfriend and be leaving us to go to college.  I better enjoy this while I can.

A New Kind of Tired

Well, we did it!  We survived our first night at home with Jackson.  More importantly, he survived.

There is one little problem.  Jackson is not a quiet sleeper.  Due to his reflux and typical little guy tummy issues, he groans, grunts, and whines in his sleep.  Of course, that means I didn't sleep for the majority of the night.  I used my flashlight app to check his color constantly to make sure he was still breathing and every time I fell asleep he let out one of his baby noises that would wake me right back up.  Finally, Colin woke up around 3:30 a.m. when I was holding Jackson upright after feeding him and asked if I had slept yet.  When I responded that I had not, he did the most considerate thing a husband/partner could do.  He took the baby downstairs and slept on the couch while Jackson slept in the pack and play and allowed me to finally get some sleep. 

Those few hours made all the difference in the world, but we were both still exhausted.  I finally understand why this job (being a parent) is so hard.  Once you are finally done changing, feeding, and holding your baby you can put them down to sleep.  Technically, this is when you should also allow yourself to nap so you can have the stamina to repeat the process (change, feed, hold....repeat).  However, the baby's nap time is the only time you have to do anything else.  Laundry, washing and sterilizing bottles, picking up the house, showering, etc.. Oh yeah, and pumping milk every 3 hours is also expected so I can keep up my supply. 

This is a new kind of tired.

I have been tired before for several reasons.  Working too many hours, having a little too much fun, traveling long distances, insomnia, red-eye flights, pregnancy, flu, the list goes on.  This is different.  There is always something that needs to be done.  I told Colin this evening that I cannot imagine doing this on my own.  I don't know how single mothers manage.    

I understand this is all going to get easier and I am honestly not complaining.  I am more than happy to be doing all of this, especially after spending so long in the hospital under direct orders and observation.  Finally, we can call the shots.  If we want to let Jackson sleep a little longer and not wake him up to change and feed him, we can.  As long as he continues to grow and thrive (we'll see how we are doing at his first well baby appointment on Wednesday) no one can tell us how to manage our time.  All that being said, Jackson is really the one calling the shots.  As usual.

Things are going to inevitably get more comedic as I lose more and more sleep.  Pregnant brain had already smoothly transitioned to postpartum brain.  Now I think I have an affliction known as new mommy brain.  I am sure all mothers out there can relate.  I am a complete moron.  Seriously.  I have had some really idiotic moments.  For example, I have failed to put a container on my pump and allowed milk to flow right onto my lap.  This may not sound like that big of a deal, however, milk is liquid gold and any waste is unacceptable AND this has happened more than once.  I need to extract my butt from my cranium, stat!

Night two, and the inexperienced parents were optimistic.  "Look at him sleep so quietly and soundly during the day.  Surely we can put him down again in the co sleeper tonight and everything will be fine.  Let's just go with business as usual and hopefully he will sleep."

Wrong!

Despite my rapidly deteriorating neural function, I have realized this kid is playing us like a fiddle.  He is not too keen on sleeping separate from us at night.  If you put him down in the co sleeper (keep in mind he has been held and soothed after eating), he starts grunting, groaning, and whining.  Pick him up and hold him or let him sleep on you, everything is fine.  That little stinker wants to be held 24/7!

There are two factors that are different at night:

1. It is quiet.  He sleeps through the hustle and bustle of our house, just like he was always sleeping through the various sounds of the NICU.
2. He is expected to spend more time on his own in his sleeping area.  We are not supposed to hold him all night for fear that we will fall asleep and smother him.

Colin woke up this morning and I was busted doing the big "No No".  I had nursed him for a while and he was sleepy.  When I put him in his co sleeper he woke back up and fussed.  So, I cleared a little area next to me (between where I sleep and his co sleeper bed), put down a blanket (in case of spit up), and snuggled.  Of course, I dozed off.  Fortunately, Jackson survived this oh so dangerous situation, but we can't do this.

I have a womb sound bear that we can learn to deal with.  This allows Jackson to have some sound to soothe him as he is falling asleep.  All the reviews of the product claim that babies feel asleep faster and slept longer.  

Not sure what to do about #2.  Guess we will figure something out to save our sanity.  Our plan for today: less daytime nap time.

We'll see how it goes.  *Yawn*

"Look at me pretending to sleep in my co sleeper.  Once mommy finally falls asleep I will execute my plan to get back over to her.  Muahhahahahaha!"

Mama I'm Coming Home

Home sweet home.  For real this time.

We are a family now.  All five of us are residing on the west side.  We all have one thing in common: major adjustment.

For starters, Jackson seems to be adjusting well to his new environment.  I can't imagine how he must feel experiencing life as a cordless baby for the first time, spending 24 hours with mommy and daddy, a ride in the car, a new house with multiple rooms, and two dog brothers all in one day.  I read several blogs and articles online about how preemies adjust to going home and it can go either way.  Some really come to life and thrive, and some have a tough time with all the new stimuli.  Even though I made a conscious effort to greatly reduce the stimuli in Jackson's NICU room this past week so we could focus on feeding and growing, I think he is doing quite well with all the new experiences.

Colin and I have had the advantage of getting to know Jackson and learning how to take care of him from trained professionals for the past 33 days.  Despite that, we are still in a period of major adjustment having him full-time and in our home.  There is a lot of organization and carefully planned logistics that we are working on to ensure that we are not overstimulating Jackson and at the same time conserving our energy so we can persevere through his nighttime feedings.  We did a decent job preparing the house considering we have not spent much time at home in the past month (plus we had a tremendous amount of help from family) so our house is pretty baby-friendly.  Still, we have to really think through everything we are doing so we can keep Jackson on a care and eating schedule so he will continue to thrive and grow.

Finally, Dakota and Sam are trying to figure out what the heck is going on.  They seemed to know who Jackson was when Colin brought them in one at a time so there was no major excitement to freak Jackson out.  I credit the fact that we brought Jackson's bassinet blankets home a few times recently and let the dogs get a good sniff.  The boys are really calm, but they seem to be trying to figure out what their role is with the new member of the pack.  I am relieved that they seem to think their job is to guard Jackson.  Perhaps the most profound evidence of this is the fact Sam would not leave Jackson's side as he sat in the magic vibrating chair while I pumped milk in the nursery.  Now if we can prevent Sam from marking everything belonging to the baby (his typical declaration of territory) we can consider this transition a victory.

I just want to take a moment to thank everyone who has been reading my blog and following us on Facebook.  I plan to continue documenting my experiences as a first time mommy so feel free to continue this journey with me.  We continue to feel so blessed and overwhelmed by the outpouring of love and support our family and friends have offered us and we appreciate it more than anything in the world.  We hope to get through this period of adjustment as quickly as Jackson can handle so we can join the world again and be completely "normal".  For now, just being home is enough.

"Don't worry Jackson, I got your back."

Please Keep Your Hands & Feet In At All Times

Jackson took us on the loops, twists, and turns of the roller coaster for the past four days.  I think we are close to the end of the ride, but I don't want to get my hopes up too high in case Jackson has plans we are not aware of.  Fingers crossed.

It all started Wednesday morning when I showed up at Jackson's house (that is what we call the NICU now).  I could hear him squirming and squawking in his bassinet so I went to give him a good morning kiss.  I immediately noticed something was missing.  As I looked in his mouth and under his chin I asked the nurse, "Where is his cannula?"  She smiled and said, "I was hoping you would notice that."

Really?  My son has had a piece of plastic offering whiffs of oxygen in his little nostrils for 29 days now.  You really thought I would not notice it was missing?

Apparently, she noticed that the cord to the cannula was under the wheel of his bassinet and she realized he had not been getting any oxygen.  His saturation levels had been in the 90's so she decided to ween him down from 100% to 50% oxygen.  When he continued to do well she took him all the way down to 21%, or room level oxygen.  After that, she made the decision to take off his cannula.  He had been cannula-free since 5 a.m. and was doing just fine without it.

Hooray!  Finally, he decided he can breathe in enough air on a regular basis and get off his little crutch.  I know 100% oxygen sounds like a lot, but he was on such a low flow of air it was almost negligible.  It is like there is a little line of oxygen molecules slowly marching towards his nose making themselves available if necessary.

He had also been feeding so well on Monday & Tuesday, the doctor decided it was time to go to ad lib feeding.  This means Jackson calls the shots on how much and when exactly he eats and no more gavage feeding.  He had to accomplish eating a minimum amount of food by mouth in 24 hours, which was determined to be 320 ml according to his current weight.

All of these changes were very exciting because they meant we were inching closer to the end of the ride.  In reality, this also meant I had two things to be completely stressed over all day long.  Is he eating enough?  Is he keeping his oxygen saturation (sats) high enough to stay off his oxygen?  I literally had my eyes glued to his monitor all day while I resisted the urge to force food down his throat.  It was completely brutal.

In true Jackson fashion, eating was not a problem.  This kid is hungry.  I recognized the profound change in his feeding behavior when I came in Monday morning.  It was as if a light bulb had gone off and he realized he enjoys drinking his milk rather than having it shoved directly into his stomach through a tube.  He easily met his 160 ml half day ad lib requirement in the 12 hours I was feeding him and actually exceeded that amount.

The oxygen was a different story.  As the day progressed, his sats started getting lower and lower.  They like to see his sats in the 90's so they know his blood is carrying enough oxygen to his tissues.  He spent an excessive amount of time in the 80's and even dipped into the 70's.  When I left at 7 p.m. I had a sinking feeling he may not make it off his oxygen.

When I arrived on Thursday morning my suspicion proved correct.  Even though the flow of oxygen he has been on is so low, he needed it.  Most of the time it is not necessary, but there are certain times, such as when he refluxes or when his tummy is really full, the oxygen helps just enough.  I tried to refrain from being disappointed and wrapped my head around the idea of going home on oxygen.  Time to focus on feeding.

The nurse told me not to get too discouraged if he was too tired to eat.  He had a rough night despite the fact he managed to eat his ad lib minimum.  He was sputtering and had several brady episodes at his 2 a.m. and 5 a.m. feedings.  Again, Jackson is a feeding champion and refusing to eat really does not happen.  He proved the naysayers wrong and exceeded his ad lib minimum again.  Most likely being back on his oxygen gave him just enough energy to easily feed.  It was glorious to experience that victory with him.

The neonatologist was also unfazed by the fact he was back on his oxygen and we set a plan to room in on Saturday if everything continued to go well.  Jackson had to continue to feed by mouth and eat enough to meet his ad lib minimum and gain weight.  If we had to go home on oxygen, so be it.  Rooming in means we spend most of the day and the night in a suite in the Family Birthing Center with Jackson.  It is our chance to take care of him on our own and without monitors, yet the nurses are right there if we need anything.  It is practice before we finally take him home.

After a successful day on Thursday (with the exception of the oxygen, which alone would not keep us in the NICU), I was relieved to arrive to much better news on Friday morning.  Jackson exceeded his feeding minimum again and this time had no issues.  He even woke up early a few times ready to eat.  The doctor asked if I was willing to try one more time to get him off his oxygen.  I was more than willing.  Going home with oxygen tanks (explosives) was something I had accepted but preferred not to deal with.  

Jackson was a feeding, breathing rock star.  All day I felt like I was watching a different baby on the monitor as he maintained sats in the 90's with no oxygen support.  I was so surprised I even asked the doctor if it was normal for a baby to improve so dramatically so fast and he verified what we were seeing was normal.  The NICU staff calls it "the lightbulb turning on".  Of course, feeding was not a problem and he was eating more and more at each opportunity he had to nurse or bottle-feed.  All Jackson had to do was get through one more night and we were on our way back to where we started in the Family Birthing Center.  

Colin and I worked until almost midnight on Friday getting the house ready.  We had the carpets cleaned so we had to replace (and rearrange) furniture amongst several other "bringing home baby" chores.  Somehow I slept that night between pumpings despite my anxiety.  One stimable brady episode (drop in heart rate requiring stimulation to recover) and the going home clock would be reset for another 5-7 days.  When you are so close to the end of the ride, the idea of even one more day is unbearable.  

I was an annoying nervous wreck as we made our way to the NICU this morning (Saturday).  This was it, are we rooming in with the plan to finally leave room 3 on Sunday?  Will we be going home on oxygen or did Jackson do well overnight without it?  Can I finally spend 24 hours a day in my home with my baby?  Is Jackson going to finally be the cordless baby I was expecting?

Yes!  

Jackson did great overnight again!  He ate his food, kept his sats up, and had no brady episodes.  Our last hurdle to get out of the room in the NICU was the car seat test.  Jackson had to spend an hour in his car seat and keep his sats up.  I refused to sit in the room for an hour watching the monitor.  Remember, my blood pressure was a problem a month ago when Jackson joined the world and I did not need any more stress.  We left the hospital and killed some time with frozen yogurt and furniture shopping.  When we got back he had passed his test.  Victory!  The ride is almost over!

Ironically, the ride ends right where it started, in the Family Birthing Center.  Just like a roller coaster, you get off where you got on.  If everything goes well tonight, we get to be those proud parents leaving the birthing center with our term baby in his car seat.  We will be the people we have envied for 33 days.  Colin said today that we will no longer be NICU parents and be able to park in our special parking space.  He quickly took it back.

We will always be NICU parents.

Hopefully Jackson will gain weight and we can blow this Popsicle stand.  Fingers crossed.  Time to get off this ride.

"I am a champion, and you're gonna hear me roar."

You Must Be This Tall To Ride

We are on the NICU roller coaster.

Wheee!!!!

Jackson does a little move I call the roller coaster when I am dressing him or moving him to the scale to weigh him before or after feeding.  He throws both of his arms up in the air and yawns like he is screaming with joy down a hill on a roller coaster.  It's pretty cute.  Then again, so is everything he does (with the exception of the toxic waste dumps we are finding in his britches, which is not his fault; the human growth formula they add to my milk is to blame for that).

Saturday morning I had a tough conversation with Jackson's nurse and one of his neonatologists.  I needed an honest assessment of when we may go home because I was growing tired of living on false hope.  I had been told a few times previously that we were looking at 7-10 days.  We were at day 7 (again!) and I did not feel like we were even close.  The doctor and nurse both agreed that it may take more time than we all anticipated and perhaps Jackson would not go home for another few weeks.  In reality, he is at the controls of this roller coaster and no one has any clear answer regarding when he is ready to stop this ride.  Perhaps his lung disease is worse than we initially thought.  Maybe he just does not have the stamina or will to feed by mouth consistently enough to get out of here anytime soon.  Is it possible he likes it in the NICU and does not want to go home?

I should point out again, we feel very lucky to have a thriving, healthy baby in the NICU.  There are many other people whose situations are so much worse than ours.  Our nurse pointed out that is precisely the reason why this situation is wearing us down.  We have a baby who has grown nearly 2 lbs. since he was born, feeds pretty regularly, and has no major health issues.  At this point we have a normal, healthy baby with the exception of a bunch of cords coming off of him and a need for a nearly negligible amount of oxygen support.  That makes it difficult for our brains to understand why we are still in here.

Sunday he had a pretty tough time feeding.  He was too worn out to do much and he seemed fussier than usual.  That day was so discouraging for me that Colin and I left after his 2 p.m. cares and feeding and floated the river for a while to regroup and relax.  When I say discouraging it does not mean I gave up.  I just felt sad and frustrated because it seemed like we were nowhere near going home.  In fact, it felt like the roller coaster was sliding back downhill and that I needed to start wrapping my head around spending a few more weeks in this room.  As strong as I have been trying to be, I was nearing the point of having a meltdown.

You know what they say about rock bottom......

Monday morning marked Jackson's 37th week of gestation.  Colin offered to come in early and take over the 8 a.m. and 11 a.m. shifts and feed him by bottle.  I refused on Sunday night and insisted that I needed to be there for him because he tends to feed well in the mornings.  Monday morning rolled around and the idea of relaxing at home for a few more hours was pretty appealing.  Of course, I had to get up and pump twice anyway so extra sleep was elusive, but snuggling in bed with Sam for a few more hours is just what I needed.  What a great husband and daddy.  I am a lucky girl to have Colin as my partner and teammate.

I got the text that Jackson had taken a whole bottle from Nighttime Sally at 5 a.m., plus partial bottles earlier on her shift.  Also, he had taken a whole bottle from daddy at 8 a.m.!  It was great news to wake up to.  When I got to the NICU at noon, he had taken ANOTHER whole bottle at 11 a.m. from daddy.  It was as if Jackson woke up and said, "Okay, I am technically a term baby now at 37 weeks.  Time to get with the program!"  Or perhaps he thought, "Mommy may have a meltdown if I don't start working on getting home, so I am going to start eating!"

He proceeded to eat nearly full feedings by mouth at 2 p.m. and 5 p.m. with me.  In all, out of 200 ml of food, Jackson at 185 ml by mouth.  We only had to gavage 15 ml in 12 hours.  That means he took 93% of his food on his own (if you can't do the math yourself).  Typically, when a baby is taking 75% or more of their food by mouth consistently, they pull the feeding tube.  At that point, the baby goes to ad lib feeding, meaning they eat on their own schedule.  They are given a total amount they have to consume in 12 hours (which is less than what they have to eat when on a 3 hour schedule with a feeding tube) and if they succeed, time to go home!

One day we are slowly clicking along up the hill, the next our arms are in the air and our stomaches are in our mouths.  Wheee!!!!!!

This is exactly what we were told would happen.  On more than one occasion, a sympathetic nurse has said, "One day Jackson will wake up and start to figure things out.  It happens fast and next thing you know you are going home."  The doctor was very encouraging on Monday when he found out how he was feeding.  He told us this is a very promising sign.  I am seriously done getting my hopes up and marking days on the calendar when he "should" be going home, but I certainly feel like I am in much better spirits considering this turn of events.

One thing that we needed to get done before we go home is an echocardiogram to diagnose what is causing, if anything, Jackson's faint heart murmur.  Since he started feeding so well all of the sudden, the echo was ordered and taken care of Tuesday morning.  The results came back "normal", meaning that his murmur is a quiet, common sound heard in many preemies and is nothing to worry about.  They won't even do a follow up and he is expected to grow out of it.  Check that off our list of things to worry about!!

Wheeeeeee!!!!!!

In all reality, I expect that this roller coaster may still have a few more twists, turns, and loops.  However, we are near the end of our ride and I hope it is mostly downhill from here.  There is a chance we may go home on oxygen, but at least we will be home.  Jackson is ready to meet his brothers, Dakota and Sam, and be with mommy and daddy 24 hours a day.  Of course, this all means we need to prepare ourselves for a ride on a new roller coaster.

The "OMG, what do we do now that we are on our own with a baby?" roller coaster.

Brrr....this gel is cold and making my gums chatter!