Tag Archives: kangaroo care

the eric update – day 78: saying goodbye. and hello. postcards?

since i have absolutely no free time, i’m going to try something new and only put a placeholder entry here. perhaps i’ll get a chance to put a more detailed account here later. or perhaps not. but for now, i’m just going to give the bullet points there are more important things to attend to.

i apologize to everyone who called yesterday who didn’t get a call back. obviously, cell phone time is short and i’m basically in “triage” mode and only returning emergency calls. after a whole bunch of voicemails it became apparent that there was some confusion about eric’s eye surgery. he was being transferred today ( monday ) and will have an assessment on tuesday. if he moves from being “prethreshold” to “threshold” then he’ll need surgery within 72 hours. the quick move was made because the expectation is that he’ll move quickly into threshold land and everyone wants to be prepared for that event. we don’t know exactly when he’ll have the surgery in the event that it’s required and i won’t have that answer until later tommorrow.

day 78: little feat

as eric gets close to transfer, the nurses get the proper paperwork in order. amidst the release forms i discovered an identification form that has his footprints that were inked on his first night in the nicu.

they sure were small. about as small as nickel.

day 78: leaving bed four

eric made great leaps and bounds while staying in “bed 4” in the nicu, which seemed like a perfect number since he’s eric “the fourth” born on the fourth of july.

we would later discover that he would be sitting in bed 4 at the new nicu, which makes us think that “4” just might be his lucky number.

day 78: reading the numbers

according to the rules that one must follow when tranferring a baby from one nicu to another, the nurses must corroborate that he is, in fact, who they think he is and read match the identification number on his nicu ID bracelet with the number on the transfer papers.

i’m foiling their best efforts to match the ID numbers by telling jokes and they’re laughing heartily.

day 78: saying goodbye to nurse nancy.

nurse nancy is superfantastic and she spent much of the day trying, unsuccessfully i might add, not to cry. eventually i was able to capture her with her “happy face” on.

nurse nancy was eric’s nurse for many of his “big steps” including being transferred to the isolette and the open, unheated bed and his first bottle feeding, so she’s very, very attached to eric.

day 78: saying goodbye to he, himself.

this is charles, “charlie” winslow – eric’s neonatologist. he’s the reason why eric is alive and words can’t really describe how highly we think of him.

he’s a nice guy, a great communicator and rides a bike to work.

day 78: nicu transport. I.

after the transport team arrives from the new nicu they quickly put eric in the transport “crash cart”. the whole process only takes a few minutes.

his “saint mary’s” nurses are standing around looking sad and i wish there was more time to say goodbye.

day 78: nicu transport. II.

little odin is resting comfortably in the crash cart, oblivious to the fact that he’s, ever so briefly, about to see the outside world for the first time.

day 78: nicu transport. III.

part of the transport team from the new nicu is talking with kris and nurse cathy b. the man on the left is the ambulance driver. the woman standing next to him is a neonatal nurse practitioner who is chatting with kris and nurse cathy b.

day 78: nicu transport. IV.

more people from the transport team. the man on the left is a respiratory specialist and the woman on the right is a registered nurse.

they’re amiable and do a great job making us feel relaxed. somehow, during the quick process of getting odin prepped for tranfer i find myself talking with the respiratory specialist about digital cameras. go figure.

day 78: nicu transport. V.

and they’re off!

little odin gets wheeled out of the nicu on his way to the elevator and the waiting ambulance.

day 78: at the new nicu. I.

we weren’t able to ride in the ambulance with odin, so we arrived shortly after he was put in his new bed.

he seems to be welcoming us with a hand wave as if to introduce us to his new surrounds.

day 78: at the new nicu. II.

of course it’s not long before he’s resting comfortably on mama’s chest.

day 78: at the new nicu. III.

in one of the many differences between the two nicus, eric gets weighed before and after nursing in an effort to more accurately determine how much milk he’s ingested. in theory, the practice should help us to make sure that he’s received enough nutrition, but the scale claims that eric has lost two grams after breastfeeding. so much for accuracy.

oh. i guess i should note that eric is gaining weight so fast that it’s almost starting to freak me out. he tipped the scales at at 4 pounds 9 ounces or about 2075 grams. that’s right – he gained 2 ounces over the last 24 hours and over 5 ounces in the past 48. while everyone is suitably impressed, it’s not good to put that much weight on that quickly, so my guess is that they might reduce the amount of fortifier in his breastmilk soon.

day 78: at the new nicu. IV.

eric’ new bed is stainless steel and the temperature of nicu is a lot cooler than we’re used to which help to add to a sterile, antiseptic feeling.
the new nicu is quite different from the old in many, many ways. while “saints” was small, at 15 beds, little odin’s new home is enormous, with over 100 beds. it also gets a lot of sick babies that are transferred from many different places so it has a much different feel. it’s odd to be thrust into the new environment, trying to adjust quickly to the new rules, while walking around and seeing so many babies with shaved heads and drainage bags, presumably alleviating pressure after brain surgery. the nicu is cooler, literally and figuratively and is much more antiseptically clinical. in a weird way, it also feels like we’ve transferred from the ‘jewel in the rough’, small, personal liberal arts school to the large, top tier, big 10 school. the veneer looks more impressive, but it also seems like it could be quite easy to get lost in the shuffle. time will tell.

uh. so, it looks like i’m incapable of writing a ‘placeholder’ entry.

day 78: at the new nicu. V.

despite all the changes, eric continues to chug his botttle feedings while continuing to look very relaxed.

because the new nicu is kept at a cooler temperature, it’s more important to keep a knit cap on his head and cover him in blankets.

many people have asked me about where they can send postcards. it seems that little odin’s quick transfer has revealed all the procrastinators in the crowd 🙂 for now, if you’ve sent a card that’s already in the mail, i’m sure the staff at saint mary’s will keep it until i can find time to come and pick it up ( in fact, i think they were happy to hear that i’d be back to pick up postcards which would give them an opportunity to hear about eric’s progress ). i don’t know the new nicu’s policy , so i can’t say whether or not people will be able to send stuff there ( i’ll find out more today or tommorrow ). i’m not ready to post my home address on the internet ( i’m not really sure why, since it’s quite easy to sleuth it on the the internet. ), but i’ll probably come up with a solution sooner rather than later. as always, thanks so much to everyone who has sent us or plans to send us a card ( or more! ).

the endless kindness of strangers ( and friends and family, of course ) never ceases to amaze me.

the eric update – day 59: even more weight gain. too big for bedding. impending transfusion and guessing games.

day 59: outgrown his bedding!

sniff. they grow up so fast. it’s hard to believe that it was on day 26 that eric received his custom bedding and he looks like he was swimming in it on day 28. but now, he’s so big, at 3 pounds 8.3 ounces or 1595 grams ( yes, he gained over two ounces in 24 hours ) that he can’t fit in his bedding anymore! we decided to give his bedding to some new neighbors who just arrived with a 24 weeker. we remembered how nice it was to have his own bedding from a thoughtful stranger, so hopefully in some small way, it’ll help the new parents transition into the nicu and their own long road ahead.

one of the nurses told us that during “rounds” today the neonatologist commented how very happy he was with eric’s progress and that he thought he had “turned a corner” and was looking very, very good lately. it’s going to be quite difficult to manage our expectations in the coming weeks now that we know that he, himself is being so optimistic – all the more so because the nurse said that he never makes predictions.

as i mentioned earlier in the week, he is looking increasingly pallid as the days goes by due to his decreasing amount of hemoglobin in his blood, which means he is getting closer and closer to needing a transfusion. for a variety of reasons our neonatologist lets hemoglobin run down farther than perhaps is done in other nicus, in an attempt to see if babies can increase their production on their own. often he’ll even go so far as to let the alarms start to increase before he’ll begin another transfusion, so i guess i’d expect to see the rate of alarms pick up over the next few days, due to the decreasing number of “boxcars” ( nurses term for red blood cells ). while he doesn’t seem to be alarming more than usual, his supplemental oxygen is gradually being increased, as a consequence of his decreased oxygen carrying capacity.

day 59: the return of kangaroo care!

i like to play games with the nurses by “forcing” them to guess when they think certain events will occur, such as when eric will get his transfusion. normally the nurses hate answering the “when do you think such and such will happen game” but i make it so much fun to play that most of them eventually play along ( in fact, i believe i may have developed quite a reputation for being able to cajole normally retrained nurses into playing ). being the veterans that we are, they know that i don’t really believe a word that comes out of their mouths and that it’s just a way to pass time. today, eric’s day nurse was quite sure that eric would get the transfusion tommorrow. or, i think it might be more correct to say that she was advocating that eric get the transfusion so that he could get it done before he goes to “full feeds” and is therefore be able to get rid of his intravenous line that much sooner ( i.e. if he went to full feeds before he got his transfusion, they’d keep his IV line in for the impending transfusion, which she was presumably trying to avoid ). however, eric’s night nurse laughed at the speculation and said that maybe the day nurse didn’t work in the same nicu as she did. the day nurse was still talking with us at the time, so it was all in good fun and i got they impression that they were gently expressing their impressions of the neonatologist’s transfusion policy.

day 59: pops gets some light reading time.

in addition to playing games with the nurses, we stuck to our increasingly normal routine of holding and kangaroo care, with and afternoon bath from kris and reading from both of us. tired of all the other reading, i decided to read to him about “mr. craigslist, master of the nerdiverse”.

the eric update – day 49: eric’s 7 week birthday!

day 49: 7 week birthday kangaroo care

let’s all give odin a little birthday cheer, as it’s his 7 week birthday today! he gained a few grams and is now solidly in the 3 pound category at 3 pounds and 3.5 ounces. he also added a half a centimeter and is 38.7 centimeters or 15.25 inches, which means he’s added 3.25 inches to his length in the past seven weeks! woohoo! he’s rapidly being weened from the cpap and is on 6 hours of nasal cannula and 4 hours of cpap. since he’s doing so well breathing on his own, i suspect that within the next few days they’ll see if eric can go 25 hours on the nasal cannula. despite having to do more breathing on his own than ever, he’s throwing very few alarms; he only seems to alarm when the nurses are doing their “meanies” or when he’s put his head in a position that’s not conducive to breathing. his breastmilk feeds stayed the same as yesterday, as they’re pulling up more undigested food than they’d like to see, so they’re going to back off a bit on increasing the amount of milk that he’s receiving. you might remember that anytime digestion slows and milk starts hanging around, there’s an increased risk for a gut infection, so they’re just going to take things slow.

day 49: ouch!

the nasal cannula needs to be taped on his face to reduce the chance that he’ll pull it out and the process of repeatedly removing the tape when he goes back on cpap has made his skin a little raw. tonight, he even has a tiny bit of flesh pull away, which he obviously didn’t care for at all; nurse peggy put little pieces of what’s known as comfeel on his face to prevent it from happening again because open, irritated sores are not a good thing when you’re enduring a prolonged stay in the nicu.

day 49: pacified. I.

eric’s getting much better at coordinating his sucking and breathing; a mere week ago, he’d alarm when a pacifier was in his mouth for more than 15 or 20 seconds, but now he can keep the pacifier in as long as he’d like. since he’s doing so well, nurse peggy said that it’s a good time to introduce a pacifier during his breastmilk feedings so he can begin to associate sucking with feeling of food in his stomach. this is but the first step in a long process of getting his used to having to coordinate the sucking, swallowing and breathing that must occur for real breastfeeding, so it’s a big step.

day 49: pacified. II.

sometimes he has trouble keeping the pacifier in his mouth with the tubes in the way, so peggy has “illegally modified” the paci by notching it so that the tubes can stay where they need to stay and he can more easily keep it in his mouth. nurse peggy is thoughtful like that.

day 49: longhair

eric’s hair is getting so long that it’s growing over his ears!

the eric update – day 48: gifts! last transfusion? no alarms (except pops induced)!

day 48: loose cannula

there’s no doubt about it. we’re back to the ho-hum days that are mostly filled with kangaroo care.

eric is being transitioned from the cpap to the nasal cannula much more quickly than previous attempts. today, they altered his schedule to alternate between 4 hours of cpap and 4 hours of the cannula. amazingly, he only had 2 brady’s (bradycardia, or slowing of his heart rate ), the entire day and both were while he was on my chest, which, of course led to endless jokes from kris and nurse jan. both brady’s were due to his head slowly getting into a position that made it difficult for eric to breath. of course, whenever eric’s on my chest he seems to enjoy putting his head in the position that will lead to a brady. i imagine that he thinks it’s a fun game to have me move his head in the correct position, only to move it slowly and imperceptibly back to the wrong one. over and over we play the game and sometimes he wins and has a brady.

eric also likes to tug on his nasal cannula, pulling the prongs out of his nose. if he weren’t doing so well breathing on his own, we’d know when the prongs were out of his nose, as his blood oxygen levels would start to decrease. but since he is breathing so well, we don’t see the “desat” and only later discover that his prongs have been out for as long as 10 or 15 minutes at a time, which is yet another sign that he’s getting stronger.

day 48: eric meets babo the ugly doll

some longtime friends, matt and erin, who we haven’t seen in awhile came into town this weekend bearing gifts! eric was happy to receive his new ugly doll, even if the nurses were all a little perplexed as to what an ugly doll was and why on earth anyone would want to buy one. but we don’t care what they think, since eric and the ugly doll got along quite famously and found themselves in long, heated discussion about which of them was taller.

day 48: eric and babo discuss who's longer

clearly, the ugly doll has no grounds for his assertion that he is, in fact taller than eric.

day 48: eric's new handcrafted knit cap

in addition to giving him the ugly doll, they also gave him a cap that erin knitted with her very own hands! the nurses were all very impressed that the cap was knit by a nicu rookie, since it can be tough to make the cap snug, but not too snug, and it should also be quite stretchy in all directions to accomodate the various forms that his very malleable head might take on from day to day. there’s a bit bucket of “discards” in the waiting room outside the nicu that have been knitted by volunteers but that haven’t passed the quality control inspection from the nicu staff, but eric’s cap won’t be in it, because it’s about as perfect as you could want it to be. thanks!

day 48: diaper change from pops. I.

there’s nothing special about the fact that i’m changing eric’s diaper, but i couldn’t remember ever providing photographic evidence to dispute any lingering suspicions that i might be trying to shirk diaper changing duties.

day 48: diaper change from pops. II.

it’s a bit more tricky to change his diaper these days, since it is seemingly impossible to not get the velcro on the diaper stuck on the shirt before you get all the cords and lines out of the way.

day 48: diaper change from pops. III.

as i change his diaper, it strikes me that as odd to think that some day we’ll actually change his diaper and not have to worry about pulling out IV or feeding lines or detaching sensors.

day 48: diaper change from pops. IV.

it occured to me that i’ve only casually mentioned his intravenous feeding and having discussed at greater length a very important element of how well eric is doing.

day 48: total parenteral nutrition.

so it’s time for a short course in parenteral nutrition, where parenteral refers to food that enters the body through a blood vessel. in what is known as total parenteral nutrition, all of the essentials ( carbohydrates, protein, fat, vitamins and minerals ) are delivered directly through an IV line in one of eric’s veins.

day 48: lipids

despite all the active research that has gone into parenteral nutrition and fact that it’s probably one of the greatest reasons that eric has been able to keep growing despite suffering from pneumonia, i can’t help but feel that the bag of fluids look suspiciously like gatorade and the the syringe surely must be filled with lard and not some state of the art blend of short chain lipids as they claim.

day 48: another feeding

day 48: eric's 16th transfusion

eric received three more transfusions today which brings him to a grand total of 17 thus far. he needed the transfusions because he still has a hard time making new blood as quickly as he breaks it down and they’re talking a lot of samples out to keep close track his immune blood counts while he has pneumonia. we were told today by nurse jan that, if things went as they expected, today’s transfusions would be the last he’s likely to receive during his stay in the nicu!

day 48: checking his lungs

eric’s lungs are sounding so good that it’s not really clear whether they’d still would say that he has pneumonia. in other words, he might just be fully recovered!

day 48: pooh borrows the cap

it’s interesting to note that while we were free to explore giving “directed donations” ( where we give the blood that eric would receive ), we didn’t because it apparently takes so long to process and screen the donations that they often get the donations back after they are no longer needed. also, the screening criteria for neonatal donations is so rigorous ( i.e. can’t have any antibodies for many common ailments ) that it’s often difficult for the parents to pass the screening test. so while the staff would never prevent us from giving blood, they’ve always strongly hinted that it’s easier, safer and faster to just get transfusion from their trusted pool of special neonatal donors.

day 48: ending the day with a little 'roo

because they have to monitor his blood pressure and other vitals closely during the transfusion, there’s no kangaroo care to be had during the process. of course, kris wasn’t going to let let three transfusions get in the way of lots of kangaroo care, so she simply had to time the sessions differently than normal. speaking of timing, while you might think that we can just waltz into the nicu and do the ‘roo, in addition to having to work around the transfusions, we also have to be aware of the nurses rounds which occur every two hours. and it’s also nice to get the kangaroo care in while he’s on the nasal cannula as the cpap mask can have a hard maintaining a good fit while he’s doing the ‘roo. so there’s quite a few “knowns” that we have to deal with in addition to the usual array of “unknowns”, such as getting kicked out abruptly in the evening, just after kris had settled in with eric, to prepare for two new admits.

the eric update – day 45: off the vent! kangaroo care! first shirt! doubled weight!

day 45: the transfer

wowza. so many good things happened today that it’s going to be hard to summarize them into an easy to digest nugget. after eleven long days on the ventilator we were quite surprised ( as were many of the nurses ) that the neonatologists decided that eric was ready to be free of the vent. apparently his right lung looked much better than anticipated after this morning’s x-ray and the doctor’s decided that he was recovered enough from pneumonia to give the cpap a try. woohoo! and you know what that means – we can hold him again! here, nurse peggy is handing him off to kris for a little kangaroo care.

day 45: at long last!  a little 'roo time with mama.

despite getting the great news that he was back on cpap and therefore able to be held, everyone thought that he would only be able to stand small amounts of kangaroo care. nurse peggy watched his stats carefully after the transfer for 5 minutes. then 10. then 15. and 20. until she finally decided that eric was doing better off the vent than on. he did spectacularly for an hour, with not a single alarm, and he was only put back in the radiant warming bed when kris decided that she had to go pump breastmilk. it was quite and accomplishment as he’s still has pneumonia. his breathing was as stable as you could ever want it, which is impressive because babies can sometimes get lazy after being on vent, as the machine does much of the work for them.

day 45: being held by pops.

after an hour of kangaroo care from mama i was able to hold him “regular style” ( i had no idea that he’d go off the vent today so i didn’t wear clothing appropriate for kangaroo care ) for a half an hour. fun! (

day 45: his first shirt. I.

as if all the great news about him getting off the vent and getting kangaroo care wasn’t enough to absorb for one day, nurse peggy announced that he’d be getting his first shirt!

day 45: his first shirt. II.

it’s a sign that his caregivers think that he’s getting more stable than ever, since it means that they aren’t so preoccupied with having to see how mottled or flushed his skin is at any particular moment. i picked a very stylish blue pinstriped top.

day 45:  doubled his birthweight!

and last, but certainly not least, eric hit a big milestone today by officially doubling his birthweight. he weighed in at 1335 grams or 2 pounds 15.1 ounces!

it’s hard to believe that he only needs to gain about an ounce to hit 3 pounds. it seems like just yesterday that we were celebrating the 2 pound milestone. gaining so much weight while fighting pneumonia is an impressive feat.

they grow up so fast!

wow! wow! wow! after eleven days of hardship, it’s really exciting to have to much good news to report.

day 45: measuring his head.

random aside – i realized tonight that i hadn’t got a shot of a ritual that occurs every 3 days – the measuring of eric’s head. since the last measurement, his head grew a half a centimeter and is now 27 centimeters in circumference.

the eric update – day 25: a tantrum and a little perspective.

day 25: the tantrum I.

with eric IV looking quite content much of the time ( except, of course, when his care routine requires that not-so-fun things are done to him ), i found myself wondering when he was having those tantrums that preemies are famous for. sure, he can get worked up sometimes, clenching his fists and thrusting his feet and making little squeaks. but i we’ve never seen a full-blown, let-out-all-the-stops tantrum. not that you want to see a tantrum, but still. and so, with perfect timing, soon after i arrived this evening, eric decided that something was not right ( of course, it couldn’t have been my voice. no, certainly it wasn’t that ) and started trying to launch himself right out of the bed. and the screaming. if there was any doubt, him pipes are developing well. this went on for about a minute and no amount of consolation from me or kris was helping one iota.

day 25: the tantrum II.

that’s when nurse jan decided it was time to bring in the passifier, because if he has a tantrum for too long then he’ll stop breathing and that’s no good.

day 25:  big hand.  little hand.

the only problem is that he doesn’t really know how to suck on the passifier and breath at the same time, so it’s a delicate balance. eventually, he figures it out and i rest my hand on him, which helps a little too, i guess.

day 25:  postcards

the postcards have started coming in! i’m not sure the nurses believed me when i told them that he was going to start getting cards from all over the world. we’ve just received a few so far, but is suspect they’ll be trickling in for awhile. we were very touched by the kind story from a nice person we don’t know who hails from santa clarita, california. it’s going to be hard to maintain my cynical side if people keep up with such random acts of kindness.

day 25: more 'roo

kris is continuing with her record setting ‘roo sessions. she might do two sessions a day at about 2 or 3 hours apiece ( i bet she’d go longer, but that’s the longest she can go before she has to “pump” ). as i said yesterday, there are many factors involved in how well eric is doing, but i really think all the kangaroo care is big factor. we’re fantastically fortunate that kris can spend so much time in the nicu. she teaches at the local college and has the summer off, so she can spend as much time as she likes with eric. and of course, she likes to spend a lot of time with him ( not that i don’t, silly. you know what i mean. ).

day 25: bearer of the ring

ahhhhhh. it’s the ol’, “put your wedding ring on his diaper to give a sense of perspective” trick. with all the close-ups, it’s easy to forget just how small he still remains ( although he has grown 3.5 inches centimeters ( arrgggh. there’s a big difference between inches in centimeters. i think 3.5 cm is a little over an inch. ) since birth. yeah!).

the eric update – day 20: full feeder!

day 20: full feeder!

as his nurse donna said today, eric enjoys making a liar out of her. just yesterday she said that it would be a few days before they discontinued his IV drip and had him solely on breastmilk. but today when we arrived at the nicu we found him sans his IV lines and taking in 5.2 cc’s of milk an hour!

as soon as we stood over his bed, he opened his eyes and made this gesture as if to say, “geee. it’s so nice to wake up and see you again.” or at least that’s what we’d like think think he was saying 🙂

the best part of getting “full feeds” is that he’s had two IV lines removed. one of them, the peripheral intravenous cardiac catheter (PICC), was causing the bulbous thing earlier in the week so it’s nice to have that gone. they also removed an arterial line from his foot.

day 20: snug as a bug

as an added bonus, removing the lines makes it much easier to move him around during kangaroo care.

day 20: beating the wrap

occasionally, when he’s getting feisty, he’ll push his feet against the plastic wrap that covers his bed which is meant to help keep the heat in.

this is probably one of the toughest photos i’ve shot as the light levels are very low so i have to have a slow shutter speed and and the auto focus wouldn’t work due to the diffuse and wierd light coming off the plastic wrap. if i were a better photographer, i would have been able to capture the times that he rammed his foot so hard into the wrap that it looked like he was going to break through it.

incidentally, i’ve been under the delusion that the plastic wrap was probably some sort of hospital grade super magical polymer. eventually i noticed the large rolls that the staff has delivered from the local restaurant distributer.