Eleven Years!

Oliver holding Mommy's thumb (8/11/12)

Today is going to be a jam packed day. Paul and the kids are coming for my discharge, and Nadia will get to meet Oliver. Ian isn't allowed in the NICU because he's less than 3 years old. I'm excited about going home for a day. The last time I slept in my own bed was July 3. It's very bittersweet. It's going to be hard leaving Oliver behind. When Ian and Nadia were in the NICU, I never went home until they were discharged, but they were each in the NICU for less than 2 weeks. It's a different story this time since Oliver will likely be in the NICU for 6 weeks. Yesterday I was talking with another antepartum mom, and her son was born at 29 weeks, but he never needed to go on the ventilator. My kids seem to have more lung troubles at birth than the average preemie as even Nadia (36w) had to be on a CPAP for a bit. Oliver's lung troubles are MUCH worse than Ian's. Ian had respiratory distress syndrome. The two main reasons why I want to go home are #1 Nadia's first musical performance is this evening (the second will be tomorrow night) and #2 today is our 11th anniversary. The gift I am desiring the most today is hugs and kisses from Paul, Nadia, and Ian and to hold Oliver for the first time. I just hope that can happen without the kids bumping my very tender belly too much. A former graduate assistant, whom I haven't seen in four years as she teaches in Boston, has been in in the area for a brief visit this week. She met Nadia, but both of us had a son in 2009. I have had to miss many special things (such as seeing Dan and meeting her son, Ray) this summer, but I won't be missing Nadia's first time singing in a church choir.

We haven't been on a date since May. I had made babysitting arrangements for a date in June (Father's Day weekend), but those had to be cancelled due to me being on bed rest. Usually we try to go out once a month.  Depending on when Oliver is discharged, we'll either go on our belated anniversary date in September or October. I'm assuming we'll be taking Oliver with us on the date so I can nurse him. In the hospital I couldn't buy Paul a card much less a gift. I did send him an anniversary e-card yesterday. Last year we considered going on an overnight date for our 10th anniversary. Ironically, I wasn't sure about leaving the kids. I had never had a night away from both kids since Nadia was born. The only time I had been away from her was when Ian was in the NICU. After this unpleasant lengthy separation this summer, I think a couple of days away with Paul in a more pleasant place (not a hospital!) sounds very appealing at some point in the future. We won't be able to celebrate the way we usually do, but by going home at least I'll get a lot more time with my husband on our anniversary. If I had a choice, I would pick to be separated from my husband and miss Nadia's musical if it meant Oliver was still in my womb, but at least there's a perk to his early arrival - I don't have to miss her first musical like I missed her first ballet recital on June 2. Although this anniversary isn't going to go down as one of my favorites, I'm very grateful that we're starting our 12th year of marriage as a family of five! I'm also excited that in 4 months Paul should be graduating. He's been a full-time student since January 2006. I was the primary breadwinner during the first 11 years of marriage, but in the near future Paul should be taking on that role for the first time.

Leaving the hospital means I can eat that brownie sundae I've been dreaming about for months, and I can try on clothes to see if any of my non-maternity pants fit yet. I am definitely not bringing shorts as some parts of this hospital are down right freezing (I saw one thermostat was set at 67 degrees yesterday). I also need to bring back a wallet so I can buy myself food, a boppy pillow for when he's allowed to start nursing, a nursing cover, some preemie clothing (as I read in the NICU handbook that they do allow the babies to wear clothing from home so it must vary from nurse to nurse), and another lens for my camera. I'm not going to bring many books because I haven't been reading much lately and books would be heavy for me to lug around if I can't stay at the Bailey House for too many nights in a row. I'm also planning to give Paul a long overdue haircut this evening and do Nadia's overdue birthday interview.

Every time the minor league baseball team (Harrisburg Senators) has a home game, they have fireworks at the end. The stadium is right across the river from the hospital. I watched the fireworks a couple of times from my antepartum unit room, and last night I watched them from my maternity unit room. It was a nice way to end my marathon stay as a patient here. I only filled out a breakfast menu for today as I was assuming I'd be discharged before lunch was served. As a fitting end to my stay here, they goofed up part of my tray. I asked for a banana, but I was given prune juice instead. I also was given 2% milk although I always requested either skim or 1%. I asked for a chocolate chip muffin and was given a banana nut muffin instead. It almost made me laugh. They don't have a kitchen (beyond a microwave and refrigerator) at the Bailey House so we shall see what I'll be eating in the coming weeks.

Paul's parents watched the kids Monday through Wednesday, a woman (Jocelyn) who goes to our church and is a student in my department watched the kids on Thursday, and another woman from church (was an elementary school teacher until she became a SAHM) who has a one year old son watched the kids on Friday. Jocelyn wrote me an email on Thursday night that really touched me. In part of it she said, "I wanted to let you know how much I enjoyed watching Nadia and Ian today! I have never watched such well-behaved, polite, happy children. They were both very good for me." Music to this Momma's ears! Next week they'll go back to Jocyeln's house on Monday, stay at our house on Tuesday and Wednesday as my mom plans to come up, and go to Paul's parents' house on Thursday and Friday. I eagerly anticipate the day when I don't need to make any more babysitting arrangements because I'll be the one caring for my three children at home. Hopefully we'll be home in 39 days (when he'll reach what would have been 38w), if not sooner.

Today is a big day for Oliver also. The night nurse told me I might be able to hold him around 8am this morning. I went down at 8:15 (before eating breakfast even though it had just been delivered), and I found out then that I won't be able to hold him until later today. I ended up being there for rounds, although that was not my intention. It went better today as I now understand a bit more of the lingo and also the doctor doing the rounds today had a more cheerful disposition about everything so it wasn't nearly as overwhelming as it was yesterday. His bilirubin count has stayed about the same so he'll continue to stay under two lights. They are going to take him off the ventilator this morning and try to put him on vapo therm. If that doesn't work, they will try either SiPAP or CPAP. This doctor didn't think anything of what showed up on his brains scan although they will repeat it on the 21st. She doesn't think it's anything serious. What a relief as the words "brain" and "bleed" are not two that you want to hear put together regarding your baby. They are moving him to an isolette today as well. It's a big day for Oliver! Hopefully everything will go smoothly, and he won't have to be intubated again as he's about to extubate himself if they don't do it asap. I did learn through attending the rounds today that his hypospadias is worse than Ian's was. The location is much farther down (grade 3). Grade 4 is the worst type, so he doesn't have the most severe grade.

By the numbers

As for my last full day in the hospital as a patient, it was a day of highs and lows both physically and emotionally. Physically, I pushed myself and walked to and from the NICU 3 times, and it's on the 8th floor. It was not a small task. The first time I was in tears by the time I got there due to the pain as well as the fact I had trouble finding it as the nurses and aides take a shorter route. I had never gone the public route before, and I assume for security reasons they don't have any signs.
The first time I went was during the morning rounds. When the doctors did the rounds in the other NICU, parents were the only visitors allowed in the NICU, and we had to wear headphones (attached to a CD player). The funny thing was that about 75% of the time the batteries were dead so we parents weren't actually listening to music. This policy was to protect the privacy. We were only to take the headphones off when the doctors were visiting our child. In contrast to the policy at this hospital, I greatly prefer that policy. At this hospital no parents are allowed in the NICU while the doctors do the rounds except you can be with your child while they are talking about your child. I lifted the phone and told the nurse at the nurse's station that I was waiting in the waiting room to listen to the doctors when they did rounds at Oliver's bed side. After waiting awhile, his nurse (Joey) came and got me. I can't walk very quickly yet, and they started their discussion before his nurse and I returned (which frustrated me as I been waiting for more than 30 minutes in the waiting room). It went downhill from there. They were using all the abbreviations and medical terminology, which meant nothing to me. It was all I could do not to have a total meltdown as things didn't sound very good. They asked at the end if I had any questions. I said "no" only because I had WAY too many questions and knew I was about to lose it emotionally. I did grasp that his bilirubin count had gone down a little so Joey asked if they could take him off the Wallaby (which she said is like sleeping on a board). The doctors approved this change. He was still under two lights today, but he was able to sleep on a more comfortable surface, which meant he didn't need Versed to stay calm. I also understood that because of the sounds they hear when they listen to his bowels, he still can only be fed 1ml of my milk every 6 hours. If he had sounded better, they would have started feeding him 1ml every 3 hours. Both sides are cooperating now so each time I pump I've been getting 10-25ml, and he's consuming 4ml a day so they froze a lot of milk today. The information that had to do with his face, heart, and lungs was upsetting and confusing.

The second time I visited him, his nurse was taking out his arterial line. WOOHOO! I was so excited because that was the first thing that had to happen for me to be able to hold him. I wasn't given permission to hold him today (the last time I asked was at 9:50pm). She said to check again at 8am tomorrow. I cannot wait. It's so hard to give birth and then not be able to cuddle with your baby. My boy needs to be loved by his Mommy!!! My second and third trips to the NICU I brought my camera in the hopes the nurse would be snapping a photo of him in my arms. I didn't take any pictures of him today.

The swelling has been a lot worse today. I no longer have any ankles. My thighs, legs, ankles and feet are swollen. Hopefully I'll be able to get my sandals on tomorrow. I never swell when pregnant, but I always swell like a balloon (legs/feet) after giving birth. The last two times the water weight was about 10 pounds. I was far more mobile today, but then this evening the pain level skyrocketed back to what it was the first day after the c-section. I might end up sleeping in the glider tonight because I have trouble pumping in the bed, and I don't want to have to get in and out of the bed many times if it's going to be that painful. The pumping has gone well. That is a boost for me emotionally. The insurance said they'll pay 100% of the rental costs for the pump while he's in the NICU (it's just $60 a month) so I have a Medela Symphony pump to use at home and at the Bailey House. When I'm in the NICU I'll use the pumps they have down there.

They did another echocardiogram today, and the results were favorable. Something that is supposed to be open in the heart while in the womb but closed after birth had still been open at the first echocardiogram, but between then and now it had closed. PTL! Also his heart looked a little better. It's hard for me to explain the problems although a NICU doctor did break it down into layman's terms for me this afternoon. I have decided to skip the rounds in the future. I'd much prefer a one-on-one conversation with the doctor. As for his lungs, he still has "issues." He's still on the ventilator, and he's breathing about 25% oxygen (room air is 21%). They are erring on the side of too much oxygen, even though it might be damaging his eyesight (he might need glasses at a very young age) as being able to breathe is more important.

I asked the resident today about my incision because it seems to be horizontal. She said that the incision of the uterus was vertical, but the incision of my skin was horizontal. I was told this means I definitely can never do VBAC. I don't think that would have been an option anyhow since I've now had 3 c-sections. With my first two the doctors used staples, but this time they used stitches, which they say will fall out on their own. I have an appointment next Thursday for them to check the incision. I'm anxious to hear tomorrow at discharge when I'll be allowed to drive again. I am anxious to get some independence back!!! I haven't driven a car since May 29.

I did better emotionally this afternoon (translated I didn't cry as much). I had lunch in the antepartum unit, and I spent about 2 hours talking with some of those ladies, which was nice. My friend, Cheri, also called me on the phone, which was also an encouragement. As for the issues with his face, they were concerned that his round face was a sign of some chromosomal problem. I said he looks just like his Dad and sister, who both have round faces. Hopefully when they see Nadia and Paul tomorrow they'll agree with me. He has lost a little weight, but they said that's a good sign (losing some excess fluid). His weight this evening was 3lb 11.6 oz.

Since I'm being discharged tomorrow morning, I thought I'd do a bit of a numerical recap of the pregnancy. I wish I had kept track of how many books I read and how many ultrasounds I had. Both numbers would be rather high!

1 - time under general anesthesia
1 - time given Phenergan for nausea (never want that again - Zofran is much better)
1 - epidural blood patch
1 - pregnancy ultrasound with RE (at 8 weeks)
2 - packages delivered to me at the hospital (books from Lin)
2 - oral medications taken to prevent contractions (Indocen and Procardia)
2 - hours a day of fetal and contraction monitoring when in the antepartum unit
2 - nights spent at Paul's aunt's house during the pregnancy
2 - blastocysts transferred
3 - times hCG bloodwork drawn at RE
3 - MFM doctors (plus 2 fellows)
3 - flower arrangements received (from Janet, Debbie, and my church)
3 - nights spent at Paul's parents' house during the pregnancy
3 - times a day vitals taken in antepartum and maternity units
3 - baby gifts received in the hospital (from Wendy, Brooke, and Debbie)
4 - hospitals (Geisinger, Evangelical, Hershey, and Harrisburg)
4 - Rhogam shots this pregnancy (all of our kids are O positive, and I'm O negative)
4 - lumbar punctures (3 epidural and 1 spinal)
4 - blastocysts (2 were transferred and 1 was frozen)
5 - days past egg retrieval when embryo transfer took place
5 - popsicles consumed a few hours after giving birth
5 - transfusions (I had one prior to the c-section, and Oliver had two before birth and two in the NICU)
6 - big bleeding episodes (first was on May 30 and last was on August 7)
7 - discharges from the hospital (first on May 31 and last on August 11)
7 - day of his birth (due on the 3rd)
8 - month of his birth (due in October)
8 - embryos as of January 12, 2012
8 - hours of pitocin after c-section (contractions and an incision are not a good mix!)
9 - weeks of wearing compression socks
9.5- hours I had wait after giving birth before I was able to visit Oliver
10 - people who were in the car during trips to the hospital in Harrisburg (Paul, Nadia, Ian, Paul's parents, my mom, Rosalie, Bob, Cheri, and Aunt Debbie)
10 - weeks of bedrest (minus one day)
10 - IV tubes inserted in my arms (on May 30-31 and August 7-8 I had two at one time)
10 - first OB appointment at 10w2d
10 - passed the three hour glucose tolerance test at 10w5d
11 - children visited me in the hospital (1 cousin, 3 nieces, 1 daughter, 1 son, and 5 nephews)
11 - eggs retrieved on January 11, 2012
12- hospital rooms (at least one night)
12 - first +++ pregnancy test at 12 days past egg retrieval
13 - P17 shots
13 - first +++ Beta at 13 days past egg retrieval
14 - people played Words with Friends with me (Scrabble) on Facebook while I was in the hospital
14 - weeks I had appointments with MFM doctors (18-31)
15 - how many ounces (plus 3 lbs) that Oliver weighed at birth
16 - inches at birth
16 - adults visited me in the hospital
18 - found out Oliver was a boy at 18 weeks at my first MFM appointment
19 - third and last OB appointment at 19 weeks
20 - nights spent at the Ronald McDonald House in Hershey during the pregnancy
20 - approximate number of pounds I gained during the pregnancy. I can't be 100% certain because July 25 was the last time I was weighed at the hospital (with clothes on right after a shower), and I had previously been tracking my weight without clothing on my own bathroom scale.
22 - hospitalizations and bedrest began at 22w0d
24 - first pair of steroid shots around 24 weeks
24 - hours a day of fetal and contraction monitoring when in the labor and delivery unit
26 - name decided at 26 weeks (Paul suggested the first name, and I suggested the middle name)
28 - second pair of steroid shots at 28 weeks
30 - weeks (plus 4 days) the last time a belly pic was taken
31 - weeks pregnant when he was born (plus 6 days)
40 - my age when I gave birth
45 - hours after Oliver was born that my milk came in (not counting the colostrum I had from the first time I pumped)
46 - days in the hospital (Ruth)
54.5 - first hCG level (at 3w6d)
58 - people clicked "like" on the Facebook status update I wrote about Oliver's birth (some of those also wrote a comment)
64 - people wrote a comment on the Facebook status update I wrote about Oliver's birth (some of those also clicked "like")
167.7 - second hCG level (at 4w1d)
351 - third hCG level (at 4w3d)

Third Day

Last night they gave Oliver another transfusion, but they determined I didn't need a second transfusion so they removed my second iv tube last night. They thought I might be a bit light lightheaded because of my levels, but I am not. I wish with all my heart that Oliver was inside me and had a fetal transfusion yesterday instead of one in the NICU. His bilirubin count has leveled off so they are only checking it once a day now. He still has two lights above him and one under him. I turned this picture to black/white because otherwise everything is blue from the lights. After my morning dose of Toradol, they took out my other iv tube that had been in since 5am on Friday morning. They switched me to oral ibuprofen. I also have taken a couple of doses of Percocet. I've been moving around a LOT more today. Last night it was a huge struggle to get in or out of bed, and now I can do it on my own. The NICU is on the 8th floor, and I'm on the 9th floor so I've still been going down by wheelchair. This morning I cried an awful lot. It's hard staying in the maternity unit because I often hear babies crying, and that often brings tears to my eyes as I wish Oliver was in the room with me. The only time I've experience a baby in the room with me was in January 2010 when I had the D&C when Ian was 5 weeks old. I'm sure all the hormones in my body aren't helping. Up until this morning I had kept myself together when I was out of my room, but this morning I lost it while waiting for an elevator as I watched a woman being discharged with her baby. I've never experienced that. I know once he's home it won't matter that he was discharged 6 weeks after I was, but it's hard right now.

I got myself together and then when they wheeled me into his NICU pod, and I saw they were doing an x-ray on him, the tears started flowing again. He's only 3 days old and has already had more xrays than Nadia has had over the past 4 years of life. They were adjusting his PICC line again. He was rather upset from the x-ray so the nurse gave him more Versed. They need him to be calm or all his numbers go out of whack. They removed his venus line, but his arterial line is still in place so I can't hold him yet, but the upside is that they aren't pricking him yet when they have to draw blood, which is a good thing. It didn't help that when I got back from the NICU the lunch tray in my room contained foods I really didn't want to eat. The hostess this morning told me that in this unit you can't order from the cafe. I had filled out my menus on Sunday while I was still in the antepartum unit. Yesterday's hostess did bring me food from the cafe. I said if that's the case why wasn't I given a menu yesterday so that I could at least pick which hospital food was brought to my room today. I told my nurse I'd just eat cereal for lunch, but she must have said something because the hostess then did bring what I had requested. I did fill out a new menu for tomorrow so hopefully that will go smoother tomorrow.  At dinner they again brought me a meal I never would have picked, but I ate part of it and didn't say anything in part because Oliver met his 4th family member today (first he met Paul and my mom and then me and today Paul's aunt Debbie), and she brought me some food.

I brought my camera down to the NICU this morning, but I didn't bring it this afternoon. I wish I had so I would have a picture of Oliver and Aunt Debbie on his 3rd day of life outside the womb. It was a very pleasant surprise. She brought Oliver a pacifier, Ian a puzzle, Nadia a pair of pink shoes, and three chocolate baked goodies for me. It really was a big boost to my spirits to have a visitor today.

The highlight of my day was when I noticed I was producing a few drops of milk when I was pumping at 1am.  I had gotten colostrum every time I pumped, but it was never enough to collect into a syringe. I felt badly because I know who wonderful colostrum is for babies, and none of my three kids ever got any colostrum (even though my body produced some each time). When I pumped at 9am, it was enough to put some in a syringe. It wasn't much, but they are only giving him a tiny bit at each feeding anyhow so it was enough. I didn't get much the next time I pumped, but then the time after that I got quite a bit more (enough for several feedings). I was proud to deliver those syringes to the NICU. At the 5pm pumping I just gave the syringe to the nurse, and she delivered it to the NICU for me. I gave them what will be a few days worth of milk for Oliver even though it wasn't much. So far I am still only getting drops from the right side. Hopefully that side will kick into gear soon as the left side is the only side giving me enough to put in a syringe right now. It feels great to do that though as it makes me feel like I'm doing something for Oliver whereas mostly I feel completely helpless since I can't even hold him.

I also was able to make a reservation at the Bailey House for Sunday night. I was told I need to arrive around noon as the woman who works there will be going to church in the morning and a 50th birthday party for a family member in the afternoon.  I'm looking forward to sleeping in my own bed on Saturday night for the first time since July 3. Hopefully I'll be able to stay at the Bailey House for several days. I plan on sleeping there all night until Oliver is able to nurse, but I will pump during the night no matter where I am sleeping. The hospital is sending me with a rental pump so we don't have to stop and buy one on Saturday. Regina, you are right about not needing clothes for Oliver for a few weeks. Ian and Nadia were allowed to wear clothing after their time under the blue lights ended, and although that hospital did have clothing available, we were allowed to bring in our own clothing if we wanted. It turns out that they don't allow you to bring in clothing at this NICU. I was bummed about that. I'll have to wait until he is discharged to dress him in his own clothing. I still think he'll be in preemie size clothing longer than they were so I probably will buy a little bit more preemie size clothing for him. I think I'll shop on eBay this weekend while I'm at home since I can't shop here at the hospital. Maybe I'll be able to shop online at the Bailey House?

Tonight is the last night of my class. I am trying to finish grading this evening. I'm almost done. Would you believe this will be the THIRD time in my life when I'll be submitting grades online to the Registrar while I have a baby in the NICU? What are the odds??? Nadia was due July 20th, which was during the 2nd summer session of 2008. I wasn't scheduled to teach any classes during the 2nd summer session. I was teaching during the first summer session, which ended the end of June. My water broke a couple of hours after I taught the next to last class of that session. I finished the grading in the hospital. Ian was due on January 20, which would have been at the very start of the spring 2010 semester. He was born on December 12, 2009. I didn't miss any classes, but others had to proctor my exams during final exam week (and they brought them to the hospital). I sat in the NICU grading exams and submitted grades to the Registrar from the NICU a second time. Oliver was due October 3, in the early part of the fall 2012 semester. However, he came the last week of the 2nd summer session (grades are due by next Wednesday) so here I am in the hospital once again submitting grades to the Registrar. At least technology makes it possible for me to keep doing my job even though I haven't driven a car since May 29.

I'm hoping that tomorrow Oliver might be able to go back on the SiPAP. We shall see. He's still on the ventilator now.

The rollercoaster ride begins

Yesterday for the first several hours they only let me have clear liquids. I had two containers of jello, five popsicles, water, and cranberry juice. Then they let me have some pretzels and dry cereal. At dinner (12.5 hours after he was born), they let me eat "real" food. They hadn't located my menus, but I was fine with the "house" diet yesterday of spaghetti with meatballs, a breadstick, veggies, and pears. Later in the evening I asked for some chocolate ice cream. They were out of chocolate, but I did have a little container of vanilla ice cream. Paul ate my breakfast and lunch trays yesterday since I was on a clear liquid diet. They found my menus, and this morning I got what I had ordered. I love the egg and cheese bagel that they make in the cafe as well as the fruit and yogurt parfait. I wish I had known several weeks ago that we could order from the cafe. Better late than never. I'll be eating in the cafe for several more weeks, but I'll have to start paying for my food after I'm discharged. I can continue to join the antepartum ladies for lunch on Fridays as an "alum." The only change I wish I could make to those menus I filled out would be to ask for some of the chocolate desserts. I filled them out assuming I would be pregnant the whole week. The woman who is the hostess for both the antepartum unit and labor and delivery called me on the phone this morning! I was really touched because she is on vacation this week. The hostess for the maternity unit told her that I had given birth. This shows how much she cares about the patients she serves.

I am planning to go home on Saturday so I can attend Nadia's musical, and I already told Paul I want to stop at a Friendly's on the way home and share a brownie sundae with Nadia. I can't remember the last time I went this many months without eating a brownie! I wish Oliver was still in my womb, but one perk of his early arrival is that my days of having heartburn have ended sooner than expected! I had been taking Pepcid every 12 hours lately, and sometimes that wasn't enough. One thing that's different about the food service in this unit compared with the other 3 units I've been in here is that they give you "real" (not plastic) silverware with each meal.

Around 8:00am they unhooked me from the IV, which meant the morphine ended. Now I'm allowed to have Percocet if I want it. I had one so far. After breakfast, they removed the catheter. They were going to take it out last night, but I asked if we could wait until the iv was unhooked because I have to go to the bathroom SO frequently when I'm on an iv, and getting out bed isn't easy right after a c-section. I still have the iv tubes in both arms, but they told me I won't be needing another transfusion - just iron for anemia.

I called the insurance to see if they would pay for Oliver to be transported to Geisinger, and they won't because it's not medically necessary. If he needed to go to Hershey, they would pay for that because Hershey is a level 3C NICU, but Geisinger is at the same exact level (3B) as this one so they won't pay, and it's very expensive to transport him by ambulance (at least $2,000). They don't have a Ronald McDonald House here in Harrisburg. They have a "Bailey House" but evidently you can only stay there for 2-3 nights at a time. It's not meant for long term stays. I put in a call to see if they have any availability starting on Sunday night. I am torn what to do. I should be able to start holding him by the end of the week, and I know "kangaroo care" (skin to skin contact) is very beneficial for the baby (and something I am greatly desiring as well). Once he is able to nurse, I will definitely want to be nearby as I'll want to nurse him every 3 hours round the clock. Of course I miss Nadia and Ian also, so I feel torn during this time when I can't yet nurse Oliver, yet I don't want to leave him all by himself (no family near by). Once I'm nursing him I might just go the "homeless" route again and sleep in the lounge in between feedings. I did that with Ian. At this hospital once the child is able to drink from a bottle, they won't agree to keeping in the NG tube like they would do at Geisinger if a parent requested. I'm really hoping that once they deem him capable of drinking from a bottle that he'll be able to nurse so we can skip the bottle sage.

The first time I went to the NICU today I brought my camera, but I forgot my memory card so that didn't do any good. I did remember the second time to bring the camera and card, but I wish I had remembered the first time because he was on the SiPAP and at one point the nurse took everything off his head/face so I wish I had been able to snap a photo. His hair is darker than I expected based on what the first NICU doctor told me when I was in the recovery room (she called his hair "light"). Both Ian and Nadia were born with dark brown hair. That hair fell out and the new hair was blonde. We shall see if the same happens with Oliver. With everything off his face, I thought he definitely resembled Paul/Nadia far more than Ian/me. Shannon (one of his NICU nurses) has a 1 year old son named Oliver (his twin's name is Wyatt) so she has no trouble remembering my son's name! The NICU here is far less noisy than the one at Geisinger, and the doctors spend FAR more time interacting with the parents. At GMC I was lucky if I got even 4 minutes a day with a doctor whereas here they have gone out of their way to seek me out (even come up to my hopsital room twice today). Every time I've been in the NICU a doctor has come and talked to me at his bedside. That's really nice. Their enrollment is low at the moment so Oliver has his own private nurse.

The medical challenges of the day included having a PICC line put in (which they had to reposition three times -they kept doing xrays to make sure it wasn't going into his heart) as well as going from the SiPAP back to the ventilator because he has pulmonary hyptertension. There also is something in his heart that's supposed to close after birth that is still open, but they're going to leave that be for now in the hopes it will close on its own. They also gave him his second surfactant treatment. Also, in his brain he either has a small cyst or has the remnants of a small brain bleed. Needless to say all this information was overwhelming, especially as I don't have a medical background and couldn't understand everything albeit they were definitely trying to describe things in layman's terms. On top of that, my legs/feet have started to swell. I knew that was coming from prior experience, but it's still very uncomfortable, and they ripped the big bandage off my belly today which hurt a lot. Plus pumping is painful at this stage of the game, and it feels pointless (although I know it's not) since my milk hasn't come in yet. Once that becomes less painful and seems more productive, that will be a big encouragement. They are processing the paperwork so the insurance will pay for me to rent a pump from the hospital, which is nice as I sold my Pump in Style that I bought in 2004 at a yard sale in 2011. More than anything, I want to hold Oliver. At the most I should have to wait six more days to hold him, and I probably won't have to wait that long. I know once I hold him it means they'll have to start pricking his heels for all his bloodwork. I do see the advantage of the arterial line. He kept getting pretty worked up every time they did something (x-ray, echocardiogram, etc.) so they gave him a sedative to calm him down (the same one - Versed, that they gave Ian prior to his first two surgeries). I feel badly that Oliver's entrance into the world has to be so stressful. It pains me to watch him cry and not be able to comfort him. My poor little boy. I know he's not a micro preemie, but at 3 pounds he still seems very small. I wish I could hit a fast forward button and arrive at the point when we're all home as a family of five. We have some preemie clothing at home since that's what Nadia and Ian started in, but I'm thinking I might need to buy some smaller size preemie clothing for a 3 pounder as my other two never dropped below 5 pounds.

P.S. The pictures of Ian, Nadia, and my sister Yvonne and her family were taken by my sister Wendy.

Oliver's First Day

Yesterday around 3:35am I woke up in a pool of blood. The nurses came immediately and started the process of taking off my bloody clothes, putting me on the monitors, and calling the doctor. Within a few minutes they were taking me (by bed) down to the Labor and Delivery unit. The bleeding was pretty bad this time, and it didn't seem to be stopping. On top of that, I went into labor. The contractions were one on top of each other, and I had that pressure feeling you get when the baby's head is almost ready to come out.

They did a speculum exam. They were trying to see the condition of the cervix, but they couldn't swab the blood and clots up fast enough. They never did visualize the cervix because there was too much blood. I was ever so glad when the speculum came out. I figured out at 3:50 that they were going to deliver Oliver because they started shaving my belly, putting in a catheter, etc. I called Paul and my mom. Paul arrived at 5:30 when I was in the recovery room, and my mom arrived at 6:00am when I was being wheeled from the recovery room to the maternity unit on the 9th floor.

Because it was an emergency c-section, they gave me general anesthesia, and Dr. Taboada told me she was going to do a vertical incision because she could get the baby out faster that way. I had horizontal incisions with my other two c-sections. I can tell that she did take out the whole placenta this time because after I had Ian I still had heartburn, and last night I ate spaghetti without getting heartburn. I also had a miniature piece of chocolate. It tasted heavenly as I haven't had chocolate in months. Before I went into the operating room they had put in a second iv tube so they could give me a transfusion. I was given blood before they even started the c-section. They drew more blood this morning to see if I might need another transfusion today. When I first started bleeding I had no idea they would be delivering Oliver. I figured it would be the same as the previous times, but it wasn't. With Ian and Nadia I had a belly pic taken after my water broke, but with Oliver my last belly pic was taken 8 days before he was born.

Four days before he was born they estimated he weighed 4lb 2oz, but at birth (4:22am) he weighed 3lb 15.5 oz. He is 16 inches long. We got at least one picture of Nadia and Ian before they were hooked up with wires and tubes, but since he wasn't breathing at all in the delivery room, we don't have any such pictures of Oliver. He was on a ventilator for less than 24 hours as they switched him to a SiPAP machine during the night last night. If he continues to progress, the next step would be a CPAP machine. Ian and Nadia were both on the CPAP machine during their NICU stays. We were wishing he would wait a few more weeks to be born, but we are very grateful for the almost 10 extra weeks he had in the womb. Paul and my mom got to go see him for the first time about 4 hours after he was born. They went back a second time about 3 hours later prior to my mom's departure. Paul stayed here with me for 11.5 hours yesterday. He was in the NICU three times as he also went when I got to meet Oliver for the first time (about 9.5 hours after he was born). I was very pleased with how easily I made the transfer from the bed to the wheelchair as the transfer from the delivery room bed to the bed in my room had been excruciating earlier in the day. I timed my visit to the NICU with a dosage of Toradol that I have been getting every 6 hours. I also have been getting morphene by iv.

He'll probably be in the NICU for about 4-6 weeks. His blood sugar was low at first. They gave him a transfusion yesterday. He might need additional transfusions in the days and weeks to come. They also were contemplating replacing some of his blood, but his bilirubin count didn't go up too much yesterday so they've held off on that. He has the lights above him and also is lying on a wallaby blanket. He has hypospadius (same urological problem that Ian had). Paul didn't have it, but my brother and his brother both did have it. I can't wait to hold him. It feels a bit surreal until you can hold your baby. I won't be able to hold him until his arterial line comes out, which they say will likely happen sometime over the next 2-7 days. One advantage of the arterial line is that his poor little feet are being spared from lots of pricks. I had hoped to avoid the NICU this third time around, but in the grand scheme of life I know it's not a big deal. Just as was true of the 10 weeks (minus one day) of bed rest, this too shall pass. At some point we might ask for him to be transferred to the NICU at Geisinger, which is much closer to our house. I would much rather be nursing than pumping, but I don't have a choice. I started pumping about 8 hours after he was born, and I've done 20 minute pumping sessions every 2-3 hours since then. They haven't started feeding him yet. I'm hoping my milk comes in before it's time for them to start feeding him by tube.

Transfusion on Wednesday

Last night I bled a little bit. It was a small enough amount that I didn't get moved to the 8th floor, but it was more than just "spotting". The last time that happened was Thursday night before I went to bed, and then by 5am Friday morning I was bleeding a lot. Needless to say, I didn't sleep well last night as I kept expecting to wake up in a pool of blood again. The longest amount of time that has passed between a small bleed and a large one has been about 36 hours so I think I'll feel less nervous if I make it until tomorrow morning without hemmorhaging again. My contractions have also been worse lately. When I was on the monitor Saturday night, I had 4 contractions in an hour, which warranted a call to the doctor. Typically I only have 1-2 contractions an hour. Yesterday and today the contractions have been VERY painful; they have felt the same as when I was in labor with Ian and Nadia. Mostly they've still been pretty spread apart, but at one point this morning I had 3 within 30 minutes.

One of the fellows (there are two) said this morning that they might have to put me on magnesium to stop the contractions. That is given by iv 24 hours a day so I asked if we could try upping the dosage or frequency of the Procardia first. They started me at 20mg every 6 hours, and I've been at 10mg every 8 hours lately. Of course I'll do the iv if it will help Oliver stay inside me until at least 35w, but I'm hoping it's not necessary. Dr. Tressler wasn't here today, but they reviewed today's ultrasound results with him since he's the one who does the transfusions. They have scheduled me to have one more ultrasound tomorrow to confirm the decision to do the third (and final) transfusion on Wednesday. Dr. Taboada commented that she was happy to see me smiling. I was smiling when I heard that it was scheduled for 11am. WOOHOO! The last two have taken place at 4pm and 5pm, and it's really hard to fast all day. I hope it really does take place at 11am. These three beautiful pictures were taken by my very talented sister, Wendy. I'll share three more of the pics she took tomorrow!

Ups and Downs

31w2d

It feels like 2012 is the year of hospitals (April at Hershey Medical and from May 30 to probably early September in Harrisburg) and health insurance issues. Not counting the $518 we paid Geisinger for one ultrasound I had in February, we are currently trying to appeal $5,437.12 worth of labwork that the insurance initially refused to pay for because it isn't covered under our maternity benefits. Hopefully the MFM office will be able to convince them that these tests were "medically necessary." They also haven't paid for any of the MFM office visits, but those they didn't officially reject. They just said they couldn't process them until they received all my OB/prenatal records (including all ultrasounds). Hopefully they'll end up paying most (if not all) of these bills. It could be worse though. They have paid tens of thousands of dollars for my hospitalizations in May and June.

Blue Shield took over on July 1, and I am confident we won't have any hassles over bills from that time forward. Last Saturday when I looked at my most recent paycheck, I noticed that they had deducted $392.82 for our Blue Shield insurance. The deductions are made every two weeks. That would be a LOT of money to pay each month for health insurance! I questioned someone in HR, and she got back to me on Tuesday and said it had been a mistake. They were supposed to take out $102.47 per pay (big difference!). That was a big relief.
I had five visitors today! My cousin, Brooke, was traveling from Philadelphia to Pittsburgh today, and she stopped in with one of her sons (Fletcher) to visit me for a little bit. They again gave her a bit of grief about coming to my room with a child (4 year old) since I was still on the 8th floor, but thankfully they granted her an exception. She brought me a cute little sleeper (size 6-9 month) for Oliver. This was Oliver's second gift! I have both of his new sleepers on display on the couch in my 9th floor room. Paul and the kids also visited me today for a little less than 3 hours. I was moved back to the 9th floor at 1pm, and they came to visit after 3pm so we were able to hang out in the lounge. While we were in there, I learned that a husband of one of the patients in this unit was a student of mine! He graduated from the university where I teach in 2009. It's a small world after all. Ian was definitely out of sorts this afternoon. We couldn't get him to feed himself his yogurt. The hardest part of the day was saying goodbye to Paul and the kids, but I did manage to do so without crying this time. These next 4-5 weeks need to FLY by like time has never flown before.

I am very grateful to be back on the 9th floor where I can control the thermostat in my room (I had piled on four blankets to try to stay warm in my room on the 8th floor), I am only hooked up to a monitor 2 hours a day, and I am disconnectd from the iv. Going to the bathroom is a real pain when I have three cords to deal with, and when I'm on an iv sometimes I am going every 40 minutes. Every time I roll over in bed a nurse has to come in and readjust the baby's monitor. I also am not allowed to shower down there. I appreciated my shower on the 9th floor this afternoon although I wish the water would get warmer in this hospital. I will really appreciate a nice hot shower when I get home in 4-5 weeks.

I'm thankful that Oliver has gone more than 3 weeks without a transfusion. I forgot to mention yesterday that the ultrasound tech showed me on the screen how long his hair is. Oliver won't be bald at birth!

Bleeding Again

It turns out the decision to return to the hospital yesterday was the right one. I would have been back here this morning anyhow as I started bleeding at 5am. Over the span of 17 hours I was in 3 different rooms on 3 different floors as I was moved to the 8th floor around 5:30am. I was put in a different labor and delivery room than I had been in before. This is my 6th room on this floor, and it's the nicest one I've been in on this floor, especially in terms of views out the windows. I stopped bleeding a few hours ago, and if it stays that way, I'll be headed back up to the 9th floor tomorrow. I am on the monitors 24 hours a day down here, and they did start me on an iv, but they didn't starve me like they did the other 4 times. I was so grateful to be able to eat breakfast, especially as I ordered a couple of things I hadn't ordered before (from the cafe), and it was the best breakfast I have eaten here (egg and cheese on a bagel as well as a parfait that included blueberries, yogurt, coconut, and granola). I will be ordering those again that is for sure! I'm hoping that when I go upstairs I can convince them to remove the iv tube from my arm like they did last time.

My sister and her family arrived around 11am. At first only my sister came in the room because the policy on this floor (which is typically just for those in labor as 2 hours after a woman gives birth they move her and the baby up to the maternity unit on the 9th floor) is that the only children allowed are the siblings of the baby.I appealed to my nurse who knew that I was usually on the 9th floor (there are no such restrictions in the antepartum unit) and also knew that I hadn't seen my sister's family in two years, and likely won't see them again for another 2 years. Thankfully they made an exception and the seven of them were allowed to visit me in my room. They stayed for one hour. Joel (whom I hadn't met before - he's 14 months old) wasn't too sure about me. I am sure if I had more time with him that he'd warm up to me, but he was only willing to come near me if he was still in contact with his Mommy. It was nice to be able to chat with the other four children about what they have enjoyed at Six Flags, what they enjoyed during their week in Chicago visiting Wendy last month, etc. The kids got a kick out of listening to the monitor when Oliver had the hiccups. I was very thankful to be able to see them, but I also felt sad because if I hadn't been in the hospital I would have spent days with them not just one hour. It's frustrating since they only come to visit about once every two years, but it can't be helped. I know that I need to stay in the hospital until I deliver, and even then I won't want to leave the hospital much if Oliver is in the NICU. My sister and her family will be leaving the USA on the 28th of this month so there's no way we'll be discharged before they leave as I won't hit 35 weeks until the 29th. When they return I'll either be spending time in the NICU or still be on bed rest.

I had an ultrasound today, and he's still doing well in terms of the anemia. Dr. Tressler had them do measurements on Oliver today because he's anticipating a transfusion next week. The day before the last transfusion (23 days ago), they estimated that he weighed 2 1/2 lbs. Today they estimated that he weighed a tiny bit more than 4 pounds! Way to go, Oliver! That put him in the 60th percentile for weight. Ian weighed 6lb 1oz at 34 weeks, and Nadia weighed 6lb 2oz at 36 weeks. We shall see if Oliver will be like his siblings and weigh a tiny bit more than 6 lbs at birth.

Thankful Thursday

I've cried a LOT today, but as the song "Count your blessings" recommends, when you're going through a rough time, that's a very good time to stop and count one's blessings.

1. I started on the 11th floor today, but at 5pm I was moved back down to the 9th floor - in fact to the same room I was in the last few weeks. This room is MUCH nicer than the one I started in today - the ability to control the thermostat, the view out the window, etc. Some of the other women on the 11th floor have been waiting for awhile for a room to open up on the 9th floor, but the nurses gave me preference (in light of how long I've been here altogether and also the fact I still have 4-5 weeks to go). There are currently 23 antepartum patients in this hospital!

2. No one brought me lunch (albeit I started asking at 12:30). I was in tears over this by 2:30 and begged a nurse to bring me SOMETHING to eat. In contrast, two different people brought me dinner! I gave my nurse the second meal (as the first taco salad was too big for me to finish so I certainly didn't need a second one, and I knew Dottie was wanting a taco salad). The extra perk was that the first woman brought me a dessert from the cafeteria! That was a special treat. I said it didn't matter as long as it didn't have chocolate, and she brought me key lime pie. It was different than what I think of as key lime pie, but it was still a tasty treat.

3. I get to see my sister and her family tomorrow morning! I haven't seen them in a little over 2 years, and it will be my first time meeting my youngest nephew (he turned 1 the end of May).

4. I got to spend 48 hours with my kids. Oh how I enjoyed reading to them, kissing them, hugging them, napping with Ian, etc. I am so very grateful for them.

5. Rosalie and Bob brought me to the hospital yesterday. It was great to visit with them during the two hour (round trip) car ride.

6. Paul's aunt let me sleep at her house last night. I slept really well. She also stayed with me for 80 minutes while I waited to be seen at the clinic this morning.

7. Ian is making progress with eating. Sometimes it's QUITE an ordeal getting him to feed himself yogurt or cream of wheat, but he can do it. He can now eat a cookie that hasn't been broken into pieces. I fed him some spaghetti (cut up) for dinner last night. He cracks me up as when he's doing a good job he encourages everyone to cheer him on. He'll even ask Nadia to watch him and asks her to tell him he's doing a good job. We're all happy to say the words he longs to hear ("I'm so proud of you" and "Good job, Ian") as well as clap for him. He claps for himself also, ha ha! Drinking from a cup (Elecare or water) is no big deal for Ian these days!

8. In general, the placenta previa is annoying to put it mildly. I would have only been hospitalized for 6 days total (the whole pregnancy) if we were only dealing with fetal anemia. I started leaking amniotic fluid on Monday night. Thanks to the placenta previa, it can only come out at a slow pace (unlike when it gushed out with Nadia and Ian). I'm not crazy about having one more thing seeping out of me, but I have a feeling if I didn't have placenta previa that Oliver would have been born at 30w6d. I should add that they haven't run a test to conclusively prove whether it's actually amniotic fluid, but that's what I believe it is, and since the fluid level is still fine, it doesn't really matter whether that's what it is or not.

9. I was able to do some online shopping during my brief time of being discharged.

10. On Monday I received a package in the mail from the same woman who had previously ordered me a book through Amazon. This time I received two anthologies (7 books altogether) that she had read and was now passing on to me. How sweet! I haven't seen her since 1995.

11. The fact that the third transfusion hasn't been necessary yet (the 2nd one was exactly 3 weeks ago) has increased the odds that the third will be the last transfusion and also that he won't be delivered until at least 34 weeks. Considering he was in the mild anemia category 2 week ago, I'm amazed the third transfusion hasn't happened yet.

12. Some people from church have volunteered to move the bookshelves downstairs and also paint Oliver's room sometime this month. How sweet is that? This will be a big help for Paul since he's very swamped right now.

I can't believe I'm doing this

Rosalie and Bob showed up at 6:40am at Paul's parents' house to take me to my 8am appointment. Oliver has stayed out of the moderate/severe category of anemia the past 5 days. Since I had been discharged, Dr. Tressler told the nurse to hook me up to the monitor for 30 minutes after the ultrasound to make sure I wasn't having any contractions. When she hooked me up she told me that Dr. Tressler was shocked that I had been discharged, and he wasn't very happy about it in light of the placenta previa. It turns out Dr. Martinez was the only one of the three doctors in favor of me being discharged prior to delivery. When he came in to talk with me, he was very stern about how serious placenta previa is, and he told me he is 100% certain I will bleed again. That caught me off guard because I am not accustomed to a doctor referring to anything as 100% certain. He said the only questions were when it would happen and how much blood I would lose. I thought he was going to tell me I needed to be readmitted, but he said he'd let me go back home if I promised "the only time my feet would hit the floor would be when I was getting up to go to the bathroom." He said I needed to be just as inactive at home as I had been in the hospital. I agreed to those terms and made an appointment for 2:30 on Monday for the next ultrasound.

By the afternoon I was feeling very overwhelmed as several people (most with medical backgrounds of some sort) were telling me via email and Facebook how worried they were, and they were questioning the safety of this decision because of the threat of bleeding to death. One friend works at the blood bank and Geisinger, and she let me know that it would likely take about 2 hours for them to get matched blood for me (unlike at Harrisburg where they know what I need and have been keeping some on hand when I've been staying there). If I really needed a transfusion asap, this would obviously be a big problem. If I had started bleeding at home this weekend, I would have asked Paul to take me to Geisinger. Additionally, Paul's mom is going to be without a car tomorrrow, which didn't seem like the best situation for me if some emergency came abut. As glad as I was to be discharged on Monday, I started to think the wisest choice might be to go back to the hospital. I called Paul first, and he wasn't sure what I should do. I called my mom next, and she felt (in light of the emails/messages) I should go back to the hospital. I then called the hospital around 5pm when I knew a doctor would be doing rounds. I spoke with Dr. Taboada, who agreed the safest place for me to be, especially considering how  far away I live, was the hospital. She said she'd admit me tonight, but I'd have to start on the 8th floor. She said if I waited until tomorrow morning I would go straight to the 9th or 11th floor.

Since Paul's mom wasn't going to have access to a car tomorrow, we worked it out with her sister that I would spent the night at her house, which is where I am now. She met us half-way at a McDonald's, which helped get the kids back to Paul's parents' house at a more reasonable time. At first I felt a big sense of relief that I had made the right decision, and then it hit me a few minutes later that I'd be saying goodbye to the kids again, and I was in tears. I know this time they won't discharge me until I deliver, which means it will be about 4-5 weeks before I go home again. Nadia was in tears at one point, and this helped me get myself together. I was completely caught off guard though when Ian started bawling in the parking lot at McD's. He kept saying over and over, "I want to go home." Out of the past 14 nights (including tonight) he will have only spent one night in his own bedroom. He will have spent 6 nights at my parents' house and 7 nights at Paul's parents' house during that time span. Many times over the past two days I was with him he kept asking for Daddy. Paul will come get them on Friday night. I know this is the right thing to do, but I'm again struggling emotionally and can't believe I am willingly choosing to be readmitted even though I could have stayed with the kids until at least Monday.