otters and lemurs and bears, oh my!

ah, I could use a break from all things clinical and simply think about meerkats...
I know one family outing we are making in the future, and that is a trip to the Minnesota Zoo. I love the zoo. Christine and I went recently because they have a new exhibit that includes...

Yes! Sea Otters!
Who doesn't love otters?

And brown bears that swim up to you behind what is hopefully many inches of safety and well-sealed glass...
Bear paws!
There are also lemurs, and they are simply awesome. Finn now has a stuffed otter and a stuffed ring-tailed lemur. They are mine until he can learn to appreciate them.

SCN from the NICU

So far, not lovin' the Special Care.

Finn is doing great. He's sleeping, eating, pooping, and breathing. He's still off the cannula, and he has not had a spell since he moved. Best of all, as of yesterday, he was 5 pounds, 2 ounces. It's his "Andrew Weight." Andrew is my cousin who was born at 32 weeks and around 5 pounds. It's sort of my gold standard in preemie weight.

Special Care is Baby Training: the goal is to get the baby ready to come home and to get us ready to take care of him. That's great. I am all for it. I can even handle modifications to our routine to accommodate this, suspicious of change as I am. What I don't need, however, is to feel like I am doing things wrong. Or, to feel like the goal is to get him home to make the insurance company happy.

We got into a routine with the NICU, and we got to know the staff. We had two months there, after all. Now we are meeting new people and getting used to new surroundings, two experiences at which I am not very adept. I have tried to keep doing the things we do. We come in around his care times, we take his temperature and change his diaper, and we hold him. Even if it's not actually his care time, this is what I do. A few days ago, Pete gave me license to leave the house without him if I am ready and he is not. What I don't think he realized is that this means he would probably never get to see Finn in the morning, because I will be ready to go when he is still drinking his coffee.

The past two mornings, I managed to be ready by 7:30. Yesterday, I left, which put me at the hospital at around 8:00. I introduced myself to the nurse, who was new to me and taking care of another baby, washed my hands, and went to say hello to Finn. The nurse said "I wasn't expecting you until 9:00."

"Yeah, I did not wait for my husband, so I was able to get here earlier."

I took his temperature and started to unwrap the baby burrito to check his diaper.

"He doesn't eat until 9:00," the nurse said.

"I know. I am just going to get him out and give him a chance to nuzzle."

"We usually don't like to disturb them twice. I'll need to get his vitals at 9, and I'll have to bother him again. They need to conserve energy. And it's just that I have these other babies at 8:00, and I won't be able to help you."

"I don't need any help. I work, so my time is limited."

"Well you should let us know if you want to change his times, and we can do something that works more with your schedule."

"ok."

I got him out. He was sleeping, so I let him continue. There's no point in offering him boob if he's sleeping. Boob puts him to sleep as it is. I held him until it was getting close to his cares, at which point, he desat-ed, and his heart rate dropped. He does this; we are pretty used to it by now. His heartrate usually pops back up, but his sats may lag behind that a bit.

The nurse came over and immediately got in there, gave him blow-by O2, then took him from me and put him in the crib to stim (stimulate) him. I just sat there in the chair. I knew that he was fine; I knew that he did not need all of that, but it's her job, and I didn't feel like I could say anything. I had already ascertained that her personality was not a cuddly match with mine; the best thing I could do was suck it up and smile and nod.

She gave him back to me when his sats went back up, and we had a nice cuddle.

Today is bath day. If this is going to be our nurse, Pete will be doing the bath.

Focal Shift

I am sure that Special Care will grow on me, and I will be fine with it. Finn is doing well, and that's the most important thing, but at this moment, I am hating it. Of course, I am hating most everything right now. If I remember correctly, this is what PMS feels like. Everything is getting on my nerves, and since Pete is around me the most, he's bearing the brunt of my frustration. I spend a lot of time sitting on my hands or biting my tongue, trying not to explode into an unreasonable diatribe because something is not being done exactly my way. The only thing that is not bugging me is Finn himself; he's beyond reproach and blame. He even pooped all over the leetly blankey I knitted as well as his new "I Love My Daddy" sleeper, and I was pleased to take them home and soak them. Babies are supposed to poop on everything. He's a real baby. I have plenty of time to be sick of that sort of crap in the future.

I have my moments when I am feeling fine, but those are bright and shiny minutes until something trips my trigger and I am back in the frustration fog again. It's the usual American Litany of Woe: there's not enough time in the day, I'm too busy, It's too hard. Oh, woe is me! I am having a harder time shifting my focus and creating that zen of which I spoke. What's really so bad?

Let's have that talk with ourselves, shall we?

Special Care is in a huge hospital that is more labyrinthine and just getting there and getting in takes up even more precious time.

But Special Care is one step closer to home, and it also means that the boy is continuing to grow stronger.

There are too many things to do before he gets home and too little time.

Too bad. Those things have to be done and they will get done. Make a list and take it one item at a time. He needs a pediatrician? Look into the list the Dr. gave you, and choose one. Then call the insurance company. And check it off the list. Move on to the next thing.

The house is a mess, and there's no time to clean it.

See above. It has to be clean, so it will be clean. One thing at a time.

I need to be at the hospital more for boob training, and I am hardly at my desk as it is.

Work it out. That's all there is to it. You need to manage the time you have until he comes home and you have time off from the work part for awhile. No one can breastfeed, pump, and work for you. Someone will have to take over some of the other things. Get the list out. Delegate. In the mornings, get up right away, pump, eat breakfast, groom, and leave the house, even if you are heading out alone.

There. I feel better. There are more gripes, but at the moment, I can't even remember them. Just admitting that I am hitting a wall, at my wits' end, tearing my hair out--choose your hyperbole--helps me to accept it and breathe. Don't worry, those gripes will come to me the next time someone makes an idiot move on the road or Pete changes a diaper the wrong way (see: not my way).

Right now, The Bunker is calling. Time to pump.

Graduation from the NICU!

Pete here folks. So - today was a big day for Finn! He has been transferred out of the NICU and into the "Special Care Nursery" at Abbott Northwestern Hospital. Karen and I just got back from our first evening visit with Finn in his new diggs.

He was transferred this afternoon from Children's hospital - brought over on the transport isolette much like what he was brought to the NICU in back on May 29th at 3AM (Abbott Northwestern is where he was delivered, it's right next to Children's and connected via an underground tunnel). Karen has more on his transfer in an earlier blog (see "Tunnel").

Suffice to say that he is doing just fine in his new room, even though it's darker than Children's with less bright colors or fun decorations; and they have these crazy loud alarms that sound like they might have been previously used on a WWII-era German U-boat. He seems to be able to sleep through them though, thankfully (I'll be surprised if this kid ever wakes up to a regular alarm at home in the future).

I'll post more on my thoughts about the Special Care Nursery and our "decision" to have him transferred there soon. For now, I'm off to bed, where my lovely and talented wife awaits in what is hopefully her own deep slumber.

by the way... stats

2200 grams (4.85 pounds)
45.5 cm (17.9 inches)

and... and... a tunnel...

Pete made the trip through the tunnel with the baby again, but this time, he was not scared out of his wits, exhausted, and entirely freaked out. Finn was transferred over to the Special Care Nursery at around 1:00, and we accompanied him on his journey from his first home to his second. It was much less fraught with anxiety, though I did watch him and his monitor on the journey over. He's off his O2 again as of yesterday, but I expect him to go back on.

He slept through the whole event. Perhaps he enjoyed the jostling and rolling--he has not been moved around that much since he was in me.He had to get back into the transport womb with the whole set up.
Sleeping...
His new area at Special Care:

We'll keep him.

you don't say...

No one tells you that you might poop when you give birth.

Also, no one tells you that when you have your baby, you might not feel like it's your baby.

We're saturated in images of creamy, animated bluebird love for our brand new infant, but after nine months (or six) in utero, when you are suddenly handed this creature, amazing it may be, but it's hard to relate to reality. It's something that has never existed before. You were pregnant and used to the kicking and squirming from inside, and you had a closeness that can't be replaced. Then they hand you a red, sticky, crying form, and you're tired and in pain, and you're supposed to be suffused with joy.

I don't know what it is like to expect to feel joy, as I was filled with apprehension. I wasn't happy about the situation because I believed that the baby might not make it. I was in benign acceptance mode. When they placed him on my belly, I was amazed he was so big, surprised he was so maroon, and pleased to hear a little attempt at a cry, but I did not feel love. I felt fear. I wanted them to take him and make him live. Once I was back in my hospital room and allowed to leave, I did not want to go and see him. I waited until six o'clock in the morning to go over to the NICU because I was afraid. I did not start to love him until a week had passed, and that love has grown by degrees.

It's probably something mothers are not supposed to talk about. I didn't love my fetus, and I had to fall in love with my baby. But it's not just me; mothers of term babies have said similar things. It doesn't feel like it's your baby, it feels a little like an alien. Dads attach right away; they've been waiting for this for months. So have moms, but there's an accompanying sense of loss as well as a raging stream of hormones putting distance between you and the new arrival. I am sure that post partum depression is not helped by the guilt that new moms feel for not floating on a blissful cloud from the moment their baby is born.

My reactions when he was born are probably more common than one would think, especially when the baby is premature. Finn has love in unquantified amounts now, and that grows all the time. Even though he's never lived with us, I know and feel that he is mine, and I miss him more every day.

end to end

I had a post natal follow-up with my midwife, a dentist appointment, and a surprise visit to my clinic last week. I suppose that it's only fair. My boy is being prodded every three hours, round the clock. I can put up with a few inconveniences.

When I arrived at the clinic, the nurse asked me "Where's your baby?" She wasn't being accusatory or anything, just curious I suppose. I should have said "In the car. Don't worry. I cracked a window," but I told the truth. I suspected that she might not appreciate the joke. It occurred to me that perhaps the fact that my baby was in the NICU would have made its way to my primary clinic with my files. I seem to remember someone at the hospital saying something to that effect. I don't think the nurse checked. She asked me if I wanted to be weighed; I did not realize that was a choice. You go to the doctor, you get weighed. I did want to be weighed, in fact. I was curious. Last time, it was 165. This time, 147.

My midwife was aware that I was no longer pregnant, but it could have been the "post natal visit" delineation that tipped her off and not my chart. It was an uneventful visit: cervix looks fine, uterus feels fine, weight is fine, blood pressure is fine, boobs look fine (actually, she said "They look wonderful.") Everything was fine. I got a little lecture about birth control because I definitely don't want to be pregnant again for at least another year. If that.

Next up was the dentist for a regular check up and cleaning. Of course, I have brushed my teeth at total of nine times in the past two months, so I knew this would not be pleasant. And flossing? I did not even floss for the week before the appointment, just to look good. It's been pretty low on my list.

Lesson learned. I get to come back twice, starting in two weeks, for planing and scaling and another time for a small filling. Guess what? I have flossed every day since then and dusted off my electric toothbrush as well as made my tea tree mouthwash, which I swig twice a day. I don't need it to get even worse in the intervening time.

It's my own fault, so I can't complain or feel bad about it.

I can only hope that my insurance covers a lot of it.

Then on Wednesday evening while Pete was holding Finn, I realized that I really had to pee. However, when I went to pee, this tiny squirt came out, not at all in proportion to the urge. "That can't be good," I thought. Sounded like a bladder infection symptom to me. I drank gallons of water and quarts of cranberry juice, and I felt better in the morning. By Friday, however, I knew that I was not going to be able to drink my way out of this problem, unlike so many others, and I dropped into my clinic.

A cup full of pee, one "O Magazine," and a quick exam later, it was pretty clear that I had a Urinary Tract infection. She gave me a prescription for antibiotics: lovely sulfa drugs. It smelled like Old Faithful every time I opened the bottle, which made me feel pleasantly nostalgic. I was compliant with my medication; you don't work with pharmaceutical care practitioners for ten years and screw that up. I'm not sure it is completely cleared up, though. I'll see how the weekend goes...

Monkeys

It's been two months since he was born, if you are counting by weeks, and at the moment, I am. The three of us have been doing this for 56 days now, which is hard to believe. It's does not seem like it's been that long, and it feels like forever. He's 34 weeks today, and the book does not have much to say about his development that is relevant. If he were inside, his vernix would be getting thicker, but Finn will have to develop his own protective coating against the world. His lanugo is almost completely gone, so that does go along with the book. Inside, he'd be doing pretty much what he is doing now: growing.

He's 2160 grams (4.76 pounds), and he's back on the short list for Special Care. Once a bed opens up, he's outta the NICU. We're happy he's doing well, but we are used to the NICU, and we like Children's better than Abbott. Abbott is a grown-up hospital, which means no monkeys. I don't know why designers think we outgrow our need for monkeys, but I don't know that we do. Children's has animals decorating it and bright colors on the walls and floors. Abbott is an Institution, and beige prevails, with taupe, eggshell, and ecru accents. Any colors present are muted, matte tones. We toured the Special Care Nursery last weekend, and it seemed dingy by contrast. Abbott is also a much larger hospital, so it's not as convenient to navigate. It's directly across the street, but it's just not the same. It's actually part of Children's and is staffed by Children's people. While a transfer is one step closer to home, and will cost less, our experience with the NICU has been good, and we'll miss it.

I "R" Shopping

I recently found myself in Babies "R" Us. See how I used sentence construction to absolve myself of responsibility? It makes it sound like I was transported there against my will and woke up surrounded by tall shelves of endless disposable diapers and artificial baby milk. I had nothing to do with it.

It was my fault, though. I have never been in one of these stores, and I figured I would check out the resources within a certain perimeter of our house to see what is available. I am committed to getting whatever we can from our locallly-owned shops, and we are fortunate to have a number of them. My favorite is Peapods, a natural baby and kid store where I can get my breast pump supplies, but there is also Linden Hills Natural Home, Baby Grand, and a couple others I have not visited yet. It feels good to put money into the local economy and support interesting businesses, plus, I don't really care for cutesy names that use "R us" or K's instead of C's, and behavior like that should be discouraged.

I was in Babies "R" Us to price car seats and look for preemie clothes. Those are not readily available in any great quantity at the local shops, though I did get a couple of cute things at Baby Grand. The carseat I am looking at is anywhere from $159 to $179, and it doesn't change much, so I will get it from the local people. We bought our co-sleeper and changing table/hutch/dresser monstrosity from people on Craigslist, and I hope to be able to get the rest of the things we need in town, though I may have to get the preemie prefolds online. It depends upon how big he is when he gets home. I'm knitting diaper covers while I pump.

The above paragraph is a prime example of what happens to my brain, without my permission. It's hard to stay on track, there are so many things going through it, and one things leads to another. I wind up somewhere I was not planning on being.

See? I just did it again.

My experience in "Babies R Us" reminded me of my experiences with weddings: there's big commerce in life-changing occurrences. Birth, Marriage, Death (in no particular order) are saturated in cash, fairly dripping in dollars. This was a slightly less crowded and demeaning Wal-Mart, focused on babies. I walked the whole store, realizing with relief that I won't ever need to go back there. I found three cute nursing tops, and they did have preemie clothes, but thanks to gifts, my cousin Andrew, and "Once Upon A Child" (don't EVEN get me started on THAT name), I may have enough teeny clothes.

Babies "R" Us and stores like it are pushing a materialism that's not really for me as well as overcomplicating baby- and childhood. The coupon book they gave me is six deals on formula, bottles, disposable diapers, and diaper genie accessories.

It goes right into recycling.

sheesh

It's not THAT hot here, and they should not be so tired.

2 Steps

When last we checked in on Finn James, he was off the O2, 1910 grams, and getting ready to transfer to Special Care.

Today, he's back on the low flow, 2050 grams, and in a holding pattern at the NICU.

It's the rollercoaster, and we were expecting it. I would have been surprised had he not gone back on the 02. Finn's thing is apnea. (My thing is Malabrigo Worsted.) He doesn't have a murmur, he doesn't have bowel trouble. He just needs to grow out of his spells.

It's a lesson in zen, really. While I would not have chosen this and was, in fact, planning for quite the opposite, I feel that we are fortunate. Had I been too attached to my birth plan and the activities of my last three months of pregnancy as well as our child's homecoming, I can see how this would be rather devastating. But attaching oneself to events in the future over which you have no control is not the best way to maintain sanity. It's good to be prepared and have a plan, but it is probably not the best idea to fall in love with that plan and then focus on it above all. Things change, and sometimes, they change fast.

While I miss Finn more every day that he grows and engages with the world, the main point of this is his well being, not my emotional health or my desire to have him home. He's making the choices as to what he can handle and what he needs, and the signs are pretty easy to read. He needs a little boost of flow to help him remember to breathe, he needs the caffeine for stimulation, and he needs more human attention. So the grown ups around him make adjustments.
I would not call this two steps back. At the same time they were putting his cannula back in, they were taking him out of the isolette and putting him into a warmer. At the same time they postponed his transfer to a step down unit, we are talking about moving to breastfeeding at 35 weeks. He may need to come home on a monitor, but he may come home before his due date.

In the meantime, what we have with him are longer cuddles, nuzzling, extended visits, and knit goods that are making him the envy of all the babies in his room.
We are moving ahead, and we will have a baby in the house--when he's ready. In the meantime, we are cleaning out and cleaning up and bringing home the stuff he will need when he gets there.

Half Million Dollar Baby?

How on earth someone could have a premature baby and either be underinsured or uninsured is beyond me. So far, Finn's care has cost a total of $237,732.38. That does not include my prenatal care, his actual delivery, or my hospital bills. We are fortunate.--our coverage is excellent. So far, the only bill we have received is for the breast pump rental.

We're half way.

Co-sleeper Co-incidence

Co-sleeping is often recommended for preemies. I was already planning on having the baby in our room for awhile when we thought he or she would be arriving in September, but now? There is no way he's going to be in another room. Aside from the fact that when he comes home, we will have been not only in another room but in another city for three months, we will need to attend to him and watch over him, especially if he comes home on a monitor. Let's face it, we are going to want to be around our baby as much as possible. We'll be the annoying parents I always privately mocked.

I checked out Craigslist, found a few of these cosleepers for sale, so I wrote to three of them. They all responded, and I eventually chose to go out to the suburb of Golden Valley to look at the lowest priced offering.

When I called, the first thing I heard was screaming kids, and then a frustrated "Hello?" I used my standard "Hello, may I please speak to..." intro, and she must have thought I was a telemarketer because she said "This is Amy," in the same frustrated voice. I was starting to form a picture based solely on my own stereotypes, my fear of strangers, and dislike of new situations (it was amazing that I had made it this far in the process). I was thinking "Oh man, I am headed out to some white trash mobile home in an inner ring suburb, aren't I?" I think it might be impossible to answer the phone when your kids are screaming and not sound white trash.

I continued in my happy, polite phone voice to introduce myself and reiterate the events to that point, and she relaxed and gave me directions.

I found the place pretty easily, and it turned out to be a nice, modest house with an Obama sign in the yard. This might not be so bad. A petite, pretty woman answered the door and showed me the sleeper. "Have you looked at these before?" she asked. I explained that they were recommended for preemies, and we have a preemie in the NICU.

"My first was a preemie," she said.
"Really? How early?"
"25 weeks."
"Same here."
"Do you want to meet him? He's two and a half now, and he has no problems."

We went into the kitchen where a normal, healthy toddler was standing in his booster chair with a handful of snacks, smiling.

"This is Atticus," she said.
"Oh! We have good friends with a two and a half year old named Atticus."
Her other baby, a 9 month old, was lounging on a play mat on the floor.

When dad came home, he went into the kitchen, and I heard him greeting the kids.

"Hi, Finn," stood out to me, and I asked "What is your other son's name?"

"Phinneus," they said.

"I was just asking because our son is named Finn."

We chatted a little bit about life in the NICU and the frustrations and adventures, and I was on my way. I figured if I stayed there for too long, I might find out that we were related or that I dated the husband in the early 90's. A little bit of coincidence can make you feel like you are not alone in the world. Too much is just creepy.

33/7

Notice anything different?
Wait, look at this one:
Now do you notice anything different?
How about right next to each other:

Can you see it now?

Yesterday, he was 1850 grams (for the second time. He reached 1850, and then lost 50 grams. Big poop.), which is 4.079 pounds, and was weaned down to a .25 liter cannula. This morning, he was 1910 grams (4.211 pounds) and after our morning nuzzle, during which he was unusually sleepy, they discontinued his nasal cannula. That's right, Little Man was breathing on his own all day. As of our departure from the hospital this evening, he had been off the cannula for ten hours. He may tire out and have to go back on, and that's fine, but it was pretty amazing to see him without it. He still desats, of course, and just when I got used to the low alarms, I am back to watching the monitors again, even though the situation is not much different. He had a good cuddle with Pete, though, and only really dropped his stats once.

It's one step closer to home. He's on the list for a transfer over to the Special Care, which is a step-down, Level 2 nursery, so that could happen at any time, as soon as a bed opens up over there. The next step will be getting him to learn to really use those boobs for food.

He's 33 weeks gestational age and 7 weeks old. We're pretty proud of him. He's had to do so much outside of the womb, using more energy and with added stress on his little systems. He looks around more and seems to be able to see things, but it's hard to say. The book says that his pupils should be able to constrict, dilate, and detect light. His first eye exam was a week ago, and it did not show any signs of ROP, though that could still develop. ROP (retinopathy of prematurity) is very common. It's "a potentially blinding eye disorder that primarily affects premature infants weighing about 2¾ pounds (1250 grams) or less that are born before 31 weeks of gestation." Because their eyes have not fully developed, abnormal blood vessels can sometimes grow and spread throughout the retina. It can lead to detachment of the retina. He'll have his second eye exam this coming Thursday. It's one of our remaining worries for him, at this point.

In the intervening time, we'll watch his progress in the breathing department and continue to encourage the nuzzling every time we get him out of his third womb.

Every day, he's grabbing more little pieces of my heart...

training boobs

"Have you tried him at the breast yet?" asked the nurse.

"No," I said.

"You really need to. If I were you, I would take him now, " she said, gesturing to Finn, who was fussing on Pete's chest as Pete positioned him for Kangaroo Care. "He's exhibiting hunger cues. See the way he's moving his head and his hands?" She seemed a little... intense about it. I felt a teensy bit like I was being scolded. Then again, it's easy for me to feel like I am doing something wrong, and some of the nurses are more paternalistic than others.

His weekend primary nurse had mentioned that we could start nuzzling, but we had company, and I figured it would be better to wait for a more relaxing time to try something new. After that, I just didn't ask. Even though he's our baby, it feels like we should ask permission to make changes or add new things. That's not entirely true, but I do need to learn to be a better advocate for myself. If we arrive at his bedside, and he has a new nurse, we have started to introduce ourselves and tell him or her our routine. After a new nurse last weekend seemed like she was in a hurry to get him back into his isolette because she wanted to leave, we feel this is the best course of action.

But this past Saturday, even with the nurse's suggestion, I decided not to move our Little Man. He was already starting to settle into cuddling with his daddy. I had definitely noticed his cues: the lip smacking and tongue thrusting is particularly fun to observe, and I was both excited and fearful to try him at the breast. It was something I was longing for, and it was something new and different with no guarantees. He can really get working on that soothie, but would he take to the boob?

Yes.

Sunday morning, we positioned him, and he went for it. He's a little too small and not quite strong enough to really latch on, but he sucks and plays, and he gets tired relatively quickly. Then we get to watch him sleep on my lap. Kangaroo Care is wonderful for the closeness, but sometimes it's also nice to bundle him so that we both can see his little face.

Mornings are best; he's more awake then, but we offer up a little (or big. very big) boob every time we get him out, which is twice a day now. In the evening, if he's too sleepy, I hand him off to Pete for a little Daddy Cuddle time. It relaxes both of them.

It will most likely take him a long time to figure out what he's doing with the breastfeeding, and I need to make an appointment to have one of the lactation specialists in to give me a hand (another thing I am not good at doing, in case you have not noticed: asking for help. Even professional help). Nuzzling is good practice, and it's good for both of us. I know that it makes me feel content and much more connected to Finn. It mellows out the whole situation. Ironically, as he gets bigger and better, we worry about him a little less, and it's easier to handle. But as he gets bigger and better, he's becoming more alert and active, and it's harder to be away from him.

We'll keep nuzzling and watch him hopefully progress. Of course, the word "nuzzler" makes me think of "niffler," which makes me happy. Our little niffler is sniffing for gold.

midsummer morning

The thing about pumping at 8:00 p.m. and going to bed at 9:30 is that you wake up at 3:00 a.m., needing to pump, and then once you are done with that, when you go back to bed, you are awake enough to think about things, and you can't get back to sleep; so you get up thinking that if you read a little you will fall back asleep, but you read about breastfeeding in the preemie book, and you read about homecoming in the preemie book, and then you think about all the things you read about in the preemie book, so you really can't sleep, and now it's 5:37 a.m. anyway, so there's no point because the alarm is set for six, but you could use a bath, and once that's done, the bed is very tempting but if you lay down you will fall asleep which is no good because it's time to get up, time to pump, time to get ready to go to the hospital, time to go to work, so you make coffee--half caff this time--and think that if you can be up, surely the husband could be up, but he's sleeping with his three pillows and at least one cat, and you think it's really not fair, but there's nothing to be done about it because it's the same thing women have been thinking for ages.

quickie

I have lots to say, but not much time to say it.
For the moment, let's go with:
16.93 inches
3.946 pounds

and doing very well

32

He was six weeks old yesterday, and he's finishing his 32nd gestational week today. Out here in the real world, he's doing well on his 2-liter high flow and 30 milliliters of breast milk every three hours. That's still not a dent in the supply side of things, which is yet another argument against the "trickle down" theory. The upstairs freezer is full again and in need of a defrost, and I am not sure where I am going to put it all. We are only putting 8 ounces a day into the baby, which leaves 36 ounces up for grabs. I may have to write a breast milk cookbook, start putting it on my cereal, or give it to the cats.

If he were still in the first womb, his lanugo would be falling off. If you remember from earlier posts, lanugo is the fine, downy hair that grows on the fetus to keep it warm. It is not a teen sensation latin boy band. Finn still has some of this fluffy blond down on his forehead and shoulders, but there has been less every week. I am surprised that he still has any hair on his leetle head, what with all the head holding and wee kisses that his parents give him on a daily basis.

Weight-wise, he is a little behind what he would be in the womb because he's burning a lot more calories out here in the world than he would be in the bubble. Still, at 3.64 pounds (1650 grams). he is not far off from the between 4 and 4.5 pounds one would expect of a fetus. Length wise, he's right on target at 15.75 inches at last check. He gets weighed every day and measured every Sunday.

Fortunately for us, the book says that "nearly all babies born at this age survive the challenges of premature birth." My cousin, Andrew, was born at 32 weeks and five pounds. He's doing quite well at 13 years old and very tall. At least, I think he's 13. I can never remember the ages of the boys in the family; there are too many of them. The three girl cousins are easy to remember because we are all ten years apart.

The book says that I am supposed to check on fetal movements from time to time. OK. Here goes:

Finn is still as squirmy as ever. He quite enjoys stretching his legs out, locking his knees, and making it hard for us to bend them again. Once his diaper comes off, it's all about stretching. Once he wakes up, it's all about stretching. Once he gets back into the third womb after a cuddle, it's all about stretching. He wriggles and grabs, tries to turn himself over, and lifts his head if he is especially uncomfortable or agitated. For instance, when he has a wet or messy diaper, when he is getting hungry, or if he has been on his back for too long. He grabs fingers, tubes, and bedding. He does not like having his temperature taken: it involves putting the thermometer under his arm and then holding his arm down.

He's starting to make more noise as well, not just crying, but little mewing sounds, puppy sounds, and baby dinosaur sounds, especially when we are holding him.

He's a good boy, and, well... I didn't say it. The shirt did...

Did you know that...

Russia is the world's top crude oil producer?
Seven mountain gorillas were murdered in 2007 in the Democratic Republic of the Congo in what turned out to be a political move to entrap a rival?
The country of Bhutan only got television in 1999?
Whales and antelopes are closely related?
Orcas will attack great white sharks and live as long as humans?

Well, I didn't, and these and a host of other interesting facts have been revealed to me through the magic of breast pumping.

ok, not really.

Pete's mom was here for the holiday weekend, so I moved my expression area into the bedroom. I am sure that I will have no problem whipping the girls out in public when there is an actual baby involved, but for the breast pumping? Not so much. It's a bit comic, and very exposed. While I have had to pump a couple of times when girlfriends or my mom was around, if I can avoid it, I will. I discovered that the bedroom is a very nice place to express. It was easier to read because I could put a magazine on a pillow and only have to let go long enough to turn a page.

When I spied the stack of National Geographics that have been mocking me for the past year from their perch in the hallway rack. Many American households have a library of these magazines, and I suspect that most of them go unread. It's like a little badge of smartness. We believe that when guests see those yellow spines on the book shelf, they will consider us erudite and cultured. In reality, they are probably thinking what I think when the tables are turned: "Ah yes, something more for your kids to clean out after you die."

Five and a half volumes later, I can't imagine reading anything else while I pump, though I only have six back issues left. If I were still pregnant, I would think that the fetus was getting smarter right along with me. Smarter and more interesting. As it is, I don't think that I am transmitting brainy trivia molecules into Finn's little brain through my breast milk. He'll have to wait for me to bore him with minor facts when he's older.


And bigger. This morning, he was 3.6 pounds. He's still on the high-flow, but he's down from 4 liters to 2.5. He gets 30 milliliters of food every three hours, and he's no longer on scheduled suppositories, which is always nice. Pete got to change a gigantic poop this morning, something we are still happy to do. Last night, he was desat-ing during cuddle time, and the nurse on duty seemed to have a laissez faire approach to the alarms, so we put him back early. I was getting mad, and it was not relaxing at all. I hear those alarms in my head when I am not anywhere near the hospital, and I prefer it when the nurses give him a little O2 bump while we are cuddling to hopefully help bring him out of it.

morning update

1520 kg (3.351 pounds) as of yesterday morning...
Still on the 4 liter high flow and doing very well. They are going to take him down more slowly this time.Christine made the little bear, and it is often used to snuggle him. Knitting is therapeutic!
We are getting ready to go over now, so we'll see if there is any more news. Hopefully, just weight gain and a quiet night.

...

I miss my baby.







It doesn't help that everyone seems to be pregnant or have a new baby. It's just before 7:00 a.m. on a Sunday, and the neighborhood is quiet, but from the kitchen, I can hear the cries of an infant--the newborn living next door. People keep telling us to get sleep now, to take care of things now, because when he comes home... like that is going to be the real inconvenience to the style of our lives, when this is actually harder.

After 5 weeks of at least two hospital visits a day, work, and daily responsibilities, we are tired. And sometimes we feel bad because sometimes, getting it together to make the trek over to the hospital feels like a chore. There lies our little son. We want to see him, and we always make the trip and spend the time: we need to. We need to be near him, even if we only watch him for a few minutes at a time while he's sleeping. But sometimes, there's the heavy sigh here at home, whether kept to ourselves or made audible: we're tired. It's too much. And we are only half way through this part of it.

It's not that we need a maid, or we need someone to take over socializing with our baby. There's really no good solution. We are the ones who need to socialize with our baby, not just for his sake and for his emotional development, but for our own. Beyond that, we have established that I am too much of a control freak to let other people scrub out my refrigerator with a toothbrush.

It's just the way that it is, and sometimes, we will complain. Sometimes, we will feel guilty for not wanting to go to the hospital. But we will go, and we will always feel better having gone, and that's the thing to remember. As he grows (1495 yesterday, or 3.296 pounds, and 15.75 inches), and gets better at the breathing (he's back up to 4 liters on his high flow--too many spells), we will adjust our visiting. Hopefully, his growth will correspond with beginning to experiment with breast feeding, and that's certainly my job, and one to which I am looking forward. We'll be there as he needs us, and we'll help each other through the exasperating times when we feel like we can't do it all. And when it gets really overwhelming, my mom weeds the driveway, and my dad cuts down rampant raspberry canes.

We could use some help in the basement and garage, too.

Flip Book

31

Finn will be happy to know that I was writing about his testicles in a public forum when he was only three pounds and three ounces , but we are supposed to embarrass our children, aren't we? He's 31 weeks gestational age today, and it's reproductive system time!

"His testicles are moving from their location near the kidneys through the groin on their way into the scrotum."

Ah, what a magical journey. Something I never did, myself, but it sounds wonderful. Finn is fully formed, but I don't really know how you can tell if everything in there has arrived at its final destination.

"Your baby's lungs are more developed, but they're not fully mature. If your baby is born this week, he or she will probably need a ventilator to assist breathing."

OK, Smarty Mayo Clinic Book, I get it. Luckily, even at a little over 25 weeks, Finn was only on the ventilator for a few days. He's been doing really well back on the high flow, and that's just fine with me. He can move back down to the low flow whenever he's ready: no one needs another 11-spell night. We've had good cuddles this week, since then, and now that we have a few days off, we can hopefully get him out a couple of times a day, if he's been getting enough rest. It's all about him, and how much he can tolerate. Lately, he's been doing great.
The doctor had no new orders for Finn, and as he said to us today "I don't have anything to say about him. He looks great." No news is good news with preemies, as is boredom.

He's definitely getting more expressive and gaining more personality. It does seem that he recognizes our voices, based on his physical reactions when we first start to talk. He settles down pretty quickly during cuddle time, and he can really suck away on my finger when I give him the chance. He also has a pretty strong bite, which makes me fear for my nipples.

How often does someone get to say something like that?

Three Rides for a Dollar

I have never been one for amusement or theme parks. I rode my first rollercoaster at 26 years old, and I am not sure why I even bothered then. It was probably peer pressure. I am not big into thrill seeking or risk taking, and I don't care for wasting money. It should not be surprising that I am not into Las Vegas, either.

It should be surprising that I am any fun whatsoever.

Amusement parks are not amusing to me, by definition:

1 : a means of amusing or entertaining amusements
2 : the condition of being amused amusement
3 : pleasurable diversion : entertainment amusement

Amusement parks could be renamed Tedium Parks or Trepidation Parks in my world. There's just not much for me to do except people watch, and then all I can think is "the herd is unhealthy." It would figure that my little man is a thrill seeker, and he's already into shocking and worrying his parents. We had become too used to arriving at the hospital and getting glowing reports from his nurses. He's been a little overachiever. I was not expecting to get to his bedside this morning and hear "He's been good for me, but he had sort of a rough night" in answer to my usual "How's he doing?" question.

Overnight, he had 11 spells. That's more than he usually has in the course of a couple of days. For two of the spells, he needed a lot of work to get him to come around. I am guessing that he had to be bagged. I did not ask. I looked down at our sleeping little baby and had that choking, desperate feeling that accompanies an all-encompassing fear of loss. I did not want to start crying at his bedside because I don't like to do such things in public, and I was afraid that if I started right then, I might not be able to stop.

He's back on the high flow, back up to 2 liters, and 30%. They checked for infection and found no signs, and his blood test was good as well.

Suddenly, after Pete had a great cuddle last night, with no spells and barely a de-sat, it's like two weeks ago. It's the proverbial step back that parents of preemies have to get used to, and that we have to expect. I know that I had finally settled into a comfortable space, at least in my head, if not in my schedule, and this was a big, fat reminder that he's a teeny tiny baby with immature systems who still has a long way to go.

We thought it could be his red blood cell level, and that he might need another transfusion, but when the doctor called Pete later in the morning, she said that she thought his level was fine, even good, and that she did not want to go the transfusion route. When they get too many transfusions, their bodies don't think that they need to make their own red blood cells, and it's hard to oxygenate when you don't have enough of those snazzy little things. The doctor also said, as Pete was reminding me in the parking lot, that he's acting like a preemie; they do these sorts of things. We thought he might have to go back on the ventilator; we thought he might have to go back on C-PAP; we thought he might have to have another transfusion. What we need to remember is that we don't really know what will happen. This is something that I was concentrating on throughout my pregnancy: trying to be as pragmatic as possible. That was relatively easy during the pregnant part (relatively), but it's much more difficult when faced with sweet little actual baby.

We had our morning visit with him, during which he had a spell, and we talked to him for a little while. I made it to the car, and Pete talked me down. I made it to work, and have made it through the day, which means I should be fine for now. Our Little Man weighed 1410 grams this morning (3.109 pounds), and he seems to recognize our voices, but it's hard to tell. Of course, we like to think he does.

I think that this whole experience will be enough amusement for me until Finn wants to go on the rides.