Saturday, May 31, 2008

Kangaroos and Rabbits...


Just back from the NICU with a progress report...


Dylan's weight went down, as expected, but not by much. He's at 1535g, or 3 lbs 6 oz. So, over the two days, it's still a 60g increase. I find that very encouraging. His feedings have also been increased to 17cc of breastmilk each, and he continues to digest all of it.


Barbara held Dylan kangaroo style for over an hour and 20 minutes tonight. It was such a beautiful thing to watch. I know from when I held kangaroo'ed with him, how relaxing it can be for both parent and baby, and just seeing the look of utter contentment on my wife's face, knowing everything she has been through over the last several weeks... it was just awesome to witness.


I brought a book of 5 minute bed-time tales with us to the NICU, and I read The Velveteen Rabbit to Dylan as he was settling down into his mother's warmth. I've never read a story to anyone before, and I found it to be strangely peaceful. I'm looking forward to doing it again. Dylan seemed to be enjoying it also. I know he would react to my voice when he was in the womb, kicking up a storm when I would first come home from work each night, and he seems to recognize it still. For the 5 or so minutes that it took to read the story, his eyes were wide open. Normally, he only keeps them open for seconds at a time, and then drifts back to sleep. I wanted to keep on reading, but thought it best to let him relax.


Anyway, that's all for now. More tomorrow...

Smiles all Around!

Our trip to the NICU last night was a great one. Although Dylan was not yet moved to the NICU2, it's only because of a lack of space there.

Dylan gained a lot of weight in one day, up to 3lbs, 7 oz or 1560 g. They did double and triple check his weight, so they know the gain is accurate, but the nurses say not to be surprised if he loses a bit between yesterday and today. Sometimes there will be variables in weight depending on whether or not he's had a bowel movement, which can make a big difference in such a little guy.

He is now receiving 15cc of breastmilk with each feeding, and he is still digesting all of it each time. The way they check this is actually a bit gross, but still pretty cool. Since he has a feeding tube inserted into his stomach, they can just hook a syringe up to it and pull back, suckinh his stomach contents up to look at, and the squirt back in. After his very first feeding last week, you could still see some breastmilk in the fluids. Now, there never is anything left before they feed him. He's eating well!

Speaking of his feeding tube, they moved it to his nose. The nurse said that it will help him with his pacifier and sucking reflex in general if the tube isn't in his mouth. Better yet though, is the fact that this means his chin and lower lip isn't covered with tape. We can now see Dylan's entire face!

And what a beautiful face it is. Several times tonight, we got to see him smile. Now, I know that the "experts" say that babies don't truly smile until somewhere around the 2nd or 3rd month, and even then, they are merely mimicking their parents, but so what? I looked at my son and could clearly see a smile on his face.

And that's all that matters.


Thursday, May 29, 2008

Good News, and 1 Week Old!

We're just back from the NICU tonight, with some encouraging news...

Dylan is ready to move from the highest level of care, NICU3, to the next level, NICU2 as soon as there is a spot available for him. Basically, this means that his doctors belive he is progressing well and is not in need of as intensive a level of care as is provided in the NICU3.

Of course, in NICU2 he is still very closely monitored and will be well cared for. The main difference as it was explained to us, is that the NICU3 is really geared to the management of problems where the NICU2 is much more aimed at getting babies healthy enough to go home.
It really feels like a graduation!

Also, in under 1 hour from the time I am typing this, Dylan will be exactly 1 week old. In some ways, it doesn't feel like it's been that long and in others, I can't belive it's only been a week.

Dylan is also done with all of his IV antibiotics and is now receiving 13 cc of breastmilk with each feeding. He is now down to just two things being delivered via IV: his nutrient package, which is slowly being decreased as he gets more and more breastmilk, and a lipid package, which will help fatten him up to better manage his body temperature.

We asked about him possibly beginning to breastfeed, and what they explained was that they don't have a set time at which they try. Rather, they base the decision to attempt breastfeeding on how well the infant takes to his pacifier and how strongly he sucks on it. Right now, he does use the pacifier, but does not suck very strongly on it. Hopefully, that improves at the same rate as everything else. Being able to feed from either a breast or a bottle is a requirement before he can go home, so the faster he can get that part of things down pat, the faster we can get him home.


And let me leave you with some new pics until next time:






Wednesday, May 28, 2008

FAQ and more Details...

Frequently Asked Questions:

Since so many family members have been asking, I thought this would be a great place to answer a few questions:

YES, the baby shower is still on. Who knows, maybe Dylan will even be there, although I doubt it.

And to answer another frequently asked question, Barbara is registered at "Baby's R Us".

No, we don't know exactly when Dylan will be able to come home. It all depends on how soon he can feed from either a bottle or breast, and how soon he can maintain his body temperature.

Making Progress:

Also, Barb and I are just back from the NICU, where we were very pleased to learn that Dylan has finaly exceeded his birth weight, gaining another ounce to hit 3 lbs, 4 oz! He is also up to 11cc of mother's milk at each feeding, up from 9cc at our last visit. This kind of progress is very encouraging. We can only hope that he keeps it up and is able to come home with us soon.

They Do the Darndest Things:

I thought I would relate this little story as told to me by Barb's mom. Apparently, while the nurse was changing Dylan's diaper, he had a surprise in store for her. It seems that he had made quite a mess in his diaper, certainly nothing out of the ordinary, even for a little guy like he is.

But just when the nurse thought it was safe to take the diaper off, Dylan unloaded again, this time right into the clean diaper. Two diapers and several wipes later, what should have been a routine diaper change was finally finished.

I guess I really am amused by the simplest things... :)

Kangaroo Care

I just thought I'd make mention of something I had never heard of before Dylan ended up in the NICU. It's called Kangaroo Care.


Kangaroo Care has nothing to do with the marsupials from Australia. Instead, it's the act of holding your infant against your bare chest, skin to skin. It's a rather simple idea, but for a first-time father, I'm completely amazed at how soothing it can be, both for Dylan and myself. It provides many benefits to the infant, including increasing the bonds between parent and child, helping to stimulate breathing and prevent apneas in pre-term babies, aiding in the retention of body heat and more.

Most importantly though, Dylan really seems to enjoy it. Normally, he will get a little feisty when the nurses check his vitals, especially when they take his blood pressure. His blood pressure is taken via a tiny cuff on his left ankle, and he really doesn't like the feeling of it. Also, he doesn't much care for his temperature being taken, either. They do that simply by holding a thermometer under his arm and holding his arm tight to his side. When they do either of these things, Dylan starts to whine or cry, flail about and arch his back to escape.


Now, if these things are done while being held kangaroo style by Mommy or Daddy, he might make a tiny whine, but mainly, he just stays still, sleeping. What would otherwise be an energy wasting ordeal for him turns into just another opportunity to catch a nap.

I'm sure many of you who have kids are reading this thinking, "What's the big deal- you're holding you kid. So what?", and I can completely understand. For me, as a first-time dad with a baby we were not supposed to be able to have, who decided to come 10 weeks early and is in intensive care... well... it's pretty darn special. Feeling his heart beating against my chest and his chest moving as he breathes... it's just very reassuring and encouraging.




More photos

These are just some of my favorite pictures to share with you...

Our first family photo...



It looks like a smile to me ...

Dylan sleeping on my chest...

Catching you up to date

Welcome to the first entry in Dylan's Den. My wife Barbara and I are happy you have taken the time to visit, and we look forward to keeping you informed about the trials and tribulations involved with our little miracle, Dylan.


For those who don't know, Barbara and I had been trying to have a child for 11 years, all with no success. We had all but given up when Barbara took a "just in case" pregnancy test before going on a vacation that might have involved some drinking, only to find that it was positive! A few more home tests and a blood test all confirmed it, and we were officially pregnant.


Most of the pregnancy was rather uneventful. Barbara had her bouts of morning-sickness and the typical discomforts of pregnancy, but nothing serious. Until she was diagnosed with gestational diabetes, that is. That threw us for a loop, as suddenly there was a need for a controlled diet and 4x daily checks of her blood sugar.


Barbara was a trooper though, and took right to the new regimen. She maintained her blood sugar within acceptable levels quite well, through a specific meal plan and through excercise on a treadmill. She was determined to do whatever it took to keep her baby healthy.
That was going well until May 10. That was the day that her water broke, at 28 weeks gestation. We rushed to the hospital in a near-panic. After about 4 hours of tests and checks, they confirmed it- she had ruptured prematurely.


The exact name for the situation is Preterm Premature Rupture of the Membrane, or pPROM. It is typically followed by labor and a premature birth. Usual treatment involves administering steroid injections to encourage faster development of the fetus' lungs and, if the mother is in labor, using drugs to stop it. Luckily, Barbara showed no signs of being in labor. They gave the steroid injections as a precautionary measure, in case she did go into labor in the near future. The lungs were a big concern with a gestational age less than 32 weeks.


Without any signs of labor, the plan was to keep Barbara on bedrest and in the hospital until Dylan reached 32 weeks of gestation. At that point, they planned to collect amniotic fluid to use in a test that would determine the maturity of his lungs. If they were mature enough, they would induce labor and deliver the baby at 32 weeks. If not, they would do so at 34 weeks. With a ruptured amniotic sack, there is a great risk of infection to both the mother and the baby, and the 34 week point has been determined to be the break-even point. It's a balancing act between the risk of infection and the desire for the fetus to have unhindered development in the womb. Barbara was not looking forward to a possible 6 week stay in the hospital, but she was wiling to tough it out, whatever it took.


All of these plans were laid to waste when on May 20, Barbara began to feel some cramps. Unsure if they were contractions or not, she mentioned them to her nurse. The nurse said they sounded like contractions, but not to worry until there were more than 6 in one hour. They continued at a pace of about 4 or 5 per hour until midday Wednesday. At that point, they were stronger and more frequent. After one particularly strong contraction, Barbara found herself to be bleeding. Two nurses quickly grabbed her up and took her to Triage where she was put on monitors for a few hours. It was determined that she was in labor, and that the baby would be coming soon, but they couldn't say how soon.


Wednesday night came and went. The contractions were coming fast and furious but thanks to an epidural, the initial pain of the frst several hours of contractions was a thing of the past. Thursday night, around 11:30pm Doctor Jackson came in, surveyed the situation and said, "We have to go, NOW".


Barbara was suddenly being pushed out of the room in her bed and I was suddenly being dressed in a hat and gown. The next thing I know, we're in an operating room and Barbara is being yelled at to push. 30 minutes later, I'm looking at my son, watching him swing his arms, kick his legs and listening to him cough and begin to whine. Then, he was grabbed up by the pediatrics group and rushed off to be assessed.


Dylan Robert joined us when he was at 30 weeks gestational age on May 23, 2008. He was 3 lbs, 3oz and 16 1/2" long. He has a full head of blonde hair.


For a 30-weeker, he is doing very well. At first, he was on CPAP to ensure his lungs were able to stay inflated, but that was removed before the end of his first day. He is now breathing fine on his own, without any additional oxygen and his oxygen saturation levels are always at or near 100%.


His blood sugar levels were a bit low initialy, but have risen to normal levels and are no longer a concern.


Over the first two days, he lost 2 ounces, but has since gained them back. He is currently still on IV fluids for the bulk of his nutrition, but is getting 9cc of his mother's milk in a feeding tube every 3 hours.


He did have a brush with jaundice during days 2 and 3, but after spending some time under a special phototherapy light, is beyond that as well. The nurse did say that it is a pretty common thing, and that it is very likely it will come back one more time before he beats it entirely.


Overall, given how difficult he was to conceive and how early he decided to come to us, things are going very well for little Dylan.