Wednesday, January 28, 2009

In Preparation


In preparation of Margaret's homecoming, Wade and I are doing a great deal of cleaning, organizing, and most importantly researching. We know that we cannot recreate the NICU, but we want our home to be a clean and safe environment for Margaret. The amazing NICU nurses continue to take great care of Margaret, and during this open-crib phase (the final phase) they have given us complete control (when we are there) of taking her temp, changing her diaper, and feeding her.

The nurses also provide us with little tidbits of information about premature babies and their care. They seem to always stress the importance of protecting Margaret from RSV (Respiratory Synctytial Virus) and other illnesses. Hand-washing, hand-washing, and more hand-washing!!!!

(These paragraphs are taken from a pamphlet by MedImmune Inc., Your Premature Baby and RSV, 2005)

RSV is a common and highly contagious virus. In most children (and adults) it causes mild cold-like symptoms. But babies born prematurely who have not received natural virus-fighting substances from their mothers, and those with lung or heart problems, are at high risk for severe RSV for the first few years of their lives. It is spread through kissing, touching, sneezing, and coughing. It can remain active for hours on household surfaces. It spreads rapidly in crowded households and in child care centers.

To help prevent RSV, you can wash hands with soap and warm water every time before you or anyone else touches your baby; wash countertops, toys, crib rails, and other surfaces often; promptly discard used tissues; don't expose your baby to crowds at malls, buses, subways, or large family gatherings; don't smoke near the baby or in the baby's house (smoke can increase danger of RSV infection); and limit contact with the baby if you have a cold or a fever.

Wade and I think it is very important for our family and friends to know about RSV and hand-washing!!! Once Margaret is home, we want visitors. However, we are going to be pretty strict about hand-washing, short visits, limited touching, and only healthy visitors (with healthy family members at home). Wade and I are going to do all of the holding for a while---remember, we have had limited holdings for the past three weeks! We hope that everyone will understand that we just love Margaret and want her to have a healthy beginning at home. She needs to focus all of her energy on growing instead of fighting an illness.

If you would like more information on RSV go to www. rsvprotection.com or www. synagis.com.

Thank you for reading this---we love you and promise to focus on cute pictures and Margaret's progress next time!!!

Tuesday, January 27, 2009

Picture Day

Sweet Angel

Little Frog
My legs are finally getting adjusted to the outside world!



Happy 2nd Week Birthday--2 donuts!!!

1800 grams---Open Crib Time!!!

Thank you Hudson, Charlie, Aunt Lolly, and Uncle Michael for my drawings and banner!
I love decorations!


Sorry it took me so long to post updates. Wade and I have been busy moving back into our home and traveling back and forth to the NICU to see Miss Margaret. After living with my dear parents for 20 days and in Baptist for 27 days, we are finally home! Wow-Wade and I both agree that our bed is the best!!!

Margaret is doing well! Last night she weighed 4 lbs. 3.25 oz. A few days ago she moved into an open crib, because she met the goals of weighing 1800 grams, holding her own temperature, and not requiring any supplemental oxygen. To go home she needs to weigh 4 lbs. 8 oz. and either take a bottle for all of her feedings or nurse. Right now she is still using the feeding tube for most of her feedings; that is why she has that lovely piece of tape around her mouth.

So her homecoming is just around the corner; it is hard to predict when it will happen but we know it will be soon. Wade and I need to figure out that car-seat!

Enjoy the pictures and continue to pray for our precious little girl!

Tuesday, January 20, 2009

Kangaroo Care

Peek-a-boo! I love my warm isolette!

Daddy loves daughter!


Mommy loves Kangaroo Care!

Comfy Spot

Wade and I are home again--well, home at my parents' house. Hopefully, we will return to our house later this weekend to give my parents a break and start cleaning our home for Margaret's arrival in a couple of weeks.

We left the hospital yesterday afternoon after my last round of IV antibiotics. Now the docs think that I either had a mild case of pulmonary edema or the early stages of pneumonia. Either way I am feeling much better and will hopefully get all of the excess fluid out of my lungs and body soon.

Today I gave Margaret 'kangaroo care' (what you see in the picture). It is strongly recommended for newborns, especially premature babies. Another name for it is skin-to-skin, and it encourages bonding between mother/ father and baby. It also reminds Margaret of her time in the womb.

I loved it! It was such an amazing feeling to have my baby girl so close again and feel her warm little body. I was able to study her beautiful fingers--so long and delicate! I was able to kiss her little forehead and rock her to sleep! Hopefully Wade will get to give Margaret kangaroo care tonight.

It is easy to start feeling sorry for yourself when you think of all of the hours that you have missed holding your newborn baby because she is in the NICU, but I continue to feel blessed because she is alive and here! People try to warn me and Wade about sleepless nights and hours of crying and feeding. They don't understand---we don't care. Of course, we are going to be exhausted, and it will be hard. However, we will have a daughter in our lives to hold, kiss, share, etc. There really couldn't be a better gift! That is what James taught us---to never take your blessings for granted, to remember what is really important in life, and how to really love one another!

Sunday, January 18, 2009

Baptist Round 3, Day 2







Margaret and I decided to switch places this weekend. While she continued to make progress in her health, I started to feel sick and short of breath. I started feeling ill Friday evening---pain in my chest area, especially when I would take a deep breath and a low grade fever. All day Saturday I stayed in bed and tried to get extra rest to see if that would help, but that made the heaving breathing even harder. So I finally had to call Dr. B., which I hated to do. I feel like I need to send him to Hawaii or the Caribbean after all of the phone calls and special visits to the hospital he has made.

I met Dr. B. in the triage once again in tears (5th visit)---I HATE THE TRIAGE!!! After a CT Scan of my chest, an ultrasound of the veins in my legs, and an Echo Cardiogram, Dr. B. decided that I just have some lingering fluid in my lungs, which is affecting my breathing. It's name is Pulmonary Edema. Luckily, I don't have any heart issues or blood clots. So we are trying to flush my body of all of the excess fluids.

Wade and I are so tired of living at Baptist Hospital. It is a nice facility, but we have almost seen all of the rooms in the triage, labor and delivery, and the ante-partum areas. So hopefully we will get out of here for good tomorrow!

Margaret on the other hand is doing well! She is completely breathing on her own and had her IV removed today. Saturday she took her first bottle. The nurses will slowly introduce the bottles. She is not quite ready to take them exclusively, so the tube is still in for feedings. On Friday at 11:43 A.M. we celebrated her one week old birthday. We sang Happy Birthday to her and gave her a (stuffed) birthday donut from Aunt Lolly (my sister Laura).

Enjoy some of the latest pictures. I will let you know if we can go home tomorrow. Please pray for my lungs now and sweet Wade (he probably needs it more than both of his girls). The funny thing is that Margaret and I basically had the same problem---luckily I didn't have to go on the vent! Take care!

Friday, January 16, 2009

Holding Margaret Belle

































My husband is in love with another woman!!!

There are no words to truly express how amazing last night was. When we arrived, the night nurse explained to us that tonight was going to be a BIG night. The nurse was going to give Margaret Belle a bath and weigh her. Then she was going to let us hold our precious baby, rock her, and feed her my milk through her tube--a dream come true!!!

The nurse said that every three nights now Margaret will receive a soapy bath, and the nurses might even let us give the bath next time. So we taped the procedure and listened to every instruction. Of course, Margaret decided to pee-pee right after the nurse was finished--very cute and what do you expect? It was cold!!! Then she weighed our sweet angel. She weighs 3 lbs. 11oz. right now, which is good. Hopefully, she will continue to gain weight with all of these feedings.

Finally, she wrapped up Miss Margaret and placed her in my arms. It was one of the best moments of my life. Wade and I have been waiting so long to have a baby and actually hold her. I thought I would be crying uncontrollably. However, I was just so happy and relieved to see her breathing on her own and so peaceful. Wade then fed Margaret by holding her syringe of my milk and letting it slowly drop into the tube. As I was singing her a few of our favorite songs, she fell asleep. God is good! I quickly switched places with Wade. I didn't know that I could fall in love with him all over again, but I did. It was beautiful! Watching Wade stare at her with his serious face, I knew that he was going to be the best father and that he had fallen in love too. What a blessing!

Thursday, January 15, 2009

Ventilator Free












Margaret Belle had a wonderful day! She is off of the ventilator, she opened her eyes for Mommy and Daddy, and Daddy was allowed to change a diaper this afternoon (I'm so jealous!!!). Around 9 am this morning the nurses removed her ventilator and monitored her closely to see how she would respond. They were able to keep her oxygen down at 21%, which is the normal percentage for room breathing. Her vapotherm is set at 4 liters. (She was at 7 liters at 65% earlier in the week, so this is great news!) She continues to bask in the bili-lite, but hopefully that will be removed in the next day or so.

Her plan is to move into an enclosed isolette this evening. Mommy and Daddy will be there to witness this move, because nurse Bonnie said this would be the best time for us to get an opportunity to hold her. The nurses also removed the tube into her umbilical cord. For the last two days they have been feeding her breast milk through a tube in her mouth, which is connected straight to her stomach. I can't wait for the day that I will be able to hold and feed her at the same time. (I try not to get too greedy, but it is so hard when you see other moms nursing their babies in the NICU!)

I have not fallen off the face of the earth--I promise! The pain from my incision and engorgement has taken over my body, and it is all I can do to pump every 2 hours, sleep, eat, and travel down to the Baptist NICU. I hate to take this pain medication because it makes me drowsy, but like Dr. B. and the nurses said this is not the time to try and be a martyr. I should be up for more visitors and phone calls soon. Wade and I are back at my parents' house for now. We might try to go home this weekend. However, it is just easier for me to live here for now, especially since I am not allowed to drive for another week and Wade is at work.

Well we will definitely tape tonight's visit, if we can. Thank you again for all of your prayers. Margaret has no idea how many people already love her and pray for her daily! We are all so blessed to have each other during these moments of fear and celebration! Take care!



Tuesday, January 13, 2009

Roller-coaster

Mommy meets Margaret Belle!

Daddy's finger next to his favorite little foot!
Wade and I woke up this morning to the Neonatologist (Dr. P.) entering the room. We were hoping to never see a neonatologist appear in our hospital room (feels like bedroom now), because an appearance means that Margaret Belle is not doing well. Anyway for a split second Wade and I worried that something awful had happened to Margaret, but Dr. P. informed us that they would need to put Margaret on a ventilator to assist her in breathing. The word ventilator really scared us. We knew that adding that instrument meant that her lungs were not strong enough to breathe on their own, but Dr. P. assured us that this step was necessary. Margaret Belle needed a break. She had worked so hard in the last few days to breathe on her own, and her lungs just were not ready for all of that work.

After our initial reaction of fear and anxiety, we decided that this was just another bump in the road. Margaret Belle's journey is not predictable, and we need to calm down and be patient. The ventilator just prolongs our chance to hold and feed her, but we want to give her lungs enough time to mature and prepare for the rigorous job of breathing.

Later in the day, Dr. P. showed us her chest x-rays over the past few days, so that we could see why she needed the ventilator's assistance. It was obvious, and Dr. P. also explained what the ventilator would do and how they would slowly take her off of it in the next few days. Dr. P. was already impressed with Margaret's response to the ventilator. She was breathing so much easier and her oxygen percentage was dropping rapidly. So Margaret spent most of the day sleeping peacefully and resting those lungs. Her heart continues to look great, and her brain scan looks perfectly normal.

So we will continue to pray for her little lungs. Hopefully in the next week we will get to hold our precious angel. I think that is what I long to do more than anything. I understand that it might be awhile until I get to feed her, but hopefully we will hold her soon.

Thank you for all of your prayers and comments. Wade and I look forward to reading them every day. My health is okay---bp is up, but I think that is a little expected after all that we have been through in the last 24 hours---what an emotional roller-coaster!

Sunday, January 11, 2009

In the Spotlight



Wade and I are overjoyed with our precious miracle. It has been a roller-coaster of a ride the last 48 hours. Margaret Belle is already a fighter. The neonatologists continue to monitor her breathing. Last night they had to increase her oxygen percentage and continue to give her vapotherm treatments. This morning they decided to put her under the bili-lite to treat her jaundice. She is stable and maintaining a good temperature. Hopefully after 72 hours, we will start to see an improvement in her breathing; the doctors say usually it takes that long with a 32 weeker.

My health is improving. We had a few scares over the last 48 hours---but everything seems to be functioning appropriately now. My blood pressure has been so low that I haven't even had any medication for it since Friday morning. I actually passed out a few times yesterday due to hypotension. I am finally off of the magnesium and allowed to eat solid food today.

Here is a video from today. Please pray for her little lungs!

(PS-We don't know what we are going to call her yet. Margaret, Margaret Belle, Maggie, Maggie Belle, Meg, Megan Belle are all possibilities. Wade and I will let you know when we decide!)

video

Friday, January 9, 2009

Margaret Belle


Margaret Belle Rick

January 9, 2009


11:43 a.m.


3 lbs. 15.25 oz. 15 inches


Our precious angel has arrived! This morning after evaluating my blood work and urinalysis the doctors decided today was the day. The cesarean section went smoothly with Dr. B. and all of his assistants taking the best care of me and the baby. Margaret Belle looks great. She is in the NICU with constant 24 hour care. She is basically breathing on her own with a little supplemental oxygen and vapotherm. Her color is great, and her temperature is stable. She has lots of hair on her head, long legs and fingers like her daddy, and a round face like her mommy!

I will have magnesium administered in my IV for the next 24 hours to ward off any risk of developing severe preeclampsia, and then I should return to my old room for a few days. Margaret Belle will probably have to stay in the NICU for a couple of weeks, but the doctors and nurses really cannot predict how quickly she will gain weight and regulate her breathing. So we will take it one day at a time. All we know is that we are truly blessed, and both Wade and I have received the best gift in the world, the opportunity to love this beautiful little girl!

Thursday, January 8, 2009

Blessingway Necklace

Thank you to my sister, Laura, for making this precious necklace for me and to all of my friends and family. I will hold it during my c-section or labor (if I am lucky) and focus on all of those positive thoughts, scriptures, and prayers. She will be here before we know it!

Baptist Round 2, Day 8, Confused

(Feel free to skip to the bottom of this entry for the real information-sorry it is so wordy.)

Well, it has not been the best day to say the least. Don't worry--nothing is wrong with the baby- just a day of miscommunication (which by the way doesn't seem to be good for my blood pressure).

I see many professionals here every day with many different opinions, and sometimes it becomes a little confusing and overwhelming. Typically, I see two different doctors a day, usually Dr. B. and Dr. C., unless they are out of the office. Then I see at least 2 different nurses in the day time and 2 at night. Every morning around 5 or 6 AM, my blood is drawn by another nurse. Yesterday, I also had a visit from a nutritionist, which I later learned is routine when a person stays over a week in the hospital. Finally, I see a sonographer twice a week for an ultrasound.

I feel like I need an agent or something to write everything down and translate it for me. My illness is not an easy one. Let's review preeclampsia. There is no cure, and researchers are still trying to predict it and understand it. Symptoms can include: excessive swelling in the hands, feet, and face; high blood pressure; protein in urine; headaches; major weight gain; and pain in the liver. Today I learned a few more possible symptoms: high red blood cell counts and indigestion. The annoying thing, which I think I have talked about before, is that most of these symptoms are normal third trimester symptoms.

So in the middle of last night, I had some awful chest pains. After the nurse checked me, we decided it was probably just indigestion. It went away an hour or so later. Dr. B. stopped by a few hours later and explained that my uric acid level was up a little but not high enough to cause any alarm. He prescribed a medication for the indigestion. He also said we should definitely make it to 32 weeks, which I found a little odd because I thought 32 weeks was tomorrow morning and of course I can make it 12 more hours. It looks like the hospital has my due date a day or two later, so I won't be 32 weeks until Saturday (confusion starts). I'm sure this sounds like a silly thing to get upset about, but when you sit in a hospital room all day marking each and every day as a major milestone it becomes a huge deal. So that upset me. I want time to speed up, and sometimes it feels like I am swimming backward.

Dr. C. stopped by next. He explained that the date is not important, and he wanted me to relax. He also explained that the goal is to have a baby and not worry about how premature she is or whether or not she will have to visit the NICU. I just get a little greedy; I have made it this far and would like to keep going for the baby's health, especially when I hear other success stories. Dr. C. helped me refocus and understand that we don't want mom (me) to get severe preeclampsia again---if only mom could stay healthy!!! He told me tomorrow morning we would evaluate the protein level in my urine and go from there (aka decide if we would deliver). Finally, he shared that my red blood count was a little high in the lab report, and that could possibly be a sign of preeclampsia (confusion growing). Both doctors also confirmed that I would have an ultrasound Friday morning, and that we wouldn't have another estimate on her weight since we just had one a week ago.

After Dr. C. left, the nurses put me on the monitor (monitoring contractions and baby's heartbeat). They do this after meals every morning and evening. However, fifteen minutes into my monitoring session, a sonographer knocks on the door and says that it is time for my ultrasound scan. What? I thought it was tomorrow--that's what the doctors just told me (confusion + anger). The sonographer showed me her paperwork which confirmed the date. Once again I understand it is not that big of a deal, but my mom was planning on coming tomorrow and I just didn't understand why I was told one thing and the sonographer another.

During the ultrasound the sonographer estimated the weight of the baby (confusion + happiness). I wasn't quite sure why she was doing this, but she had great news. Her estimate was 3 lbs. 15 ozs.! Remember it could be 6 oz. higher or lower due to human error, but it is still nice to know that she is getting close to 4 lbs.

I tried to take it easy the rest of the day. They monitored me again after lunch, since my blood pressure was high. Her heartbeat was above the red line which really scared me. However, once I calmed down, she was back on her baseline and stayed there for the remainder of the session.

So that's all we know for now. The lab will investigate my 24 hour urine test in the morning, and then we will know what the weekend will bring. Please pray for the baby, my dear husband, my blood pressure, indigestion, urine, and SANITY.

Monday, January 5, 2009

Baptist Round 2, Day 5

Well, considering that we really don't know what each day will bring, Wade and I seem to be pretty calm and positive. Sometimes the doctors talk like we could deliver in the next day or so, and then they make us think that we will keep going until there is a big change in my bp or urine (which could be a few more weeks).

Yesterday we revisited the NICU to see if there were any babies about the size or gestational age of our little girl. However, it is really hard to compare babies and how well they are doing, because each little one is so different and his/her health is dependent on many different factors (gestational age, weight, breathing ability, and their ability to keep their temperature stable.) We saw some babies about 3.5 pounds like our precious angel; however, they were born at different gestational ages and just are reaching 3.5 pounds now. It was reassuring to see them doing well. We also passed a room on the way to the NICU with a brand new 4 pound baby girl! The nurse held her up for us, and the baby was breathing on her own, regulating her own temp., and doing fine at just 4 lbs.

Although the NICU provided us with more information and helped me and Wade feel more confident about our little girl's health, the visit also triggered some painful emotions about James. We saw a little baby boy weighing just 1 lb. 13 ozs. , and he was alive and doing well. James was almost 8 ozs. heavier than this little guy. So riding back in the wheelchair to my room I couldn't control my tears and my longing to know my little man. Wade admitted that the same thoughts had crossed his mind. We know that we will love this little girl more than anything in the world; however, we just wish we could have spent a little time loving James too. I cannot believe it has only been 9 months since we lost him. The pain eases but doesn't go away.

Back to this pregnancy---the results from the 24 hour urine test are in!!! The protein level was up a little, but the doctors are not worried about it and are not going to induce me yet. They are happy with the results from the blood-work also; the uric acid level had actually decreased. The plan is to probably keep me here for the duration of the pregnancy. How long that will be is the question. Hopefully our little girl will stay in another week or two---let's keep her growing as long as possible!!!

Friday, January 2, 2009

Baptist Round 2, Day 2

Dr. B. and Dr. C. have decided to keep me in the hospital throughout the weekend, and then we will reevaluate on Monday, after another 24 hour urine test and ultrasound. My blood pressure looks pretty stable for now, and I had about the same amount of protein in my urine test. However, both doctors feel that I might be in the early stages of preeclampsia, since both the bp and protein levels are inching up a little bit. Plus, I am experiencing some swelling in my hands and legs. The docs would love for me to get to 32 weeks or even further along, but they both agree that we don't want to get too greedy and allow severe preeclampsia to attack.

So we will just take it easy this weekend and see what next week brings. I feel very comfortable here, and Wade and I both know that our little girl is being closely monitored (which makes us feel very safe and secure).

Have a good weekend!!! By the way, we made it to 31 weeks!

Thursday, January 1, 2009

Home Sweet Baptist

Happy 2009!!! Wade, Baby, and I made it to 2009, and we are thrilled! However, we decided to ring in the new year in the hospital. Yesterday was a pretty low-key, typical day--watching football, eating great meals, playing math computer games with my adorable and bright nephew, and watching more football. During Dick Clark's New Year's Special, I started to notice that I was having a few uncomfortable contractions---they were a little too close together and little too uncomfortable. So I decided to go ahead and take my medicine and test my blood pressure. Unfortunately, my bp was a little higher compared to my weekly trend. Therefore, I decided to wait a few minutes and try checking a second time. Once again, both numbers were higher. I felt awful about calling Dr. B. at 10 PM on New Year's Eve, but I knew he would want me to considering those painful contractions and my bp.

Minutes later, Dr. B. was recommending that I come on in to Baptist to monitor the baby, the contractions, my urine, blood, and blood pressure. Trip number 3 to the triage was frightening, because I hadn't felt contractions like this since losing James. Plus, I didn't know if that meant my placenta was about to abrupt like last time or if I was just experiencing a preterm labor. The monitoring of the baby proved that she was doing well and that I was having real contractions. My bp was high but pretty typical for a triage visit, and my urine was clear of protein. The blood-work came back normal, except for the Uric Acid level; it was a little elevated. (Don't ask me what that means, because I don't know.) Dr. B. said it was something to watch but nothing too concerning. The nurse also administered a Fetal Fibronectin Test (fFN). This test apparently can predict whether I will go into labor in the next two weeks. It came back negative, which is a good thing; however, it has more to do with contractions and nothing to do with bp or preeclampsia.

Needless-to-say it was a long evening. Dr. B. came by our triage room around 12:30 AM and evaluated the tests. Then he told us that we would be admitted to the hospital and stay for at least a few days to monitor my bp, contractions, urine, and blood-work. He also wanted to double my dose of procardia. Happy New Year!!!

I didn't sleep much last night, because I had an IV administered, started a 24 hour urine test, and had the contractions and baby's heartbeat monitored all night long. The procardia luckily does double duty; it helps with bp and slows contractions. It definitely did it's job, because in the morning my bp was lower and the contractions were gone. Therefore, Dr. B. said I could stop the IV fluids. He also wanted to give me another steroid shot to just make sure the baby's lungs were ready for delivery. He said my future in the hospital and the delivery of our little girl would depend a great deal on this 24 hour urine test. Friday morning we will know what will happen next. Dr. K. entered the room shortly after Dr. B. and once again confirmed the facts. She also told me that I would have an ultrasound later that morning.

After the dreaded steroid shot, I went in for the ultrasound. The baby is still breech, practicing her breathing, has a great heartbeat, and measures well. She is about 3 pounds, 6 ounces. Did I mention that she is also adorable?

So many things could happen tomorrow. The doctors will either decide to send us home, keep us here for the remainder of the pregnancy, or set a date to deliver this baby. Wade and I both just want the best for our little angel, even if it means she has to come weeks early and visit the NICU. We know she is in God's hands and has the best team of doctors and nurses here at Baptist to care for her. Continue to pray for our 2009 sweetheart. Hopefully by Valentine's Day we will have a new little love at home!