NICU - Day 70

Date: January 31st
Gestational Age: 38 weeks 1 day
Weight: 2720 grams (2 grams away from 6 lbs!)

Madelyn is 10 weeks old today! Her feedings are staying the same because she is having a lot of residuals (sometimes more than she even ate). She did have one feeding where there was only a 2 ccs residual, which is the minimum amount to feed normally without having to contact the nurse practitioner.

A little dried milk under her lip. 

We made an effort to "practice nurse" today. They need to keep track of every little bit she eats, so we can't breastfeed for real, so I pumped and then we tried just simple latching on. She was able to do this right away! She would only take a few sucks before she would turn her head or whine but it was a good start!

When Dan arrived tonight after he got off work, he had gifts from his coworkers. Iowa State bibs (ew) and a Wonder Woman costume! I can't wait until I can dress her up as Wonder Woman.

Maddie was lowered from a RAM of 5 to a RAM of 4 with an oxygen floor of 40%.

NICU - Day 69

Date: January 30th
Gestational Age: 38 weeks!
Weight: 2635 grams

"I wonder what this cord does..."

I worked all day and then came down to spend time with Maddie. They started her back eating at noon today and she is getting 6 ccs every 4 hours. She gets grumpy about 30 minutes before she is supposed to eat and cries to get our attention and so that we don't forget to feed her (waking herself to eat is #4 on the "My Goals for Discharge" list). She cuddled with me for a little bit but I didn't get to the hospital until super late, so she mostly slept while I fell asleep in the recliner. They are also cycling her NVN.

She pooped twice today and that, to me, is quite the accomplishment. We will continue to celebrate poops until they become common place. They are a bit concerned with her getting a diaper rash due to the acidity of her stools and they want to avoid that (rather than try to heal it after it happens). We are now using disposable washcloths to wipe her butt and applying a thick cream at every diaper change to decrease the chances she'll end up in pain.

NICU - Day 68

Date: January 29th
Gestational Age: 37 weeks 6 days
Weight: 2665 (wet)

Dan was the parent present for Maddie today, so all updates in this blog come from the information he relayed to me.

Madelyn had her eye exam this morning. Her right eye has improved a little bit (it is now Zone 2 Stage 1-2) but not enough to be able to skip an eye exam next week. Maddie had a spell during her eye exam. Her nurse reported that this is not unusual because babies hate eye exams.  Maddie also got a 20 minute full body massage from the physical therapist (she apparently doesn't hold a grudge for almost being hit with stool last week). Dan tried using the "baby toothbrush" on Maddie (I don't know if this means he failed or only partially succeeded). Maddie was pretty congested today, so Dan had the nurse suction her mouth and nose. They discontinued Maddie's morphine today and raised her dextrose.

Maddie's staff doctor and the surgeon both stated that it is not unusual that Maddie had not pooped yet (this was in the afternoon) and that she is progressing well. They usually wait to feed the babies until most of their fluids have drained off, their tummy is flatter, and they have pooped. Maddie will return to intermittent feeds once she can eat. They were only doing continuous before because of her ostomy.

Maddie is due for her vaccines next Tuesday. The staff doctor apparently described our compromise on this to some sort of peace treaty.

Tonight just after I had gotten home from work, Dan called me and told me he had good news and bad news. I asked for the bad news first because it had been a LONG day. The bad news was that Dan got poop all over his hands! It was (luckily) Maddie's poop. She made such a mess that she needed a bath afterwards!

NICU - Day 67

Date: January 28th
Gestational Date: 37 weeks 5 days
Weight: 2770 (wet)

Still intubated

After extubated

Before I got over to the hospital this morning, I got a phone call that Maddie was being moved to Bay 3! This is the second time we have been over here as she was moved from Bay 1 to Bay 3 two days after she was born. Bay 2 and Bay 3 are essentially the same level of care. They were able to drop her SIMV rate from 15 to 10 this morning (she had started on 20 after surgery). Maddie is now in a super small room without a door (just a curtain) which means that it gets very noisy. There is a baby down the hall that has been crying like a cat for the last 10 minutes. I feel sad listening to the baby going on and on. Maddie however, rests quietly, her hand inching up and up towards her intubation... I think she is saying, "Take this out before I do!"

Pre-extubation

Maddie was extubated this afternoon and had her PICC line taken out. She is happy to be back on her regular cannula from before surgery. No stool yet, so no eating yet. This makes her a big grumpy. She was lowered on her morphine, but she seems to be coping with that well. Surgery came and said her incision looks really good. It is currently covered with a bandage, but that is just so it won't rub against her diaper. She can now wear clothes again too!

Daddy and his princess

Dad came and visited today. Maddie as usual, enjoyed the extra attention. We cuddled for part of the afternoon. It took a lot time to get all the things done before she could be held (labs, x-rays, get RT to come get the ventilator, etc.).

Before massive diaper.

Maddie peed all the way up to her shoulder blades today. The diaper weighed 107 grams! That is a lot of pee. I am really glad that she is peeing off her water weight. I have decided that I will measure my weight minus water from now on. I'm not exactly sure how to do that, so I'm just going to assume 1/5 of my weight is water and announce my weight based on that assumption.

After massive diaper. All dressed up in her "uggs".

NICU - Day 66

Date: January 27th
Gestational Age: 37 weeks 4 days
Weight: 2590 grams

Today was the big surgery day! Maddie was irritated that her food stopped running at 3 am. All day yesterday, Mom had been putting milk on Maddie's pacifier and giving it to her. She was thrilled with that and took two sucks of her pacifier this morning and then spit it out, irritated that she didn't get any milk on it. Mom and I both held her before surgery since we didn't know when she would get to be held again.

"I will scream until you feed me."

Transporter

All wrapped up and set to go!

Sad Daddy (nervous about surgery)

Surgery went fabulous. They were able to close her up without issue. She can now poop out of her bottom like a regular baby. Madelyn was groggy after the surgery but was still a little fiesty, grabbing on her intubation. We even got a little smile out of her. Dan read to her this afternoon from Chronicles of Narnia. The nurse tried to put her left arm down several times, but she continued to raise it above her head. Maddie needed a new PICC dressing and when the nurse came to start, she pointed out that I was laying in the recliner in the same position, with my hand by my head.

Kisses from Grandma

Madelyn will likely be extubated some time tomorrow, so I'm going with my original plan to work Wednesday and Thursday this week and spend the rest of my time with Madelyn. When the extubate her,  I want to be here to cuddle with her.

Kisses from Mommy

Maddie and I are very jealous that Grandma Ann gets to go to Wisconsin this weekend as you can tell by the below conversation...
Mom (Gma Ann):  Sorry Maddie, I won't get to see you next weekend because I'm going to Wisconsin [for Ladies' Weekend].
Me (Mommy): You know Maddie will be praying for a blizzard so that you can't go.
Mom (Gma Ann): I will be going. Maddie has about 21 years before she can go.
Me (Mommy): She can't go next year?
Mom (Gma Ann): You have to be 21.
Me (Mommy): Don't people take their babies?
Mom (Gma Ann): Only if they're under a year.
Me (Mommy): Maddie will go next year, she measures by her adjusted birth date.
Mom (Gma Ann): It depends on when the trip is next year. It could be in late February or March.
Me (Mommy): Oh, like none of you ladies has ever shaved a few months off your age.

Live Updates on Surgery Day

For those irritated that I have become lazy in my blogging, here is your super updated events for today. Maddie is getting her intestines back together today and we are all anxiously waiting. 

7:00 Last cuddle with Grammy Ann for a couple weeks

7:20 One last cuddle with Mommy before surgery

7:50 Diaper change, remove outfit, and temperature taken

7:55 Swaddled in her blanket with a hat and pacifier

8:00 Heading down to the ER with her nurse and a respiratory therapist

8:10 Surgical team realizes they didn't get a consent signed for her art line 

8:15 Surgical resident arrives, consent signed, informs us that Maddie may need another ostomy. Decision will be made during surgery. Surgery will take 2-4 hours likely. He says she is getting her anesthesia started now. 

8:25 Dan, Mom and I are sitting in the NICU waiting room. 

9:20 Renae and Kelsey arrive to wait anxiously with us

10:00 They made the incision. (We found this out at 11:20 am)
11:35 Since we haven't heard anything, we head down to get food at the Marketplace
11:40 Surgeon walks by Mom (Grandma Ann) and says everything went well
11:50 Dan and I go and see Maddie. She looks good but drugged. They're going to do a x-ray, so we head back to the waiting room to eat our food.

12:00 Surgeon and his 7 minions came and talked to us. They went in at her ostomy site, hooked the intestines back up, tucked them inside, and sewed her back up. She also had her art line placed. 

NICU - Day 65

Date: January 26th (Happy Birthday Great Grandpa Rosauer!)
Gestational Age: 37 weeks 3 days
Weight: 2530 grams

Today is Grandpa Rosauer's 92nd birthday. We tried to call him but it was either busy or rang and rang.

My mom came to visit and Maddie got to cuddle all evening with Mom and I. Maddie spent much of her day sucking on her pacifier cheerfully as Grandma Ann was dipping it in breast milk to make it more tasty.

Dan signed the consent for Maddie's surgery this morning. It would be like the surgical team to have him sign it when I'm not here so that they don't have to answer my incessant questions. I doubt that this was actually planned, but it wouldn't surprise me with how much I seem to irritate them.


Tonight was Maddie's last night with an ostomy. Exciting! She will hopefully never again need one. I am hoping that we will have a better idea of her intestine length after tomorrow's surgery.

NICU - Day 64

Date: January 25th
Gestational Age: 37 weeks 2 days
Weight: 2505 grams (5 1/2 pounds)
Height: 18 1/2 inches

Madelyn had a pretty quiet day. No changes today during rounds, just lots of talk about surgery on Monday.

Dan and I took our niece Kate to the Amanas for "Winter Fest". We made snowglobes, decorated cookies, made hot chocolate, and most importantly had our faces painted. Kate had a "fairy" design, I got a purple "girly stach" and Dan looked like a villian from a children's movie (mustache, goatee, and creepy eyebrows). The lady that painted our faces took a picture and if she posts it, I will be sure to share it on here.

Tonight we had a birthday party for my Grandpa Rosauer. He turns 92 tomorrow. I can't even imagine what it would be like to be 92 years old. He handles it pretty well. Maddie was unable to attend, but was the subject of much conversation.

NICU - Day 63

Date: January 24th (Happy Birthday Aunt Janelle!)
Gestational Age: 37 weeks 1 day
Weight: 2445

"I cannot believe Mommy put me in a ladybug hat."

Today is Aunt Janelle's birthday. Maddie continues to work on her handwriting. It seems to be pretty good for a 9 week old.

Big smiles for Aunt Janelle!

Madelyn started being fed at 3 ccs every hour today. Her labs came back with a low hemoglobin level, so she needed an IV to get blood. This took four nurses to accomplish because Maddie apparently has the veins of her mother. She cried through some of it but I cuddled her to try to ease some of her pain. The nurse that was finally able to accomplish this feat deserves recognition. She is training to be a ARNP and did fabulously!

The anesthesiologist stopped by to discuss Maddie's surgery for next Monday. It will be in the pediatric operating room! It is scheduled for 8 am.

She also impressed me (and not so much her nurse and the physical therapist) again today with her abilities. Maddie's bag was leaking and her nurse was trying to get the size of the hole right on the new ostomy bag. We had a disposable washcloth laying over her ostomy and the nurse lifted it to check to see if the hole in the bag was big enough. Before she could re-cover the ostomy with the washcloth, Maddie shot stool out of her ostomy site in a rainbow fashion. It was the funniest thing I have seen in awhile. The physical therapist quickly moved to the side of her bed saying something about not normally having to worry about standing at the foot of a girl's bed. Maddie gave us a look like, "Did I do that?" and feigning innocence. It definitely hurried the nurse's cutting of the bag to get it on before Maddie could try that again! Also, this occurrence meant another costume change.

Today was another big day for visitors. Grandma Ann (who wasn't thrilled when Maddie had to stop cuddling to get her blood transfusion), Aunt Renae, Aunt Kelsey, Jordan (KJ's boyfriend), Great-Aunt Megan and Elaina (my cousin). Maddie was happy to cuddle with everyone who wanted to.

NICU - Day 62

Date: January 23rd
Gestational Age: 37 weeks
Weight: 2375 grams

I went to work again today and worked 10 1/2 hours. I had to do my health screening at work this morning and the woman who took it had to stab me a couple of times and then moved the needle around in my arm. Super fun times.

After work, I drove back down to Iowa City and gave Maddie a bath tonight. Maddie was increased to refeedings of 16 ccs every four hours. Surgery is scheduled for the 27th at 8 am.

Learning to read with Daddy

Dan read to Maddie and helped me give her a bath tonight. Maddie was well-behaved during this.

She looks scared, but she wasn't...very.

NICU - Day 61

Date: January 22nd
Gestational Age: 36 weeks 6 days
Weight: 2255 grams

Cutest little Yankees Fan!

Maddie is wearing Build-a-Bear Designs. You too can
dress your preemie in designs by Build-a-Bear.
Found at your local mall. 

Maddie enjoyed her Wednesday with Mommy. Daddy came to the hospital later than Mommy, so that meant plenty of time for dressing up as a miniature Yankee. Maddie slept through ALL of this. Not even a peep out of her.

The Child Life lady stopped by to see how we were doing and brought Maddie some more beads for her Beads for Bravery (it is getting very long!) and massage coupons for Mommy (VERY appreciated).

NICU - Day 60

Date: January 21st
Gestational Age:
Weight:

Maddie was happy for Mommy and
Daddy to return to her tonight

Baby Bright Eyes!

I got to return to work today and meet with some of my "kids". For the most part they were happy to see me back. This will be quite an adjustment traveling back and forth from Waverly/Denver to Iowa City every day.

Tonight, Maddie was awake and ready to be read to. Dan enjoys reading to her from the board books or Chronicles of Narnia, whichever one Maddie looks like she wants to hear. She seems to follow her black and white board book when Dan shows her the pictures and he finds that exciting.

Maddie was increased to 14 ccs of refeeding every four hours to her lower intestines. She doesn't always have that much out every four hours, but they then refeed as much as she has.

NICU - Day 59

Date: January 20th
Gestational Age: 36 weeks 4 days
Weight: 2275 grams

I did not sleep last night. I ended up coming over to the NICU at 8 am and ended up sleeping for a couple of hours in the recliner in Maddie's room.

I went to Waverly today to meet with my boss and make a plan for my return to work. I wasn't able to start working today because I need a note from my doctor approving me to return to work and the University of Iowa is closed for MLK Jr. Day. I am hoping that tomorrow I will be able to get the note early so I can get some hours of work in before I return to Iowa City. Maddie is doing well today. She is not giving the nurses too much trouble.

NICU - Day 58

Date: January 19th
Gestational Date: 36 weeks 3 days
Weight: 2290 grams

Madelyn had another big day. She got to cuddle for a few hours with her family.

Happy Grandma!

First up was Grandma Deb who was already planning their next cuddle session before this one was even completed. Maddie has that affect on people. Then she cuddled with her great-aunt and great-uncles.

Joey and Teresa

Lavern and Pam

Madelyn then cuddled with Mommy (not pictured). I did not take a picture because I was trying something new to see how good I am at multi-tasking. I was cuddling with Maddie, pumping milk and talking on the phone all at the same time. It was a bit difficult, but we managed.

Maddie was a little bit more irritable today. She cried several times and she is not normally a baby that cries. I talked to the nurse practitioner tonight and she is going to keep an eye on her and order more labs if she continues to struggle throughout the night. They tested her for a urinary tract infection a few days ago, but were worried that the sample started to grow because of contamination, so they are testing it again.

NICU - Day 57

Date: January 18th
Gestational Age: 36 weeks 2 days
Weight: 5 pounds!

Madelyn had a great day today. She hit five pounds!

Maddie also got to be held by Aunt Kelsey for the first time. She was held by Aunt Renae as well because, well, how could she resist.

Best day ever for Aunt Kelsey? I think so!

Maddie loves kisses.

 Maddie wrote Mommy and Daddy two notes last night. She has such nice handwriting!

Reading in bed. I have a feeling that this
will be happening a lot as she gets older.

I clipped Maddie's fingernails for the first time today. I was a little nervous at first, but she stayed calm and didn't jerk her arms.

What a happy aunt!

NICU - Day 56

Date: January 17th
Gestational Age: 36 weeks 1 day
Weight: 2255 grams (3 grams shy of 5 lbs!)

Madelyn is EIGHT weeks old today! Where has all this time gone? She is also very close to hitting 5 pounds and I am VERY proud!

Grandma Ann was able to come and visit today after work. Maddie enjoyed cuddling with her. The speech therapist came by to evaluate Maddie today but Maddie refused to talk to him. Actually, he came to evaluate her sucking reflex. She displayed that she can, in fact, suck on a pacifier but also showed him that she was not a fan of him sticking his gloved finger in her mouth. He recommended that we put breast milk on her pacifier several times a day so that she will get the taste of the milk as well as the filling aspect of her feeding tube. We have actually been doing this for a really long time, but just not several times a day. He also mentioned that he was going to talk to her GI and NICU teams to see if we could start giving her a little bit of milk in a bottle. He mentioned that this may not happen until after her surgery.

Maddie has been getting really good at getting her ostomy bag off. Today was the first time since she started wearing clothes that I came in and she was wearing the same outfit from the night before. She made up for this by needing her bag changed at her 2 pm and 10 pm re-feedings. If she weren't so cute, I don't think the nurses would be so nice about it. Also, Maddie's re-feedings went up to 12 ccs every 4 hours.

Totally relaxed.

It seems Maddie will be wide awake and then as soon as Dan or I start to hold her, she falls asleep. She is also very talkative, looking at us and babbling about her day. I have been improving on my ability to remove Maddie from her bed by myself. The nurse helped us re-do some of her tubes and cords to make this easier for me. It seems like every time we pull her out, her cords are more messed up than the time before.

Tummy time on Daddy's chest.