Monday, January 26, 2015

Owen's NICU Story

Within an hour of you being born, the hospital decided to transfer you to Tacoma General's NICU, as they were better suited to care for a baby of your gestation.  The transport team from TG came down to get you, and we said goodbye to you in your tiny incubator before you left.  Daddy followed the specialized ambulance up to the hospital, while I stayed in Olympia, waiting to be discharged.

I started using a breast pump at the hospital right after you were born, and continued pumping every 2-4 hours around the clock until you were discharged 3.5 weeks later.  Luckily, once my milk came in, I had a great supply, and have had more than enough milk for you.  You did receive donor breastmilk for 24 hours while we waited for my milk to come in, and my breastmilk was mixed with a human milk fortifier everyday to provide you with extra calories while in the NICU/ICN.

You needed a CPAP machine to help you breathe for the first 24 hours, but then moved to room air and did just great.  You occasionally had episodes of apnea and minor bradys, but we quickly learned that is to be expected with preemies.

In the NICU, we had a private room.  Every morning, a team of doctors/nurses/other health care professionals would round on all of the babies, so everyone on the team got to hear the same information at the same time.  This was also a great time for us to ask questions!  We got to know all of your nurses very well, and had a few favorites (Danielle, Jorden, and Amanda).  After only 3 days in the NICU, (Wednesday, December 3rd) we were informed you were being transferred to the ICN (Intermediate Care Nursery).  This was because you were one of the bigger and more stables babies in the unit, and more "delicate" babies were coming in that needed the higher level of care you no longer needed.

The ICN provided much less privacy and room than the NICU.  We immediately missed our nurses and space from the NICU, but knew we would just have to settle in and make the best of it.  Either Daddy, I, or both of us spent every single day with you.  We made sure to attend daily rounds, and as many care times as possible (you were on a 7/10/1/4 schedule).  At each care time, we took your temperature, moved your O2 saturation probe to the opposite foot, changed your diaper, and the nurse listened to your heart, lungs, and stomach.  Those were also your designated eating times.

You needed a bili light for several days, which included a pair of "sunglasses" to protect your eyes.  The light made getting you in and out of your incubator/bed more difficult, but we wanted your jaundice to pass as quickly as possible!

You had an NG tube in that allowed your milk to be fed to you directly into your stomach.  We started allowing you to try breastfeeding right away, but it took you until almost your discharge date before you really got it down.  You also started taking a bottle while in the ICN.  Learning how to take all of your daily volumes by mouth was your major goal for discharge, and really the only thing keeping you in the ICN.  On Thursday, December 18th, you finally took 1/3 of your daily volume by mouth, which was a huge accomplishment.  That next day, Friday, neither Dad nor I could be at rounds, due to me being sick and Dad being home with Lane.  Dr. Willham, the neonatologist assigned to you for the majority of your time at TG, called us that afternoon to say that once you took 1/2 of your daily volume by mouth, we could move you to "modified demand" feeding, which meant we waited for your cues of hunger before feeding you, but wouldn't allow you to go more than 4 hours without a feeding.  This was to test out your ability to take enough food in everyday on your own schedule and still gain weight.  Well over that weekend, you hit the 1/2 mark!  So Monday morning at rounds, I brought up moving you to a modified demand schedule, as I truly felt you were ready to try.  Luckily, both the neonatologist (Dr. Golden) and the nurse practitioner (Alta) agreed with me, and gave us the green light for a full demand schedule!  The nurse took your NG tube out, and it was so nice to see your tiny face without any tubes/wires!

So, we spent that afternoon focusing on breastfeeding.   Later that afternoon, our nurse asked if we wanted to "room in" with you that night, because as long as you continued to feed well and gain weight, you would be discharged soon!  So, I got to call Daddy at work, and asked him if he wanted to bring you home in time for Christmas.  I cried and cried as I talked on the phone, as we never expected you to be discharged in time for us to celebrate Christmas as a family at home.

We spent the rest of the day getting plans in place for Molly and Lane, and performing your car seat challenge (which you passed easily), getting your Hep B vaccine, giving you a bath, and moving into the private room in the ICN.  Daddy and I spent two nights rooming in with you, performing all of your care and feedings.  You were finally free from all of the monitors too, and we were free to walk around the room with you without being tethered to any machines!  The first night, you lost 30 grams, and the nurse and doctor told us if you gained ANY weight the second night, we could go home the next day.  We worked really hard at feeding you frequently, and the nurses waited a few extra hours before weighing you to give you as much time as possible to gain weight.  And you did!  You gained 10 grams the second night, and so Christmas Eve morning, we got the green light to take you home.

It took us several trips to the car to get all of our stuff out of the nursery and our Treehouse room, and Daddy had to run to the store to buy a cooler to take all of my frozen breastmilk home.  Walking out of the nursery with you in your carseat was such a strange and exciting moment- no more scrubbing in each day, no more signing in, no more name tags, no more daily doctor exams, no more cafeteria food, and mainly, no more having our family separated.

This experience was one of the most difficult things we have ever faced, and we could not have done it without all of the help and support we received from family and friends.  You are one tiny but tough little boy, and we love how perfectly you fit into our family.  We love you Owen!