Remainder of Weston's Hospitalization

Over the next several days - December 28th - 31st, Weston's only goals were to eat and grow. I ended up spending all my time at the hospital including overnights so that we could get him off formula supplementation and strictly on breastmilk. In order for him to be dismissed, he needed to nurse exclusively for 24 hours and increase his weight. Fortunately, I had amazing nurses that helped me out tremendously with the nursing thing. Nursing a preemie is A LOT different than a full term baby, so I'm glad I had experts to help me out. Also, the lactation consultant happened to be a friend of my mother-in-law and had been praying for our family for several weeks, so we had a special connection. She was an absolute blessing and a huge encouragement to not give up. Weston would get pretty tuckered out from nursing - it was a whole lot easier for him to receive the tube feedings, but now he needed to work at being fed. He was an absolute champ and surprised all the staff in the ISCN. The difficulty was trying to keep him awake to make sure he was getting enough nourishment.

I grew very attached to our nurses because they were so understanding and compassionate. All of the nurses work 12 hour shifts and several days in a row, so we had 3 consistent nurses during the day shifts and 1 consistent nurse during the night shifts. The ISCN can have 22 babies, but over the holidays it was unusually slow, and there were only 4 babies there including Weston. Because it was slow, Weston got a lot of special care and two of our nurses were on orientation, so most days there were two nurses caring for Weston - the orientee and the preceptor. As our time in the ISCN was coming to an end, I was thrilled to be able to go home with Weston and be together as a family of four, but, I was also nervous taking Weston home and caring for him without the expertise of our nurses. My favorite nurse, R'Lou was going to be off work the 30th and 31st and it was so hard for me to say goodbye. She was so supportive and encouraging - I honestly wanted to take her home with us. I have never been more impressed with the care these nurses gave us - they truly are phenomenal.

On the 31st, our nurse woke me up and said that we had a lot to do to get ready to be discharged. Discharged?!? I thought we would be staying until January 2nd when he would be 37 weeks. Our little overachiever had done so well nursing, that he was gaining weight well. He weighed in at 5lbs 1oz and even though it wasn't back up to his birth weight, the staff was pleased with his progress. Our agenda for the day included more education, a hearing test, car seat test, and eek - circumcision! I gave him a bath and shortly thereafter an audiologist came to the room and checked his hearing. He passed with flying colors! Then one of the pediatric physicians came in to have me consent for Weston's circumcision. Unforunately, when they brought him back to do the procedure, they decided to hold off until he was a little - ahem - "bigger." (He's now scheduled for February 8th, but don't tell him!)

Last thing was the car seat test. Amaya had this done because she was below the recommended weight and  did well, so I was hopeful that Weston would do just as well. Unfortunately, I didn't remember that we needed the car seat base, so after a frantic call to Steve, he brought it up on his lunch hour. The nurse was struggling to get the straps tight enough on Weston to be considered safe, and I freaked out again. She recommended borrowing someone else's car seat that was a little smaller or purchasing a preemie car seat. He was being discharged today! Where on earth are we going to find a smaller car seat or a preemie car seat this late!?!? Plus, if the car seat worked for Amaya, surely it would work for Weston!!! Fortunately, another nurse came in to check on us, and was able to make some adjustments and got Weston all snuggled in tight.

After 90 minutes in the car seat, he passed the test wonderfully. They just wanted to make sure he didn't stop breathing, oxygen level stayed within normal limits, and his heart rate remained stable while in the car seat.

I packed up our room and Steve picked us up after work and we were headed HOME! Praise GOD!! We made a quick stop at my parents to pick up Amaya and went home. My sister and her family were visiting from Nebraska to celebrate Christmas and New Year's and we missed quite a bit of time with them while in the hospital. So, when we got home and settled, Joshua, Jordan, Carol, and my dad came over for a little bit.

 

It was a different New Year's Eve for us... Instead of our usual party with family, we stayed up to midnight watching a movie and rang in the New Year with our new addition! Even though it was different, it was the best New Year's Eve ever! So glad to be HOME!!!

Visitors

For Weston's baby book, I wanted to make a list of all the visitors that came to see him in the ISCN, so this post is more for my memory, than anything else...

Patricia Markus - RN in allergy
Rebecca Partridge - RN in allergy
Tricia Stevens - RN in allergy
Danielle Connor - RN in allergy

Grandma and Grandpa Gustafson
Grandma and Grandpa Horning
Mike, Arwen, Ben, Annika, Lydia, and Miles Gustafson
Dan, Carol, Hannah, and Hope Springer (Joshua and Jordan saw Weston when he was home)

Nancy Anderson (our beloved friend from Wal-Mart)
Brad, Angie, and Josh Hansen (Nancy's son-in-law, daughter, and grandson)

Jen Hull (wonderful friend)
Susie O'Connell (Jen's mom)

Pastor Steve and Lori Eckert

Weight and Blood Pressure Updates

Weston has had three weight checks since he came home from the hospital and so I thought I better get updates out and on "paper" so I can remember when I get around to his baby book. (I still haven't done Amaya's yet... but most of the important stuff is already on our blog, so it should be easy. Finding time, on the other hand, is another story.)

Weston was discharged on December 31st (more about his last few days in the ISCN in another upcoming post) and his doctors wanted him to get a weight check within a few days of dismissal. His last weight in the hospital was 5lbs 1oz. On January 3rd, we met with Dr. Wade and he weighed in at 5lbs 5oz - almost back up to his birth weight of 5lbs  6oz. On January 11th, we met with out primary doctor - Dr. Horn and he weighed in at 5lbs, 15oz! While Weston was in the hospital, the dietician met with us and wanted me to supplement his feedings with formula with a little extra calories and I was hesitant because I worked so hard to get him to nurse well and some of it was my own pride. Dr. Horn reassured me that we were on the right track and as long as his growth curve was on the up and up, there was no need for me to supplement feedings with formula. Weston had another weight check on January 25th and he was 7lbs 9oz!!! All my worrying about whether he was getting enough milk, was completely unnecessary! Some of his preemie clothes were starting to get a little snug and when I put him in his carseat, he was definitely getting bigger. However, for him to gain a little over 2 pounds in his short little life far surpassed my expectations! Way to go Weston!

I also had a couple appointments this month for a blood pressure check. On January 2nd, I met with Dr. Hokenstead (I thought it was going to be the doctor who delivered Weston, but it was her husband!) My blood pressure was still a little elevated, so I was supposed to continue the Labetalol until I returned to see him. I was disappointed because the medication made me so tired, and I was afraid my blood pressure wouldn't normalize (even though they told me it could take up to 6 weeks for it to go back to normal.) A few days prior to this appointment on the 16th, I began feeling lightheaded (a sign that my blood pressure was lowering) and sure enough, my blood pressure was 100/64. Typically, they would taper the dose of my medication, but because I was having symptoms of lightheadedness, they discontinued the medication completely. Praise God! I have my 6 week follow up appointment the beginning of February with Dr. Harms, so they will recheck my blood pressure again, but I should be just fine.

Thank you to everyone who has been praying for Weston's and my health! Overall, we are doing wonderful!

First Bath

Weston was tolerating tube feedings and nursing really well, so on December 27th, the nurses were able to remove his IV from his hand and he was now able to have a BATH! My nurse, Erica suggested I call my parents and have them bring Amaya to help out with the bath. All of my nurses were outstanding, but Erica was special in that she really made Amaya feel special and involved.

Amaya was anxious to help out!

Here's our little man getting ready for a swaddle bath. The blanket was kept on him during the entire process so that he would keep warm. So... will he like his first bath? Scream and cry?

For the most part, he enjoyed his bath... and several baths later here at home, he really likes it and sleeps great afterwards!

Here Erica is showing Amaya how to wash his arms.

All nice and clean!

 

Our little man got into a little bit of mischief after his bath... he ended up pulling out his NG tube! Maybe he figured since he got his IV out, his NG tube should come out too! Since I wasn't nursing exclusively yet, Erica had to put the NG tube back in. 

I apologize for the pictures being so dark. We weren't able to use our flash while in the ISCN because they didn't want to startle or overly stimulate him.

Discharge and Sun Tanning

On December 26th, I was finally going to be discharged. The plan was for me to continue to take medication and monitor my blood pressure for a few weeks. It takes FOREVER to get discharged - waiting on prescriptions, physician rounds, and discharge instructions. It was so frustrating for me to go back and forth between my room and Weston's - I just wanted to be with my little man! I felt like I was ignoring him and granted, all of his cares were being done by highly trained and experienced nurses, but I wanted to be the one taking care of him! After lunch, we got everything squared away and I was free to spend all my time with Weston.

The great thing about the ICSN is that I truly could spend 24 hours a day there. He had his own private room and there was a couch that pulled out to be a bed. Initially, I thought I would be staying overnight with Weston, but the nurses explained that until he was showing cues that he wanted to nurse overnight, I should go home to my own bed and get as much rest as I could. And I honestly think that my recovery was so quick because the nurses encouraged me to rest as much as possible. Sleep is a wonderful thing, however,  I felt guilty for leaving Weston at night... even though he was in very capable hands. I also felt guilty because I knew that Amaya needed time with me... I really struggled trying to find a balance - I was pulled in so many directions and any choice I made, I felt like I was letting someone down. In the end, Weston's needs came first while Steve and my parents took care of Amaya's needs.

Steve returned back to work on December 27th. My parents took care of Amaya while I spent the day at the hospital. On rounds that morning, the physician said his bilirubin levels were creeping up and that since he was in the hospital, we might as well treat him with phototherapy. His color was a little yellow, but nothing too terribly bad. He had quite the set up and fortunately tolerated all the equipment well. Here's a picture of him sun tanning!

The nurses really stressed the importance of holding him skin to skin (kangaroo care) to help reduce stress, increase his ability to nurse, and of course, to share that bond with him. But because Weston needed to spend most of his time under the lights for the next 48 hours, so I wasn't going to be able to hold him as much. Even though I couldn't hold him, my day was busy enough meeting with the physicians, the lactation consultant (who is a good friend of my mother-in-laws and had been praying for our family), a social worker, and dietician. We also had a very large binder full of information that we needed to read about taking care of a preemie and it's amazing how much I learned about the difference between a preemie and a full term baby. And in between visitors, I was either nursing or pumping every 2 hours. The day seemed to fly by!

What was most encouraging was that all Weston needed to be doing was eating and growing and once he got the nursing thing mastered, he would be discharged. We thank and praise God daily that he is one healthy and strong little boy! 

Christmas Day at the Intermediate Special Care Nursery

When Amaya first saw Weston, I think she was a little disappointed that she couldn't hold him right away. With all of his tubes and wires, it was difficult for me to hold him and nurse him, so the nurses encouraged us to refrain from having him held by a lot of people and to decrease the chance of him getting sick.

Amaya has been absolutely amazing through this entire pregnancy - dealing with my morning sickness and being tired all the time, comforting me while I had shingles, and being understanding while I was on bed rest. She has adapted very well for a 4 year old, and while she loves being with her grandparents, she needed some time with us.

On Christmas Day, Steve and Amaya brought our stockings to the hospital so we could celebrate Christmas. For us to actually open all of our stocking stuffers it took us nearly all day because I had a room in postpartum and Weston was down the hall in the intermediate special care nursery (ISCN).  A video camera was set up in his room so we could watch him on TV and any time he was awake and alert (which was few and far between) we would hustle down the hall and see what was going on. And I was pumping every 2 hours, so any little drop of milk I got, we brought down to the nursery to have the nurses feed it to him. I think this was the most challenging part for me - I was supposed to be recovering and taking care of myself, yet our precious baby boy was down the hall from me and I was supposed to be caring for him. I was very rarely in my room, with the exception of showering, eating, and pumping, so it was difficult for my postpartum nurses to do all the education they needed to complete. The doctors stopped my blood pressure medication with hopes that my blood pressure would go back to normal after delivery. Unfortunately, it was still elevated and I was told it could take 6 weeks for my blood pressure to get down to normal. I was restarted on my blood pressure medication and they decided to keep me one more day in the hospital. I was frustrated, because all I wanted to do was be with my little boy.

Steve and Amaya spent the entire day at the hospital with me and Weston. And she got the best Christmas present of all - an opportunity to hold her little brother.

 Nothing is sweeter than watching Amaya talk and sing to Weston. While I was pregnant, she would sing, "Twinkle, Twinkle" every night to Weston. And the first time she sang it to Weston in the hospital, brought tears to my eyes. She's a wonderful big sister and adores Weston already.

Here's another picture of Amaya holding Weston later in the evening. If she could have her way, she would hold him all the time! 

 

The ISCN staff was absolutely wonderful! With it being Christmas, we received a baby monitor from the social workers, a fleece baby blanket from the nursing staff, a onesie and hat from the secretaries, and two small blankets and a stuffed animal for Amaya from the Hospital Auxillary Ladies. It wasn't the Christmas we were expecting or planning, but it was the best Christmas of all! 

Early Christmas Present

Well... in case you haven't guessed... Weston Paul is here! He just came a little earlier than our scheduled January 2nd induction date. He's already 2 weeks old and the time has flown by so quickly.

When I last left off, I was optimistic that we'd make it to 37 weeks. My fluid levels were good, blood pressure under control... although at my next appointment on December 20th.. my blood pressure was back up and I was also having more headaches. I was due to have blood work done and a urine sample collected at this appointment along with getting pre-registered for a January 2nd induction date. Unfortunately, my urine results came back as a +1 for protein... so the OB ordered another 24 hour urine with instructions to call on Saturday for results.

Saturday morning came and my blood results were just fine, although my platelets had dropped quite a bit from my last blood draw, but they were still within the normal limits. Unfortunately, my 24 hour urine results weren't back yet and Dr. Gill told me to call back later that evening and explained that sometimes the lab gets backed up on the weekend and turn around results are slower. About an hour later, I got nauseous and eventually threw up. I hadn't been feeling the greatest, but I couldn't pinpoint it to anything specific - I just wasn't myself and felt like something was wrong. Nausea and vomiting were two of the worrisome symptoms of preeclampsia that I was supposed to report immediately. So, I called the triage nurse and she wasn't too concerned and thought that I just had the "stomach bug." I started crying on the phone because I knew that something was wrong.... and I realize that I can be a hypochondriac at times, but I really, really was concerned. The nurse told me that if it made me feel better and would relieve my anxiety, I was welcome to come in to get checked out. Steve had plans to work on the nursery all day, but instead we gathered my hospital bag and packed a bag for Amaya to spend the night at Papa and Grandma Gustafson's "just in case" I was admitted.

After dropping Amaya off, we checked in at triage and discovered that my urine results STILL weren't in... my blood pressure was slightly elevated, but could have been related to the flurry of activity. Once Dr. Gill contacted the lab, she said it would be about an hour for the results to come back and we'd figure out a plan from there. Steve grabbed some lunch and we decided to watch the movie, "The Guardian." A couple hours later, Dr. Gill and the consultant came in and my protein level was at 368! (300 is the cutoff for preeclampsia). With my protein results and elevated blood pressure, little Weston was going to be born this weekend and induction would start right away.

Needless to say, I was shocked... I knew I wasn't feeling good and I realized that at any time I could develop preeclampsia, I guess I just didn't think it would really happen. We transferred over to Labor and Delivery and the activity began. Lab work done, an IV put in, blood pressure checks every 15 minutes, baby monitoring, IV fluids hung, and magnesium sulfate started. Magnesium sulfate is a medication that helps to prevent seizures... it gave me a crazy, out of body experience for the first half an hour, but after that, I just felt tired. The plan was to begin a medication called Cytotec to help ripen my cervix - and I was only 1cm dilated, so I knew it was going to be a long process - just like with Amaya. Cytotec is given every 4 hours and I would be checked at those intervals to see how I was progressing. The evening turned into night and night turned into day and finally after four doses, the consultant made an executive decision to go ahead and artificially rupture my membranes at 2:30pm since I was still only 1-2cm dilated. (This was the scariest experience for me only because he was rather rough, didn't explain what the plan was, and did it way to quickly for me to even process what was happening.)

Quickly thereafter, my nurse started IV Pitocin to start contractions. Around 4pm I started noticing some cramping, but nothing was picking up on the monitor, so I wasn't sure if it was truly contractions. Then around 5pm, the cramping got worse, but my nurse said that it still wasn't picking up on the monitor, but said I was probably in the early stages of labor and that it would still be awhile. At 6pm, I began to panic because that consultant was going to come in and check me at 6:30pm and since I was pretty shaken up after his last visit - I wanted nothing to do with him. Steve was my advocate and explained to my nurse that the consultant was NOT allowed to step foot in my room again. (The only time I've been this scared to receive treatment from a medical professional was when I was 9 and had my teeth cleaned and I ended up biting my dentist because he was too rough!) Everyone - nurses, physicians, residents, lab techs, anesthesia - everyone has truly been phenomenal with compassion, understanding, and patience - so to have one rotten egg, was disappointing and highly unusual.

Dr. Gill came in to check me and at 6:30pm, I was finally dilated to 4cm! The contractions were pretty bad, so we decided to get the epidural in place and give me a little relief. The epidural got in at 6:46pm and was supposed to bring my pain down to a 0-3 on the pain scale. Unfortunately, it wasn't really doing the trick, but I wanted to give it a little more time to kick in because it can take up to 20 minutes for it to reach full effect. Shift change occurred for everyone and Dr. Lexie came in at 7:30pm to check me and I was at 6cm! I don't have a high pain tolerance, but didn't want to bother the nurses, so Steve once again, spoke up for me and the nurse anesthetist came in and gave me an extra dose of pain medication through the epidural at 8pm. A few minutes later, I told Steve that I had a tremendous amount of pressure and there was a definite urge to push. Even though the resident had just been in, my wonderful nurse grabbed her from the hallway and I was at a 10!! Weston was going to make his arrival soon!!! Once my water broke with Amaya and I got an epidural in, my labor advanced very rapidly - looks like Weston was going to take after his sister too! Since Weston was only 35 weeks and 4 days, the staff wanted me to deliver in the OR, just in case something went sour. They wheeled my bed down the hallway and I couldn't see Steve... HE WAS IN THE BATHROOM AND GETTING CHANGED INTO SCRUBS!!! I was so worried that he was going to miss the birth of his son, but he made it! Once we were in the OR, I pushed 3-4 times and as Steve says that, "Weston shot right out!" at 8:27pm.

Steve cut the umbilical cord and Dr. Lexi brought him up to my chest to hold. He had a pretty strong cry, but he was also grunting a little. His Apgar scores were good - 8 and five minutes later a 9. Here is our first picture minutes after delivery.

The neonatal staff worked quickly to get him weighed, measured, and assessed. He weighed 5lbs 6oz and was 19 inches long. I told Steve to stay with Weston while they were checking him out thoroughly. Because he was grunting a little, they decided to put him on a CPAP to give his lungs a little extra pressure and help him breathe. An IV was placed in his little hand, some blood work was drawn, and they inserted a tube in his mouth for him to receive feedings. There was a concern that if he needed to be on CPAP longer than 6 hours, that he would need to be transferred to the NICU at St. Mary's instead of staying in the intermediate special care nursery (ISCN). Fortunately, he was able to come off CPAP around 4:30am Monday morning and stay at Methodist just down the hall from me. I was relieved that Steve was able to be with Weston - it was so hard for me to be apart from Weston and not know what was going on. This picture is his isolette - it was covered for a couple days for him to be able to maintain his temperature, but I was still able to hold him and nurse him.

Later that afternoon - on Christmas Eve, my parents brought Amaya down to meet her brother. Here is our first family picture! 

 

And a picture of my parents with Wes - and Amaya intensely watching him.

 

 

He had a cardiac monitor to assess his heart rate and breathing, frequent blood pressure checks, a pulse oximeter to measure his oxygen level, an IV for fluids, and a tube down his mouth to supplement feedings until my milk came in. Eventually, they moved the tube to his nose once his breathing was well established. It was a lot to keep track of, but all the physicians said he was the picture of good health, just needed to eat and grow. What a huge answer to prayer! He is our strong little boy!

 

More to follow....