Phillies Phan

We're into the "hurry up and wait" stage since day-to-day progress will be slow. Foster is up to 4 lbs 2 ounces (was down to 13lbs 15 ounces) and receiving 21ccs of milk every three hours through his nasal-gastric tube. They didn't recheck his bilirubin today, but we expect in 3-4 days he'll be off his lights and the IV nutrition. Around 34 weeks (he is 32 tomorrow) they will start him on a bottle and when he's proven he can balance sucking, swallowing, and breathing, we will attempt breast-feeding.

When Phillies tickets went on sale this year, I bought tickets for last night's game, assuming we'd get to see one more game before Foster arrived. It was supposed to be his first game (in utero), but we had to go without him. It's embarassing that I'm already dressing him up in silly outfits, but this (sterilized) ice cream cup really fit him perfectly (although it stayed on better when he lay on his back). I'm sure he'll be mortified some day that we subjected him to such public humilation. Sorry big guy.

Warning to male readers, the following involves a discussion about breast pumping... do not read further if that makes you uncomfortable! Since I want to breast feed as soon as possible, and Foster is currently receiving my breast milk via the tube, I need to pump every 2-3 hours to keep up my supply. It is pretty demanding, but it makes me feel like I am doing something productive for Foster. I even had to rent an economy hospital-grade pump since the store bought option can't keep up with my pumping schedule (eventually I can use the store bought variety when I am not exclusively pumping). Last night I had to tote the whole apparatus to the Phillies game, hoping I'd find a private place to pump. Luckily the security guard doing the purse inspection stop didn't bat an eye at the cooler, bottles, and pump...he was probably too scared to ask. I did find a family bathroom that had a electrical outlet and locked door. I quickly discovered that one way to seriously anger drunk Phillies fans is to use the family bathroom for 20 minutes. I guess many people like to use it to avoid the long lines at the group bathrooms. About 10 minutes into the pumping, I had two very loud beligerant drunks trying to pound down the door. Not the ideal environment for milk production. Luckily by the time I left the room, the angry guys were gone. I only got a few strange looks from others who had been waiting more patiently in line. I'm sure it will continue to be an adventure finding quiet places to pump!

The name....

Foster is still doing well today...but nothing much new to report. Whereas he used to be under three different types of lights for his bilirubin, he is now under one. His bilirubin held steady at 8, which means his liver is metabolizing some of it, despite the removal of some of the lights. Since he is now off the CPAP, he was moved from an open bed to an isolette (think incubator), which decreases the risk of infection and is quieter. It makes diaper changes a little more challenging, but I'm sure he'll sleep more soundly.

We've had lots of inquires about Foster's name and we come up with a new story everyday. Ironically, at the celebratory dinner with the grandparents last night, the first dessert on the menu was Banana Foster. Truth is, he isn't named after a dessert, a beer, or a small town in Missouri. If he was named after a beer, it would be Guiness or Sierra Nevada, not a crappy Australian beer. I happened across Foster as a surname, and liked it as first name. Since we have aspirations of him being an outdoorsy mountain man, it is also a derivation of Forrest. By definition, Foster means to "promote the growth of" or "to care for or cherish", both which fit his situation right now. We need him to grow, grow, grow!

Friday addendum

Foster is now officially off the CPAP (no more tubes up his nose!) and up to 11 ccs of food every 3 hours. His bilirubin is down to 8 (from 12 originally), so only a few more days under the lamps (when the bilirubin is 4 or 5). Today was his first meeting with Chris's parents, so I think he was just showing off for them!

One week birthday, A-OK!

Foster is one week old today! It seems like it's been a long week, but hopefully the next 3 0r 4 in the NICU will fly by. Despite his processing of food (i.e. pooping up a storm) they decided to put in the PICC (peripherally inserted central catheter) yesterday. In the long run, it will save him multiple needle sticks, but we were hoping he didn't need one. The doctors don't want him to fall behind in his nutrition, so this will ensure IV access for his TPN (total parenteral nutrition...IV food). Infection rates are actually lower with the PICC lines compared to peripheral catheters, so I'm sure the doctors made the right decision. This morning he'll have his bilirubin checked again, but he will likely still be in the tanning bed for a few more days. He is up to 4 hours on, 4 hours off the CPAP (continuous positive airway pressure) and the next step is off completely...today or tomorrow. He hates the nasal prongs, so that will be happy day for everyone when he doen't need that. I'll add a brief update later!

Six Days Old! Foster had a great day yesterday. He started processing his feedings which will now be increased to 5ccs from 3ccs (every 4 hours), he gained 10 grams, and he is doing great off the CPAP for 3 hour stretches. Since he started processing food, it is less likely he will need a central IV line that threads from a peripheral vein into a larger vessel by his heart. His progress over the next couple of days will determine if he needs the central line for more IV nutrition. He has developed a strong suck and is enjoying his pacifier...the first step before a bottle, then breast. He'll have to learn how to suck, swallow, and breathe at the same time. Right now he's at least got the sucking and breathing down.

Chris has been getting some work done between visits to the hospital and I am going back to work on Monday, in order to spend as much time as possible with Foster when he finally gets discharged. Luckily, both of our schedules are flexible enough to accomodate for our NICU visits during the workday.

Thanks for the comments and well wishes...your support and encouragement keeps us going everyday!

I got a good question from a friend. Why is his bilirubin high? When normal red blood cells in the blood breakdown, the liver usually processes the products (one of which is bilirubin). Since premature babies have immature livers, the bilirubin can easily accumulate in the blood. The bilirubin usually reaches its peak on the 4th or 5th day of life, so hopefully Foster has reached his peak and it will gradually decrease. The most common treatment for high bilirubin is phototherapy under UV lights, which converts the bilirubin into a form that can be excreted in the stool or urine. To protect his eyes, Foster gets to wear super cool purple shades while sunbathing.

Five Days Old! We got another session of kangaroo care with our little joey this morning. Foster had a quiet night under the lights and was obviously very content on Dad's chest off the CPAP and lights. He had a short spurt of hiccups which seemed to ebb after a little pacificer sucking. Foster had a head ultrasound yesterday, which is a routine test in preemies. Due to lung immaturity at birth and periods of apnea (decreased breathing), they can have brain hemorrhages. He had evidence of a resolving Grade I ventricular bleed on the left side, which they say is of little concern and will unlikely result in any clinical signs. They will perform a recheck ultrasound in 10-14 days. After his breast milk feedings (through a oral-gastric tube) he still has some "residuals"....food left undigested in his tummy. It is common for the GI tract to work slowly at first, and basically he just needs to produce a big poop to get things moving! When he does start needing more milk, he has lots of frozen stores ready for him. Foster's bilirubin level is 10 right now (it started at 12) and needs to get down to around 5 before they take him off the lights. They are increasing his "sprints" off the CPAP to 3 hour intervals today...great progress on the breathing. That's it for today!

4 Days Old!

Hi everyone! To keep you updated on Foster's progress, we're creating this blog that you can check everyday. We'll try to update it daily with any news and/or pictures on his progress. For those of you just tuning in...a brief recap of the last week. Last Saturday, May 16th, Chris and I had a great time at our Jack-and-Jill baby shower. Unfortunately, many of us picked up a stomach bug that resulted in major GI distress. After my 12-hour bout with it, I realized I was having contractions. Thinking I needed to get rehydrated quickly, I went to the hospital for some IV fluids. Despite IV fluids, bedrest, and an arsenal of drugs, labor eventually prevailed and Foster arrived at 1:23pm on Friday the 22nd. Luckily our hospital, Capital Health Systems in Trenton, NJ (only 10 minutes from home), has an amazing NICU and Foster is now in excellent hands until we can bring him home.

Today 5/26: Foster is 4 days old and doing well. Last night was the first session of "kangaroo care" which is skin-to-skin contact. Chris got the honors of the first hour last night and I got my chance today. It's great to feel him curled up on your chest and resting quietly. Foster is doing well...still under "triple" phototherapy (three types of lights) for his high bilirubin, but his levels came down a bit today. High bilirubin is common in preemies, and just takes time to resolve. He has to wear cool purple shades to protect his eyes while under the lights. He didn't lose any weight yesterday, which is great. They can continue to lose throughout the first 2 weeks. He is 3lbs 15 oz now (at birth, he was 4lbs 6.5 ounces). He is on CPAP (continuous positive airway pressure) the majority of time, which is administered through nasal canulas (tied onto his hat in the pictures) They are trying him off of CPAP for 2 hour stretches, three times a day. So far he's done great off it...keeping his oxygen stats up. They will gradually increase the time off CPAP until he is completely independent of it.

Chris and I are doing well, although it's strange to be home from the hospital and not have him with us. We have 24/7 visitation rights, but we make 2-3 trips to the NICU a day, trying to schedule them when he can be taken out from under the lights for 1-2 hours to hold. Since he is supposed to still be in the womb, he should sleep 18-20 hours a day, so we try not to disturb him too much if he is quiet. It is very hard not to wake him up though! We are currently fighting over who gets to change his diaper...how quickly that will change!