Ella 02/25 evening update

We just got back up to our room from the NICU.  It is all good news tonight.  I fed Ella a bottle (we have to feed her while she is on the lights, no holding) and she sucked it all right down and kept it down.  She has been eating well enough they haven't had to give her a feeding tube.  I also got to change her first poopy diaper.  This is huge.  The only way to eliminate the bilirubin is through stool so we told her to get pooping.   Her weight is up a little to 4 pounds 8 ounces (it was 4 pounds 6 ounces in the middle of the night last night). And her bilirubin is slowly going down.  I couldn't ask for better progress!  

Baby Ella: Day 1 and 2

February 24th from 8 a.m. on:

Our schedule: I go down to the  NICU every three hours. They have us take her temperature and change her diaper and then I try to nurse.  This generally takes an hour and goes by sooo fast.  I am then supposed to come back up to the room and pump.  This takes about 30 minutes and then if I am lucky there is about an hour and a half to try to sleep. This time usually consists of me just falling asleep and then a nurse comes in to check vitals etc.  At this point I have honestly not slept more than 2 consecutive hours since Sunday night.  All day Friday adrenaline carried me through but I was a zombie by Saturday morning. I have never felt so tired or lonely as I made the walk to the NICU over and over Saturday night. 

At 24 hours old (8/25 at 2 am):
-Ella's weight was at 4 pounds 6 ounces.
-Her blood sugar was stable and no longer a concern. This was the primary concern in initial NICU assessment.
-Ella had nursed for about 3 minutes during one feeding despite attempts every three hours.  Not unexpected.  She had eaten a bottle in the NICU soon after birth. All other nutrition has been from IV.
-Ella is in isolation due to unidentified infection.  This means all hospital empoyees going in have to scrub in, wear masks and gowns.  Even to drop something off. Any equipment going in and out has to be completely sanitized. Visitors have to scrub in and if they have had any illness, wear a mask.  It is somewhat unnerving to have your baby treated like a biohazard.
-Due to high bilirubin she is under the lights with a little mask to protect her eyes.



February 25th 4 a.m.--
Ella's nurse for the night was in with her other baby when I got there so I got be alone with her for a bit, changed her and took her temp.  And then I had a little talk with Ella about what we need her to do to come home.  And that little lady listened, she nursed for about five minutes.  I was so excited  and so was her nurse.

8 a.m.--
Wop, wop.  Our morning report was not great.  Despite the lights, Ella's bilirubin levels continued to rise (13.9 should be around 3 or 4). She cannot be off the lights, even for nursing. So we don't get to hold her anymore.  JD did feed her a bottle and she did alright.  They will continue the formula with a bottle if she will drink it, otherwise they will use a feeding tube. 

Ella Paige

Our tiny little Ella Paige was born early Friday morning, February 24th, at 2:50 am. She weighed in at a whopping 4 pounds 13 ounces and is 17 inches long. It has been a crazy few weeks that ended in her early arrival into this world. Her gestational age was 35 weeks 2 days.

Things had been going along fairly well with the pregnancy. The baby measured a little small and because of the blood thinners I take to maintain the pregnancy I started weekly non-stress tests a few weeks back.  I was then exposed to parvovirus B19, also called Fifth's disease. This is generally not a very serious illness except to unborn babies. Fifty percent of adults have already been exposed and, once you're exposed, you're immune (like chicken pox). When we discovered the exposure, I had my blood drawn and tested positive for only a recent exposure. This meant that baby Ella now had a chance of getting the virus. I was now supposed to do twice-weekly non-stress tests and have a weekly ultrasound. The ultrasound study on Tuesday the 21st revealed that Ella was in the at-risk category for anemia, which is a major risk for babies who acquire the Parvo virus. I then went down the hall for the NST and it showed several decelerations in Ella's heart rate. At that point my doctor admitted me, explaining that they would monitor Ella closely and then induce me somewhere in the next 48 hours. But after baby's heart rate stayed pretty stable for 24 hours and a repeat ultrasound was less concerning than the last one, they let me go home and put me on the schedule to be induced on Tuesday the 28th with more close monitoring in the interim. I actually fel uneasy with this because her movement had drastically slowed down over the last week or so. I did not sleep that night knowing that I couldn't feel her moving.

On Thursday morning, JD watched the girls while I went in for another NST. That testing was concerning enough that they transferred me down to labor and delivery again for more prolonged monitoring. So, JD packed up the girls and took them over to my parents' house yet again. By the time he got to the hospital, they had pretty well decided that Ella needed to come join us.

JD will take over the reporting from here:

They started Laura on Pitocin a little after 1:30 and thus began a grand drama. Because they were worried about the baby's ability to tolerate labor, they started with very low-dose Pitocin. The result: nothing. Because Laura wasn't contracting at all, they had to increase the dose. This brought contractions but baby didn't dig it at all. So, they would decrease the dose and baby would stabilize but the contractions would stop. Then they would increase the dose and contractions would return but baby would rebel. And so they danced. An oxygen mask helped Ella's heart rate stay more stable but it still decelerated after contractions, which suggests that labor is really not her thing. About 12 after starting the process, Laura was only dilated to a four the doctors finally decided that a c-section was the way to go. Wanting to try everything possible to avoid that (which might be explained to some degree by the fact that the specialist in charge was 36-weeks pregnant herself), they tried one last thing: moving Laura all the way onto her left side. Presto. Baby stabilized, they cranked up the Pitocin, contractions started coming like hiccups, and minutes later all hands were on deck.

We had the maternal fetal medicine specialist, an intern, a medical student, labor and delivery nurse, three NICU transfer nurses, Laura's mom, and me in the room when the pushing started. Counting Ella and Laura, that was ten ladies and one terrified man.

Laura again:

The NICU team looked her over in the delivery room and worked with her for a little bit, she was crying and breathing on her own.  They let me hold her for a quick minute and took her off to the NICU.  JD went with her and my mom stayed with me. I feel so blessed that I just felt calm and peace throughout all of this.

After their assessment the main concern was that her blood sugar levels were way too low, they should be over 50 and she was at 35 (this can cause brain damage). The secondary concern was her white cell count indicated an unidentified infection.  They couldn't assume it was Parvo so they began treating her with two broad spectrum antibiotics. Her breathing was rapid with room air but not enough that she required oxygen.

To remedy the blood sugar they quickly gave her a bottle.  She did great taking the bottle but her blood sugar dropped to 28 then 21. So they put in an IV and by the time I went down to the NICU at 8 am the blood sugar was no longer a concern.