Not as soon as we thought.

I want to start this off by assuring everyone that Ava is still doing very well. Nothing has changed with her. However, yesterday was a very difficult day for me. I was finally able to speak with the doctor for more than a few seconds (over the phone albeit). I was shocked when he informed me that Ava will not be going home for at LEASt another two weeks. The nurses have been making it seem like it would be very very soon, as in next week. I was asked to bring in her carseat and everyone has been talking about how soon she is going home. So to hear that was like a punch in the gut.

His reasoning is that he wants to get her off the caffeine and he does not feel that she is "reliable". She still desats and bradys with feeds and the doctor feels as if this is just a matter of being uncoordinted and that with time and patience she will get the hang of it just fine. The problem is not that she doesn't want to eat but rather that she tries to inhale her milk without breathing. If you haven't noticed, breathing is kinda low on Ava's priority list and has been for the last two months. That needs to change. When she is not eating, she has been breathing GREAT without the cannula, so that is not the issue at this point. But if you have ever tried to suck on a bottle you would actually realize that suck/swallow/breathe is a little more complicated than it seems. Especially when you are just a little nugget like Ava. She hasn't been doing this her whole life like most 2 month olds. So, while we ARE certainly getting closer, we are not getting closer as fast as everyone has been letting on.

I want to clarify that I do not want to rush Ava out of the NICU. Yes, I want her to be home, but moreso, I want her to be ready. The hardest part about hearing that news yesterday was that I was led to believe that she was going home in a few days, I was in a completely different mindset. I was preparing at home and getting ready for her. I was feeling like my trips to the hospital were soon to be over. Being that I have been through this before, I should have known better. I shouldn't have gotten my hopes up until I was literally IN the car with my baby, driving home. But it's a tough thing to do...not get your hopes up. I respect the doctor's opinion, and to be honest, I agree with it as well. I don't trust Ava at this point and even though I feel confident that she would be ok at home, it would be scary. So, we just have to be patient and give her the time she needs to be ready. And before we know it, all of this will be a distant memory. When Travis was in the NICU, things were much more intense and he was there twice as long as Ava has been there already. And even THAT is a blurry fog to me. So I know that we will get through it, move past it and one day or life will be just as normal as any other family of four. I am seriously longing for that day!

"Getting Closer..."

Ava is certainly getting very close to coming home. She has been off the cannula for a few days now and has been doing well. She also has been doing great with her feedings for the most part. Her biggest issue with feeds is not that she does not want to take them but rather that she is SO eager to take them that she sometimes has a hard time pacing herself and remembering that she can't just eat, she has to breathe as well. She is getting it though and with time she will become more and more coordinated. She is only 36 weeks today so it's understandable that she doesn't have it perfect yet. She weighed in at 4lbs 9oz. Her gain has been slow since she started taking all her feeds by mouth because she burns so many calories eating. They allow her to create her own feeding scheudle and she has pretty much stayed on an every 4-hour schedule which I think will be great when she comes home.

I have a few questions for the doctor that I have not gotten the chance to ask yet but hopefully will soon. One of my biggest questions is if they will send her home on a monitor. I have heard that they only do if the baby is on oxygen, but with her history, it would make me feel a lot more comfortable. I am also wondering if we will be required to "room in" with her. This is standard for all parents to room in with the baby for one night at the hospital before they go home, but I am hoping that since this is not our first rodeo that we don't have to.

Last night Joe brought Travie up for a quick visit with Ava and he got to hold his baby sissy for the first time! He absolutely loved it! He was so doting and sweet with her. Touching her head and singing to her. It was precious and now I am even MORE anxious to get her home where her and Travie can really begin to bond. It's so amazing to me to see my two miracle babies together, and I can't wait until that is an everyday occurance! Hurry home Ava!

Who is that baby!?

It won't be long...

I have been hearing a lot of that lately. Nurses come by to ask how Ava is doing and everyone's response is the same, "she is going to be home SOON!" I have had RT's and nurses asking me left and right if they have given me a time frame or a date yet for her to go home! What an exciting thing to be asked. So far, the doctor has not talked to be about when Ava will be going home, but we do know that it will be soon. Starting today she is being allowed to take all of her feedings by mouth, either by breast or bottle or both. Let me tell ya, feeding is NOT a problem for this girl! She looooves to eat! And that makes me a very happy mama! Feeding is still a huge issue with Travis so this is such a blessing.

From the sounds of it, once Ava masters her feeds, they will send her home, even if she is still needing oxygen. I have a feeling she won't need oxygen as they have dereased her to one liter and ever since that change she has only been on 21%. I hope she can come home completely tube free but obviously if it means she comes home sooner I would be more than willing to bring her home with oxygen. I know she would only need it for a short period of time if anything. One way or another, we are nearing the end of our NICU stay. I could not be happier about this. Ava will be 9 weeks old tomorrow. It has been a long nine weeks although it is NOTHING compared to how long we spend in the NICU with Travis. I pray that she just continues to eat like a little piggie and can get off the cannula and be home with us very very soon. I will keep you all posted!

I took this picture as I left for the NICU last night. The sky was SO beautiful and shortly after I took this picture we had a huge thunderstorm. We need the rain so bad so it was very exciting!

Blog Makeover!

I just wanted to say a HUGE thank you to my friend Katie for giving my blog a makeover! I love it so much and hope you all enjoy the new look! Thank you Katie for spending the time to do that for me. I really appreciate it!

You can go visit Katie's blog over at http://yehfamilyhappenings.blogspot.com/

35 weeks

Ava is 35 gestational weeks today. I should be huge and waddling and uncomfortable right now,but instead I have spent the last 8.5 weeks getting to know my little girl on the outside, watching her struggle and fight, and overcome. During my pregnancy, I had many little goals set up. My first goal was to make it past the time my water broke with Travis (19w6d). Then it was to make it past 23w2d, when Travis was born. Then "viability", 24 weeks. I made it that far and was so relieved. My next goal was to make it to my third trimester. I never made it. But my ultimate goal was to make it to 35 weeks. I swore that if I made it that far I could totally and completely relax. Clearly, I missed that one by a long shot!

Things have been going rather smoothly in the NICU, which is what we love! Essentially Ava is just working on eating and figuring out her breathing so that she can come HOME. There have been lots of little comments made here and there by nurses and RT's working with Ava about how she is "gonna be outta there in no time!" It's still impossible to know exactly when that might be, but at least we are getting closer. Currently she is taking two feeds by mouth per shift (12 hour shifts). Once she has masted that for 24 hours she gets to move up to the next step. She ALWAYS does great for me. Usually she nurses for 15-20 mins and then takes about an ounce from the bottle. Her weight gain has been up and down since it takes so many calories just to eat, so she is about 4lbs 6oz right now. Her most recent eye exam showed Stage I ROP. It is really not a concern unless is progresses. I don't really have any expectations of that happening. Otherwise, there is not much else to report on Ava. She is just an eating, peeing, pooping, growing little baby. I do believe we have reached "feeder grower" status!

55 Days Old

Ava is 55 days old today! That is almost two months. Wow. My little girl is getting bigger and bigger each and every day. I am so proud of her progress. She struggled a little bit with all the changes that were made quite rapidly but she seems to be adjusting now. She passed her first "step" of oral feedings, which was taking one feed per shift for 48 hours. Now she is moving up to 2 feedings per shift, which is half of her feedings. I will be there for 3 of the feedings today which means she will breastfeed for 3 and take a bottle for one. She nurses GREAT! It makes me so happy since Travis never successfully nursed. I enjoy that bonding time that I never got with him. Even bottle feeding a baby can be bonding, but with Travis it was torture for both of us and that makes me really sad.

Ava weighed in at 4lbs 5oz last night. She has steadily been gaining about an ounce per day for the last few days! So we know she can eat, we know she can grow. Literally the only thing holding her back is her breathing. As soon as she masters that, she can come home!! I have NO idea how long it will take her. Could be a couple weeks, could be longer. We will just have to wait and see. Currently she is only on 2 liters and usually only needs minimal oxygen if any, so hopefully it won't be too long! We are SO ready for her at home!!

Ava EATS!!

Just a quick update this morning. I called to check on Ava this morning and recieved some of the best news ever! Before I get to that, she also weighed in at 4lbs 3oz! Ok, onto the great news. They lowered her flow to 2 liters. The most important part of that is that she is now allowed to eat by mouth! She has been doing non-nutritive suckling at the breast for a few weeks now, but today they offered her her first bottle. Generally it takes preemies a while to figure out how to eat. Suck, swallow, breathe is harder than it sounds. And in the case of Travis, he NEVER ate well, and still does not. He came home with a feeding tube and had it for almost a year. After we pulled the tube, eating was a HUGE challenge. We would both end up in tears and I would have to essentially force feed him. It was horrible and awful beyond what I can describe in words. I have begged and pleaded with God to let Ava eat. And guess what? SHE TOOK THE WHOLE BOTTLE!!!! I cried. This is amazing. Incredible. Wonderful. An answer to many prayers. Feeding is something that keeps babies in the NICU, and it looks like that may not be a problem for Ava. I realize that this is just the first bottle. But the fact that she took the FIRST bottle, no problem, well that is HUGE. I am so proud of my sweet baby girl!

A Brothers Love

I have to admit. I have always wanted two girls. Mostly because my sister, Jennifer and I had/have an extremely close relationship. I feel as if she is much more than a sister. She is my best friend. I have always wanted MY own kids to share that bond too, so the way I pictured my life in my head was with two little girls just a couple years apart. And then.....along came Travis :-). And of course, I would never ever trade him! Now we have Ava, and I am so excited to watch their relationship grow. I didn't have a brother growing up, so it is going to be really neat to see how they interact and what kind of relationship they will have. I imagine Travis will be quite protective of his baby sister. So far, he is in love. When I talk about Ava he begs to go see her, and when we are there, he talks to her, touches her ever so gently and, well...he just loves her. I love this picture because we have a picture that is almost identical of my sissy leaning in to kiss me after I was born. I was in the same type of plastic basinette. It was the first kiss of a lifetime of love and I pray that my children feel as blessed to have each other as I feel to have my sisters.

Good News, Bad News

That's kinda how it goes in the NICU. You can never JUST move forward. You have to move forwards and then backwards a little before you can keep moving forwards.

Yesterday Ava DID reach 4lbs! YAY! She also got moved to an open air crib! I have pictures of that but I left my camera in the NICU last night so those will have to wait. They stopped her Dopram completely, but last night she began having apenic episodes again, so they restarted it at 2mg. I am trying really hard not to let this discourage me, but I won't lie, it's pretty upsetting. Mostly because I thought she was really better and no longer needed drugs to help her remember to breathe. I was really hoping she had "outgrown" her episodes. It is also upsetting because the doctor wants to get her off the medicine before he decreases her flow on the high flow. In order for her to eat by mouth, her flow has to be decreased, so it is all a chain reaction and this ONE medicine is holding us back, which is quite frustrating.

I am hoping and praying that soon she can move forward the way she needs to. This is a long hard journey and I am ready to be done with this part of it.

Overdue Update!

I apologize for the lack of posting! Ava has been doing very well the last few days! Currently she is on 4 liters of high flow. The goal is to decrease her flow so that she can eat by mouth, but the conflicting matter is that she is also on a medicine called Dopram that helps her remember to breathe. The doctor wants to get her off that medicine before decreasing her flow as they are unsure of the long term side effects of Dopram. So for the last couple of days he has been weaning her dopram and depending on how her night went (I have not called yet) she will be off the Dopram today. As long as she does ok, they can start weaning her flow as well. She may not be technically allowed to eat yet but we are allowed to do non-nutritive suckling and she latches onto the breast extremely well and is very effective when she nurses. So I have high hopes that she will be a great eater!

Curently Ava is getting 36mls of breastmilk every three hours. To give you an idea of how much surplus I am making, I am able to pump about 240mls every 3 hours! She is doing well with her feeds and tolerating them fine. I am anxious to find out her weight from last night. She has been teetering right below 4lbs for a few days now so I am hoping that she hits that milestone today! She really is getting SO big! I love being able to hold her and snuggle her every time I go in. She is so much more alert these days and I am so in love!

A couple days ago, they tested her out to see if she could regulate her own temperature in an open air crib. Unfortunately she got a little bit on the cold side so she will stay in the isolette a little bit longer. My guess is that she will be in an open crib within a week. Once she hits that 4lb mark it becomes much easier to regulate her body temperature.

Natrually, I am getting pretty anxious and excited to bring her home. The bigger she gets, the more she feels like just a normal baby. In some ways it feels like it is just around the corner and in other ways, it feels so far away. The reality is that all she needs to do is eat, breathe, and grow. She is not requiring any oxygen so the cannula is there just to give her flow to help her remember to breathe, so hopefully she won't need it much longer. I really feel as though eating is not going to be a problem for her so once they allow her to start, that could happen pretty quickly. And she IS growing, so we have got that one down! It sounds so simple, but this process could take a while. If I had to guess, I would say she will be home in 3-6 weeks, but who knows! Only God!

The Highs are SO High!

I think what contributes to the NICU being such a roller coaster is not just that the lows are so very low, but that the highs are so high. Each time Ava moves forward, I am not only completely overjoyed and excited, but I become equally nervous because every step forward has potential to become steps backwards. Obviously we want her to move forward, but sometimes it can be just as scary at times.

Last night with Ava was amazing. She had our favorite nurse taking care of her, so she was already off to a good start. It really makes all the difference in the world to have nurses that you love and that love your baby...but that is an entirely separate post that I will be writing soon! When babies are on Sipap or CPAP, the head gear used to hold it on can cause reddness and breakdown on their skin, so every 12 hours an RT comes and removes all of that head gear, massages her head and gives her a little break. That is usually when she gets weighed and bathed also. Well last night, after they took her off the Sipap, she did AMAZING. She was actually doing better than while she was on it. She was not receiving any blow by oxygen or anything and was keeping her sats WAY up. It was so awesome to see. Because of this, the nurse and RT asked the doc if we could try her again on the high flow. He agreed! Ava was on NOTHING for about 45 minutes and did amazing the whole time! It was so exciting, and felt amazing to hold my little baby without so much attached to her! We also weighed her and she weighed in at 3lbs 11oz! She is getting SO big! So as of last night at about 9:30, she has been on 4 liters of high flow. She had one minor episode this morning but has otherwise done well. I am so hopeful that this lasts because if she can get her breathing figured out, then we just have to figure out eating, which I think she will be great at. At the same time, I am nervous to get too excited so we will just have to wait and see and hope and pray that she can do it!