Wednesday, December 31, 2008

Portrait of a Pregnancy After a Preemie: Part Two

Our 10 week 6 day old little one... who can argue that's not a baby????

I'm almost thirteen weeks pregnant right now and, while that is not anywhere even close to a full-term 40-week pregnancy, it's more than half of how far I made it last time. It's a little hard for me to explain, but I'm finding that I don't take a single day of this pregnancy for granted. I find myself thanking God at random intervals during the day for how smoothly things have gone so far. And I'm really not wishing any of it away. I'm perfectly content with this exact moment in time...

Some things I'm focused on right now:

1. Enjoying these last 7 weeks before the restrictions start. I'm spending time walking on the treadmill, picking up my children, and staying OUT of bed!

2. We are making a conscious effort to help C. graduate on to some new things without rushing her. She recently switched from the high chair to a booster which will help greatly when I'm not allowed to lift her anymore.

3. Feeling endlessly grateful that the nausea is lessening each and every day. I feel a large part of that is due to a new prenatal vitamin with mega doses of B-vitamins in it. But, even with the nausea, I've been incredibly grateful to not be getting sick constantly like I was last time around...

4. Still getting all the way back on my feet. At 10 1/2 weeks pregnant, I caught some nasty gastro-intestinal thing that made me sicker than I've ever been in my life. The doctor made me go to the ER where I received IV fluids and medications. I've felt fine for awhile now, but tests keep showing that I'm still dehydrated. I'm drinking enough water these days to float!

Some things I'm anticipating:

1. Increasingly frequent appointments- I remember with my first pregnancy, I would have happily trotted in that office every week if they wanted me! I just loved hearing how things were progressing. I certainly don't mind going, but I would gladly trade frequent updates for a non-high-risk pregnancy!

2. Even less queasiness and more energy- If past predicts the future, I should be feeling better and better in about a month or so... something to look forward to even as I cherish all the weeks in between!

3. Getting nagged to gain weight- I'm not sure why it is, but I always lose weight when I'm pregnant even when I eat well. Since I don't start out at all overweight, this becomes an issue around about the 4th month. Up until then, my doctors don't seem to care much. But usually when I waltz in at four months with maybe a half-pound weight gain under my belt, I get a lecture. Now, I realize this might sound like a dream come true to some people... being told to gain more weight. But, the thing is, it still makes you feel like a failure. I already know I'm down a few pounds right now from my starting weight, so I'm guessing it'll be the same ol' story...

Some questions for all of you:

1. Have any of you had to spend time on bed rest while remaining the primary care giver for other young children? How did you cope?

2. Have any of you had experience consulting with a perinatologist? If so, how did those appointments differ from more typical OB appointments?

3. Have any of you had a child after having had a classic c-section (that's a c-section where they cut you vertically instead of laterally)? Did the surgeon have to do a repeat classic?

Any input is so very appreciated.

I'll keep you all updated as the weeks roll on... as always, feel free to ask me any questions or provide any insight in the comments or through email!

Tuesday, December 30, 2008

Birthday Cake Thoughts...

So here are a couple things you should know about me...

1. I refuse to shell out $20+ for a grocery store bakery cake that tastes like it's frosted with Crisco and is often airbrushed with psychadelic colors.

2. I have nothing against boxed caked mixes.

3. I love making my kids' cakes, but I'm not one of those super-mommies who manages to create those amazing scenes on their cakes either. I'm somewhere in the middle.

My kids are little yet-- just turned 3, almost 4, and not-yet-born, so I haven't had the most experience making birthday cakes. But I do enjoy it! Usually...

Here are a couple cakes from past birthday celebrations...

My son's zebra cake for his 2nd birthday.

When our little girl was 2, her favorite food in the world was grapes. So there you go.

This year, as C's third birthday loomed before me just as I was recovering from my energy-sucking illness, the thought of coming up with a creative cake idea almost drove me to tears. I kept meaning to get online and find some wondrous design I could try to replicate. But it didn't happen. In the end, I bought two Funfetti cake mixes, baked about thirty cupcakes with Tinkerbell liners, whipped up some buttercream icing, tinted it pink, and topped them with pastel sprinkles...

Honestly? I think they were even more popular than the cakes I usually make. Fact is... kids love cupcakes.

So I guess my advice is... think about your audience. Decide what really matters. Is it more important that my neighbor thinks I'm a pastry genius or that my children have huge, cake-crumby grins?

Long live the cupcake.
Even on her first birthday, C. was a fan of the cupcake!

For more kitchen advice and ideas, check out Tammy's Recipes!

Update 1/29: Be sure to check out all the wonderful cakes at the Birthday Cake Round Up, hosted by Life As MOM!

Monday, December 29, 2008

"My Story..." Monday: Surgery and Unfamiliar Ground

When we found out that C. would have to be transported to Chicago for surgery, everything moved so very fast. We had very little time to think about much other than the sheer logistics of how we were going to manage the trip. Once we were actually on the road, we had a chance to think about the fact that we had no idea exactly where this hospital was, what it was like, if we would like the doctors, or even where we'd be staying. Like so many times before, we just had to trust that things would fall into place.

Arriving at the Chicago hospital was a touch overwhelming. While it's true that our daughter had been cared for at a children's hospital right in the heart of Indianapolis, it was a much different setting. There, we walked amid college students and residents on wide sidewalks through grassy areas. In Chicago, we were right in the heart of a busy city block. Traffic, both pedestrian and vehicular, was staggering and the lobby of the hospital was crowded and incredibly noisy. We waited our turn to speak to the individual at the information desk, received visitor passes, and got directions to the NICU. When we arrived there, we found out we had beaten our daughter. But only by minutes.

That first day was basically a "settling in" day. We got to know the nurses in the NICU a little bit. They seemed "tougher" than the nurses we were accustomed to, but very knowlegable and competent. We met Dr. Shapiro who would be performing C's surgery bright and early the next morning. We talked to a supervisor who gave us directions to the apartment we would be staying at. This was a fairly new project of the hospital's... they had taken over an apartment in a building several blocks away and would rent it by the night to out-of-town families with a child at the hospital. It was a great idea because the Chicago Ronald McDonald House was a long ways away and hotel rooms were expensive in the area.

I'd love to tell you that everything was peachy keen with this apartment. Unfortuately, the best that can be said is that it was clear someone had tried very hard to put up a coat of fresh paint, leave clean linens, and fresh soap. The effort was there. The building, however, was very old and in rough shape. And so... the hallway had a lingering, nausea-inducing smell to it, the heat ran incessantly forcing us to open windows during a Midwest winter, and, most disturbing of all, we arrived home one evening to find my freshly washed breast pump components crawling with roaches. Yeah...

But, anyway, what mattered most was not where we were sleeping at night, but the care that our little girl received. Dr. Shapiro had shared these statistics with us... without surgery, there was an 85% chance our daughter would go blind and a 15% chance she would retain some kind of vision through correction. With surgery, the statistics flip-flopped and she was down to a 15% chance of going completely blind with an 85% chance that she would have some vision. There was no doubt we were doing the right thing...

We returned to the hospital at 5:45 am on Thursday morning and met with her surgeon. We sat with mega-sized cups of coffee in the waiting room. And just waited. We didn't talk much. There wasn't too much to say. We just waited for Dr. Shapiro to come back and tell us how it went.

He came back just before 10 am to tell us that things had gone well. He ended up having to do two different procedures on each retina in order to attempt to resolve and halt the detachment. That had been the "worst case scenario" but now, hearing that it went well, it didn't seem scary. We were able to head back to the NICU and await C's return to start her recovery.

Our little girl had bandages over both eyes and was still sedated. She had also been re-intubated. When you've had a preemie on a ventilator for so very long before and it was such a huge battle to come off of it, it's very scary to see that tube in place again. All sorts of fears roll through your mind... you become terrifed that your child won't be able to get off the machine again, that you've started over on that horrible roller coaster ride. It doesn't matter that you know it's standard procedure for surgery under general anesthesia, it still leaves a sick feeling in your belly...

As it grew later and later on Thursday, we grew increasingly agitated that no attempt had been made to remove the ventilator tube though C. was receiving almost no oxygen or pressure through it. My husband questioned the resident on rotation and he said that the fellow had ordered that it remain. We essentially clawed our way up the food chain until someone finally called the neonatologist on call and they got the go-ahead to removed the tube. And, when they did, little C. breathed like a champ. No problems.

Our next mission was to try and get C. transferred back to Indianapolis the next day so we didn't have to stay over the weekend. We certainly didn't want to take chances if she was still in any danger but, as long as she was stable enough, it seemed best to get back to our "old stompin' grounds". Dr. Shapiro saw no reason for her to remain in Chicago and signed the release to get her back to her usual caregivers.

Friday morning, we met the transport team by C's bedside and this is what they said:

"We'll see you back at IU Medical Center."


Our daughter had been at Riley! We loved Riley! We knew everyone at Riley! We must have looked completely panicked because the ambulance driver actually called Riley and talked to Dr. Lemons, the head neonatologist (and a man I absolutely adore). He checked, double-checked, and triple-checked and sadly told us that they were over-full. C. was healthy enough for IU's Special Care Nursery. And so, off we went to yet another new place...

But it was with great optimism that we left Chicago. Our baby girl's retinal surgery looked like it had been a success. We were going to pick our son back up. We now knew our daughter was one of the "healthier ones" because those are the only babies who can leave Riley...

We headed back to Indy.

Next week, I'll tell you a little bit about what it's like to have a child with MRSA (hint: it's nothing like those crazy "super bug" scare stories you read and hear...)

Wednesday, December 24, 2008

Happy 3rd Birthday!!!

(Oh, yeah... and Merry Christmas Eve to all of the rest of you too!)

Last Saturday, we celebrated C's 3rd birthday. But her actual day is today! I made a vow the day my little girl was born that I would never let that fact go unnoticed.

(Pink cupcakes with sprinkles were fun, girly, and tasty... and much easier to deal with than cutting a cake!)

(A new apron made by Bama... and a whisk! That whisk was the favorite gift!!)

(An apron, a tiara (from her brother), and frog slippers-- what an ensemble!)

(Yum! Cake time... and note the ever-present whisk...)

It is hard to believe that it has been three whole years since our little girl's dramatic entrance into the world. It's also hard to believe that for just over a month I now have two 3-year olds! Lots of fun ahead!

Enjoy beautiful holidays with your loved ones and I look forward to sharing more with you in the very near future. Thanks for bearing with me last week as I recovered from one nasty bug that landed me in the ER. So good to be back on my feet!

Monday, December 22, 2008

"My Story..." Monday: Christmas With the Threat of Tragedy

The fact that my daughter was born on Christmas Eve is sort of bittersweet. For the most part, I just feel sorry for her. I feel bad that she'll never have a party actually on her birthday. I hate that her day can get swept up with the other festivities so easily. And, I'll admit it, it annoys me when people wrap her birthday presents in Christmas wrap just because it "was handy".

At the same time, I'd be lying if I said I didn't recognize the power the day of her birth adds to her story. There's something wondrous about her triumphant arrival into the world on such a special day. The idea that her miraculous cry filled the room in the wee hours of Christmas Eve morn tends to somehow make it all the more inspirational. Would she be any less amazing had she arrived on, say, October 5th? Nope . But there's a little magic that goes along with that Christmas Eve date...

The fact that C. came into the world crying was the very first victory. But we knew our worries were far from over. We had been told, multiple times, that our daughter still had a less than 50% chance of surviving the next 48 hours. What did this mean? It was a coin-toss if she'd make it through Christmas...

You would think this would have put a huge damper on the holiday. It would make sense that, as I fought to recover from a massive surgery and our precious little girl fought to live, Christmas almost fell by the wayside. But you know what? That's not what happened. Not at all...

Though we knew, absolutely knew and understood, that C. might not make it, we spent no time dwelling on that fact. A lot of that is thanks to the deep and instant love and faith my husband and I had for this tiny, determined little life we had created. And, truly, I think a lot of it is because of how others reacted...

We were so lucky.

Between my sister's repeated "what a fighter!" as she heard the story of C's birth to my mother's immediate launch to plan her visit to her newest grandbaby... from my sister-in-law's arrival with a precious pink stocking and angel ornament within hours of her birth to my mother-in-law's abiding faith that she was meant to be there for Christmas... there was so much spirit and love and prayer around us that it would have been hard to fall into a pit of despair. I don't remember anyone saying one discouraging word to me.

It was the leanest Christmas my husband and I have ever had to face. I know plenty of others fall on much harder times but, for us, it was a difficult, challenging year. I grew up with generous, abundant Christmases. Early in our marriage, with our two incomes and a firm grip on our finances (we were both bankers), we were able to spoil each other quite lavishly. But in 2005, with an infant and a baby on the way (sooner than we had anticipated!) and recovering from an extended period of unemployment, we had a budget of $20 to spend on each other...

I remember every gift we exchanged that year. I remember the gloves I painstakingly tracked down on sale at Target for my husband. I remember the 9x13" cake pan he bought me. I remember the crossword puzzle books I chose for him. And I remember the ring he somehow found on clearance with a garnet flower (my son's birthstone) with a tiny diamond in the center (what should have been my daughter's birthstone)...

But, as Christmas night fell deep and dark under a blanket of heavy, wet snow... we received a call from the NICU just to say that our little girl was feisty and stubborn and doing well. And we knew...

We had been given the most precious gift of all.

Sunday, December 21, 2008

E-Book Winner!

Thanks so much to all of you who participated in our Bloggy Progressive Dinner! Special thanks to all of you who contributed your yummy salad recipes here at Parenting the Tiniest of Miracles. Even this non-salad-eater was tempted by those combos!

The winner of FishMama's fabulous e-book, FishMama's Guide to Cooking With Children, is...

Random Integer Generator

Here are your random numbers:


Timestamp: 2008-12-22 01:39:58 UTC

Number 9... Lora!

I've already sent you an email, Lora, with some more info. Thanks to all of you for the great comments!

Tuesday, December 16, 2008

Not Another Ho-hum Salad

Truth: I don't like salad. I really don't. I absolutely adore those restaurants that allow you to choose between soup and salad because I just think soup is so superior. In all honesty, if the only option is salad, I usually just pass. At events where you're automatically served a salad, I tend to nibble and push the stuff around my plate. I am one of those people. I truly don't understand women who claim they're happy making a meal out of salad. That's just not me...

But last April I attended a wedding and was served the salad course along with everyone else. I nibbled. And nibbled. And my eyes grew wide. I plowed through that entire salad. I was so thrilled by the unique combination of flavors, such a far cry from the "lettuce and tomato with balsamic viniagerette" to which I was accustomed. I still talk about that salad... just ask my mom.

It took me awhile to hunt down a recipe that replicated all the delicious flavors weaving through that salad but, now that I finally have, I'm going to save you the legwork. Without further ado...

Baby Greens, Pear, Bleu Cheese, and Candied Pecan Salad
(the recipe I found calls for walnuts, but I the one I fell in love with had candied pecans... use whatever appeals to you!)


  • 3 tablespoons fresh lemon juice
  • 1 tablespoon Dijon mustard
  • 1 medium shallot, minced
  • 1 1/2 teaspoons chopped fresh thyme
  • 1/2 cup olive oil

  • 1 5-ounce bag mixed baby greens
  • 2 large ripe pears, halved, cored, thinly sliced lengthwise
  • 1 cup crumbled blue cheese
  • 1 cup candied pecans (I bought mine candied, but they can be easily made by simmering in a simple syrup)

Whisk first 4 ingredients in small bowl to blend. Gradually whisk in oil. Season dressing to taste with salt and pepper.

Toss greens in large bowl with enough dressing to coat. Divide greens among 6 plates. Top with pear slices, dividing equally. Sprinkle with cheese and candied pecans. Drizzle lightly with remaining dressing and serve.

Delicious! Once you dress this salad, it's best eaten right away. Now this! This salad I would choose over soup...
For more great recipes, check out the Recipe Swap hosted at the Grocery Cart Challenge!

To go along with today's Progressive Dinner stop, I am giving away one copy of FishMama's Guide To Cooking With Children ebook. To enter, just leave a comment. One winner will be selected on Sunday, Dec. 21st.

What salads are you serving up this holiday season? Or are you serving a soup? Either way, we'd love to have you share! Post your recipe on your blog and come back and link up with us. Don't have a blog? Feel free to tell us what you're fixing in the comments!

Don't miss a course! Be part of our Bloggy Progressive Dinner all week long!

Monday, December 15, 2008

"My Story..." Monday... will be back!

Just a quick note to let you all know that I will be continuing the story of our journey to Chicago on Monday, Dec. 29th. For today, I've already got a lot of juicy food-related yumminess to share with you all in honor of our Bloggy Progressive Dinner!

Next Monday, December 22nd, I'll have up a new "My Story..." post talking about what it's like to celebrate Christmas while your child hovers between life and death... it's an emotional story but, as you know by now, it has a happy ending!

A Couple Touches of Christmas...

Merry Christmas!

Back in October, I shared with you all how much I dislike Halloween decorations. On the flip-side, I absolutely adore Christmas decorations. Here are just a couple of little touches we bring out each year that help make the season special for us...

(My grandmother made ornaments for all of us each and every year of our childhoods... this Santa was the one she made in 1976, the year I was born...)

(This is Sparkle Cat. I adore Sparkle Cat. It is an ornament my mom gave to me when I was a college student. It always has a place of honor near the top of my tree... my hubby is not as big a fan, but, hey... :))

(This ornament is very special to me because it is the very first my daughter received and she actually received at on the day of her birth, Christmas Eve 2005. It was made for her by my sister-in-law's sister-in-law... does that make sense?)

(My Nativity Set. I love the classic, almost Renaissance-like beauty of it. I can imagine passing it down someday to a grandchild...)

(My Three Kings. My mom's mom made these for her. They were passed down to me as soon as I had my own home. I've loved them since I was a very little girl... I hope my little girl will love them too someday.)

For more beautiful decorations and signs of the holidays, be sure to check out BooMama's Tour of Homes.

For more wonderful Christmas recipes, make sure to be a part of our Bloggy Progressive Dinner which kicks off TODAY with Joy's fabulous drink recipe! The Progressive Dinner will be going on all week long so don't miss a course!

Sunday, December 14, 2008

Slacking and Celebrating All In One Week!

As I mentioned a couple weeks ago, I've been in kitchen slack-off mode. The name of the game right now is just coming up with meals that I can stomach putting together and that my family will eat. That is my only goal. Given my truly un-ambitious streak right now, this makes it a strange week for me to do my very first Menu Plan Monday post for Org Junkie... but, hey!, why not?

So here's what'll be happening in our home this week:

Breakfasts: cereal, oatmeal, or English muffins
applesauce or yogurt
milk or juice

Lunches: sandwiches, soup, lo mein, bagel pizzas, pasta
milk or water

Mon. 12/15- (ultrasound day!) Frozen Chicken Parm dinner, pasta, broccoli
Tues. 12/16- Hot & Sour Peanut Noodles
Wed. 12/17- Grilled (ahem, grill PAN) Chicken, mashed potatoes, salad (this is a fabulous
salad, people... be sure to join us for our Bloggy Progressive Dinner this whole week...
I'll be sharing my salad recipe on Wednesday)
Thur. 12/18- Grilled Ham & Cheese Sandwiches, soup
Fri. 12/19- Veggie Omelets, Toast, Applesauce
Sat. 12/20- We're celebrating C's 3rd Birthday! Tradition holds that the birthday child gets his or
her favorite foods at the party so we'll be having macaroni and cheese, hot dogs, and grapes.... and
cake, of course! Poor girl never gets a party on her real day... Christmas Eve.

For a lot more interesting menu plans, head on over to Org Junkie! To start joining us on our Bloggy Progressive Dinner, be sure to head over to Five J's where Joy is serving up drinks today!

Saturday, December 13, 2008

JL's P.S. Fest 12/13/08

p.s. I think FishMama's idea of using ice cubes to water a tree is brilliant!

p.p.s. Jen's suggestion for an Exersaucer alternative looks great for families on the go!

p.p.p.s. I think Judy's craft idea for empty yogurt bottles is one of the cutest things I've ever seen!

p.p.p.p.s. Make sure you stop by all this next week and check out our Bloggy Progressive Dinner!!!

Friday, December 12, 2008

Portrait of a Pregnancy After a Micropreemie, pt 1

When I found out that I was pregnant with our third child, I was thrilled. My husband and I had always hoped to be blessed with another baby. Not for one moment was I anything but excited. Well, that's not completely true. I'm scared too...

For those of you who may not have caught my post on the topic, my daughter was born four months early due to preterm labor of unknown causes. This is a blessing and a curse because, realistically, the odds are good that it won't happen again but, at the same time, there aren't too many "pro-active" things I can do to prevent it either.

Here are some ways that my current pregnancy is very different from my previous two...

On Monday, I go in for a trans-vaginal ultrasound to get a very specific, clear picture to date the pregnancy as accurately as possible. This is critical because I will have to have another c-section (my first was a classic-- VBAC is not an option) and they want it done not before 36 weeks but not after 37 weeks. We want the baby to be as mature and developed as possible, but they can't risk hard contractions because the odds are too good that I would face internal uterine rupture. This is far different from having my water break at home when I was 41 weeks along with my son...

This ultrasound will also be used to determine whether or not I still need to have the surgery I was originally supposed to have on November 14th. If so, I will face surgery while pregnant, sometime after my 16th week. It's a scary thought to me...

I'm ten weeks today and, so far, I have very few restrictions. I'm only allowed to walk for exercise and, of course, I face the limitations that any tired and nauseous pregnant woman faces. There's only so much I even want to do. But, at 20 weeks, I've already been told the following restrictions will have to be in place:
  • No extraneous walking or exercise.
  • No intercourse.
  • No lifting anything over 20 lb (this will include both of my children).
  • At least a couple of hours of bedrest per day.
  • Careful attention to any and all pressure and twinges (with C, what I thought were painless Braxton Hicks contractions turned out to be the real deal...).
  • Likely consultation with a perinatologist on top of regular (frequent) OB visits.
What does all this mean? Well, basically we have to do some planning now. My 3-year old son who will be 4 by then should do fine through the day with no lifting. My little girl who's almost 3? Different story. She's still in a crib, still in high chair, and she seems so tiny! But we'll have to make some adjustments. Bedrest? The thought makes me laugh. But, if I really think about it, my children are happy to color in coloring books, flip through books, or sing songs with Mama even if I'm horizontal. And, well, watching Little Einsteins or Veggietales isn't going to kill them.

I feel humbled by my last pregnancy. I take nothing for granted now. I am trying to enjoy each and every day of this journey and to find comfort in faith. I will do everything in my power to ensure that this little bean stays where he or she belongs for as long as possible... and I will trust the powers greater than my own to handle the rest.

Thursday, December 11, 2008

Cheaper Re-Hydration

I've been on a roll around here with a lot of "sick-themed" posts. That's what happens when the household succumbs to the germs!

My daughter has had a rotten fever and head-cold and her appetite's been off. Fortunately, she's very willing to drink fluids. We've been giving her the Walgreen's brand of Pedialyte because we managed to pick it up for next-to-nothing way back when. If you don't have a pediatric electrolyte formula on hand or if you don't want to spend the major cash that some of those things cost (especially when it's the middle of the night, you have no sales or coupons, and you're desperate), here a couple of alternatives, courtesy of my much-loved pediatrician (and father of four)...

For children over one year-

Half-strength Gatorade (one part Gatorade, one part water)


Quarter-strength Kool-Aid (one part Kool-Aid, three parts water)

Either of these solutions is mild-tasting, easy to digest, and helps get fluid and some simple sugar into your child. The bonus? For finicky kids, there are a lot more Gatorade and Kool-Aid flavor choices than there are Pedialyte!

For more frugal tips, be sure to visit Crystal's Frugal Friday!

Three Things They'll Give You in Pre-Term Labor

If you happen to go into labor really early (i.e. before 30 weeks), here are three things they will almost definitely give you when you're admitted to the hospital:
  1. Magnesium Sulfate- This is beneficial for multiple reasons but the most "across-the board" benefit is that it can be helpful in stopping contractions and, thus, stopping, or at the very least slowing, the progression of labor. Women who've received it will tell you- it causes nausea and intense "hot flashes". Not the most pleasant sensation but, really, given the circumstances, it's not the worst thing in the world either.
  2. Antibiotics- At this point in a pregnancy you have not been tested for group-B strep yet. The safest thing they can do is give you antibiotics "just in case". Even if you don't have it, it won't hurt you or the baby. They give you these through the IV and you probably will not even notice.
  3. Steroids- Steroid shots are often given to the mother to try to boost lung development in the fetus. These shots are usually given in the buttocks and they are delivered in two doses, spaced 24 hours apart. I was told they had only been proven to be helpful if both doses are administered.
It's likely you could receive other drugs and treatments too but, in a pre-term labor situation, I can all but guarantee those are three medications you should be prepared to receive. For the record? In my case, the magnesium did not stop my labor, I was negative for group-B strep, and I only managed to receive one dose of steroids. But, hey... it was worth a shot!

Wednesday, December 10, 2008

Taking An Accurate Temperature

When my first child was born, I read all the articles and books and learned that the most accurate way to take a baby's temperature was rectally. Okay. And, trust me, I've taken baby temps that way. The "experts" said that getting a temperature orally isn't really too accurate until about age three. I was resigned to this method.

Some friends and family advised us that we should get a tympanic thermometer so that we could check our son's temperature quickly in his ear. It sounded like a grand plan. We made the investment and it promptly got relegated to a dusty shelf someplace. I have no doubt these devices are accurate in the hands of someone highly trained in their use. But, whenever we used it, we could get back-to-back readings of 95.3 degrees and 104.1 degrees in the SAME ear. This did not seem like it would be helpful.

When our daughter arrived four months early, one of the challenges in the NICU was to keep her body temperature constant. Babies that small have difficulty regulating their own temp, so the nurses constantly monitor it and adjust their isolette (incubator) settings accordingly. Taking your baby's temperature (along with changing her diaper) are two of the first jobs you're allowed to take on when you have a child in intensive care. So it's exciting! I was surprised to see the method they used... axillary, or underarm. For these teeny, tiny babies where precision is important, this is the method they used.

So you know what? That works for me! If it's good enough for the NICU staff and babies, it's definitely good enough for our at-home needs.

Taking a temperature under the arm is quick, requires no lubrication, no undressing, and the child can easily just sit on your lap and read a book or sing a song. Checking for fever is no longer a big event around here. It's also much easier to take a temperature of a sleeping child this way...

Just a few things to keep in mind if using the axillary method:

  1. Axillary temperatures tend to read one degree lower than oral. Rectal tend to be one degree higher. So if your child has a temperature of 99.2 under the arm, just know that that's equivalent to 100.2 orally.
  2. Do make sure the child's clothing is loose enough that the thermometer is touching skin on all sides and not cloth as this could affect the reading.
  3. Kids DO squirm. One of the easiest ways for me to get my children to comply with this process is to sing the following silly song as I weave the thermometer in circles to go under their arm:
"Here comes the bumblebee from the farm...
Going to get (insert child's name) under the arm!!!"

That always earns giggles and cooperation.

The underarm method... it Works for Me!

Tuesday, December 9, 2008

Recovery Break

I feel my presence both online and on this blog has been a bit sporadic for the last few days. I'm sorry about that. Until C. and I both manage to fight these fevers and head-colds, it's not likely to change much.

Please check out the button on my right side-bar for more information about an exciting party we have going on next week! Parenting the Tiniest of Miracles will be part of a bloggy progressive dinner and we would all LOVE to have you participate.

Also coming up soon:
  • an update on what a high-risk, after-preemie pregnancy looks like so far
  • I'll talk about spending Christmas with a child on the brink of death, far from home...
  • a special celebration as our little girl turns the big 3!
Thanks for hanging in there with me!

Monday, December 8, 2008

"My Story..." Monday: Going to Chicago Instead of Home

C's first eye surgery didn't do the trick. I received a call a week later that her blood vessels were going haywire in there and Dr. Neely said that he'd like to go and do a "filler" laser surgery to zap all the ones he could see. Her first surgery had been a relatively quick and simple affair, so we agreed and he said he'd do the surgery the next morning, Wednesday, at 8 am. My husband juggled work yet again, and we showed up at the hospital at about 7:30 in the morning.

I had spoken to Dr. Neely several times on the phone by now, but this was the first time I met him. I talked to him briefly before the surgery and he said he'd come out to the waiting room to talk to us when he was through.

We waited in the family lounge with our son, keeping him occupied with little books and toys. One of the saddest things for me to watch during our hospital stay actually had nothing to do with the NICU babies... it involved the siblings. So many parents would drag their older children into the family lounge and expect them to just sit there quietly and wait without one single thing to play with or look at. Many a time, children far older than our one-year-old would wander over to check out his playthings simply because they were so bored and no one was even talking to them. When my husband would read to A, he would soon have a whole gathering of children around him, eager to hear to a story. He didn't mind, of course, but it was sad that their parents didn't think to do more for them. This is a hard time for the sibilngs too...

Anyway, I digress. C. had her second surgery and Dr. Neely felt it had been a success. There was only one problem... she had gone into respiratory distress. The anesthesia they gave her, Versed, seemed to just shut her down. She would forget to breathe on her own. They had to put her back on the C-PAP so that the pressure from the mask would "remind" her to draw regular breaths. Our hearts sank. You wait SO long for you child to move off of breathing equipment that to back-slide is simply devastating. They also had to put a heat-lamp over her to help her regulate her temperature. Even though the doctors and nurses assured us that she would be back to her usual self once the Versed wore off, it was terrible to watch. We kept thinking, "Isn't there something they could give her? Some way to reverse the effects?"

But we just had to wait.

Not surprisingly, the medical staff was right and, by that evening, C. was happily breathing with only the nasal cannula again and she was regulating her own temperature without issue. She was back to her usual self and we were delighted, still anticipating a release date just around the corner. Our world was bright and we were optimistic. We started talking to the nurses about what tests she would need before she went home. It was getting exciting!

But the next Tuesday, my phone rang again. I was in the playroom of the Ronald McDonald house with my son. It was Dr. Neely. This is what he said,

"Mrs. S., I just checked C's eyes. I'm very concerned about the progression of her ROP and I can see signs that the retina is starting to detach. If that continues without correction, she'll lose her sight. I feel strongly that she needs to be seen by a retinal surgeon who specializes in premature infants. There are three of them in the country- one in California, one in Detroit, and one in Chicago. I've spoken to Dr. Shapiro in Chicago and he'll be around so that's where we want to transport her."

Believe it or not, my phone lost service at that exact moment. I scrambled to another section of the building with my son in tow to call him back.

"When?" I asked.

His answer suprised me:

"Either tonight or tomorrow."

I got off the phone and called my husband. He had just started a new job. The day before. He told me he'd do his best to get a few days off. As I filled him in, another call came through on my phone. It was Dr. Lemons, the head of neonatology.

Dr. Lemons called to help me secure lodging for while we were in Chicago. He gave me a couple of options and volunteered to make the necessary phone calls. It may seem like a little thing, but I'm not sure most department heads take the time to do that for a family. I was so grateful for his help.

My husband called back to say he had managed to take the next three days off, despite only having been at the job for two days. That was a huge relief.

Next, we had to find care for our son. We couldn't schlep him into the heart of Chicago with us. We didn't know where we'd be staying yet and we didn't know the layout or rules of the hospital there. My husband called one of his sisters and she agreed to watch A. We arranged to drop him off that night.

As we scrambled to pack his stuff, our stuff, and make arrangements, my phone rang yet again. It was a nurse from our current NICU. She told me this:

"Mrs. S., I 'm very sorry, but because- technically- C. is being discharged to go to Chicago, she is no longer considered a patient and, as a result, we can't keep any of her things here for you. Including the breast milk."

The breast milk. All 200+ bottles of it. Eight ounce bottles. What would we DO???

I sputtered, I stammered, I darn near begged her to help somehow. We had a tiny mini-fridge in our room. That's it! We couldn't fit more than six bottles in it. She said there was nothing she could do. Hubby called his sister. She thought they could store some of it. Maybe. I was desperate. I ran to the Ronald McDonald House main desk and told them our issue between tears. The volunteer at the desk said he'd see what they could do.

This all probably happened within twenty minutes and then my phone rang yet again. This time it was another, more seasoned nurse, who apologized up and down and said there was NO reason that we had to unload all that milk. They would store it. We could get it when she was released after our return to Indiana. Phew. I hung up, filled with relief but also frustrated that we had been so overwhelmed for no reason. As I put my phone down, the on-duty manager at the Ronald McDonald House knocked on my door. She offered me the use of their deep freezer, an industrial-sized freezer kept under lock and key. I was so touched by their willingness to try to help us at a moment's notice. Fortunately, as it turns out, we didn't have to transport all that milk.

We loaded the car and headed out to drop our son off at his aunt's house. It was very late by the time we got back to the Ronald McDonald House for the night. Before turning in, we decided to visit our little girl and wish her sweet dreams. We headed to our room and tried to get some sleep. We knew we'd be rising bright and early to follow our daughter's ambulance to Chicago.

We had no idea what was in store for us. But we knew it had to be done. More on that next week...

Saturday, December 6, 2008

JL's P.S. Fest: 12/6/08

p.s. These Candy-Cane Cookies shared at A Simple Walk sound yummy and festive!

p.p.s. Amy's latest baby blanket that she knit up looks so cozy... I really need to get better at knitting!

p.p.p.s. This post on Simplifying Christmas over at Life As MOM was a great reminder to enjoy the season... without being preachy.

p.p.p.p.s. Happy 3rd Blogiversary (a day late) to Angie at Baby Cheapskate... hers was the first blog I EVER read! Excellent material over there... make sure you stop by with well-wishes for her!

p.p.p.p.p.s. Here's another great post on the beauty and simplicity of the Christmas season at Amy's Finer Things... great ideas!

p.p.p.p.p.p.s. I think the whole concept behind Style Klutz is brilliant! I really enjoyed her tips for walking in high heels this week!

Happy St. Nicholas Day! Did you get any treats in your shoes this morning?

Friday, December 5, 2008

Blessed with Hand-Me-Downs

I don't know about you but, to me, hand-me-downs are one of life's great blessings. My husband and I are each the youngest of three children and we have ten nieces and nephews. Since my son was a newborn, I have received boxes full of beautiful, classic clothes to use thanks to my sister who has two boys of her own (and taste very similar to mine!). My brother has girls, so when C. arrived, I had a new source. My siblings and siblings-in-law will tell you-- there is very little I will turn down. Similarly, as we've had essentially back-to-back pregnancies, my sisters-in-law and I have passed a box of maternity clothes between us, each adding more as she goes.

I adore hand-me-downs. I can't imagine how much I've saved.

If you have a preemie, especially a very tiny preemie, you usually end up with a fairly large collection of preemie-sized baby clothes. These are garments designed for babies under 5 lb and, while I'm sure they all look super tiny to most people, there's actually a huge variance in how preemie sizes run. So, within your collection, you probably have a spectrum of sizes.

The thing about preemie clothes is this... hopefully, your siblings, friends, and neighbors won't need them. You can pass on those 0-3 month sleepers and feel confident they'll fit for at least a couple of weeks (!), but preemie clothes? Even small-ish newborns find newborn size clothes a better fit.

If you don't know anyone personally who has a preemie, I encourage you to talk to your local children's hospital. Whatever hospital has the highest level NICU in it. (FYI, this is often a teaching hospital.) Many of these hospitals are happy to accept used preemie clothes. And, in reality, my preemie clothes would be the only size that was completely "new to me". So they're in excellent shape. For all sorts of reasons, there are lots of NICU preemies who don't have families supplying them with clothing. The nurses are happy to have a collection on hand to use for these babies. Clothing, like blankets, can be washed and re-used. It happens, even in hospitals, all the time.

Most clothing drive campaigns for preemies request new garments. And that's wonderful. But if you're looking to contribute, and what you have to offer is gently used, contact your hospital... odds are good your generosity will be much appreciated and you won't have to shell out extra cash to make a difference.

For more frugal ideas, visit Crystal's Frugal Friday!

Thursday, December 4, 2008

Three Things to Know About Emergency C-Sections

One thing I've noticed more since having a c-section is, not only how many other women have them, but just how many of them are classified as "emergency c-sections". I was reminded of this just last week as I spoke with a friend and she kind of laughed and said, "although, I don't really think my c-section was truly an emergency..." I thought more about that and realized that, realistically, all unplanned c-sections seem to get labeled as emergencies. Here are three different scenarios, all of which get the same label: emergency c-section.

  1. A woman has been in labor too long or has pushed for too long and the doctor decides that it is time to deliver the baby by c-section. There is not necessarily anything "wrong" in this situation. It's just safer after a period of time to deliver surgically. In these cases, they usually get everything prepped and can wait a bit for the anesthesiologist.
  2. It is determined that it is unsafe for the baby to be delivered vaginally but the woman is not in any sort of hard labor. Usually there is some risk to the health of the baby and/or mother in these situations. It is imperative that the c-section be performed. Nonetheless, in these cases it is not uncommon for the medical team to wait for the arrival of a spouse or family member. Time is a factor, but it's not a life or death situation to postpone the c-section for a half-hour or so.
  3. Things go horribly wrong and the baby has to be removed NOW otherwise risking severe injury or death to mother or baby. In these cases, there is no wait for the anesthesiologist; these are the cases that cause "typical" laboring mothers to have to wait for their epidurals. They are high priority. Prep often happens in transit to the OR and the doctors wait for no one. These c-sections happen at breakneck speed.
I outline these differences not to "rank" how bad one's experience is versus another. Quite frankly, I *hate* birth story competitions. I just think it's important to know what a wide array of situations the term "emergency c-section" can encompass. I know when I hear that term I tend to think that something went suddenly and devastatingly wrong. Happily, that is not always the case.

Wednesday, December 3, 2008

Early Intervention

This morning I will meet with our First Steps coordinator for the last time. We have a "case closing meeting" and it's a great milestone!

First Steps is the name of our Early Intervention program here in Indiana. Different states use different names ("Birth to Three" seems to be common), but it's all the same idea. It is a program designed to ensure that children between the ages of 0 and 3 receive any therapy interventions they may need to help them succeed and reach their highest potential.

My little C. turns 3 on Christmas Eve and, as a result, she will be receiving her therapies (speech and occupational therapy) through the school system from here on out. I've already met her new therapists and they're lovely. I'm excited about this next step. But I'll be forever grateful to First Steps.

Early Intervention worked for us in so many ways.

First of all, it was so helpful to have a team of experts come out and evaluate our child and let us know how she was doing. So much more relevant than trying to compare her to charts in those "What to Expect..." books. We were given a summary that broke everything down so we could see very specific skills that would be emerging soon and areas where she could use a little help.

Secondly, once a plan was in place, our therapists came to our home. Since I had given birth to two babies in less than a year, this was a huge help to me. I didn't have to schlep two babies, an oxygen tank, an apnea monitor, and feeding gear all over the place.

Thirdly, because we were already involved with First Steps, our transition into the school system was simple. All of C's paperwork and history was forwarded on, saving us a lot of extra work. Her new therapists have comprehensive reports about her abilities and progress to help them structure a plan that will help her continue to develop and succeed.

I want to encourage other moms of little ones (preemie or not) to educate yourselves about your state's program. Know that you can contact them if you have any concerns. Some things that worried me (like my son not walking until he was 15 months old) turned out to be nothing needing intervention. Some things I may have just written off as an annoyance (my daughter's persistent tongue thrust when we tried to feed her solids) ended up being resolved after a few sessions with an OT. It never hurts to ask.

Here are just a few more reminders to help make the road as smooth as possible:
  • Keep your contacts straight- The first person you'll need to get in touch with will have a title like "Intake Coordinator". Then you'll be assigned a "Service Plan Coordinator". There will be an evaluation team. There will be therapists. Make sure you know who you should call with questions.
  • Know your rights- I want to be very clear here. I am NOT advocating that you be a demanding, bossy, law-quoting parent. I, personally, do not think that's the greatest way to go about things. But read your packet of information. And don't be afraid to speak up. I made it very clear, in a very polite way, that I wasn't interested in my child working with a "developmental therapist" in place of an occupational therapist (Dev Ther are more plentiful and cheaper to hire in our area). Our First Steps team was very receptive to my reasons and helped me secure an OT within a few weeks.
  • Be there when you say you will- Keep your appointments. With the Early Intervention staff and with the therapists. If you can't be there, be sure and call just as soon as you can. This is just common courtesy.
  • Try to be your therapists' "partner"- Early Intervention therapists can just as easily meet with your child in a daycare setting as at your home. But if you can be there, that's fabulous. Pay attention. Ask questions. See if your therapist has recommendations for games, activities, or toys that will help expand the skill-set he or she is currently working on.
  • And, finally, don't forget these important people at the holidays- I'm not saying you have to buy an expensive gift. You could make an ornament with your child. Bake some yummy cookies. Buy some pretty soaps. Whatever. But, honestly, my kids see their therapists more often than their local aunts, uncles, and cousins. They're a big part of their lives! My son still gets excited when he sees the penguin ornament on our tree given to him by one of our therapists. It's a really meaningful relationship for them. Honor that.
I learned about it after our little girl was born four months early. But, for all children, I would say knowing about Early Intervention Works for Me!

Tuesday, December 2, 2008

The Kitchen Slack-off Plan

Okay, so I'm actually really embarrassed and pretty reluctant to write this post. But I'm going to write it anyway. Because right now, at this exact point in my journey, this is the advice I have to offer...

When push comes to shove and the thought of cooking brings tears and nausea, just slack off. I have an abundance of chicken breasts, ground turkey, sausage links, and all manner of veggies in my freezer right now. I can barely stand to look at them, let alone come up with a meal plan for preparing them. I'm in the first trimester of a pregnancy and, while I am blessed and thrilled and overall doing great, I am also tired and nauseous. No big surprise.

And so, when my husband got paid and my monthly grocery money rolled in, what did I do? I'll tell you...

I went through my coupons and pulled out all the ones for frozen meals and Hamburger Helper. For chicken patties and ready-to-bake pizzas. For soups and "rice and sauce"-type side dishes. And I hit the store.

As I rolled my cart through the check-out lane, my cheeks flamed a bit. I don't usually shop this way. I can usually take pride in my array of fresh produce, lean meats, and my giant bags of flour because I bake all my own breads. I sometimes glance at others' carts and wonder how they can pay so much for convenience...

But you know what? The teenage cashier didn't bat a lash. And I think my husband was kind of excited to see some of the types of things we used to eat in college. And, as I served my children Lender's bagels spread with peanut butter instead of Mommy's homemade this morning, they didn't notice.

But everyone's happier when Mommy's happy. Slacker or not.

For more tips, check out Kitchen Tip Tuesday!

Monday, December 1, 2008

"My Story..." Monday: Those Two Words

As February came to a close, it marked two months of NICU stay for C. And two months of living in one room at the Ronald McDonald House for the rest of us. Still, our spirits were good. C. seemed to be getting bigger and stronger with each day. She was closing in on 3 lb... finally. She was receiving oxygen through only a nasal cannula and she had made the move to a "big girl bed"... a crib. This was a huge, welcome step! It's nice to be able to just pick up your baby rather than have her "trapped" inside the isolette. She had also just started receiving one or two feedings a day through a bottle instead of just through an NG-tube. Things were moving right along.

Part of the usual Tuesday afternoon routine in the NICU was for the ophthalmologist and his assistant to come through and check the babies' eyes. They were looking for signs of Retinopathy of Prematurity, or "ROP". In a nutshell (and I'm really over-simplifying here), ROP causes the tiny blood vessels in the eye to grow rapidly in a haywire fashion. This can cause problems with the retina and, in the most severe cases, causes the retina to start to detach which will ultimately lead to blindness. Treatment for ROP depends largely on the severity of how it presents. In minor cases, they often leave the babies alone because it seems to correct itself. In moderate to moderately severe cases, they go in and do laser surgery to "zap" some of those random blood vessels and hopefully halt the growth. In the most severe instances, the baby needs to have retinal surgery.

Getting checked for ROP was nothing new on our agenda. So far, things had looked pretty good with C's eyes. That particular Tuesday evening, however, I received a call from the eye doctor. He recommended that C. have a round of laser eye surgery because he didn't like the pattern of vessels that was developing. His partner would perform the surgery the very next morning.

We still weren't overly concerned. Maybe that seems odd but the only way I can explain it is this-- it's all relative. With everything our daughter had been through, this was a pretty minor procedure. And we knew another family whose little girl had had the same surgery.

The surgery itself took less than a half-hour. My husband stayed in the waiting room with our son and I went back to see her after she was back in her module.

I spoke to the ophthalmologist who had performed the surgery; she seemed pleased with how it went and said they would continue to monitor any signs of ROP in their weekly checks.

As she was leaving, the neonatologist in charge of C's care at the time stopped by. At our hospital, the neonatologists rotated which babies they treated every two weeks. This is a little disconcerting at first since it seems like you just about get used to someone and then they're gone. But, over time, you start to realize something-- each doctor has his or her own forte, their own ideas, their own solutions. By changing doctors, you give your child the best opportunity to get that "perfect" fit, that ideal solution at just the right time. Like when Dr. Winchester suggested the steroids to get C. off the vent. It's like getting a "second opinion" over and over without having to go anywhere. I believe it's a wise system.

Anyhow, our neonatologist at the time was a man named Dr. Trautman. There are two reasons I'll never forget him. The first is that he is the one who got us in with our current pediatrician who I love beyond belief. Dr. Trautman did the research in our area (two hours from his own) to find a superior doctor and got us in, though he most certainly was not accepting new patients. I am so thankful for that.

The second reason I will always remember him is this...

As he ran through C's chart with me and talked about how she was doing, he suddenly said,

"I think it's about time we start talking about those two little words."

I know I met his gaze with a blank stare. I had no clue where he was going with this.

He smiled and said,

"Going home."

The impact of those two words is too much for me to describe. For a brief moment, I thought he was teasing me. I quickly realized that no one with a heart could be that cruel to a NICU parent.

When your baby first settles in at NICU, they tell you that your first target release date is your baby's due date. If you make it out by then, well, you can consider yourself lucky. C's original due date had been April 15th so this seemed amazingly early. We chatted for a few more minutes and Dr. Trautman said he thought we, along with the director of neonatology, should start working on a two week timeline to go home. I rushed back to the waiting room to share this amazing news with my husband.

We did indeed meet with the director and he confirmed Dr. Trautman's opinion that two weeks was reasonable. We prepared to bring our daughter home mid-March.

Another call from the ophthalmologist changed all that. I'll tell you about that next week...