daily update

Mark went back to work yesterday and today. I think it went pretty well for him though he was extra tired last night.

Claire got to play dress-up with Nana today. She wore a paper crown and a green polka-dot shawl. They have also had fun dressing up her stuffed animals and dolls.

Emily continues to do well. She gained 6 grams since yesterday. They are waiting till she hits 1200 before they give her milk that hasn't been frozen first. (They are concerned about some virus that very small preemies sometimes get from unfrozen milk.) I got to hold her 90 minutes today.

I put some new photos on Flikr yesterday.

News

Emily is doing well. She is up to 1061 grams and is taking 5cc every 4 hours. I've been able to hold her for and hour or more every day. They are moving her up to 6cc. So far each time she gets to 6cc she's had a problem handling it. Pray that she will be able to tolerate the increase. She is still on 2 liters of air through the cannula and doing fine with breathing and heart rate at this setting.

The milk supply is increasing daily and I'm producing enough now to feed a typical newborn.

I washed preemie and newborn clothes today. So cute and small...though they are way too big for Emily at the moment.

Claire can't get enough of the new swing. I tried it out too with her on my lap. Loads of fun...

Trouble with feeds

Emily was off her feeds for about 8 hours today because she wasn't digesting well. They decided to decrease the frequency of her meals and the quantity of milk. She was up to 6cc every 3 hours. Now she is at 4cc every 4 hours.

Mark asked about the chair situation. There is a glider in the other two NICU nurseries. Emily will be moved to one of them once she is more stable and needs less care. (Probably once she isn't receiving nutrition through the IV.)
He also found out the name of the NICU manager who is currently on vacation and he wants to ask about donating a chair. (Not that we have one to donate.)
He also asked if the NICU staff receives training on Kangaroo care. They PA (Physicians assistant) said that is it a topic in their continuing education sometimes.

growing

Emily is up to one Kilo. That's 2 lbs 3 oz. She is taking 5cc of milk every 3 hours. Last time she got up to 6cc she started having problems. Hopefully she has grown and matured enough to continue tolerating this quantity of milk.
I got to hold her for a record 1.5 hours this afternoon. It was so nice bing close to her. I was very uncomfortable by the end. The chairs they have in there are not adequate for this length of sitting on one spot.

Claire got to go on a field trip to the beach with Nanna and Mark. She had a great time in the waves.

Nice Visit

I had a nice visit with Emily today. She is doing well. She gained back the weight she lost the other day and is at 971 grams. (Maybe the weigh-in wasn't accurate before?) She was swaddled and sleeping peacefully when I arrived. I pumped milk and enjoyed looking at her. Then I got to hold her. Ar first she was swaddled but she got too warm so then I held her skin-to-skin. It was pure bliss. She was sleeping so sweetly and seemed content. Then I got to change her diaper and take some pictures. By this time she was awake and alert. I pumped again and put my hand on her head and talked and sang to her. She seemed very interested.
I'm starting to get to know the nursing staff and am feeling more comfortable with them. Emily has had really nice nurses the past several days.

I'm looking forward to having taco salad for dinner. Thanks Hartenburgs for taking care of luncheon and for sending the leftovers :)

On Track

Emily seems to be back on track. She is taking breastmilk again. They are starting out very slowly and monitoring her closely.
She had a few bradys yesterday but none today. She has adjusted well to being on the cannula again. She lost some weight since yesterday though-- 20 some grams.
I got to hold her this morning. It seemed like so long ago since the last time. She is so very tiny and so very precious. She seemed very comfortable and seemed to be sleeping deeply as I held her.

Claire: future botanist

Claire loves "gardening" she helps her grandmothers put weeds in a bin and pulls off leaves and flowers to add to the heap. She also likes to help with the watering. Today I was out front with her and in the space of two minutes she correctly identified the rose bush (not in bloom) and a geranium which had pink blossoms. Later she also identified the red geranium. She has enjoyed spending lots of time in the yard this summer. We haven't filled up her "swimming pool" very recently. She was requesting it this morning but I don't know where her swim clothes are. Maybe later.

little step forward

Emily is doing a little better today. She hasn't had any more Bradycardia spells (Will refer to as "Bradys" from here on out.) They have lessened the amount of breathing support she is getting from the SiPAP. She is back on photo-therapy. They did an x-ray this morning but the doctors hadn't reviewed them yet at the time of my visit this morning.


I sat and read a Beatrix Potter book to her while holding her arm and shoulder in my hand. She was sleeping peacefully. She seemed more comfortable today. She complained when the nurse changed her position and tried to go back onto her side. I mentioned this to the nurse who decided to return her to her side. I changed her diaper for the first time. I felt happy about being involved in her care today.

Weight gain: Emily is up to 963 grams. That is 59 grams over her birth weight and equal to 2 lbs 2 oz.

more set backs

Yesterday afternoon I didn't hold Emily because they were giving her a blood transfusion which took a little over 3 hours. Good news is Claire got to see Emily for the first time. She was very interested in Emily's tiny toes.
During the afternoon Emily spit up some milk and her belly was distended. The nurse extracted a lot of air from her belly which was back to it's normal size before her next meal. The nurse practitioner decided to continue feeding her on the same feeding schedule as before. Today they did an x-ray and discovered that her intestines were distended so they suspended all feeds and put a thicker tube with some suction down her throat to her tummy in order to keep her belly empty.

She had lots more Bradycardia episodes during the night last night. They were longer spells and her oxygen level dropped. The blood transfusion did not help with this as they had hoped. They changed her nasal cannula for the larger and more supportive SiPAP which she was on the first several days in the NICU. The SiPAP has helped with the Bradycardia spells.

They also drew blood for tests and started her on antibiotics today in case her symptoms are due to infection.

On a brighter note, Emily gained back the weight she lost during the first several days (50 grams) and has been gaining several grams per day.

This afternoon I prayed the Cannon for a sick child at her bedside and I couldn't stop crying. I'm so sad that she is sick and so sad that I can't hold her (because of the SiPAP) and sad that she can't take any milk right now. I just want her to be well and to grow so she can come home.

Ups and Downs

Sorry it's been so long since we updated. We've been having difficulty connecting to the blog.

Emily was baptized "Emelia" by her godfather on Tuesday after Saint Emelia, the Capadocian saint of the 4th century who was mother of 10 children 5 of whom were sainted: Saint Macrina, Saint Basil the Great, Saint Peter of Sebaste, Saint Gregory of Nyssa, and Saint Naucratius.

Emily had a good first week. She required photo-therapy for jaundice. She has been weaned from the humidifier which was adding moisture to the air in her isolette. She is being weaned from the canula also. (This blows air into her nostrils to help with breathing. She didn't have any episodes of Apnea, Bradycardia, or oxygen desaturation during the first week.

Yesterday Emily started to have a few set backs. The chest x-ray showed that her heart was becoming a bit congested. The Doctors started her on Lasix which should help her to get rid of the extra fluid. (This is common preemie medicine for VSD.)

Emily started having Bradycardia episodes last night and had several this morning. The doctor also said her hemoglobin is slightly lower than normal so she may need a blood transfusion soon.

On a happier note, now that she is off phototherapy, Emily and I have been enjoying Kangaroo Care. Let the bonding begin! Her nurse today is super nice and makes a point of caring for my needs as well as the baby's. I am really touched because I haven't felt very welcome in the NICU up till now. Also, her doctor asked me how my pumping was going. I appreciated the encouragement on this front too.

Please Pray that the new medicine will be effective, that the Bradycardia episodes will stop and her hemoglobin will go back up to normal. Pray for me to be able tocope with the ups and downs and the separation.

Jen Home News on Emily

Home again. It was great to be re-united with Claire after being in the hospital since last Tue. I hated being separated from her. Claire was fascinated looking at my incision and she had to check out by belly button as per her habit.

I took two naps this afternoon and managed to have just enough uumph to go see Emily this evening with my dad.

Lots of news about Emily today.
First a concern and prayer request, Emily has a heart defect called VSD or ventricular septal defect. Claire had a small VSD which closed on its own. Emily has a moderate sized hole between the two lower chambers of her heart which the cardiologist says is less likely to close on its own. He said it may cause too much blood flow to the lungs at some point which would be treated initially with medication. (I just realized Mark already mentioned this in his post earlier.) Please pray that the VSD will not put undue stress on her lungs or pulmonary blood vessels and that it will close on its own.

Good news, Emily was given a tiny bit of milk every 6 hours today and has tolerated it well so far. She has an ultrasound of the head today and everything looked normal.

She is doing very well with the nasal canula which is just providing a little pressure to help with her breathing.

They took out the umbilical line today. Hurray! this means one step closer to Kangaroo Care. I have high hopes that I will be able to hold her tomorrow.

cute little peanut

cute little peanut
Originally uploaded by hudsonthego

Now we can see Emily's face. The doctors say her breathing and everything else is so stable that they will try feeding her some colostrum today! We are very excited. This good news cheered us as Jen checked out of the hospital today. Please continue to pray for Emily's continued stability and growth. The cardiologist called us at home and said the VSD is "moderate-sized" so they will monitor it closely over the next few weeks. Pray it heals rather than requiring surgery. Claire's VSD healed, but her's was smaller.

Update Saturday

I just spoke with Jen and Mark on the phone and things seem to be going well. Jen is up and walking a bit already. Leaving her room on the seventh floor to visit Emily on the 8th floor, however, is exhausting and taxing on her recovering body. (Why, oh why, do they keep the postpartum rooms on a separate floor!?)

Emily had a great first night with no "events": her breathing, oxygen saturation, heart rate, and body temperature all stayed steady and strong. Her breathing was mostly unassisted though the pressurized nose feed remains attached for the time being.

Later, unfortunately, the NICU staff had difficulty inserting an IV line yesterday and that stressed Emily out. They had to make several tries and redos stretching over a few hours! As a result, Emily had some "desaturation" episodes, meaning her oxygen levels fell a few times last night.

On the flip side, having the IV set is one step to closer to removing the umbilical line so that Mark and Jen can cuddle with Emily for some mutually needed and desired skin-to-skin "Kangaroo" time. The nurse told Jen that they might be able to remove the belly line latter today. Hopefully, that means Jen can soon implement her idea of setting up her lawn chair in the NICU to relax with her little one against her chest.

The planned baptism had to be rescheduled because of the extended IV procedure and complications that were keeping Emily and the NICU staff occupied. The new plan is to have the sacrament performed tomorrow afternoon.

first Emily pics

avoiding intubation


with CPAP attached


holding Dad's hand

More Details

Emily Ruth had an apgar score of 8/9 (0ut of 10/10) and weighed in at 2 lbs. Her lusty cries, kicks, and punches were a comfort to her parents, especially in contrast to their previous experience with Claire who made only a peep or two, was intubated, scored 4/5 on the apgar, and was, in Mark's terms, "more floppy." If that floppy preemie blossomed into the beautiful, intelligent Claire we know and love today, the future looks bright indeed for Emily Ruth. :o)

Jen said the surgery went as smoothly as hoped. The anesthesiologist was fabulous and got the spinal tap on the first try. Emily was not under stress and was delivered in the sac, which is ideal. Mark said they removed the sac intact and carried it to a table before slicing it open and letting Emily out. How wonderful!

Jen was feeling confident in the timing of the cesarean and in the medical care team. Both Jen and Mark (and I with them) wept for joy and thankfulness at how well it all went and how healthy Emily appears to be.

Thanks be to God for the competent doctors as well as the providential timing of the bed rest, hospital admittance, and delivery. We thank Him for the advance notice and the steriod treatment that allowed Emily's lungs to be readied for postpartum life. We thank Him for all the medical advances that have allowed us to care for IGUR (intrauterine growth restricted) premies. And we thank Him most of all for answering our prayers for protection and grace.

Please pray for continued protection, wisdom, and peace; for strong and steady growth for Emily Ruth; for parent-infant bonding; and for a smooth start to a successful breastfeeding relationship as soon as Emily's body is ready for that transition.

Emily's NICU nurse said that the tube in Emily's umbilical, which is providing sustenance for her, will probably be in place for three or four days before they are able to switch to an IV feed. Mark and Jen will probably be able to hold her after that switch has occurred as the belly tube is more sensitive to movement and gets in the way of skin-to-skin cuddling. For now, Mark and Jen are contenting themselves with gazing at her tiny loveliness, speaking softly to her, and maybe holding a little foot or hand through one of the Isolette doors.

-Jen Brigid

welcome, Emily Ruth

Our new daughter was born today at 5:47 PM and we are thrilled.
She came into the world kicking and screaming quite enthusiastically, considering her diminuitive sub-2-pound weight. She fought off the doctor's attempts to insert a breathing tube, so for now she just has a nose-piece supplementing oxygen. Pray her lungs continue on this good start!

Pictures and more details coming soon.

Littlest "B" to be Delivered Tomorrow

[This is Jen Brigid posting on behalf of the Hudsons.]

Jen Marie is scheduled to have a caesarian section tomorrow evening at 5:00 p.m. The littlest B, Emily Ruth, will be at 30 weeks gestation, that's ten weeks early, folks, and two weeks earlier than Claire. Emily Ruth is also weighing in on the light side (860 grams/1.896 lbs); she's lighter than Claire was at her birth.

The reason the doctors have ordered the caesarian is because the baby's heart rate has slowed a handful of times since Jen has been in the hospital indicating that the baby may not be getting sufficient oxygen. Not getting enough oxygen is a very bad thing, especially for the little one's brain. Jen is now on oxygen herself to help increase supply for both.

The caesarian is delayed until tomorrow in order to allow time for a steroid treatment to take effect and begin stimulating the baby's lungs in preparation for a premature entrance into life outside the womb.

Please pray specifically for several intentions:

• Pray that Emily Ruth experiences no harm and no damage of any kind, whether to the brain or any other part, both during the remaining hours of uterine life and also once outside the womb.
• Pray for emotional and physical protection over Jen, especially for the spinal tap procedure, the caesarian surgery, and during recovering.
• Pray for divine peace, comfort, and strength for all four of the Hudsons as well as for their extended family.
• Pray for wisdom, discernment, and courage for Jen and Mark in advocating for the best interest of Emily Ruth and Jen.
• Pray for insight, compassion, wisdom, and skill for the doctors, especially the anesthesiologist, the perinatologist (obstetrician), and the neonatologist(s).
  
• Pray with the priest who will (we hope) be present at the surgery to administer the sacrament of baptism to baby and holy unction to both. Pray for divine healing grace and protection.
  
• Pray for immediate and extended opportunities for maternal-infant bonding and (non-nutritive) breastfeeding postpartum (see Kangaroo Care article referenced previously on the MarkHu blog after Claire's birth) and for an easy, quick transition to breast feeding for both mom and baby. Pray for doctor and hospital staff support in pursuing this goal.

Thanks for joining the angels and saints in surrounding the Hudsons with prayer and love during this incredibly hard time.

accelerate

baby scheduled to be delivered Thursday due to heart decelerations ... more later

the hospital stay

Our priest's wife summed it up best:

Please continue to pray for Jen, as she was admitted to the hospital today, as a precautionary measure. Though the baby has been growing, the doctor is not completely satisfied that it has grown enough and so has put Jen in the hospital until she delivers. There is no imminent danger, but we need to pray earnestly that the baby can continue to gestate as long as possible.

Thanks for your prayers.

This time, we went in for different reasons than the previous hospital stay (a few weeks ago for blood-pressure monitoring.) We expect this to be the final phase before the delivery, but are unsure how long it will be. The perinatologist wants to measure growth again next Tuesday. The hardest part is being apart.