The Fog

Annika came home last Friday (10/22), so we've spent our last week in the fog that envelopes all households with a newborn. We've been keeping a low profile as Annika's immune system is very immature, she's had respiratory problems, and in general we've just been really tired!

Miss Annika is doing well, lots of sleeping, eating, and pooping. Mommy and Daddy have been getting all the snuggles we can while trying to keep the big brother and big sister entertained as well.

Friends near and far have been so helpful, and even though we received such an abundant supply of meals while we were making trips back and forth to the NICU, we've continued to have people offer to keep us well fed--what a blessing!

Our biggest struggle since bringing Annika home has been transitioning from the bottle to the breast, but after getting a nipple-shield yesterday and deciding to breastfeed exclusively for 2-3 days, I think we've made a breakthrough and it's been 24 hours since she's needed to take any of her feedings by bottle!

Hopefully the next post won't be so long in coming and will be filled with cute, snuggly, newborn photos...and of course trick-or-treating pics as well!

On the 12th Day in NICU...

My baby got to try...bottle feeding for the first time! :)

Annika continues to improve each day, slowly but surely. As of today, she's down to room air (21% oxygen) again, on 2.5L worth of air flow on the nasal cannula. She graduated yesterday to an open-top crib instead of the isolette and she's been maintaining her body temperature quite well. She is being given a 3-day course of Lasik (a diuretic to reduce water retention) to eliminate the extra fluid she has from being on IV's for 10 days. We can see the reduction in the puffiness in her face, but the main goal is actually to help reduce extra fluid retention in her lungs. It seems to be working well, as her respiration rate has come down steadily over the past couple of days and except for occasional "episodes" she's staying nicely in the optimal range (20-60 breaths per minute). Because of the reduced respiration rate and longer alert periods, she was allowed to try bottle feeding starting last night, and when we were visiting this morning, I got to give her a bottle! :)

To follow up on my last post, I'm sure most of you heard the update either in person, or via Facebook updates, but we learned on Monday (I think, it might have been Tuesday...my days are running together) that Annika had a probable case of pneumonia on top of the premature lung disease from being born at 35 weeks without any steroid lung maturation. Sunday was a rough day, but we actually didn't become aware of the condition until she was starting to make progress again. Honestly, as rough as last weekend was, we feel very blessed that my Group B strep status was unknown when labor began. What seemed like an unnecessary precaution at the time (I've been negative with both other kids, and was again this time we found out later) turned out to make a huge difference in Annika's life. If we had known that I was group B negative, they wouldn't have started her on antibiotics immediately following birth. Without the antibiotics, the pneumonia could potentially have been even more serious than it was, and Annika could have had an even rougher start than she did. Though the journey still seems far from over, we've already starting to see God's hand working throughout the situation. Though it would never have been what we would have chosen, we can still see how much worse things could have been and how God has been keeping us and our daughter safe when we could not have done anything to protect ourselves on our own.

I think the hardest part for me is still that we're just not sure how much longer she'll be in the NICU. She's making progress on all the goals she needs to be, but I think it'll probably still be a week or two before she's ready to join us at home. It's just a bit frustrating, because everyone says she's doing well, but no one is able to tell us how long the rest of her progress might take. She's really setting the pace right now, so it's just really up to her at this point. I definitely want her to be healthy and as ready as she needs to be before we bring her home, but it gets harder and harder to leave her as she's more aware of our presence and also as we're able to do more and more for her. At the beginning it was obvious we couldn't care for her in the medical condition she was in, but now it seems like almost everything she needs we could do at home with the right equipment. However, they have protocol and so she'll continue teaching mommy a lesson in patience.

We finally got pictures of our whole family together (aren't the kiddos all just too cute?) and I just am so excited to think about our little family returning to "normal" though it may be awhile before that actually happens. In the meantime we'll treasure the time we get to spend with her and rejoice in each step she takes toward coming home!

Week 1

Well, I feel significantly better this Monday morning than I did last Monday at this time. I can't ever say I enjoy any part of labor, other than when it's over. However, I absolutely cannot believe my baby girl is one week old tonight. I don't think it's possible for someone to work herself more into my heart than Annika has this week. Not being able to hold her is incredibly difficult, as it feels like there's not any way to let her know how much I love her without doing so.

I apologize in advance, this may be a bit all over the place.

The first week has been rough, I never imagined this would be as hard as it has been. In fact, before last week, I guess I really never imagined the NICU being part of my story ever. Your entire perspective on everything changes instantly. Leaving the hospital without your baby is something no parent should have to do. I think perhaps I was even more poorly prepared, because while I knew that at 35 weeks she would likely have to stay, I saw it as more of a speed bump than a long term stay. After a week, I don't really know what to believe.

Annika is stable for now. She's still on the ventilator, which she's been on since Thursday morning. They've been able to adjust her settings lower over the past few days, but I haven't really heard talk of trying to take her off it for the past couple of days. I think it's mostly due to the fact that while she's holding pretty steady, she's not really making the forward progress the neonatologists would expect for someone of her gestational age and size. Though she doesn't seem to be in pain, she's fairly lethargic most of the time, and they feel like she's "sick." What they haven't figured out is if it's just the trouble breathing that's tiring her, or if she has some sort of bug that they haven't identified.

Yesterday we were there when they rounded, and the one neonatologist in particular seemed fairly puzzled and concerned. She was not re-assuring to a mother's heart. Their biggest concern is that they would expect a baby of her age to have started producing her own surfactant within the first 1-3 days following birth, and there's no indication that she's done so. Her chest x-ray is still very cloudy, she's still taking too many breaths per minute, which is making her oxygen usage ineffective on her own, and is working to hard to breathe. As a result they've started to investigate if there are other structural issues putting more stress on her lungs. Annika had an EKG yesterday, which didn't really turn up anything explanatory or terribly concerning. She has a few small, very common holes in her heart, but according to the cardiologist almost any baby would have visible holes at this age, just most aren't given an EKG because they close on their own in the first few months following birth anyway.

Today she has tests for liver functionality due to some bilirubin numbers that are atypical, and she'll also have another blood draw to see if she's still has elevated levels of antibodies that are usually indicative of infection. I never thought I'd be hopeful that my child had an infection, and it still concerns me, but if she has a bug that she's not getting antibiotics for, it might be a quick and "easy" solution.

The unknown is what's so difficult for me right now. If someone could tell me that she'll be fine and give me a timeline for when she's coming home, I feel like I could deal with it, somewhat regardless of when it might be. I've already mentally extended my "2 weeks at most" perspective I had before and during her birth. I'm trying to prepare myself for a long road.

Unfortunately, I'm also concerned about the doctor's concern. I don't know about all moms, but I can imagine all sorts of terrible outcomes. I know the statistics on 35 week preemies says they almost all do just fine, but yet all of us know that there are always exceptions to statistics and there's not a worse fear as a parent than the thought of losing your child.

We're trying to take things one day at a time, stay present for our kids at home, and make time for each other, but many times it seems that there's just too much uncertainty to find any "normal" in this stage.

We still cannot thank everyone enough for continued concern and support: calls, meals, offers to help with kids, and asking about how Annika is doing. Thanks for loving our daughter with us, even though most of you haven't yet met her. Thanks for loving us well too! Hopefully the next update can be more encouraging.

Welcome Baby Girl!

As nearly all of you have probably heard, we had our baby girl this past Tuesday. Annika Caroline made her (fast) entrance into the world at 4:43am, and weighed in at 4lbs, 13oz while stretching out to 18."

Though she did make it to 35 weeks gestational age, her lungs are not fully developed. So, the past several days have been a roller coaster ride of adjusting to being a NICU-parent. We're not sure how long this road will take. For the first three days it seemed that we were only moving backwards, with Annika ending up on a ventilator by Thursday morning. She's been holding steady since and today she's actually been making forward progress going down in both oxygen percentage and number of breaths the vent is taking for her. We're hoping that she'll continue to make forward progress, but no one can really tell us when or how that may happen. The kids are both thrilled to have a little sister, but a bit confused as to why they're not able to hold her much (they've both gotten to do so once before she was vented) or play with her, or have her live here at our house. All in all they're doing OK.

Her bilirubin levels rose steadily over the first few days, but she started to poop yesterday, and the levels were down today, so she's only on a bili-light now, and was able to retire the bili-blanket. Even though she hasn't been able to work on eating yet, she's receiving intravenous nutrition, and after initial weight loss, she's picked back up a couple of ounces over the past two days, so we're hopeful her weight is on the way up for good.

So, we're taking things one day at a time and hoping and praying she'll be able to join our family at home as soon as possible. Leaving her behind when I checked out of the hospital was one of the hardest things I've ever done in my life, for sure the hardest thing as a mom!

Thanks for everyone who has prayed for us and Annika, brought us food, called, taken care of the kids, or supported us in so many other ways, we couldn't have made it through this past week without it!

Be Careful What You Wish For...

Who hasn't heard this line a million times? And yet, every so often you realize just why you hear it all the time. Sometimes what you wish for...comes true...just not how you'd planned. For any of you who may not be in the parent camp and are worried about too much mommy TMI, just scroll down to the bottom for the 'what's next' section. We covet your prayers even if you don't want the details!

Many of you know I had my regularly scheduled 34 week OB visit on Tuesday. This pregnancy has been going along without a glitch so far, but on Tuesday there were some anomalies in the regular-visit checks they always run. My blood pressure was up (though still in a borderline range) and I was spilling protein. Given my history of pre-eclampsia with Joshua, I was immediately sent down to the lab for a blood draw and to get set up with a 24-hour urinalysis fo ra more accurate count of how much protein was actually spilling over the course of a day. I was also put on partial bedrest until my follow-up appointment and NST this morning.

James and our friends have been awesome, and the past two days have been spent being able to truly lay-low for the most part. I've been feeling OK, but anxious to see what we're really dealing with.

This morning started out quite well. All of my blood work came back normal, no elevations or anything that would be concerning or indicate stress from the pre-eclampsia, etc. Baby and I had a non-stress test (NST) and everything looked perfect. Heart rate looked great, baby had a good number of accelerations as they like to see, and all indications are that the placenta is functioning well and not being too stressed either. My blood pressure numbers were almost the same as they had been on Tuesday (low 130's over low 80's) and still in an only slightly elevated range and as an added bonus (at least from the view of all women, pregnant or otherwise) I'd actually lost almost 3lbs since Tuesday! However, the results of the 24-hour urinalysis were also waiting for me. According the my OB/GYN the typical amount of protein collected over a 24 hour period should be <.3, my number was 2.2. Yep, more than 7x the "elevated" amount! Unfortunately, this alone is enough to classify me as severely pre-eclamptic. :(

I'm home now on bedrest for the rest of the pregnancy, monitoring my blood pressure throughout the day and watching for any of the other warning symptoms that signal worsening pre-eclampsia. Baby and I will be monitored by my doctor in the hospital or the birth center every two days and have labs drawn each time. If anything changes, I will be hospitalized until the baby arrives. If I present with one more "severe" symptom, I will likely be induced immediately. The best-case scenario at this point would be to make the pregnancy continue until the baby is 36 weeks gestational age (October 10th), we are hoping to be able to make it at least through this weekend when the baby would reach 35 weeks maturity. Given the severe nature of the case, we will almost definitely have a baby on or before October 15th regardless of what happens, as delivery is the only treatment/remedy for pre-eclampsia.

Waiting is not without risks to my health, delivering immediately not without risks for the baby, it's a balancing act at this point. Would you pray with us that we and the doctors would have wisdom to find the right course of action for the best outcomes for both of us? Also, pray for me as I feel so torn between what's best for the kids I already have and doing whatever it takes to protect this baby within, I feel like it's a no-win situation. Lydia is confused and Joshua is worried. :( Would you also pray for James this type of uncertainty and needing to be both the day-in-day-out prarent and the working parent puts a lot of stress on him as well and we all feel like we're on a roller coaster we can't get off?

Thanks so much for all the love, hugs, prayers, offers to help, and support we've been surrounded by over the past few days. We are so blessed to have such a supportive group of family and friends!

It's Fall

Fall has arrived here in Wisconsin, and after a brief return of the humidity of summer last week (which this pregnant lady is beyond done with) we're back to breezy, sunny days and chilly nights perfect for snuggling under a blanket. I love fall!

I'm in full blown nesting phase, which is currently manifesting itself in a need to plan and store food for when this baby arrives. This morning I'm not sure what possessed me to get these yesterday, but they were beautiful, free, and I'm blaming it on the nesting bug.

Not looking forward to all of the peeling, seeding, and cooking down that awaits me today, but the end results will be worth it. Nothing better than homemade tomato sauce/marinara on a cold winter evening. :)

I've got a bunch of other nesting-related projects going, but I'm running out of energy long before I accomplish everything, so I don't think this baby should count on being the first of my babies to have a nursery finished BEFORE she arrives. I'm pretty sure she'll have to wait until 4-6 months just like the other two. Though all the essentials are there and the clothes are even washed and in the drawers and the changing table is stocked, so we're prepared on a supplies front. (In fact with the deal-hunting/couponing I've done for diapers over the past months, if I cloth diaper ~50% like I did with Lydia, I might never have to buy a diaper once she arrives...a girl can always hope, right?)

I'm also trying to soak up these last few weeks of "just" being mommy of two of the cutest kids on the planet. I've been trying to be more intentional about getting an extra hug here and a snuggle there before this next little one arrives. They're just so precious, and while I know I won't love them any less as we add another, they may feel a little less treasured for a bit simply because of all the attention and energy getting through life with a newborn takes. So, I want to pour into them now while I can, and really, I just can't get enough.

Anyway, a sure sign of fall at our house is always the arrival of the pumpkins. I know it's only September, but pumpkins are way ahead of schedule this year, and our CSA farm hosted their annual pumpkin party and end-of-season crop gleaning yesterday. We've been members of this CSA for two years now, and the pumpkin pick was a highlight of our fall last year, so we knew we'd be back. We spent much of the afternoon yesterday wandering the farm, picking crops that were at the end of their production (past the point they were "worth" the farm-worker's labor-hours to try to get more saleable harvest, but with much tasty, usuable produce remaining) and opened up to the CSA members to take whatever they could use for their families. Sadly, the peppers around here have had a bad season, so none of the beautiful red peppers got last year, but the tomatoes made up for it. Oh my, so many. :)

We also picked broccoli, lettuce, a stray onion or two, and carrots.

Then it was off to the pumpkin patch. Joshua was really into it, trying to make sure he had "the biggest one." He wants to decorate his pumpkin right away of course, but we're trying to convince him that he should wait a bit closer to Halloween. He's also looking forward to roasting and eating the seeds. :) Lydia looked at us a bit incredulously when we told her she could just walk into the field and pick any pumpkin she wanted. She settled for one right on the very edge of the patch anyway... As always, no matter what they choose it makes for some fun pictures. :)

So, now I guess all we need to make this fall complete is the little pumpkin waiting to make a debut and making mommy think 6 weeks sounds like a long time!

Smaller, Bigger, or the Same?

Yesterday I had on an outfit I remembered wearing in one of the few belly shots I have from my pregnancy with Lydia. I also realized that the pictures were taken within a week of the same point in the pregancy also, so I thought it would be interesting to compare.

At least for me I feel the particular shirt I'm wearing makes the bump look different sizes, so it's hard to compare unless you've controlled for that variable. ;-)

Anyway, what do you guys think, how does the size compare? Bigger this time, or last?

The first picture is me pregnant with Lydia at 30ish weeks. The second is pregnant with baby #3 at 31 weeks exactly.

P.S. Please ignore the "just woke up" look in the current picture...it's true, but not so flattering!