Thursday, May 04, 2006
a Group for Preemie Blog Moms...
http://groups.yahoo.com/group/PreemieBlogMoms
Come and join!
Liz
Wednesday, May 03, 2006
Saving babies....
The money you donated in the name of Corinne and Kaitlyn McCarthy for March of Dimes WalkAmerica will support the fight against premature birth by:
-Funding research to find out why premature birth happens and how it can be prevented.
-Supporting families whose babies must spend time in neonatal intensive care units (NICU).
-Expanding the number of NICU Family Support programs.
-Assisting health care professionals to improve prematurity risk detection and address risk factors with patients
-Educating women about the signs of preterm labor and what to do if they have them.
-Advocating for expanded access to health insurance for mothers and babies.
-Providing women with the latest information about pregnancy and premature birth.
I decided to participate in this special event just 2 weeks prior - and if you can believe it, I raised almost $1,600 In just 2 weeks!!!! THANK YOU ALL for your support!!
Special thanks go out to:
Cynthia B, Billie W (online friends); Jackie & Gary C; (my dad's long-time best friend - my brother is named after "uncle Gary"); Whitney C & Ashley K (my Step-sisters); Clarissa C and her sister Katrina L (my cousins); Danielle D (Kaitlyn's primary nurse from the NICU); Derinda (a long-time SF friend); Alyssa H (real estate clients/friends); Chris W, Susan H, Julie H, Rita H. (Co-workers/clients/bosses from my former tech days); Gille and Mame (Kaitlyn's grandparents); Cheri N,Stacey B, Mary T (local twin moms); Kerry O'G & Spencer P (friends via my brother);Diana T (a close friend of mine); Linda W (former co-worker from years ago); Angela S (a neighbor growing up in LA); Pappy & Mimi (Kaitlyn's grandpa).
It's not too late - you can still donate if you'd like- the link is to the right hand side of my blog: click on March of Dimes.
SF Walk details
Well, our walk day dawned with typical San Francisco Fog, so we swaddled up Kaitlyn and headed out for our first real exercise in over a year, and of course Kaitlyn’s first long ride in our new jogging/walker stroller.
Kaitlyn slept almost the entire time. We were joined on the walk by many of Kaitlyn’s nurses, doctors and social workers from the hospital, as well as fire-fighters from Brian’s Fire Department.
Afterwards, some of Kaitlyn’s nurses and doctors got to hold her, which was such a nice treat for them, seeing how all of their life-saving efforts helped her to be with us during this eventful day. Did you know that the March of Dimes is the organization who funded the research to give preemies with immature lungs surfactant to help their lungs develop. Sadly, this wasn’t enough to help Corinne, but today Kaitlyn is off oxygen and her lungs are on their way to heal.
It all brought tears to my eyes. Our March of Dimes Walk Ambassador, a 3 year old former preemie and his mom spoke about their story. I was lucky enough to get to meet Zach and his mom, Michelle while Kaitlyn was still in the NICU. One of my doctors was Michelle’s sister and they agreed to meet with us to give us hope for Kaitlyn’s future.
Other Medical updates
Well, as always, our life seems to be filled with scheduling juggling doctor visits, nursing to start hopefully soon, medical supply delivery, work and trying to get Kaitlyn to eat:
Weight & growth – 10 pounds 10 ounces! Also, her increases are right on schedule compared to her last doc visit. This is good news (so that even with her vomiting, she’s still gaining appropriately). She’ s only on my breast milk (yeah, I can feel I’m accomplishing something for her); her height and her head growth are on par proportionately with her last visit. Her head is a little small on the charts, but her weight and height are finally on the charts (about 5% I think). Remember that this is her ADJUSTED age. She’s almost 4 months (tomorrow) and not 7months from her actual due date.
I had a tough visit at her Pedi's office. Her appointment was right in the middle of a feeding/pumping session. So I sat in the office waiting for it to finish, as she proceeded to throw up. Then, a mom and baby came out after visitng the doc, and sat down to breast feed a noisily sucking babe. It was all I could do to keep it together. I sat there, holding her feeding pump, tubes, cleaning up vomit of my breat milk, listening to a babe eat. I can't tell you how much I wanted to change places. Once I went back into the room, I completely broke down with the nurse and started balling. Some times I'm just not very good at holding everything together.
Eyes – Kaitlyn had an eye appointment yesterday, and the Doc said he felt that what he saw with her eyes crossing (Infantile Esotropia – is a type of Strabisimus) was definitely caused from preemie hood. He wants to wait 2 months to see her again and hopefully it may clear up on it’s own. He said it’s good that both eyes are crossing (as opposed to just one as I originally thought). Here’s some info on it:
In many areas of treatment for infantile esotropia (IE - a congenital, inward turning of one eye), the best choices remain unclear - including the best type of surgical approach, non-surgical options and optimal timing of any of these interventions. The large body of literature on the subject of IE mainly consists of retrospective studies, cohort studies or case series. The review found that there were no trials indicating which treatments, or timing of any such treatments, were best.
Here’s some more info I found on: http://www.ehnpc.com/ Esotropia
Strabismus is the tern used to describe any type of misalignment of the eyes. Esotropia describes a misalignment of the eyes in which the eyes turn inward, toward the nose. There are several types of esotropia; some of the more common are described below.
Infantile Esotropia
Formerly called congenital esotropia, it is now known that most children with esotropia early in life are not actually born with it, but develop it within the first few months after birth. By definition, the term infantile esotropia is used to describe esotropia that is present before six months of age.
Infantile esotropia has several distinguishing characteristics. It is usually marked by very significant crossing of the eyes. Children with infantile esotropia tend to have very little hyperopia (farsightedness), and sometimes do not require glasses. Amblyopia (poor vision in one eye) is often not present, meaning that children with infantile esotropia often do not need to patch their eyes. Because there is equal vision in the two eyes, affected children will often alternate between using one eye and then the other, so that sometimes the right eye appears turned in and at other times the left eye appears turned in.
Infantile esotropia usually requires early surgical intervention because glasses rarely help to straighten the eyes. Early surgical intervention to straighten the eyes has been shown to increase the likelihood that the child's brain will "lock on" and begin to use the two eyes together. This allows for the possibility of the development of depth perception.
Children with infantile esotropia can develop other misalignment of the eyes. These problems occur in some children even after successful early surgery, and can include floating of one eye upward (called dissociated vertical deviation), pattern strabismus (marked by upward or downward turning of the eyes when looking in side gaze), and nystagmus (a back and forth wiggling of the eyes which may be present all of the time or only when one eye is covered).
Our doctor, who is often involved in studies (as he was for treating ROP early in preemies) told me that a study he was involved in has shown that 30% of preemies can end up with other eye disorders, such as IE. For now, we will just wait and see. He also said she was slightly near-sighted (about -.1), It’s still too soon to tell if she will become more near-sighted, (He said at about 18 months you can get a good idea of how the vision will turn out long-term). He also did not see any bad affects from the ROP and it seems to have stabilized.
Head Bobbing – I haven’t really mentioned this much in the past, as everything we’ve spoken about it the docs didn’t seem worried, but it’s still continuing. Kaitlyn bops a lot, she shakes her head and body. The eye doc and her pediatrician think it might be caused from her vision, but again, we don’t know
Smiling – Not happening. Kaitlyn still isn’t smiling and she is still averting her gaze from us. This is soooo hard. How I just want her to show that she’s happy and appreciative of my interaction with her.
Vomiting – Still happening. Not all the time, but enough that it’s hard and we still do a lot of laundry all the time. Not sure if I’ve ever mentioned it or not before, but whenever Kaitlyn passes gas, has a BM or coughs she also tends to vomit. Yikes! Her GI doc said this is a type of pressure reflux or something like that.
Vocal Chords – Her cry is still “quiet” - the main thing you hear is air rushing in and out. This is also the case with her new “talking” She has actually figured out how to “talk” – she basically takes a large inhalation of breath and as she does that the air makes a squawking noise. I think she’s definitely doing it on purpose and likes to interact with me when she’s making the noise.
Eating – not happening. She continues to show no interest what-so-ever in eating. I can get her to take a few swallows of milk with this device I found called a “soft-feeder” it’s a soft silicone thing shaped like a small cup that I can put in a drop of milk into her mouth. Sometimes she swallows it, sometimes she pushes it out with her tongue, and she usually vomits at some point rewarding me with her efforts. At least, she is swallowing some, which I think is a great sign.
Feeding – We’re getting the hang of her g-tube – Basically Kaitlyn is hooked up to her feeding pump 12 hours out of 24, and we just decided to change it to 14 hours today. I’ll detail this for those who are also g-tube parents, the rest can skip ahead if you want:
She is supposed to get 900 or so ml a day (we are waiting to get a new volume amount with her new weight). We connect her to a continuous feed at 8:30 pm at a rate of 60 ml/hr. We used to do this for 8 hours, but we took matters into our own hands and decided to make a change last night. The feed would stop at about 4:30 am, then at 6am we would give her about 100ml/hr for 1 hr. We often got a lot of vomit at that feed. So instead, we decided to increase the number of hours of the continuous feeds, as it was almost the same anyways, and do 60ml/hr for 10 hours, which means she is done at 6:30 (normally she would have been fed from 6-7am).
Then after that she’s on a Q4 (every 4 hour “bolus” feed) so at 10 am, 2pm, 6pm she gets 110ml over an hour.
The night time feed goes really well, we rarely if ever have any vomit.
10:00 pm
Well, I wrote the above earlier today, and have just spent the last few hours trying to calm Miss K down. Recently in the evening she hasn't been very consolable, and she does not want to look at me, but she wants to be held, sometimes. I sat here tonight, with her looking away, her eyes crossing, frowning. Why is this so hard. Sometimes more than others I think about that fateful amnio and how much my life changed. I sat here holding Miss K tonight and I told her about her sister Corinne that was looking over her. Sorry to end on a downer....
Mary and Molly - 2 of Kaitlyn's NICU nurses post walk
Post walk with M & M
Kerry (one of Kaitlyn's NICU nurses) during the walk. She was there during my delivery with Rose (who I've mentioned in the past)
Brian, Liz and sleeping Katilyn during the walk in front of the foggy Golden Gate Bridge
Posing in front of dad's work - a fire truck, of course Miss K is sound asleep
Dr. S, who was there when I delivered and called us EVERY day that she had Kaitlyn.
Proud dad with Kaitlyn in the jogging strollerThursday, April 27, 2006
Take your daughter to work Day!!!
Absolutely! Spring is finally here, and I haven't done anything fun for so long (remember yesterday's post?). Well here are a few pictures from the day........
Kaitlyn operating the fire hose. She's holding on tight! (A fellow fireman's grand daughter in the background)
Kaitlyn wearing dad's helmet.
Liz wearing dad's helmet and turn-outs (fire jacket).
Ok, isn't this what a fire helmet is supposed to be used for?
Kaitlyn steering the fireboat (well, the fire captain in the background is helping a bit!)
Kaitlyn with his dad the fireman at work on the fireboat.
Dad's wearing a FDNY shirt.
Liz and Brian in front of the transamerica building out on the bay. What a beautiful day (finally!)
The fireboat. SFFD has 2.
Afterwards, I took Katilyn for a walk down on the piers to the ferry building. It was time for her to eat and so this was the first attempt at feeding on the go. Her feeding pump is in the small black bag, you can see the tubing lead down to her; I think the adventure on the boat tuckered her out.
Yes, I'm sad. Remember yesterday I said that her right eye is becoming lazy....we'll here's proof of it. Not all the time. But when she does it (more often in the last few days), it's just terrible. Another doctore appointment to schedule.
Wednesday, April 26, 2006
Random Thoughts...Merry Christmas in April...
Well today Kaitlyn is "drinking" (via pump) milk from Christmas Eve! How funny is that. At least those are some days that I can remember what I ate - today she is enjoying a fabulous Christmas eve dinner that my mom cooked.
I'm still pumping 3 times a day. Can you believe it? I've been using a breat pump for a few days shy of 7 months! I pump it out of me and then I pump it into my daughter. The irony of it!
On Saturday Brian and I went to visit Kaitlyn's NICU twin, Ethyn (who also is a twin-less twin). This was the first social visit I've had in I don't know how long, and the first time we've taken Kaitly anywhere besides the doctors office. It was soooo nice to spend some time with other parents who totally, completely understand how difficult our life is. We took some pictures, I'll post them soon.
Kaitlyn won't eat anything. It's so frustrating. I think people don't really understand how hard this is. Family, friends, unless you can live a day or two in our lives, it's hard to comprehend the future that we have ahead of us.
I think that one of Kaitlyn's eyes might be becoming "lazy". I've noticed it more and more lately.
She still really avoids looking at us. Sometimes she gets upset when I hold her and would rather be put down alone. I think this could be the beginning of preemie sensitivity issues. She avoids our glaze. She's almost 4 months adjusted, and by this time, normal parents have been rewarded for all of their sleepless nights with months and months of smiles. Not us.
Now, don't get me wrong. I am rewarded just by looking at my sweetie pie, I don't think there's a more beautiful baby anywhere (yes, I'm a proud mama), and my heart melts when I see her.
I'm trying to work, every spare minute I have is spent working if I'm not taking care of Miss K. It's been great getting back into work at least, as it does take my mind off everything and I really love my work.
Some days we she vomits a lot, some days it's hardly at all.
The week before we visited the most amazing place. http://www.georgemark.org This is a respite and hospice home for children here in Northern California. MEDICALLY NEEDY PREEMIE MOMS NOTE: they would love to help you! They have agreed to provide respite care to us for Kaitlyn. This means that we could go away (gasp! go away) for a few days. The place was absolutely amazing and is the only one like it in the entire US. It's about 35 miles from our house. Amazing, amazing wonderful place. I started tearing up in their beautiful chapel, (as well as a few other times when I was there). Just knowing I could (and was allowed) to take a break. For me? Wow. Thinking back of my ordeal, starting back in July - I guess this is the sacrifice we make for motherhood? I just never expected it to be so hard.
Please spread the word about the George Mark home. They are there to help! I told them about all my on-line preemie friends and they told me to spread the word! I'll probably put this again in a separate post.
We are supposedly getting nursing care to help us starting next month. Our insurance only covers it for a limited number of days, so I feel the need to stretch it out as long as possible. I'm about at my wits end (as is Brian) .
The March of Dimes Walk is on Saturday! Thank you alll so much for your amazing generosity in supporting us. We've raised almost $1,200! This is the March of Dimes main fund-raiser for the year. If it weren't for MOD, our daughter probably wouldn't be here with us today!
The weather is finally beautiful today!!! Yes, it lifted my spirits, but have I done anything to enjoy it? No.
As I said, random thoughts.
Thursday, April 20, 2006
New Kaitlyn Pictures

With the warm weather, I was finally able to dress Kaitlyn in some of her great new outfits from friends. This outfit was from my mom's employees down in Southern California! Thank you JFF!
I took this picture today! The girls hung out when dad was at work.
Kaitlyn got a bath today (sorry the pic is a bit blurry), but I thought you might like to see her g-tube in her tummy.
Here is the feeding tube attached to the g-tube, sticking out of Kaitlyn's clothes. It's not attached to the food in this picture. When we feed her, we connect the feeding bag (that's connected to a pump and hanging on an IV pole), open the clamps (it's white) and start pumping.
Kaitlyn out for dinner! Yes, we went to the city last weekend to try out the new pump that allows us to pump without gravity, meaning the food bag doesn't have to be hung over the pump. Kaitlyn was quite curious about dad's mustache.
She's "talking" in this picture, not smiling, even though it looks like it.
Yeah, dad's mustache is now gone, this was on easter sunday.
Kaitlyn on easter sunday in her new BOB jogging stroller, the stroller was one of the wonderful gifts from all the realtors in my office. Walking in support of my girls & Official Announcement & New Cousin!

I'm sorry I wasn't able to mail everyone our birth announcement, I mailed out 100 and still would have loved to send so many more. So I'm posting it here for all to see.
Help Prevent Premature Babies
March of Dimes has an annual fund-raising walk in support of trying to prevent premature babies. I just last weekend decided to walk and raise funds myself in names of my girls.
I set what I thought was a lofty goal to raise $1,000 figuring if I got half-way there I would be happy with the short notice (2 weeks).
Well, I was so shocked today when I hit that goal already! So many of you have reached out to us in so many ways, and now in support of this great organization! Thank you!
I haven't gotten much exercise what so ever in the last year (still recovering from my 3+ months of bedrest) so the 6 miles will be exciting for me to walk. I may even try to bring Katilyn along in our new jogging stroller (courtesy of all the real estate agents in my office), but I would have to pump feed her on the road, so we'll see.
Here's a link to the girls Walk America page. I do have a picture of both of them together, Corinne is holding Kaitlyn's hand. (It may be hard for some to see) Nurse Rose positioned them for this picture, and it means the absolute world to me to have them together in the same bed.
http://www.walkamerica.org/kcmccarthy
If you live here in the Bay Area and would like to join me for the walk, I would love some supporters and company!! It's at 9 am in SF in the presidio. The details are on my walk page.
Update on Kaitlyn:
Well, she's still vomiting. I keep hoping that it will stop, but that just doesn't seem to be the case. The pump at night is going great and allowing us to finally get some much needed rest. Thankfully, Kaitlyn is a fabulous sleeper, so we set the pump on a continuous feed for 8 hours. We fill up the milk (my breat milk) 1/2 through and change her diaper, but other than that she sleeps the whole time!
Yesterday the wonderful Early Intervention Specialist (Jan) from the hospital came to visit Kaitlyn and indicated that she is doing wonderfully! This is such great news. I'm always worried about developmental delays due to her extreme prematurity.
She's really starting to reach out for objects and look at her hands a lot. It's so fun to watch her learn.
Her "communication" is definitely delayed, as I still haven't seen much in the way of smiling. The one I caught on film was about the only little smile session we've had. Most babies start smiling around 1 month and she's now 3.5 months adjusted.
She's not eating at all. She used to nipple a bit on occasion, but nothing any more what-so-ever.
Kaitlyn Has a Cousin!
Yesterday, Stella McCarthy Tessier was born in CT! Brian's sister Elissa had a baby, 7.5 pounds and we are so excited that Kaitlyn will have a girl cousin her same age! Unfortunately, they live on the opposite side of the country, and with Kaitlyn's poor lung condition, we aren't allowed to fly anywhere, so they won't be "seeing" each other for quite some time I'm guessing. But mom and baby are doing really well.
Thursday, April 13, 2006
Failed Her Lung Test and New Pictures of Kaitlyn
She will have to be retested again in 6 months. This basically means she still does have Chronic Lung Disease and that she is still very susceptible to respiratory illnesses....Thank goodness she didn't the cold I had for 2 weeks - maybe it's all my breast milk.
In general the vomiting is reduced, but it still happens. Just today WHICH happens to be Brian's first day back at work, I had 2 big projectile vomits. Kaitlyn has no desire to eat whatsoever. I used to be able to get her to nipple a bit (20 ml's or so), now she just "plays" with the nipple with her tounge. At least she lets me put it in her mouth, where a month ago she fought the whole time and hated anything in her mouth.
She's getting to the point now where she is starting to put her hands in her mouth, exploring them. Anything in her mouth is a good thing. As we have a long road to go with her oral aversions.
Here are quite a few new pictures of Kaitlyn. She actually "looks" bigger in these pictures. She's almost 10 pounds now. Sounds like a lot to weigh, but remember she is officially over 3 months old and 10 pounds isn't very much for a 3 month old baby. (even though she is 6 months old technically)
Dad and I love kissing those chubby cheeks
Dad's been playing around with the facial hair - I'm personally not a big fan. Fireman can't have facial hair (besides a mustache) and so I think that's why so many firemen have mustaches. I think he looks like he should be a CHP officer with his aviator glasses or something.
Kaitlyn hanging out on Dad's shoulder. I had just given her a bath, so you can see her little blonde hairs sticking up.
Remember how small she used to be? She actually looks like a real baby here!
OK, this was Kaitlyn's first attempts at smiling (sadly, she hasn't done it since and this was a week ago). It was so great. She was sitting in her car seat, I was preparing her milk and when I went up to the car seat she very intently noticed me and then smiled - a few times. Enough time for me to get the camera and catch one! My heart just melted on the spot!
This is Kaitlyn's wonderful "Auntie Rose". Rose was Kaitlyn's NICU nurse when she was first born and has always been there with a supportive shoulder. She was so incredibly nice to come to our house to help me with Kaitlyn when Brian flew back east to attend his Grandfather's funeral. Kaitlyn had a feeding clinic appointment in SF, and Rose came with me. On the way home we decided to take a few pictures in front of the Golden Gate bridge.
It was super windy, and Kaitlyn wasn't very happy in the cold
Kaitlyn had a hold of Rose's hair in this picture, so Rose was laughing in pain as Kaitlyn was pulling her hair. We had some good chuckles.
OK, I guess I'm a terrible mom, but she was obviously not happy at all with the wind and she made me chuckle. Now remember, you can obviously tell she's "screaming" but with her paralyzed vocal chord it sounds more like a muted high-pitched "teradactyl" throaty noise. I don't know how better to explain it than that.
Now, if you know my husband, you KNOW that he never uses the computer. I think he's sent 2 emails in his life (both to me when we first started dating). But this picture was so great I had to quickly get my camera. You can see his continued experimenting with facial hair. Kaitlyn seems intrigued by it!
Kaitlyn doing some tummy time looking at her "Happy Apple". One of Kaitlyn's Early intervention (E.I.) specialists lent it to us as she really likes to look at it. I guess it's an older Fishcer Price toy from the 70's that isn't made any more. Kaitlyn is propped up on her green "pickle" as Brian calls it. See her clasping her hands. She loves to explore her hands.
Some more kisses from Dad
Kaitlyn actually reaching out for her dangly toy. It's so fun to watch her learn.
Close up up tummy time and hand clasping. Her eye brows get so red all the time. It's like she concentrating so hard they turn red.
Tuesday, April 11, 2006
The vomit report
In general, however, I have to report that Kaitlyn's vomiting has decreased. She's now on a feeding pump 12 hours out of 24 hours a day (8 hours of it at night).
On her 2nd night of the pump, it became unattached, and I "fed the bed" meaning that the pump slowly pumped milk into her bassinet all night and I have no idea for how long. That was the first day that Brian left to go to his grandfather's funeral in Pennsylvania so things were a little crazy.
We were so lucky to have our wonderful friend Rose from the NICU come and stay with me for 2 days while Brian was gone. She was so amazing, and for the first time EVER I was able to sleep the entire night. Kaitlyn stayed in the room with Rose and Rose let me sleep uninterrupted. I felt so comfortable, knowing little Miss Kaitlyn was in great hands and I got to sleep 2 nights.
That's all I have to report for the time being.
Kaitlyn has a lung capacity test tomorrow, that will check to see how her lungs due in a reduced oxygen environment.
I think I need a secretary just to manage Kaitlyn's almost daily doctor visits as well as all the phone calls I am on regarding her care.
On a good note, I think Kaitlyn's development has really made some changes the last 4-5 days or so, Brian even noticed it as soon as he returned. She seems to look at us more and has a bit more control of her hand/arm movements. It's really fun to see her figure things out a bit at a time - and of course, this is especially great news, as so far developmentally, she doesn't seem to be very far behind where she should be. She still isn't smiling (I caught about 3 smiles a few days ago, but then none since)....We are hoping that with vomiting less she'll be more happy!
She's also now only on my breast milk - no longer fortified. So we aren't sure if the reduced vomiting is from: no more NG tube at the back of her throat, no more fortifier or reducing the amount of food that she gets at any one time - or more likely all of the above.
At Katilyn's weight check yesterday, she weighed in at 9 lbs 10 ounces!
Wednesday, April 05, 2006
Some changes...but cross your fingers....things are improving
-We have discontinued Reglan yesterday (a reflux drug) with no bad effects (we didn't think it was doing anything anyways).
-We stopped adding formula fortifier the last 2 days and vomiting seems to have decreased
-We did our first night of "continuous" feeds for 8 hours and we had no vomiting
-Otherwise we are pumping 130 cc's over an hour 6 times a day (except for the 2 times last night where we pumped in 260 over 7 hours while we all slept). Although Bri and I didnt' sleep much, as were were on vomit alert. I think this will help when Brian leaves tomorrow to attend his grandfather's funeral and I will be alone (except for wonderful nurse Rosa coming to help)
-I find it fairly frustrating that I spend hours a day pumping the milk out of my breasts and now spend hours a day pumping it into my daughter.....Ironic isn't it? this isn't how it's supposed to be.
-I had a small succsessful nipple attempt today, where Kaitlyn took about 20 cc's nice and slowly, but then had a smal gag and spit up everything she just nippled, (but it was a good attempt)
-Kaitlyn's pediatrician and partners have been great and are really trying to get everything cordianted between all of the doctors, and Katilyn's primary pediatrician (Hi Dr!) is checking in our blog and even gave me her personal contact info so we can get a hold of her.
-K had an EI appointment here today (early intervention) and once again, she seems to be doing very well developmentally (still no smiling), but the EI person confirmed that she is having some small hand reaching attempts at objects!
-K was 6 months old yesterday and 3 months adjusted yesterday.
-K had her last synygis shot of the flu season yesterday for RSV (It cost $1,500, thank goodness insurance covered it)
Monday, April 03, 2006
More sad news
On Sunday morning, his grandfather, Edward McCarthy Sr passed away. He was 88 years old. He lived in Pennsylvania, near Brian's parents in Pittsburgh. Brian's grandpa used to attend Brian's hockey games when he was little and Brian misses him terribly.
We are doing all we can to get Brian to Pittsburgh for the funeral this coming Friday, which means that I'm on vomit patrol soley on my own.
I may have mentioned in the past, but one of our favorite nurses for Katilyn in the NICU was Rose from Brazil, and she has so generously offered to come to our home and help me out while Brian is away if she can get some shift trades at work. I don't think anyone else can help if they don't have nursing skills or at least know how to operate a feeding pump.
Being fed by a pump
There are 2 ways to feed babies on feeding tubes, Bolus and Continuous Feeds. Kaitlyn has always been on Bolus feeds. Bolus feeds are the way a “normal” baby eats, they suck a bottle/breast fairly quickly (5- 20 min a session) and then don’t eat again for a number of hours. Preemies on the other hand have digestive/reflux issues in which bolus feeds can be a problem as their stomach’s cannot handle the v0lumne of food at one time.
A feeding pump allows for a slow drip of food into the stomach. It’s hoped that the feeding pump will allow for Kaitlyn to better handle the milk which will hopefully diminish the vomiting.
We started Kaitlyn on a feeding pump on Saturday. It was very frustrating, as the pump was delivered to us on Friday night, with no instruction what so ever. (The home health delivery company was supposed to have someone that could show us how to use it, but that wasn’t the case).
So Saturday afternoon Brian figured out what to do, and the Doc instructed us to try it out with half her food delivered over 30 minutes. Thankfully, it seemed to go fairly well. An hour later, we delivered the remainder of her feed (normally she would have gotten 130 cc’s every 4 hours).
It’s now Monday morning, and her vomiting HAS decreased. It’s not gone, and we are still feeding her over an hour versus continuous. There’s varying thoughts regarding feeding either bolus or continous. Long-term bolus is better, as it teaches the baby to feel hungry and want to eat, where continuous feeds don’t - but preemies have problems handling that much volume over a short period of time. Thankfully, Katilyn’s digestive system (bowels) have never had a problem, it’s more digestive (reflux) and air bubbles that cause her all the projectile vomiting we believe. In some ways, we still wonder how much she really has reflux, as the test she had back in the NICU showed that she didn’t, but she shows all the classic signs of reflux, (upset, arching her back, vomiting, vomiting an hour or 2 after her feed). She’s been on reflex meds now for some time, but I never really saw much of a difference.
Saturday, we found ourselves in a huge state of depression. It really set in that Kaitlyn’s eating issues are a long-term problem. People ask how she’s doing, and we say she is having terrible eating issues. I think people who don’t understand preemies think, “Oh, she’s isn’t latching on to my breast and is spitting up.” Instead our daughter projectile vomits everything you just worked so hard to get down, all over you, herself, the floor, the couch, what ever she is sitting on, it’s awful!
OK, it’s been about 1.5 hours since I wrote the above. Due to an extremely upset Kaitlyn and multiple vomiting episodes. She was covered in it. Projectile vomit, all over everything. I’ve changed her, and she’s finally calmed down. This all happened about ¾ of the way through her feed on the pump. This is the first time for me that the pump session went like this. Other sessions, she’s been calm throughout it and only threw up a little bit afterwards. It’s so frustrating.
On a positive note, we think that she is starting to somewhat reach for a hanging toy on her chair. Reading this, it sounds like she knows that she’s reaching, I wouldn’t say that yet, it’s almost like wow, there’s a toy, and my hand seems to be affecting it somewhat. We’ll see if this continues and she gets a bit more coordinated.
She still isn’t smiling, which babies should be by 3 months (which Katilyn will be tomorrow, 3 months adjusted, and 6 months from when she was born.)
Here's Kaitlyn being fed by pump (the pump is behind her), she's not looking very happy, this is her typical expression as an 'upset' episode gets started (which usually leads to vomiting)
Reaching for the toy (purposively? who knows)
Katilyn looking at the dangly toy I mentioned in the post above
Wednesday, March 29, 2006
Back home from surgery!
Our experience at the hospital still had more problems before we left however. I spent the night with Kaitlyn, we ended up having our own room and the Pediatric Ward nurses and docs were very nice. However, during the night, the nurse changed Kaitlyn’s IV bag incorrectly, and hung a bag that didn’t’ have any dextrose. This means that she didn’t have any food (besides electrolytes) and when the day nurse realized it at 10 am, she immediately took a blood sugar level and Kaitlyn had extremely low blood sugar (think, Diabetic shock!). They quickly remedied the situation, though, and hopefully she won’t have any ill effects from it. But, my goodness, how in the world can this kind of thing happen?
I was able to carry her into the operating room, of course I had tears streaming down my face. The Pulmonologist was there to do a bronch scope on her (and they want her awake for that, as they want to make her cry (how terrible) so they can see what her vocal chords do). I decided I didn’t want to watch, so I left her in the Operating Room’s capable hands, but it was so scary and terrible!
The Pulmonoloigst came and talked to us shortly there after and confirmed that Kaitlyn’s left vocal chord is indeed paralyzed – he said the good thing is that it is paralyzed “open” meaning that she can breathe. But, it seems likely to me that is what is causing her not wanting to eat, as when a person swallows, we close our vocal chords to keep what we are swallowing out of our lungs, If only ½ of her chords can close, that would make milk go into her lungs. She did have a swallow test while she was still in the NICU which showed she didn’t’ aspirate (milk go into her lungs), so I think it’s only intermittent. We usually find she seems to aspirate a bit when she throws up, as it goes down her lungs. If she was really aspirating, should probably would be very sick at this point, as fluid in the lungs causes pneumonia, and she’s still healthy.
What’s the outcome of having a paralyzed vocal chord, will she be able to speak? Only time will tell. It may heal on it’s own, or it may never heal. If it doesn’t heal sometimes the chord that works learns to over-compensate and move all the way over to the chord that is paralyzed. It’s our chords touching that allows us to speak. If this is the case, she will likely have a horse voice permanently, and she will likely have speech delays obviously.
The paralyzed chord seemed to have been caused from the PDA heart surgery she had when she was 4 days old. (if it were caused from the ventilators it would likely be bruised, swollen, etc), and the doc said it looked fine. During the PDA ductus surgery that she had a risk is damage to the chord nerve from either nicking or cutting it. The reason she had to have her PDA closed was that she was born to early and a babies heart in utero has this valve open so that the amniotic fluid can circulate, as that’s what the baby breathes while in utero, once the baby is born, the valve closes which makes sure that fluid doesn’t go into the heart/lungs. Many preemie babies have to have their duct closed either from drugs or if the drugs don’t work from the surgery that Kaitlyn had. Was this another Doctor error? We’ll never know.
After that, she was put under General Anesthesia and put on a ventilator! This is what scared me the most. I was afraid with the condition of her lungs that she may not do well after wards and have to stay on the vent.
Thankfully, she did really well, and they were able to remove her from the vent not long after surgery! This was great news.
The surgeon came out to talk to us and said the insertion of the G-tube went great. He put the scope (so he could see the insertion) through a cut he made in her belly-button, and the g-tube is inserted directly into her stomach a bit higher and to the side of her belly button.
It was bigger and stuck out more than I thought it would, but from my understanding the type they used is actually the lowest profile G-tube “button” that there is. It’s called a Mik-key.
They first started using her feeding tube with Pedialyte and she seemed to handle it well, so throughout the day yesterday, they increased her intake of fluids and then switched to my milk until eventually we gave her the full feed she was taking before we left for the hospital, and she handled it like a champ. We had some small spit-ups but because it went so well, we were released to go home last night at almost 8pm.
The nurses taught us how to feed her with the g-tube. The nurse told us that were as parents were the easiest she’s ever had to show (maybe it’s because we’ve been feeding her with the NG tube for 2 months now). It’s a different system than what we did before, but it does seem to be easier, the milk flows so much faster (too fast, we have to slow it down so she doesn’t get too full too fast), and no more ugly tape and tube on her face! It’s so nice to see her beautiful face with nothing on it. Just think, since she was born, she has ALWAYS had something on her face. Since 10/4/05! Except for the few times that it was pulled out (usually be the little peanut herself). The tube had caused a red indention on her cheek that will hopefully go away. It’s looking better today already.
Now, 5 feeds into being home, I wish I could say that she hasn’t thrown up, but that’s not the case. She has continued to throw up, only time will tell.
With her vocal chord issue, this could be a definite long haul for us.
She really seems to be feeling good and recovering nicely!
Kaitlyn didn't fit her baby "hospital gown" very well. This was in the room where we undressed her and the nurses prepped her for surgery. I was a nervous wreck.
Here I am holding little Miss Kaitlyn.
We were taken into the surgery area (gowns only permitted) and whisked into this Doctor Conference room. Brian and I sat there for about 10 minutes before the anethesiologist and Docs came in to talk to us. You can see how I'm feeling now. Kaitlyn however doesn't seem to be all that concerned, she's sound asleep. I was given a surgery gown, hat and shoe covers and allowed to carry her into the operating room. I didn't watch her be put under, as they had to do the bronch scope first, which I didn't want to stay and watch.
This is yesterday, about 24 hours after surgery. We had just fed Kaitlyn through her new G-tube for the first time. You can see her G-tube on her belly. You may have to click on the picture to view a large copy of it. The skin colored stuff around the "button" will go away, it is there to help protect her skin for a week or so.
The hospital knitters (women who make and donate hats and blankets to sick babies) made this cute hat. We put it on Kaitlyn as we were about to happily walk out the door! Here is Kaitlyn's goofy face again, I think she was happy to go home too!
Dad's got a ghotee growing while he's off on Paternity Leave. While in the fire department he can't grow one as the oxygen mask he has to wear fighting fires wouldn't get a good seal (that's you never see firemen with beards). He goes back to work in 2 more weeks.