4 months

Tomorrow Oliver will be four months old.  Four months!  He currently weighs 8 pounds, 4 ounces and is about 19 inches long.  In the past two weeks, Oliver has moved to low flow oxygen, and is doing great on it.  Oliver also moved to a new pod.  He had been back in a corner, but the light switch started buzzing, and the physical therapist refused to sit next to it.  So off we went into a private room.  It is a twin room, so it's a little bigger, and it's used for respiratory isolation, so it always has an air purifier running.  I like the privacy, but sometimes I wonder if he doesn't get forgotten since he's out of sight now.

Oliver got a new neighbor last night.  Another 24 weeker, a little boy born at 1 lb 2 oz.  I talked to his dad today when he ducked his head into Oliver's room, and said, surprised, "oh, you have a big guy."  I think seeing O gave him a little hope.

So, so tiny (Oliver's first picture, he's smaller than my shoe)

It's hard to remember just how tiny Oliver was, and how scared we were, how scared all parents of preemies and sick little ones are. So many wires, tubes, needles.  Not being able to touch them, or even really see them from all the bandages and head gear.  It's overwhelming, and every part of you fears losing them.  While I wanted to tell that new dad, "I've been in your shoes, and it'll be ok," you can't say that.  There's no guarantee, and even now I still can't tell myself that it's going to be ok.  It's so, so easy to think that, but one thing his doctor has mentioned several times is that with Oliver's stage of lung disease, even a cold can be fatal.  I'll be so happy when cold and flu season is over, and we can feel safe to introduce Oliver to his family and so many friends who love him and want to meet him.   I said a prayer for them on my way out, also thanking God that that part of our journey is over.

Such a big guy!

Oliver had another ROP eye exam yesterday, and his eye surgeon is concerned with a spot on his right eye.  He'll have another eye exam on Monday to check on it, but they think they will probably schedule surgery after that exam.  They had told me before that they would do both eyes at the same time to avoid putting him under anesthesia twice, so I assume that is still the case.  Looks like we'll find out on Monday.

The past few weeks Oliver has been showing signs of an oral aversion.  He began to pull away from and swat at his bottles, and fussing when trying to nurse.  On Dec 17 they started a swallow study to see how he was eating, and then on the 19th they implemented a 2 day nipple break.  Coming out of the break, they wanted him to start with thickened feeds.  Unfortunately, there is no approved thickener for breast milk, so this meant he had to start getting formula.  This just absolutely broke my heart.  I'd already failed to keep him safe during pregnancy, and now I was failing to feed him.  I've come to terms with it, because it's more important that he eats than what he eats, but I'm not happy with it.  He's getting 90 ml approximately every 4 hours as he demands, and as of today he's taken 50 ml a few times by mouth.  I did request that whatever he still needs via gavage be breast milk only, so he's at least getting some.  Depending on when his surgery is scheduled, the physical therapist and speech therapist would like to do a barium swallow study to see how he's eating, and if he needs to remain on a thickened feed.

 We had originally been told that Oliver could not come home until he was on low flow oxygen (which he is!) and he was taking all of his feedings by mouth.  Since we have now passed his due date, his doctor is willing to discuss bringing Oliver home on a feeding tube.  David and I have a Care Conference with his entire medical team tomorrow to discuss the different options we have regarding bringing him home.  It would not be until after his ROP surgery, so we're still looking at probably 2 weeks, but the countdown is on!

Christmas was hard, not just because it's the first one in almost 20 years that I haven't spent with my grandmother, but because Nathaniel was sick.  A sick kid at home means not touching the sick kid who's in the hospital.  Oliver's first Christmas, and I didn't get to hold him.  But now with both Nathaniel and David on antibiotics, I fully plan on making up for that with lots and lots of snuggle time for New Years.  Nathaniel, of course, was oblivious and thoroughly enjoyed himself.  He had way more fun unwrapping gifts than anything else, helping himself to Momma, Daddy, and Oliver's gifts as well.  What did Santa bring Nathaniel?  I think Santa did an excellent job this year.  We went to church on Christmas Eve and I cried my way through candlelit Silent Night, all FOUR verses, DAVID!  It had snowed while we were in there, and it was still coming down, so we had a very white Christmas.  David and I bought a minivan a couple of weeks ago, so we had no trouble getting out to the hospital, even in the snow.  Yep, we're minivan people now, but at least I waited until we had two kids (Harv!).

Hopefully, hopefully, Oliver gets home soon, gets this eating thing licked, and is doing well enough that we can head back to Illinois in April.  We had been hoping to go home for a week in February, but since Oliver will still be on oxygen we can't fly, and we can't make the drive for just one week.  So two weeks in April is now the goal.  Can't wait to see all my family and friends. 

15 weeks old

So alert

Oliver is 15 weeks old today, actual age, still negative in adjusted age.  But not for long.  This coming up Sunday, Dec 16, is my due date.  It's hard to believe I should still be pregnant.  It's hard to remember what being pregnant is like.  Oliver now weighs 6 lbs 15.6 ounces.  He's already bigger than Nathaniel was at birth.  Now that he's the size of a "regular" baby, it's hard to remember that he still can't be treated like a regular baby.  His senses are still very sensitive.  Many babies born at his age have hearing problems, but not our boy.  He jumps at any loud noise at all, and some not so loud.  Unlike term babies who like to be rocked side to side, he actually needs to be rocked head to toe.  The physical therapists work with him, and me, every day to break my habit of soothing a term baby, and training me on ways to handle a preemie.  When he's home, a physical therapist will visit us at home for a year or more, continuing to work with us on new exercises.  Lights still bother him, and although he's entered the stage of having lights on during the day, they're still pretty dim.



Mobile providing entertainment

Although Oliver will need glasses for nearsightedness, right now his vision is right on track with any newborn's, seeing best in the 12-18 inch range.  In a couple of months, though, while a term newborn's vision would continue to expand, his won't, and we'll get him fit for glasses when he's about 3 months old adjusted.  He has a mobile that he loves to watch and listen to.  Oliver had his weekly ROP exam today, but I haven't received the results yet.  The eye surgeon and his neonatologist will work together to determine whether he should have the laser surgery before he is discharged, or if it can wait.  They would prefer he have it before he leaves the hospital, because being ventilated again could set him back some, but if his eyes are still improving they hate to do it too soon, when they could still get better.

His right hand is almost always up near his face

There is the same discussion going on with his needed hernia surgery.  Some of the docs think they should give it extra time.  His nurse, however, really feels he should have it before he's discharged.  Veronica also wants to see them do it with just a spinal instead of putting him fully under, so that he won't have to be ventilated for it.  It's really too bad they can't do both at the same time.

Another Christmas outfit

Oliver has already outgrown preemie clothes, and is making his way through the NICU's stash of newborn Christmas outfits.  He's out of newborn diapers and into size ones.  Good thing I didn't buy any newborns.

Worn out after physical therapy

It hasn't really felt like Christmas for us, since we're so far from home and all our usual traditions.  Friday night we took Nathaniel to the zoo for their yearly Zoo Lights festival.  It finally felt like Christmas!  Nathaniel loved the lights, but didn't seem to notice the animals, except the giraffes.  They were hard to miss.

Pretty lights!

Usually I'd have Christmas cards made by now, and ready to go out, but I'm still waiting on getting some pictures back of Oliver.  AND... I was planning on taking some pictures of Nathaniel in a Christmas outfit this week, but then I dropped a bowl on his face and gave him a black eye. 

Way to go, Mama.

Eventually, I'll get some decent pictures, make cards, and get them out, but it may be cutting it close or even a little late.  I think this year, people will understand.

14 weeks

Look at those cheeks!

Oliver is 14 weeks old today.  He weighs 6 pounds, 3.8 ounces, and is 17 inches long.  He's also extremely more alert these days.  Yesterday, we moved Nathaniel from half days at daycare to full days so that I can spend more time with Oliver.  Yesterday morning when I arrived at the hospital, Oliver was waiting a ready to eat.  After nursing (taking well over half of his feeding, a new record!), he remained awake, just looking at me and around the room, until his physical therapy session at noon.  Usually after PT he's pretty tired, but at that time he was still very alert, so we nursed again for his 12:30 feeding.  And he still didn't fall asleep!  He finally passed out around 2:30, so when his 3:30 cares rolled around, neither myself nor the nurse thought we should wake him up.  He had another eye exam around 5:30, which further wore him out.  He slept off and on throughout the rest of the evening and pretty much all night.

This morning when I arrived, he was still sleeping.  I had gotten there at 9 am for his PT session.  We mostly focused on massage, trying to get him to relax.  He still likes to keep his shoulders tense and up near his cheeks, which is not only bad for his muscles, but also his neck... gunky stuff is getting into the rolls and he's not letting it air out.

The NICU - 's bringing out the Christmas outfits

Oliver is still on the high flow nasal cannula, but he's down to 2 liters of pressure, which means he's getting really close to moving to low flow.  In rounds this morning, they discussed moving it down even more, but they want to try to wean the percentage of oxygen he's getting first.  He's been right around 40% for a few weeks now, but during feedings and PT he needs an increase, sometimes up to 50% or even more.  Until he gets back down into the 30s, they probably won't move him to low flow.  Oliver's eye surgeon reported that his eyes are making progress.  His left eye no longer shows any sign of Plus Disease.  His right eye is still improving.  They've decided to wait a full week until his next eye exam, which is a relief.  He really, really hates those.

Check out this adorable baby - Oliver says hi

In the past week, several of the nurses he's had hadn't seen him since he was teeny tiny.  Everyone exclaimed that they couldn't believe how big he's gotten.  He's looking more and more like his  brother every day.  Look at these adorable little feet:


Such cute little piggies



With my ring, for perspective

The big question I get asked is when will he come home.  And the answer is still we don't know.  He has to eat better, he has to breathe better, and he has to get through surgery.

Nathaniel, for the second time since we moved here, has brought a cold home from daycare.  He spent all night last night coughing.  He's currently coughing his way through a nap.  Colds scare the hell out of me now.  I'm scared to hold Oliver, for fear I may pass it on, but I also still need to spend time with him, feed him, learn how to care for him.  It would not bother me at all for him to need to stay in the hospital through most of cold, flu, and RSV season.

Forget these pears, more cheese please!