Emma's Eyes

We had another appointment with the pediatric ophthalmologist today and Emma's eyes are looking great. In fact, the doc said he was "no longer worried" and believes that Emma will NOT need surgery. There is still evidence of Stage 1 - Stage 2 Retinopathy, but her eyes have continued to improve over the last two weeks. We'll go back for another exam in about 6 weeks, just to be on the safe side, but it is a big, huge, relief.

We're going back to the Special Care Nursery tomorrow for another appointment with the lactation consultant... it will be interesting to see how much weight Emma has gained. Compared to the early days, she now seems *almost* chubby to us :)



P.S. Big thanks to the Day Hospital team at work for the lovely personalized bib and to Grandma's friends Judy and Tayler for the cute outfits! :)

Emma's Due Date

It's hard to believe, but 112 days after she was born, Emma celebrated the arrival of her original due date. That's right, if everything had gone as planned, Emma wouldn't have been born until today... As I've mentioned before, you can't judge a micropreemie's progress merely by looking at her chronological age. Instead, you have to adjust things by how many weeks early she was born. So, as strange as it seems, Miss Emma is simultaneously both 112 and 0 days old today.

Emma celebrated by sleeping, eating, smiling, and just hangin' out:









We had a follow-up appointment with the lactation consultant at the hospital this week. Emma was weighed on the Special Care Nursery scale again and it seemed that she had gained only 2 ounces in 5 days, a fair bit less than the docs like to see (30 grams, approximately one ounce, per day is considered ideal). So, after some discussion, we've been asked to increase the fortification of her feeds. Even though she's receiving 100 % breast milk, the docs still like to fortify it with vitamins, lipids, and nutrients. The increased fortification is meant to beef up the caloric content of the milk so she can put on more weight. Emma's new ratio of milk to fortifier will add 4 calories per ounce to her feedings. When you're as small as Emma, those four calories make a big difference.

We also had our first visit from the Public Health Nurse today. According to her scale, Emma weighed 5 lbs., 4.5 ounces. That means she's gained about 3 ounces in 2 days... Looks like the fortifier is working as it should :)

Our First Outing

We went to see our pediatrician today and, let me tell you, getting all four of us out the door by 8:00 a.m. was a feat of organization requiring military planning... we were only 5 minutes late and only had a few meltdowns [Miss Michaela does NOT liked to be rushed in the morning] :~/

The doctor wanted us there early so we wouldn't expose Emma to too many germs from other sick kiddies in the waiting room... we were whisked in within minutes and Emma was declared to be "perfect" (well, we knew that already, but it's always nice to be validated :)

Emma has gained 100 grams since her discharge from the SCN and now weighs in at a "hefty" 5 lbs., 2 oz. She's having longer periods of alertness every day. This pic was taken while she was wide awake (from 7:30 to after 10:30!) this evening


I haven't spent a more enjoyable 3 hours in a very long time :)

Welcome Home Emma!

After 104 days, Emma finally came home on Thursday. We've spent the past 2 days enjoying her, often with silly grins on our faces :)

Emma appears to be adjusting well, although she does seem to have her days and nights mixed up. She's been most alert/awake between midnight and 4 a.m, which does NOT make for a very alert Mommy the next day. As the NICU/SCN was pretty busy 24 hours a day, I guess Emma will just need time to get used to the more 'normal' rhythm of home life.

We'll certainly continue with regular Emma Report updates, though likely not daily posts. For now, please enjoy Michaela being a very helpful Big Sister....

She's home!

Pssttt...

... Emma's coming home!

I'm almost afraid to say it out loud (don't want to jinx it, what with the Curse of the NICU, and all), but it looks like tomorrow morning, we'll be bringing our baby home :)

The eye doctor came in late this afternoon and Emma's eye exam went well. There is still evidence of Stage 1 - Stage 2, Zone 2 ROP, but overall the condition has improved since last week and the doc said it is very unlikely to worsen. He still wants to see her again in 2 weeks, but we'll go to his office for the appointment.

So, once we get the OK from the SCN docs at rounds tomorrow, we'll be bringing Emma home...

Yikes... now we have a million things to do tonight to get ready :)

Still Waiting...

Emma is just shy of 5 pounds today. Her last spell was a week ago, so she's ready to leave the SCN...we're just waiting for the pediatric ophthalmologist to come in for her eye exam... hopefully that will happen tomorrow or Thursday..

waiting, waiting, waiting.....

Waiting For Emma....

...to come home







bassinette............ check
crib..................... check
changing table...... check
car seat .............. check
diapers & wipes....... check
blankies & toys....... check
itty bitty clothes.... check
excited Big Sister.... check
eager Mom & Dad ...... check

keep your fingers crossed.... only a few more sleeps to go :)

100 Days

That is how long Emma has been in hospital. In honour of this monumentous occasion, a little gift was waiting for us when we arrived in the SCN today:













Another example of the NICU/SCN staff's thoughtfulness, the card was signed with love from all of the nurses who were in the unit today.












Emma "celebrated" by having a bath and getting dressed up for the occasion:






















100 days = 2400 hours = 144,000 minutes = A Very Long Time.

Thankfully, we can now see the light at the end of this long journey :)

Steady she goes!

I had a good visit with Emma tonight. Nothing new to report - she's doing well!

Fourteen Weeks and Big News

Compared to Emma's early rollercoaster days in the NICU, the past week has been rather boring (well, except for the little spell she had while in the ambulance en route to CHEO for her eye exam on Tuesday, an event that bought her another week in the SCN).

Today, Emma spent her 98th day in hospital sleeping and eating and sleeping some more.

So, what might the Big News be? Could it possibly be that we now have a planned discharge date? Perhaps :~)

We're going to try to respect the Curse of the NICU and not say exactly when the team told us she could go home, but you might want to stay tuned late next week :>

Pics, Pics, and more Pics

Another uneventful day in the SCN... :)

Credit where it's due

Last night I expressed my dissatisfaction with the hospital, both here and via email to the two physicians that run the SCN. In the spirit of fairness, I should tell you that I did receive a very prompt reply. The doc was quite understanding and indicated that he'd be looking into the issue to make sure it didn't happen again.

I had a very pleasant (and 3000% longer) visit with Emma tonight. Her 9pm feed went well, although she wasn't all that awake and required a bit of oxygen to help her along. Overall, she's doing quite well.

She did have a "spell" en route to the eye exam earlier this week, but travel is hard on the little ones. Hopefully this doesn't delay her coming home too much.

Emma's Eyes

Emma eye exam today indicated that both her eyes have improved since last week. There is evidence of stage 1 and stage 2, whereas last week's exam indicated areas of stage 2 and stage 3. Since ROP can progress rapidly Emma will be seen again next week, but according to the doc by 38 weeks (which Emma will be on Friday), the probability of worsening ROP is relatively small.

Now I'm pissed

Over the past four months I've put up with my fair share of hospital bureaucracy, and for the most part I haven't complained about it. Given the dozens of nurses and doctors we've dealt with, annoyances like conflicting information and the occasional health care professional with marginal interpersonal skills are to be expected. Most of the staff have been great, and watching Emma improve has helped me to focus on the positive. But tonight the Ottawa Hospital has really pissed me off.

With few exceptions, Laurie visits Emma during the day, and I visit during the evening. I hold Emma for a while, feed her, hold her for a while longer, and put settle her in to her cot for a sleep. I arrived at the hospital tonight to find out that the nurse had just called our home to advise me that I would not be allowed to visit.

Now before anyone's stress level gets too high, Emma is doing great. They did let me see her for a few minutes, but then I had to leave because they were setting up to perform a "three hour sterile procedure" on another baby in the same room.

For those of you who haven't been in the SCN, there are three rooms, and the one Emma is in has space for 8 or 9 babies. It has two large entrances, neither of which have doors. Parents visit with their children in the room, hold them, change them, feed them, etc. It's about as far away from an operating room as you can imagine while still being in a hospital.

So I don't get to hold or feed my baby tonight, and neither do any of the other parents with babies in that room.

"Three hour sterile procedure" -- Isn't that what an operating room is for?

Looking good!

Emma's eye exam went well. Both eyes are showing signs of improvement. More later...

A Really Big Girl

Emma has officially tripled her birth weight... she weighed in at 4 pounds, 10 ounces this afternoon!

Actually, the docs are a bit concerned that she is gaining too much weight and have given her medication to ensure she isn't retaining fluid (which can make it harder for her to breathe and may account for her ongoing need for oxygen during feeds). By this evening she had lost 90 grams (about 3 ounces), so hopefully her need for the O2 will decrease.

She had a busy day... we had 2 good sessions with the lactation consultant and Emma did really well with her feeds. Today was also bath day and Emma had the nurses giggling when she managed to cover Mommy and herself with a mid-bath poop [Emma will now be sooo embarrassed to read this blog when she's a teenager :~) ]

Emma is going to CHEO (via ambulance) tomorrow morning for another eye examination. Depending on the results, she may have to stay at CHEO for a couple of days in order to have surgery... I'll update tomorrow evening.

No news is good news

Nothing new to report - Emma appears to be holding her own, only requiring a bit of oxygen to help her out during feeds.

Happy 3 Month Birthday!

Wow, it is hard to believe it has been 3 months, but look at how far she's come:

Emma at 3 weeks
Emma at 3 months









Overall, Emma continues to do very well. Unfortunately, however, she had a Little Ugly Spell this morning, which means she will likely have to spend another week at the SCN (as one of the discharge criteria is 7 days without a spell). We're disappointed 'cause we were really hoping she'd be home this week, but we obviously want what's best for her and that means a few more days in hospital.

13 Weeks

91 days, but who's counting!

Emma was put back on a bit of oxygen today to avoid exhausting her. She's feeding well, but it takes a lot of energy. Other than being a bit tired, she's doing well.

The prongs are off!

Just spoke to the NICU - Emma spit up a bit last night and got some into her nasal prongs, so they took them off and decided to try leaving them off for a while. So far, so good!

Another major milestone

Emma is now a Really Big Girl, breaking through the 4 pound barrier. In fact, this evening, she weighed in at 4 lbs., 2 oz having gained over 2 ounces since last night!

After needing more oxygen over the past several days, Emma did really well during her feeds today. We didn't need to increase her O2 at all (she cruised along at about .05 litres/min.) and she didn't have a single significant desaturation all day!!!

In other exciting news, Emma was able to breastfeed like a champ for more than 15 minutes today without having any breathing problems (a major achievement for a micropreemie). She was getting pretty tired, so we stopped and offered her a bottle of EBM, not thinking she'd take much more milk. Well, she hoovered down 15 ml and was looking for more, so we gave her another 10 ml. I can't tell you how exciting/encouraging this accomplishment was, but I was thrilled. Emma definitely made progress today! :)

Who's Who

We knew our girls looked alike, but could you tell who is who? :)

The Ups & Downs Continue

Emma is back on oxygen. As we've mentioned, most times she needs only a tiny amount, but she's consistently needing more at feeding time, so they've put the nasal prongs back on her. After more than a week of being tube-free, it's a bit hard to see them on her again. The diuretic she was given on Monday didn't do as much as the docs had hoped to remove the excess fluid accumulation in her lungs, so they've also decided to put her back on bronchodilators (Ventolin and Flovent puffers). Emma was on these for a while when she was in the NICU at the General, but she hadn't needed them in many weeks. She will likely need them once she comes home, too. We're not yet sure if she'll come home on oxygen or not.

Emma also had another eye exam today. The good news is that the ROP has improved somewhat in her right eye. The bad news is that is has progressed a bit in her left eye. It is still stage 2-3 (mild to moderately abnormal blood vessel growth). Stage 3 is when laser surgery is considered, although the opthalmologist said today that this treatment is not yet warranted in Emma's case. She'll have another exam next week to monitor the situation. Unfortunately, Emma's left eye was bruised during the exam today, so she'll need to be on antibiotic drops for several days now too.

The one positive development of today was the fact that Emma moved into another room in the SCN. It's the one known as: "The Last Stop Before Going Home Room." Let's hope her stay there will be short and sweet....

Pics