Welcome to Holland

I had wanted to post this a long time ago but couldn't find it! It helped me a lot in dealing with all of the new unexpected things when Emerson was born.

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It is all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."

"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."

But there's been a change in the flight plan. They've landed in Holland and there you must stay.
The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills... .and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."

And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very significant loss. But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.
c1987 by Emily Perl Kingsley. All rights reserved

6 Months Old!

Emerson turned 6 months old last Wednesday! It’s hard to believe it’s been that long already, the time sure has gone by fast. He’s come a long way in those six months; grew from 3lbs 2oz to 11lbs 4 ½ oz! He’s growing very fast in length, up to 24 ½ inches so he’s grown almost 10 inches since birth! He is still in mostly newborn clothes but is starting to fit into some 0-3 especially in length and he is now in size 1 diapers. Since the last update he’s gotten his second round of immunizations, he did pretty well. We are still behind about two months on shots but that’s okay. He goes back to the Dr. next month and then we are hoping to start the monthly Synagis shots to protect him from RSV. (Just hoping insurance will cover them as they are costly!) He should have another developmental screening coming up soon here then he goes to Sioux Falls in November for NICU follow-up clinic and in December to SF for his appointment with the ophthalmologist. Overall he is doing quite well! He is doing everything he should be for his adjusted age (4 months) and most of the things he should be for his actual age. He rolls over consistently and has become very vocal! We are working on sitting up right now and it sure is hard work. We finally got the okay to stop fortifying his milk with Neosure and it seems to have helped his reflux quite a bit. He has been a bit grouchy as of late, I think he is working on getting some teeth. Although we’re still staying away from crowds, we have been taking him for walks almost everyday and he really enjoys those, we will both be sad when it gets too cold to go out! (I get a bit crazy from time to time being stuck in the house!) We are gearing up for the cold/flu/RSV season, which we are absolutely dreading. We stocked up on Purell and Lysol and will have some more restrictions for visiting until spring rolls around. We’d like to avoid or lessen the chances of him getting sick these first two years especially as his immune system/lungs are still behind.

Sleeping through the night!

Emerson is now just over 4 ½ months old and weighs 9lbs 15oz. He has grown to 22 ½ inches, so is quite long! On the growth charts for adjusted age he dipped a little below the 10th percentile for weight, but is still about the 45th for height! He is still in newborn clothes/diapers. He had a doctor’s appointment last Thursday and it went well, the Dr. was pleased with his progress and where he is developmentally. We actually finally got cleared to only go to the Dr. every 4 weeks instead of 1-2! It will be so nice not having to get him all ready and drag him out to the Dr for a 2 minute weigh-in! He did not get his 4 month shots though since it had not been long enough since he got his “2 month” shots so we’ll be a little bit behind on the vaccination schedule for a while. We also had his first developmental screening two weeks ago. Although he was 4 months old, they evaluate by adjusted age so he was screened for a 6 week old. He is doing everything he should be for a 6 week old and most everything a 4 month old would be doing as well! He’s started to be quite active during the day and is finally starting to like playing with some of his toys. He’s pretty well on a schedule now; he eats every 3-4 hrs during the day and does his last feeding about 8pm. He’s taking in about 18 oz a day. He usually sleeps one stretch of anywhere from 6-8 hrs and night now, which is great! We are so grateful that he has been so healthy with no major setbacks. We couldn’t have asked for a better outcome! Even though he is quite healthy, he will not be having any major outings for quite some time. His immune system is still not fully developed and his lung tissue is very sensitive, a minor cold could put him back in the hospital, which we definitely do not want. We will not be taking him out of town, except for Dr. appts until he is around a year old. There will be plenty of time in the future for outings, and we'd rather be safe than sorry.

8lbs 7oz!!

Emerson is now almost 4 months old actual, 6 weeks adjusted. He weighs 8lbs 7oz and has grown to 21 3/4 inches. He is just above the 10th percentile for weight on the adjusted age chart, still not on the chart for his actual age. But he is growing well, he is starting to fit into some newborn clothes finally. Althouh many of them are still too big. Even though he's nearly 8 1/2 pounds, he's all muscle so still doesn't fill out clothes! He has started sleeping 5, sometimes 6 hrs at night, which is great! He is very active and loves to play on his activity mat now. He likes to support his weight and jump on your lap so we're hoping he grows into his jumperoo soon! He also rolled over for the first time stomach to back. He now smiles all the time and has been laughing as well. He's also learning more sounds, he coos a lot and will definately let you know when he's hungry! He had his second appointment with the eye specialist in Sioux Falls on Saturday. The appt went well, his eyes are finally mature and the blood vessels look great so we don't have to go back until December. Emerson, however, did not enjoy the ride as much as last time. He was definately ready to be out of his carseat! We are glad to not have to go back to SF until his NICU follow-up in November. He still has to go to the Dr. here every 2 weeks for weight checks. He also finally got his two month immunizations. He was not a big fan.

Reached his Due Date!

We’ve been home from the hospital now for one month. Everyone is adjusting well especially now that Emerson is eating about every 3-4 hours instead of every 2-3. A little extra sleep at night at least! He has been sleeping pretty well, although he seems to prefer his crib to his cradle, I think the cradle mattress isn’t very comfortable so we ordered a better one and hopefully he’ll sleep more soundly in his cradle then. He is still spitting up quite a bit and started choking on it sometimes in the night, which was very alarming to us but the doctor said it’s nothing to worry about. His due date was May 8th, kind of exciting since his adjusted age is what we have to go by for reaching milestones and all that. So developmentally he is considered to be a one week old instead of his actual age of 11 weeks. He is reaching milestones ahead of schedule though. He is holding his head up very well now and is attempting to roll over. It’s pretty amusing to watch, he gets everything up off the floor except his head so his feet are way up in the air. He now weighs 6 pounds 11 ounces and is 20” long! However, he is still small even for his adjusted age though so we will have to continue fortifying his breast milk with the NeoSure. I was looking forward to being able to stop but it looks like we’ll have to do it for a while yet. The doctor said he is very strong for his age and is growing well so we can’t ask for much more! He still has to stay away from crowds though so I don’t think he will be able to go to his baby shower which is rescheduled for the 6th of June. He is starting to have longer periods of time where he is awake and alert, which is fun for us. He likes toys with lights and music and especially enjoys his GloWorm. My c-section incision has finally closed most of the way, after 11 long weeks! Still a bit sore though depending on what I do. Hopefully next time around I won’t have any complications! We’re busy planning our trip to Sioux Falls for Emerson’s Dr. Appointment. It’s a bit more complicated since he is getting pumped breast milk so I’ll have to pump in the car a few times and keep it refrigerated. Should be interesting!

Two Months Old!

Emerson turned two months old yesterday! He had a doctor’s appointment on Thursday and he weighs 6 pounds 3 ounces and is 19” long. He is definitely growing well. He seems to have a little issue with reflux, so we started feeding him smaller amounts more frequently so he won’t be in so much pain. He takes in about 15 ounces over a 24 hour period, which is pretty good for his size. He goes to the doctor every 2 weeks to check on his weight gain and everything. This last time he had his blood drawn to check his hematocrit level because it was low before we left the NICU. Thankfully though it had increased so he won’t need a blood transfusion! Even though he is two months old, he won’t be getting his 2 month immunizations until he reaches 10 pounds, so we have a while to wait yet. He is started to make different noises and is more alert. He holds his head up pretty well when you are holding him and when he is on his stomach. He turns on his side quite a bit but can’t yet roll over without a little help. He just got the new precious planet mobile and he loves watching the light show on it and the music seems to calm him pretty well. The doctor did confirm that we have to stay inside pretty much until fall at least, so that will be a little hard this summer. He does have an appointment coming up in Sioux Falls for his eyes because the blood vessels were still immature last time. Hopefully they have matured by now so we don’t have to worry about ROP.

Smiles!

We’ve been home for over a week now. Everything has been going pretty well. He has been eating well about every 2-3 hours he takes 50-60 cc’s so just about 2 ounces. His breastmilk still has to be fortified with NeoSure so he is taking all feedings by bottle at this time. The doctor said that when he gets to 40 weeks we might be able to stop fortifying it, which would make things a lot easier. We took him to his first doctor’s appointment here in Huron and it went well. The doctor was pleased with his weight gain and didn’t really have any concerns. He now weighs almost 5 ½ pounds and is 18” long! He has been sleeping pretty good in either his cradle or his crib, we are lucky because after having been in the NICU for so long he is used to sleeping on his own. The hardest thing is not being able to take him out of the house really. We have to avoid crowds and limit visitors because his immune system is still immature and it is still RSV season. I did take him out for his first ride in his stroller. He must have enjoyed it because he slept the whole time!

We're Free! (sort of...)

It’s been quite the week! He started doing better with his bottle feedings so they moved him up to being able to take his full volume 6 times a day and then the next day they moved him up to 8. He got us a little worried though because he lost weight one day because he was using so much energy to eat. Luckily though the next day he gained again so it didn’t throw us off schedule for being able to go home. He was really happy when they started letting him be able to eat on demand. He was getting hungry before he was able to eat so he’d get pretty upset. Shaun came up on Thursday night which was nice so he could help get everything ready before we went home, they had told us it would be Saturday unless he didn’t gain weight so we had a few errands left to do before we went home. His hematocrit had been low so one of the doctors had thought he might need a blood transfusion before he went home. We had the labs redrawn on Friday and even though they decreased a little bit more, the doctor was confident that he didn’t need a transfusion. He wasn’t showing any signs of needing one; he didn’t have any problems with his breathing or anything and the level that showed the new red blood cells he was making was pretty high. We were very glad that he wasn’t going to need to get blood. On Friday he had his car seat trial where he had to sit in the car seat for an hour and make sure his heart rate and breathing stayed okay. He passed the test and luckily he was just big enough to be able to fit into his car seat. If he had been any shorter we would have needed one made especially for preemies. He had his circumcision Friday night and the doctor did his discharge exam later that night so we would be ready to go on Saturday. Saturday morning he was given his Synargis shot to protect him from RSV. He also had his eye exam on Saturday morning and it went pretty well, we just have to go back in 4-6 weeks because the blood vessels in his eyes are still a little immature. That is pretty normal though considering he wasn’t even supposed to be born for another 4 weeks. The doctor told us that this is as early as they let babies go home and most of them aren’t ready to go that early. Once all of our stuff was packed and ready to go, we were discharged. It was exciting to finally have him unhooked from all his machines & monitors! He did really well on the 2 hr ride home; he pretty much slept the whole way. When we left the NICU he weighed 5lbs. 2 oz, so finally over the 5lb mark! At home we settled in pretty well, just had a ton of stuff to put away. He is still too small to fit in most of the baby gear we have like the swing and bouncer. He stayed on his schedule pretty well and is eating about every three hours and he has been sleeping well in either his cradle or his crib. Hopefully he stays this laid back! We had a pretty quiet Easter with him although we did dress him up in his Easter outfit and bunny ears. This week we have our first appointment with our doctor in Huron.

One Month Old!

Wow, a lot has happened since the last update. He would have been 35 weeks last Thursday and he also turned one month old that same day. It’s hard to believe that much time has gone by already. He’s changed so much! He now weighs 2130 grams or 4lbs 11 ounces. He is also now 43.2cm in length so he’s grown nearly two inches since birth! He is in the 50th percentile for length and head circumference. But he is only in the 12th percentile for weight. He got to go into an open crib finally last Wednesday night. He had a little issue with maintaining his temperature at first and we thought he might have to go back into the isolette but then he figured it out and has been fine ever since. He’s been doing pretty well with his bottle feedings. He is at 40cc’s now which is his full volume. He gets that 4 times a day and if he does well he’ll move to 6 times a day and then 8. He fell asleep during his last feeding so hopefully he’s more alert this evening. We’re hoping to be able to leave early next week if all goes well with his feedings. That would be amazing! They keep saying that he’s doing really well for how little he is; he’s about two weeks ahead of where he should be for feedings. So if he takes a few extra days to get his full volume down that’s okay. He had his one month head ultrasound and it came back normal so we don’t have to worry about that. He will have his eye exam on the 11th and his circumcision will be done sometime this week. I’m finally feeling close to back to normal, just waiting for my incision to close completely. I’ve been putting wound gel in it everyday and it would be nice if it were healed by the time of my 6-week postpartum checkup, which is coming up soon.

Time to Get Dressed!

It’s hard to believe we’ve been in this hospital for four weeks already! He’s been doing really well with bottle feedings. They kept him at 5cc’s for a few days but then they moved him up to 10cc’s and today they just changed it to 15cc’s four times a day. The doctor said if he does well today, he’ll get to go to 20 cc’s tomorrow which would be over half of his feeding in the bottle instead of the tube! I just finished giving him his first feeding of 15 cc’s and he did awesome, I think he could have taken more he was trying to suck on my hand when I went to burp him. He has been gaining weight well too; he’s now at 1965 grams or just about 4lbs 5oz. So he’s finally gained a pound over his birth weight. He still isn’t in an open crib yet even though he can maintain his temp on his own but hopefully they’ll move him in the next few days. If he keeps doing as well as he has been it sounds like we’ll only be here for a few more weeks. I am hoping to be home by Easter but we’ll see, I’m not counting on it too much! He’s been wearing clothes now too finally and getting wrapped in his own blankets. Most of the preemie clothes are still pretty big, but we have a few tiny sleepers that fit him perfectly. He goes through his clothes and blankets pretty fast so he has me busy doing his laundry all the time. He has his one month head ultrasound coming up in a few days and he’ll also have an eye exam soon to make sure everything looks good.

First Bottle Feeding!

He got his first bottle feeding yesterday! 5 cc’s and he did awesome, didn’t choke or gag at all. Tonight when I gave him his bottle feeding he downed it right away and looked at me like, “Are you kidding?!? Where’s the rest?!” Hopefully tomorrow they will increase how much he gets in the bottle and how frequently. Right now he’s only getting it twice a day. He’s also been gaining weight well the last few days. Tonight he weighed in at 1795 grams which is 4 pounds!! He would have been 34 weeks tomorrow so I’m hoping they move him into an open crib. He’ll also be able to start wearing outfits tomorrow so we’ll have to see if any of them are small enough to fit! Luckily he has a lot to choose from; even the nurses were showing each other his huge stash of clothes! Now he just need to keep gaining weight and eating well and hopefully we’ll be out of here in a few weeks.

Emerson ditched the PICC and I ditched the Wound Vac!

He has still been doing really well, we're pretty much just waiting for him to gain weight at this point and grow so he can be able to start his real feedings without the tube. He did pull his feeding tube out completely yesterday. He didn't cry at all but it freaked me out. Tonight his weight was 1700 grams or 3lbs 12 oz which we were really happy for because he hadn't gained much the few days before. Hopefully he keeps it up so we can get out of here sooner. This week should be pretty exciting because on Thursday he would have been 34 weeks. At that point they can take the cover off his Giraffe bed so he can see light. He should also be able to move into an open crib as long as he's 1800 grams by then. He already does a good job of maintaining his temperature, even when he doesn't have a hat on. 34 weeks is also when they said he would start being able to do real feedings. They'll start pretty slow with only 5cc's of breastmilk in a bottle but it's still pretty exciting. He did get his PICC line out so it's easier to hold him now that he's only hooked up to the monitors. He loves to be held I think because he's started kind of fussing when we put him back in his bed. He's also started make some noise before his feedings which they said was really good because it means he knows he's hungry. He also decided that while he likes his pacifier, he prefers to suck on his hands. My excitement of the week was that I got my wound vacuum off on Monday so for the first time in over two weeks I was finally not hooked up to anything! It’s so nice to not have to drag that thing everywhere I go. The incision is still open so I have to put this gel in it everyday but it’s better than the alternative. I went for my blood pressure checkup and they said it was alright finally so now I don’t have to go back for any appointments until my 6 week checkup.

No more lights!

He has been doing really well the past few days. He is off the phototherapy light, which is nice because that means we can hold him for longer than a half hour at a time. He has been being more alert when we've been holding him too. He keeps his eyes open for about 15 minutes and looks all around before he falls asleep. It seems like his looks change everyday! At first he looked exactly like Shaun did when he was a baby but now it's getting hard to tell who he looks like. He's starting to fill out in his cheeks a little and he has a bit of a double chin! He was doing so well with feedings that they decided to increase by 2cc's every 6 hours so he's been really moving up. Today he gets 27 cc's at his first feeding and by the end of the day he will reach his goal of 30 cc's per feeding! The nurse we had last night said that as soon as he reaches his goal today or tomorrow they might start trying to feed him small amounts with a bottle. That would be great because it would be sooner than the 34 weeks we were told originally. Since he's getting such big feedings, they've decreased the amount of IV fluids he's getting and will be taking the PICC line out of his arm within the next few days. Once that is out he won't be hooked up to anything but the monitors for his breathing and heartrate. Also once it is out he'll be able to start wearing clothes! Just short sleeve t-shirts and onsies at first but it's pretty exciting. We already have a full drawer here of just preemie size clothes, although I'm sure most of them will still be plenty big on him. He was weighed last night and he is up to 1600 grams, or 3lbs 8 oz. He gained 2 oz in one day! Shaun came back on Friday and left late last night. He got to give Emerson a bath for the first time and was pretty nervous doing it. He did a great job but Emerson decided to liven things up and pee all over him. He actually made it through the little hole of his Giraffe bed and out onto the floor. You wouldn't think such a little guy could have so much pee! It seemed like the weekend went way too fast! I had a lot of visitors the last four days and I finally left the hospital for the first time in two weeks. I had a lot of fun but didn't realize how exhausted I would be! Even though I love the company, I'm a little relieved to get back to my normal schedule.

Back up to Birthweight

Well today he would have been 32 weeks, so that means only a few more weeks until he can start to try eating from a bottle and not the feeding tube! That is one of the goals he needs to reach before he can go home. He also needs to weigh 2000 grams or more and yesterday he finally gained a little weight so we're on our way. He weighs 1450 right now, which is 3lbs 3 oz so he is up one ounce from his birthweight. His feedings got increased to 4cc's every 3 hours and every 12 hours they will increase it another 1cc as long as he is doing well with it. Hopefully this will help him to gain weight a little quicker. I did get to help give him a bath the other day and he seemed to really enjoy it, especially having his hair washed. He has quite a bit of hair to comb through already and it's a bit unruly in the back! Other than that he is doing well, he just needs to sleep and eat now so he can grow. Shaun had to go back to work on Tuesday and it's been a little weird being here by myself, especially since I was so used to his help! We are both counting the minutes until he'll be back on Friday night for the weekend. I'm feeling better each day as well and I got good news at my wound center appointment yesterday, I should only have to have the wound vacuum on for less than one more week! Originally they had told me it would probably be on for up to 2 months. I will definately be excited to get it off and finally not be hooked up to any machines!

Finally got to hold our baby!

His echo came back and his duct did close so he got to start feedings again. He's been doing well with those and they are going to increase how much he gets tomorrow. He had a head ultrasound at a week old and it came back normal, one less thing to worry about! Last night they took him off the cannula so now he is breathing completely on his own and he has been doing well with it. We got to hold him finally when he was a week old, it was a little scary because he's so tiny and you have to make sure his neck stays just right so he can breathe. He's been opening his eyes a lot more and today when I was holding him Shaun and I were talking and kept looking back and forth between us. We've been getting to help with a lot of diaper changes and they've started to get easier. He's still on the phototherapy for jaundice but we're hoping maybe tomorrow he can get off of that so he doesn't have to wear his goggles all the time.

No more CPAP!

A lot has happened in the last day or so! He got his umbilical line out today so tomorrow we can hold him for the first time. Tonight he also got to get rid of his cpap and get a cannula instead. It's great because we can finally see his face without the mask on! He's still only on room air, just a little bit of pressure so he remembers to breathe. Tomorrow he might get off of the bili blanket then he can ditch the goggles too and we can see him with his eyes open. He ripped off his goggles a few times today and was looking around, it seems to mellow him out when he can see what's going on. He's still pretty wild, outside of taking off his own goggles, he's managed to pull out his nasal cannula and kick off the wrap on his foot. Tomorrow he has an echo to see if his pda has closed and if it has he can start feedings again.

Troublemaker!

He has been doing an amazing job with breathing. It looks like he won't need to be put on a ventilator. He's been on just 20-21% oxygen for the past few hours (which is just room air). And he got to move down to a different cpap machine since he needs less pressure. They did do an echo and he has a pda but they said that was pretty common for preemies and they're giving him a 3 day dose of a type of ibuprofin that should help it close. He has to stop feedings though while he's getting the medicine. Although he was weighed last night and it looks like he didn't lose any, he may have actually gained a few grams. He was really wild when we saw him last night and kept pulling at all his wires and setting off the alarms. He's clearly a troublemaker already. I did get to change his diaper last night. Even though I've changed about a million diapers, I was nervous because he's so small and I didn't want to mess with any of his lines. Then I also got to hold him while he was weighed. I'm getting discharged from my room today so I'll move down to stay in his room.

Little but Feisty!

He's still doing really well, he hasn't had to be intubated yet. Everytime we go to his room the doctors say to be prepared for him to be on the vent next time we come but he's hanging in there! He got his first feeding today! He seemed to do well with it so we're excited hopefully he can start gaining some weight. He's pretty feisty though and keeps trying to escape his "nest" and grab at his wires. They told us if he keeps doing as well as he is we may be able to hold him tomorrow already! He got one of his first birthday presents, apparently he was born on Dr. Seuss's Birthday so a local elementary class gave him a hardcover Dr. Seuss book. I'm finally feeling better, off of the magnesium sulfate thank god! My incision had to be opened though and it was not a fun experience. I had a clot underneath so it wasn't healing properly and now I have a wound vacuum hooked up for a few weeks. Hopefully no more suprises!
The baby shower was supposed to be this weekend but I believe we are rescheduling it for after we bring him home. Phone calls will be made to let everyone know sometime soon.

Emerson Harlowe, Born March 2, 2009 - 3lbs 2oz, 15.75"

Although Emerson's due date was not until May 7, 2009 he had to be delivered early at 30 weeks due to my health. We went to what we thought was going to be a normal prenatal appt on Friday, February 27. My blood pressure was 168/108 and I had protein in my urine so we began to supsect pre-eclampsia. I was admitted to the Huron Regional Medical Center Friday afternoon and the inital tests came back encouraging. My liver levels were not elevated and blood pressures were stabilizing as long as I laid on my left side. So it looked like I would be able to make it longer in the pregnancy on strict bedrest. Then on Sunday night things took a sudden turn for the worst. I began experiencing intense back and side pain, which turned out to be my liver. After labs were drawn and my levels were shown to be rapidly increasing, it was decided I would have to be transferred to Sanford Hospital in Sioux Falls and the baby would have to be delivered immediately. My parents and Shaun's parents took off for the drive to Sioux Falls immediately and Shaun and I waited for our transport in the medical plane.


The pre-eclampsia had developed into HELLP syndrome. We had a quick ultrasound to check on baby's size and last minute labs were run before my c-section.


At 4:38am on Monday March 2, 2009 Emerson was born. He had a loud healthy cry from the start and his Apgars were 8 and 9, great for a full term baby even. He has quite a bit of dark hair and he's definately a long baby like Shaun. He has not needed a ventilator yet, which has impressed everyone for how early he was born. Luckily I did end up getting both shots of betamethazone in before delivery so we think that helped his lungs mature. He has his very own NICU room at Sanford so I will be able to stay with him when I'm released.