Monday, March 31, 2008

Monday

Mikan had his pic-line removed today because he is tolerating his feedings enough to get all his nutrition from the feeding tube. His oxygen requirements remain around 60% and his respirator rate is 30 breathes per minute. Digestion continues to be a success. His CO2 levels have remained consistent, so we have not been able to wean ventilator support. His body may still be getting used to living with a closed ductus.

I really wanted to post something that was a lie because tomorrow is April Fool's day, but my conscience (Jenna) has let me know that this is probably not the best avenue for practical jokes. Steve and Sandy visited tonight and brought shakes, mmmmmmm.

Sunday, March 30, 2008

Sunday Evening

Mikan's digestive health seems to be improving. He is consistently increasing his feedings and may be completely free of the pic-line (IV) fluids by tomorrow morning. All feedings are still being done through the feeding tube. He has to be off of the ventilator to take feedings orally. However, he has made very little progress in his respiratory well-being. He is still on the ventilator at around 50-60% oxygen with 35 breathes per minute. He has lost around 70 grams of fluid (at little over 2 ounces) because of taking a diuretic (I believe it is called lasiks). Hopefully, the increased feedings and less fluid retention will help his lungs.

Pete and Sarah visited with Tia and Liam this weekend. Also, Mary Beth and Drew also visited. It was good to see all of them. Tia and Liam did a pretty good job at Mass on Sunday morning.

Mikan likes to poop whenever the diaper is off. This includes whenever Jenna or a nurse changes his diaper. But, it is especially entertaining when he does it right as a nurse lifts him up and tries to weigh him.

Saturday, March 29, 2008

Saturday







Mikan has been eating well and pooping and peeing well, but with the help of a feeding tube, suppository, and diuretic. So, is he doing well? ... I guess so. His vent needs are still higher than they were before surgery, and he is still retaining a lot of fluid; however, he did lose some weight today, which is good. All of this is "normal" though. Unfortunately, he just looks uncomfortable a lot of the time, and there is little we can do to appease him.

I got to put some clothes on him for the first time today. His preemie outfits looked a lot smaller when he wasn't in them.

Today John and I went out for breakfast with John's dad, Nikole, Maria, and Maggie. Maggie got agitated when her food didn't arrive fast enough, so she took to eating the packets of jelly on the table as a way of coping.

As newer babies are admitted near us, we realize how fortunate our situation is at the moment. Everything could be a lot worse. Even though it is hard to understand that sometimes, it seems that we are reminded of it often enough being at the hospital as often as we are.

Friday, March 28, 2008

Friday

This morning the doctor said that Mikan looked like an entirely different boy since the surgery. He questioned what went on in the Operating room. This was because of how swollen Mikan's face and body is from fluid retention. We've joked about our baby being switched at surgery. He is currently 3 lbs. 4 ounces. Yesterday he was 2 lb. 12 ounces. So...yeah. Not real good with his body not processing the fluid. But, it is not terrible either. Current pictures would give the casual viewer a false impression growth.

He continues to work on digesting breastmilk/colostrum. He currently receives 6 cc's every four hours. The doctor told us we need to give him a pep talk because of Mikan's high CO2 levels and unchanging lung x-ray. Anybody out their with pep talk pointers for preemie's?

We've tried the following strategies...
1.) Going out for ice cream without him. (Once you get things straight we'll bring you with us).
2.) Modeling our lack of fluid retention in our own bodies. (Look at us. We're your parents. We're cool. We don't retain fluids. Why should you?)
3.) Admitting to him that we asked him to gain weight earlier, but we did not qualify the statement with a phrase like "fluid retention does not count." We were not specific enough in our ground rules. (One sign he is a Gensic)

We're looking forward to a weekend hopefully filled with filled diapers.

Thursday, March 27, 2008

Thursday

"This is one of the biggest I've ever seen." This was a comment from our surgeon yesterday made in reference to which of the following...
a.) Mikan's girth
b.) Mikan's brain capacity
c.) Mikan's ductus opening
d.) All of the above plus one.

As for the "dex," Aunt Deb hit the nail on the head with dextrose/blood sugar levels.

Mikan continues to recover from surgery. He is still very groggy and touchy. He is not in the incubator right now because he has a chest tube that is draining post surgery fluid. We think the chest tube will be out tomorrow and that we will be able to hold him then. He received 25 cc's of blood today which helps his hemoglobin. He is pretty swollen from surgery, blood, and preemie life in general. They started feeding through the tube 3 cc's every three hour's.

I did see Fievel Mousekawitz in the 1st grade room at school today which made me think of Mikan as our little Fievel and the song, "Never Say Never." It's on YouTube, check it out. We got our deep freezer today, it was dented a small amount in the back you can't see so we got 10% discount. Nice.

Wednesday, March 26, 2008

Surgery and -9 Weeks


Above is a post-surgery picture. We were happy that Nurse George took Mikan into surgery today. Overall, from our understanding of the situation, the surgery went well. It took longer than expected because Mikan was apparently very "touchy" during the procedure even after all of the paralyzers and anesthesia. He bled a little more than expected too, so he needed extra blood during the surgery. He is recovering in the NICU now. He is a little groggy still, with a chest tube added to the list of devices on his body that make him look pathetic at times. However, his ventilator needs were reduced this evening already. That doesn't mean anything permanent, but at least he was comfortable when we left him. He is receiving pain killers as well.

John and I went out to dinner today after the surgery. We won't be able to hold him for awhile and his movement has been minimal. With all the stuff he's hooked up to, all we can really do is stare at him. When we are away from the NICU for awhile, we will ask each other, "Well, you wanna go stare at our kid for a little bit?" I wonder how many parents have that exchange. Thanks for everyone's prayers during this anxious time.
video

Tuesday, March 25, 2008

Tuesday

The plan is to finally have surgery on Wednesday. His PDA still seems to be the issue. His blood cultures show no signs of infection and he appears to be otherwise healthy. We are hoping for a turn around in his cardiovascular health after surgery. For more information on the surgery (patent ductus arteriosus ligation) follow the link.

Today the doctor said some things that made us feel like Mikan is not a typical 28 week baby. First he said, "To be perfectly honest with you, Mikan is acting more like a 26 week baby than a 28 weeker." He said this in reference to his being on the ventilator for the past almost 3 weeks. He also said, "This is bizarre," referring to his PDA not healing itself after the rounds of medication and him being almost 31 weeks gestation. I guess it all depends on how Mikan performs after his surgery.

The doctor has discontinued the use of morphine for pain. He said, "I really don't think there is any reason for him to be experiencing pain at this point."
Mikan heard this and probably thought...
a. "I have two tubes in my mouth, one is shooting air into my lungs at specific intervals, sounds kind of painful to me. Also, every 3 hours I get poked in the foot and they draw blood from me. Not to mention the two suppositories yesterday, the pic line in my left arm, an IV in my right, a temperature probe on my belly, two respiration probes on my chest, and a wrap on my foot measuring my blood oxygen levels."
or
b. "Yep, no pain at all. I am John's son, not Pete's."

Monday, March 24, 2008

Monday


Well, like any other day, we received some good news and bad news. Good news is that Mikan's third head ultrasound turned out normal with no signs of bleeding. Bad news is that his chest x-ray and echocardiogram weren't very good. He will most likely have surgery this week. Our doctor had a meeting with a cardiologist to discuss Mikan's ductus today and we will hear the results of that meeting tomorrow and possibly know more about a scheduled time for the heart surgery. He is still pretty swollen from all of the fluids that are constantly pumped into his body each day.

John and I bought a much needed chest freezer today. John can't stop talking about all of the fruit and pies he will be able to store year-round.

Uncle Steve and Aunt Sandy visited today and brought a wonderful dinner. We appreciate everyone's continual prayers.

Sunday, March 23, 2008

Easter Sunday

Today was a pretty good day. We were hoping that Mikan would "rise again" on Easter, and he appeared to try as much as he could to fulfill our wishes. He was taken off the jet vent this morning since the doctor said he may have been moving around too much for it to be fully effective. The tube kept losing its position and making Mikan's oxygen levels yo yo. John and I are happy he is off the vent because now we will be able to hold him more often. He seems to be doing well so far on the other vent. He had to get a larger tube placed down his throat since he is getting bigger. Mikan also tolerated his feedings well today. He is now eating 4 ccs of milk every 3 hours. He got more of Grandpa Kartje's blood today as well. The nurses still hear a heart murmur, and his chest x-rays are still cloudy. This is all evidence of an open pda. The doctor still wants to order an echocardiogram for tomorrow morning to assess his possible need for surgery.

Yesterday, Cindy and Jim brought Mikan a Star Wars blanket that they made him. This one has Darth Vader on it. So now he has the Dark Side and the Jedi Force blankets. All the other babies are jealous.

John and I attended mass at the hospital chapel this morning, then Zach, Maria, Grandpa Kartje, Grandpa Gensic, and Grandma Gensic came to visit us today. We visited with Mikan and then made several different restaurant stops to meet our Easter cravings. Maria, ever-paranoid about her bladder visited several different bathrooms around South Bend, some more than once.

One of the babies near Mikan got Easter pictures taken in an Easter dress. It was a pretty big ordeal, and I watched the nurses pretend to be really excited about it at the time, but then complain about how much trouble it caused afterwards when the Mom wasn't there. We didn't put Mikan through any of that stress, so below is the result of his Easter photo op.

Saturday, March 22, 2008

Holy Saturday

Mikan had a decent day today. His lung x-ray remains a little cloudy (an apparent symptom of the ductus). His carbon dioxide levels fluctuated a little today but were good enough to reduce his vent support marginally. He digested a couple of cubic centimeters (cc's) of colostrum today. By digestion, I mean that the colostrum is no longer in his stomach. We are still waiting for him to stool. We hope that tomorrow morning's lab results go well. We are once again looking forward to possible surgery next week to solve the ductus problem. He must be infection free for surgery on the ductus to be an option.

Yesterday Granny Kartje visited with Alexa, Autumn, Stacy, Lily, and Kobe. Angela and Allen visited last night also. This afternoon Aunt Cindy and Uncle Jim visited and we dined together at Fiddler's Hearth. Later in the evening, Ben, Jake, and Connor visited. We were able to play football downtown at the College Football Hall of Fame. It was pretty fun, the field is a nice, soft turf and was dry for having had 4 inches of snow yesterday. After playing football, we went to Burger King and then La Rosita's Neveria and Paleteria. To finish it off, we ate an apple pie in the hospital lounge.

Today Jake had to be reminded that he was in the NICU after an outburst while watching the Purdue game in the waiting room. It was frustrating to be watching the first half of the ND game while Purdue was in a close finish.

Jenna pledges an Easter picture will be posted tomorrow. Happy Easter!!!

Friday, March 21, 2008

Friday Evening

This afternoon, Mikan had many pictures taken of him for a "Neo-Nest" promotional pamphlet. Earlier this week, he was video taped for a promotional video. Mikan is a star. During the two videotaping and picture taking episodes, he has done well (kept his oxygen levels up and had consistent heart rates). However, in both cases, after about 30 minutes his oxygen level has dropped and he has showed signs of fatigue. Coming down from a high.

Today, he needed about 65%-80% oxygen for a portion of the afternoon. He then had his carbon dioxide levels measured and they were much above normal. Later in the evening, his oxygen need decreased as his carbon dioxide levels also decreased. A small pendulum swing.

The two most commonly used terms in the NICU are "dex" and "wean." Wean is used to describe reducing all levels of support. For example, "We are trying to wean his oxygen" or "We are trying to wean his ventilator rate." What is funny to me is that wean is used in the following manner, "We are trying to wean him onto breast milk." I'll leave an explanation of "dex" to those of you who comment before revealing the truth in an upcoming blog.


Thank you all for your continuing support. I am 20 for 24 in picks (96th Percentile). Jenna is 18 for 24.

Early Good Friday Morning

Mikan is doing okay. Jenna was able to hold him Thursday. Because of the jet vent, it is quite an orchestration to be able to get all of the equipment in the right places to be able to hold him.
Mikan's lung x-ray does not look ideal. He may have underdeveloped lungs or pneumonia, both of which are fairly common for preemies. He is on antibiotics. He has also been given regular doses of morphine because of his frequent attempts to fight the jet vent. While the doctor continues to end conversations with phrases like, "He is not doing anything out of the ordinary," pneumonia does not sound good and the PDA is still an issue. I am looking forward to a mini-break with Easter.

Wednesday, March 19, 2008

30 Weeks

Mikan is 30 weeks old today. Today brings with it a whole new set of concerns, just like every day it seems. The doctors are now running several blood tests to check for infection since his white blood cell count was a little high today. He still is very active and doesn't appear to have an infection, but the doctor said this is a primary concern right now since he wouldn't be able to go into surgery if he was sick. For the next 2 days he will be closely monitored for infection and treated if necessary. He is already on a few preventative antibiotics. Early next week, assuming he is healthy, the doctor may order another echocardiogram to check the status of his ductus. He resumed feedings today, but isn't digesting them too well yet.

Tuesday, March 18, 2008

Last night Mikan made the nurse work. His oxygen saturation levels fluctuated quite a bit throughout the night and into today. The nurses increased the pressure on his ventilator to help compensate. Currently he is getting 31% oxygen pumped into his lungs at a pressure of 30 cm H2O, 380 times each minute. This combination has made his CO2 levels be ideal.

Grandpa Kartje came today and donated blood. This is good because my (John's) blood has CMV in it. CMV is a virus that does not really effect adults but is lethal to babies. Therefore, the blood I gave on Saturday will go into the general blood bank. Mikan may need his Grandpa's blood if he does have surgery or if his hemoglobin levels drop any further. Currently Mikan's hemoglobin is around 8 or 9 and has been steadily dropping since it peaked around 11 after his first transfusion.

Right now, it is uncertain whether Mikan needs the PDA surgery. There may be other factors causing his progress to be slow. He has noticeable lung scarring, which may be caused by the ventilator. He also has a white blood cell count that indicates possible early infection or simply stress. Our hope is that it is a lung issue and not infection. The nurses have commented that babies usually grow out of the lung issues.

Mikan is peeing pretty well. When given an opportunity last night, he was able to spray his head with urine. If the doctor does not think surgery will be eminent, then Mikan may be able to start digesting his mom's "liquid gold." This past weekend, the NICU made me take some "liquid gold" home with me to store in our freezer.

Monday, March 17, 2008

Monday

Today we got a chance to sit on the top of the roller coaster track for awhile, for the first time in several days. Mikan 's ductus is still open according to the echocardiogram taken this morning; however, it has shrunk. His oxygen support has decreased today and all of his blood gas levels looked good. So the doctor decided to hold off on the surgery until he ran a few more tests to see if he thought the ductus would close on its own. We will know tomorrow the results of those tests. But he looked good today, still squirmy as ever, a consistent comment that all the nurses make who watch him. We haven't been able to hold him in while since he is still adjusting to his new vent, but he appears comfortable.




Mikan heard that they might be doing surgery on him, so he decided to start trying to close up his ductus valve and flip the doctor the bird.

Sunday, March 16, 2008

4 Full Weeks living in the Hospital

We have had more relaxing Sunday's. As of five doses of heart medication, the PDA is still apparently the cause of Mikan's issues. His jet vent rate has been adjusted a couple of times to try and help his gas levels be within the good range. The medication has caused his urine output to be lower than normal. Tomorrow he will have another echocardiogram to see more absolutely if his PDA needs to have surgery. If the echocardiogram still shows signs of the PDA, then he will most likely have surgery on Tuesday. Currently, he is fidgeting around enough to appear healthy for the surgery. Our doctor has checked for signs of infection in the lungs and blood, with all tests being negative. However, there was some bacteria found in his urine this afternoon. We'll find out more about this later, the doctor didn't seem too worried. Hopefully it is nothing, but he has been started on antibiotics as a precaution. Mikan is acting as if he does not have an infection.

Because of the heart medication, he is retaining a lot of fluid and gained about 2 ounces. His body appears to be "fuller." The new jet vent is loud and makes his body shake. Therefore, he has a large yellow ear muff on whichever ear he is not laying on. Whatever points he earned with the ladies via the Star Wars blanket have been negated with the big yellow ear muff. That's alright, he is a little young.

Saturday, March 15, 2008

Saturday



"He handled that diaper change and assessment pretty well!" says the nurse.
All I could think was, "Anybody that just had a shot of morphine, a dose of paralyzers, and their oxygen jacked up could handle pretty much anything pretty well."

So Jenna and I are becoming neurotic oxygen watchers. In our hopes that the second round of PDA medication works, we are trying to will Mikan's oxygen saturation levels within the appropriate range. (His first round did not work as evidenced by a second echo cardiogram today) However, today we switched ventilators to a vent the pulses around 360 small breathes into his lungs each minute. The nurse called this a step sideways and not necessarily backwards. He had to receive morphine and paralyzers to adjust to it though. Tomorrow or Monday we will most likely know if he needs heart surgery. If he needs it, the earliest he would have it would be on Tuesday.

John gave blood today in case Mikan needs blood transfusions after surgery. This was a big step for him after passing out the last time he gave blood. But he handled it like a man and bragged about it afterwards. He even got a free t-shirt!

John played outside today with the McCoys, and John's parents took John and I out for milkshakes today. It felt good to be out. This was the second time I had ridden in a car in the past month. Unbelievable. I am beginning to feel a lot better and able to do more though. We'll get out more, eventually.

The picture of Mikan and John was from last night when John held him. During the kangarooing, Mikan picked up his head several times and adjusted his position so that his arm would lie under his head. It's amazing that he had enough neck strength to lift his head up, but he has been pretty active. We thought his little arm under his head was pretty cute.

Friday, March 14, 2008

Baptism


Today Mikan was baptized. Father Chris, Elizabeth, Sofia, Judy, Nancy, Jenni, Annette from St. Adalbert were all in attendance. Also, my sister Nikole and mom came up with nephew Jack and niece Maggie. Maggie was sporting some celebrity sunglasses to try and pass for 12 years old to see Mikan, but it didn't work. Mary Lou also stopped by with some muffins and Lourdes water, which we are thankful for.

Today was a small roller coaster. To start the day, at around 4 am Jenna turned in some milk and found out Mikan's carbon dioxide levels were pretty high. Therefore, they had to turn up his ventilator rate from 35 breathes per minute to 50 bpm. When I stopped in before going to work, the nurse said he may have to switch to a different ventilator which would be a necessary step backward. So, I called Jenna after mass and she said the 8:00 am gas reading looked better, so he could stay on the regular ventilator. The gas problems may be a symptom of the PDA. Just because they can't hear the murmur, he still may have the PDA. But, throughout the day, his carbon dioxide levels declined; therefore, he did not need to switch ventilators. Instead, he was able to wean support back down to 40 bpm.

His lung x-ray looked cloudy this morning. It is probably because of the PDA. They did do a culture on the lung fluids to check for infection, and apparently there is no infection. He will have another lung x-ray tomorrow morning.

He will have another echo-cardiogram tomorrow to check the status of the PDA. His hemoglobin oxygen saturation levels and cloudy lungs both indicate PDA issues.

Nikole brought a Star Wars blanket to decorate the incubator. I'm pretty sure Winnie the Pooh and Sunshine Bear on the other isolettes are afraid of Mikan now.

Thursday, March 13, 2008

Thursday


Today went well. There were no signs of a heart murmur again today. He received his second dose of heart medicine. Tomorrow, if all goes well, he will receive a final dose and then resume his milk feedings.

Today Mikan and I became movie stars. One of the doctors at the NICU patented a "neo nest" that allows for easy transfer when babies with ventilator tubes and other monitors are going to be kangarooed by a parent. We were asked to be in a video that demonstrated how to use it. The video will be distributed to other hospitals as a way of promoting kangaroo care since only 8% of hospitals in the U.S. allow children on vents to be held. So Mikan was bothered with a lot of bright lights and people messing with him, but overall he handled it ok. I don't think we get a NICU bill discount though for participating.

John thought it was ironic that the only day we had a male nurse (today) his name was George, and Mikan was named after George Mikan.

Wednesday, March 12, 2008

1 week, or 29 weeks, or -11 weeks


We choose option C: -11 weeks.

This morning Mikan had a plethora of procedures performed on him, like usual. He had chest x-rays and stomach x-rays. The echo-cardiogram showed that his ductus has enlarged; therefore, the doctor started him on his heart medication today to try and close it. He has stopped feedings for 3 days while he takes 3 doses of the medicine. Hopefully this closes the ductus so he won't need surgery.

Today his hemoglobin oxygen saturation levels where up and down more than usual. The nurses seemed to think this is normal; however, when his isolette beeps and flashes continuously all day, it is hard to have calming, relaxing visits with him. So today was pretty stressful for John and I. Nurses were constantly watching him and adjusting his oxygen levels. I think Mikan had a crush on one of the nurses.

John went back to work today. We are still staying at the hospital near the NICU. The itinerant lifestyle has worked out well for us so far. John and I are used to the itinerant lifestyle; however, we are remorseful we won't be seeing a few national parks this week with Jake, Ben, Matt, Annette, and Gil as a result.

Uncle Steve visited today and confirmed that Mikan was much cuter in person than any picture could capture. I agree.

John went to stations of the cross today at school, which was a good way to gain strength for the next undetermined amount of time, possibly 18-20 years. Thanks to everyone who is also praying for us.

Tuesday, March 11, 2008

Today Mikan had his echo-cardiogram and and brain ultrasound. We know the brain ultrasound revealed no blood vessel leaks, so this is good. The echo-cardiogram showed that the PDA (ductus) may still be an issue that he may start receiving medication for tomorrow (normal for 28-weekers).

His belly girth was extra large this morning. So they had an x-ray done to see what the problem was and check for infection. He was not infected, so they put a suction down his throat to remove air from this stomach. They also stopped his feeding to prevent further expansion. Then they gave him a second suppository to try and unplug him. This worked. He pooped for the first time today (meconium). It was very black and tar-like. It really stuck to his bottom. It seems like he would lose some weight after all that business.

We enjoyed lunch courtesy of Mary Ann. We were visited by Grandpa Kartje and Uncle Jar today also. Yesterday we had visitors: Granny Kartje, Uncle Ben, Rose, Cousin George and Monica.

Jenna has been feeling better. We finally were able to take a walk outside together and enjoy the nice weather.

Seeing other babies in the NICU who appear to be in worse shape than Mikan reminds us that we are fortunate to be in the situation we are in, despite the apparent severity of it.

Thanks to everyone for your prayers. We continue to take one day at a time.

Monday, March 10, 2008

Monday Evening



If you know family/friends who would like to know about what is going on, please email them the website address. Thanks!

Well, when I said that his oxygen levels were ideal, I did not quite completely understand the situation. While his hemoglobin saturation level was between 90% and 100%, this was not ideal because the amount of hemoglobin he has in his blood is lower than ideal. Therefore, he will be having a series of blood transfusions (about 10 mL each) to try and increase the amount of hemoglobin in his blood. The number of transfusions depends on how well Mikan responds to them. After the first transfusion, his blood pressure increased and his hemoglobin saturation went down to around 85%-95%. This might mean his hemoglobin count has increased. His blood pressure certainly increased with the transfusion, which is a good thing.

The doctor told us that Mikan will be on a ventilator until he gets a little bigger. The doctor wants him to save his energy and gain strength before trying to rely upon himself for breathing again. However, he has been weaned from 40 breathes per minute to 30 breathes per minute and continues to breathe on his own sporadically.

This morning Mikan spit up some of his colostrum. He has not been digesting most of his feedings. This is somewhat expected. Whenever this happens, they just remove whatever was in his stomach and replace it with another milliliter of colostrum every 3 hours. If he needs medication to shore up an artery in his heart, then colostrum feedings will be stopped for a period of time to help his kidneys handle the situation.

He had his eyes open throughout the conversation we had with the doctor. After we were done with the doctor, he asked Mikan, “Did you get all that about the hemoglobin saturation stuff?” Mikan quickly responded by pointing to his foot where he has been poked about 10 times to get blood draws.

Tomorrow, he will have an ultrasound of his brain to check to see if there has been any blood vessel issues there. He will also have an echocardiogram to check his heart.

Here are some things that suck about the situation:
-Watching Mikan cry and not being able to hear him (because of the ventilator tube runs through his vocal cords).
-Watching Mikan cry and not being able to do anything about it.
-Asking a nurse when the next time it will be okay to hold Mikan
-Constantly finding out something new about what is “typical” or a “common operation” in the NICU
-Telling people who visit they can’t touch Mikan.
-Watching nurses take blood from Mikan twice a day to test his levels.
-Using an industrial strength pump.
-Feeling helpless much of the time.
-None of his cousins are old enough to see him.
-Watching Jenna recover from the C-section.

Here are some good things about the situation:
-Knowing Mikan is in the best place for him to be.
-Watching either one of us hold him.
-Constantly learning new things about the human body.
-Coming to a new and deeper respect and appreciation for life and God’s continual creative powers.
-Using an industrial strength pump.
-Knowing how many people are praying and thinking about Mikan.
-Aunt Joe learned about blogs.
-Calling Linda Kartje “Grandma”
-Watching his body take shape and trying to guess who’s body part his body part most closely resembles.
–I think he is going to be getting a hunter orange baby “Dwight Shrute” hat, so he and I can be cute twinsies.
-Helping Jenna recover from the C-section.
-Being able to share the experience with you all (ustedes).

Sunday, March 9, 2008

Sunday Night

As of Sunday night at 10:30 EDST, Mikan is showing signs of an upswing. He was taken off of the jaundice light this afternoon. His blood pressure has increased to be within a normal range. His ventilator has been turned down to 30 breathes per minute. He is keeping his oxygen levels at ideal levels while breathing regular 21% oxygenated air. His salt levels are down to near normal levels. It appears as though he has began to increase his weight. Each Sunday night he has his length measured and the girth/circumference of his head measured. Tonight his weight was around 780 grams (1 lb 11.5 oz), which is up from last night's approximately 700 gram (1 lb 8.7 oz) measurement. His length is 13.5 inches.

The current worries are the following...
-He may need medication or surgery on his heart for a PDA issue. This is an underdeveloped artery in the heart. However, the increase in blood pressure is a good sign on this front. If he has to have the medication, it has side effects for his kidneys. The surgery would be a fairly common occurrence for such young babies.
-His salt levels had been elevated for what seemed like a long period of time. His kidneys still need to develop a little.
-Whenever we hold Mikan kangaroo style he struggles in the transition back to the isolette (human word for the common chicken word incubator). During the transition, he is off the ventilator for a small period of time. His heart rate and respirator rate dips quickly and then resumes to normal.
-Overall, the kid is pretty sensitive. Not emotionally, but physically. He'll work on that.

"I am here because I have a .....bah dah ummmm ahhhh... son in the NICU." I struggled to vocalize the situation I was in. I had to tell the security person why I wanted into the hospital around 10 pm last night. I suppose every first time parent feels the reality of the situation at varying levels at varying times. However, things have happened so quickly and so unexpectedly that Jenna and I are beginning to understand the reality of the situation in small pieces in different ways. For example, last night we set the alarm for 4 am so that Jenna could keep her supply coming. About a month ago, I had visions of waking to a crying child and then helping with feedings. I would rather wake to a cry than an alarm, but it is what it is.

My parents visited today and had lunch. We were able to talk and eat Barnaby's pizza in some piece and quiet in the Family Lounge. Jenna and I continue to live in places based on hospital availability. The last couple of nights we have been fortunate to be staying in one of the two NICU parent rooms.

Jenna is reading Greek Gods, Heros, and Monsters next to his isolette this evening. We're pretty sure he understood every word based on the following vignette:
"Mikan, what is special about the monsters named Cyclops?"
Then Mikan slowly lifted one hand to cover one of his eyes.

Tonight our nurse was Mary, maiden name: Stump. She played basketball for my dad at Central Noble.

We are starting to dig in and are inspired by the support we are continuing to receive through thoughts, prayers, food, and other assistance.

Saturday, March 8, 2008

Saturday

So far Baby Mikan looks good. He is still on the ventilator, but breathing room air and often breathing on his own in addition to what the vent gives him. He is still using a jaundice light, and his sodium is still a little high. Today his blood pressure was a little low, but nothing the nurses were concerned about. He did lose another 10 grams. Right now he weighs about 1 lb 8 oz. He is still tolerating his feedings.

Mikan loves Kangarooing. His vitals seem to be at their best when one of us is holding him. He gets irritated when he has to return to his incubator.

I got released from the hospital today. Tonight we are staying at a Parent Room in the NICU. We are going to try and stay at Ronald McDonald House as often as possible. When there isn't room anywhere in the hospital, we will have to travel back home, something we don't want to do at this point. We went home for the first time late this afternoon to repack bags and dump all of our old stuff from the hospital rooms. It killed me being away for only a few hours.

Nikole, Annette, Gil, and JT visited us today. We all agree that JT could eat Mikan if he wanted to. I think he's about 10 Mikans in one. But boy is he cute! It was nice to visit with them, and they helped us move out of the hospital.

Thanks for everyone's support during this time. Right now we will continue to take each day one at a time.

Friday, March 7, 2008

2 Days Old

Mikan is now 1 pound and 9 ounces. He is on a ventilator. This morning he was working awfully hard to breathe on his own. His carbon dioxide levels were pretty high, meaning he was not exhaling as well as possible.

Jenna's colostrum continues to come slowly but surely. Mikan has been digesting it well and the NICU nurses continue to feed it to him.

Jenna has noticed her legs and feet swelling. The doctor said it was because of all the fluids she received during the C-Section. She was up walking around a lot more today. She's still really sore, but each day seems to be a little better.

This evening Jenna was able to Kangaroo Mikan for 1 hr 45 minutes, until the next shift change. He appeared to love it. His oxygen levels were good, and he was doing a lot of breathing on his own.

It seems that right now Mikan is only minimally using the ventilator. He is doing well on it. His CO2 levels were decreasing, just like the doctor wanted them to. The ventilator is just another tube strapped to his already taped up and wired body.

Oh by the way, today I realized that I misunderstood the holding technique. It's not "kangaroo style" it's apparently "kangaroo care." My bad.

Tomorrow Jenna will probably be discharged from the hospital. It seems extremely unnatural to go home while Mikan will remain in NICU for at least a few months. We will probably be trying to stay at the Ronald McDonald house in the hospital between trips home.

Thanks again to everyone for their prayers during this time. We know they are working. Mikan continues to hang in there. Each day brings a new challenge, but we are faithful with everyone's continued support and God's help, our family will make it through this.

Thursday, March 6, 2008

34 Hours

Mikan continues to be in the "honeymoon" phase. As of 7:10 pm Thursday evening, he is ventilator-free. However, he is reliant on oxygen (at a varying percentage anywhere from 30% to 60%). All the same tubes are attached to his body as before. He is in an incubator. Jenna was able to produce colostrum today that was fed to Mikan. Six hours after being fed the colostrum, it was no longer in his stomach. This is either because he digested it or because he spit it all up.

Normal for a 28 week baby, yet scary, Mikan will occasionally forget to breath. To try and help prevent this, he is being given caffeine, a stimulant, through his IV. Sometimes, this does not work. If I am holding him when this happens, I just have to shake his hand a little and then he starts breathing once again. If this starts happening more frequently, he may be placed on a ventilator. The reason this is happening is because at 28 weeks, his brain stem is not fully functional.

He is very small. He lost a little weight since yesterday. I got to change his diaper, take his temperature, and clean him off tonight. Jenna was able to hold him "kangaroo style" for about 45 minutes this evening. The nurses call it "kangaroo style" because of the skin to skin contact between the adult and baby. According to some research, "kangaroo style" holding helps the baby regulate heart rate, oxygen levels, and get in rhythm with mom. Jenna definitely feels a lot better being able to touch Mikan in a less obstructed manner. If I were to have named it, I would call it "Marsupial Style" or "Koala Bear Style." Kangaroos get too much of the marsupial attention. Remember Crocodile Dundee?

Jenna's parents visited today along with Alexa. Official regulations for visiting the NICU are the following...
-Jenna and I can go whenever we want, except for shift changes.
-Grandparents can go whenever they want, except for shift changes.
-Anyone over 12 years of age can go with Jenna or me whenever we want, except for shift changes.
-You must have had the chickenpox vaccine or had chickenpox (but not currently).
-Anyone sick or contagious is not allowed.
-Jenna, Grandparents, and I are the only ones allowed to touch Mikan.

Also, my mom found out that it is against the rules to walk around and look at other babies.

So, on the roller coaster we are still pretty high, yet reluctant. Babies typically put up a good fight early and then run low on energy and struggle a little bit. His feet resemble mine (very stumpy toes, but pretty wide). He is very active with his arms and legs. He likes to have someone's hand over his legs when he kicks. I think that he kicks just to see if there is any resistance.

We remain in constant thanks for the graces, prayers, thoughts, cards, and flowers we have received over the past weeks.

He sleeps with his arms up near his ear and his thumb and pointer finger touching while the middle, ring, and pinky fingers are extended. First blog comment that correctly names this position gets a prize!

Wednesday, March 5, 2008

It's a Boy or He's a Man...you pick.

Today at 10:57 am Jenna delivered Mikan Josiah Gensic into the world. He is 1 pound 12 ounces. He is about 13 inches long. He is currently breathing on his own. She delivered via C-section after showing early signs of infection. Jenna felt a little nauseous this morning and the heart monitoring showed signs of stress. Therefore, the nurse attempted to keep her calm as she called me at around 9:45 am at St. Adalbert on my cell phone.

Mikan is currently hooked up to the following devices.
1.) A C-pac that increases the amount of oxygen he gets into his lungs.
2.) An oxygen monitor that measures the amount of oxygen in his blood.
3.) A feeding tube that goes down his mouth and into his belly.
4.) An IV that is connected to his umbilical artery.
5.) A heartrate monitor.

Mikan has some large bruises. His feet, legs, and back have bruises. We are expecting him to be jaundice in the upcoming days.

The doctors and nurses tell us that he is doing very well. While they are experienced in premature babies, and know these types of things, it is hard to tell he is doing well based on just seeing how small Mikan is and all of the wires and tubes he is hooked up to. He is very small.

We are expecting a roller coaster of events in the upcoming weeks. Usually, the first 24 hours after delivery go pretty well. This is because the baby is still living off of some of the mom's nutrients. We have been briefed about many of the possible issues Mikan may face.

Jenna is on antibiotics and is recovering at the hospital for at least the next 72 hours. She is on powerful painkillers.

If everything goes well, Mikan will come home late April to late May. I got to hold Mikan kangaroo style for about 30 minutes. He likes to keep his arms above above his head in a "receiving a touchdown pass" posture.

Thank you for your continued thoughts and prayers. They have worked so far...
-We made it to 28 weeks.
-He got his steroids in.
-Jenna had the doctor she wanted deliver the baby.
-I was able to get back to the hospital in time.
-We both have supportive families and schools.
-Jenna's uterus appears to be in good shape.

Tuesday, March 4, 2008

28th Week!!!

Today marks 28 weeks of being pregnant. That is a huge milestone. So far, so good. Our second doctor confirmed the baby was breech by feeling around my belly this morning. The baby's heart rate still looked good this morning and so far we haven't had any contractions.

My dad came to visit today on his way to work in Chicago. We played cards and talked. He also brought our laundry! Thanks Dad!

This afternoon I got a massage from a massage therapist. He comes every other day now. So, I think I'll take advantage of that. I can't really complain of a lot of pain right now, but whose going to pass up a free massage? Come on. I mean I'm lying here anyway.

A math teacher at my school stopped by today to bring a basket of goodies from the school and drop off some research papers for me to grade. So I will keep myself busy for awhile with the papers. Looks like the pleasure reading will be put on hold.

Monday, March 3, 2008

3rd Monday

Another day inside Jenna, the baby must be in heaven. Tomorrow culminates week 28. The doctor and Jenna discussed C-section scenarios this morning. Also, a NICU person came in and gave us information about the blood bank and possible needs for blood transfusions once the baby is born.

The NICU person is working on some research related to sleep patterns and breastfeeding. The researchers have found that women who breastfeed continually and did not store their milk provide their babies a better understanding of night and day. For example, breastmilk that is dispensed at 2 am should be fed to the baby at 2 am on a following day (possibly due to chemicals in the milk that are released by the mother at that particular time of day). There may be mixed messages sent to a baby if it is 6 pm but is getting fed milk that came from a mother that pumped at 6 am. Interesting.

Jenna did not eat her apple today, and the doctor came this morning. Irony, I think not.

We are thankful for your continued thoughts and prayers. We hope to keep this good thing going. Any time in the NICU will mean limited time together as a complete family during that period. I am also thankful for the prolonged winter weather. I think that Jenna is enduring more happily with the snow, sleet, freezing rain, and cold weather happening outside.

We are looking for recommendations on a good pediatrician in the South Bend/New Carlisle area. Drop us an email or give us a call if you have a name for us. Once again, thanks.

Sunday, March 2, 2008

Sunday: Exactly 2 weeks later

So far things are the same. Nothing major to report. Today marks two weeks that my water has been broken.

The doctor came in this morning to do an ultrasound. She didn't measure the baby, she just wanted to check up on his position and my fluid levels. She confirmed that the baby was now in breech position. There is also a sufficient amount of fluid around the umbilical cord right now, which she was happy to note. She also thought the baby looked bigger, although nothing quantitative was measured. We will have another ultrasound in about a week. She told us that 88% of women who come in with their water broken deliver within one month. Right now I am halfway there. Each day is better for the baby.

John and I watched IU embarrass themselves at Michigan State this afternoon.

We are thankful to have lasted this long, but still apprehensive about the future. 12 weeks in the NICU, or any time there at all doesn't sound like fun. This is the reality we are facing though; the doctors and nurses remind us of that. Although we don't have any control over the situation, it is still scary to think about. The nurses told John today that he would be able to visit the NICU if he wanted. This would be to prepare him for the atmosphere of the room and get an idea of the size of what our baby might look like. I unfortunately don't have that option. I am kept on a tight leash.

John is afraid every time he leaves for work that I am up and moving around when I'm not supposed to. He already gets irritated when I am taking a little too long to brush my teeth, or if I have to go to the bathroom more than once every four hours (like I'm faking it). I got a nice glare today crawling out of bed. He said, "Didn't you just go to the bathroom before dinner?" Dinner was 2 hours prior. I drank a lot. And I'm pregnant. That is why he usually goes for walks only when there are visitors around :)

We are continually thankful for the support from so many people. Thanks for your prayers, we are praying for all those concerned for us as well.

Saturday, March 1, 2008

Saturday

So far, so good. Everything remains the same.

The doctor came to visit this morning and watch the baby monitoring since the nurses had so much trouble with it last night. Based on where they found the heartbeat he thought it may be in breech position. But who knows what position the baby will be in when it's finally time for delivery.

Stasia, I only was able to knit the baby hat because I had a circle loom and detailed directions. I only know how to crochet, so the message you sent was kind of like a foreign language to me :) Sorry.

Today John went to the Storm Spotter Training at St. Joseph County Public Library. I think he just enjoys heckling the meteorologists since he is already certified in this area. But he did make it on the evening news. There was a shot of him raising his hand.

Jake Gensic came to visit us today. He brought up an old school Ms. PacMan hand held video game joystick that plugs into the TV. That should keep me busy for awhile, constantly trying to beat my own high score. John tried to call first dibs on holding the baby. I informed him that I naturally had first dibs since I've been the one sitting in the hospital bed for weeks, and I'm the one that is doing the actual baby birthing. He relented and settled for second dibs. Jake then called third dibs. John and I are not sure if we are accepting further dibs from people who are only in the room with us, or if we will accept internet dibs. If internet blogging dibs are acceptable, John and I claim third and fourth dibs on Jessica and Sam's baby and Pete and Sarah's baby. Too bad in-laws. We called it.

We continue to thank everyone for their thoughts and prayers. They are continuing to work.