Grow Mikaila Grow

2009-04-18T21:18:00.017-04:00

I know, I know. It's been a while. Kim put up these pics long ago and I haven't carved out the time to populate the space in between with narrative. In the last post I mentioned that we made a little move down south to the Tampa/ St Pete area. Well, that didn't last long. Long story short, I took a position in the Albany area and we decided to re-re-locate to our home in Alplaus, NY. So, we're back. For the moment, Kim is staying home with Mikaila. Mikaila came back from Florida (via plane, in the midst of the swine flu epidemic by the way) with what I would characterize as moderate separation to sever separation anxiety. Kim can't leave the room for 2 consecutive minutes without inducing a panic. Her anxiety manifests itself in many forms, most of which are not particularly convenient for us. However, they all pale in comparison to our current sleeping arrangements. You see, Mikaila simply will not sleep in her crib. Frankly, she won't be left alone for any significant period of time. So, she sleeps with us in our bed. Kim finds it cute. I, on the other hand......... well, I'm not so pleased. We hope to develop and execute a transition that gets her back into her crib shortly.

Looking at the pictures though it seems I should provide a bit of detail on her time in Florida. We drove down to Florida, Mikaila, Grandma Ducky and a trailer in tow to begin a new life in Florida. The plan was for Kim to begin work, Davia to watch Mikaila and for me to head back to Albany to get the house ready to be put on the market. I did a bit of networking down there to develop opportunities but just as I was gaining some traction down there, I received a job offer in the Albany region that I had to take. So again, long story short we decided to head back north leaving the fun and sun of Florida behind. However, much fun was had in the intervening months as evidenced by some of the photos herein. Mikaila went to the beach, had her first boat ride, swam in the pool, went out to eat often and for the most part, got a chance to interact with a world that she had only observed through a window. The kid gloves came off in Florida: we took her out to eat a dozen or more times, took her shopping, to a bar etc. She has had some of those same experiences since her return but it all began in Florida. Many thanks to Kim's brother Mikie and Denyve for there overly generous hospitality. They opened up their lovely new home to us and we certainly could not have done it without them.

When we left the Albany area, Mikaila was struggling to keep herself stable while sitting up. While in Florida, about two weeks after our arrival, she began to crawl thereby dramatically changing the dynamic for those in charge of her caregiving. A mobile Mikaila is much more difficult to deal with. One must account for her whereabouts at all time.

On Fathers Day, she began to walk and our lives have been forever changed. We will post photos and videos

I'm now finishing this post the morning of September 16, many months after I began. I will follow up with another very soon. Enjoy the photos, videos and pyrotechnics.

Mikaila Kissing Herself in the Mirror

Mikaila Just Starting to Crawl

Mikaila Kissing Tigger

Mikaila Horsey Ride

Mikaila Walking

Mikaila Crawling Through Her Tunnel

Happy Birthday Mikaila!

2009-03-24T19:44:00.008-04:00

Wow! It's hard to believe it's been a year since we welcomed little Mikaila into this world some 12 weeks earlier than anticipated. If you will recall, although she arrived on March 24, her original due date was June 18. We received so many inquires as to Mikaila's status in the early moments that we decided to start this blog to serve as a mass communication mechanism. I believe this blog has served it's purpose faithfully with the only limiting factors being the talent, time and inclination of the writer.

We had a very small family get together on Saturday to celebrate the first anniversary of Mikaila's arrival. She received a ton of fun presents, many of which were related to the sun, sand and fun of the beach. You see, we are making a little (probably temporary) move to the Tampa/St. Pete area, in the Gulf Coast of Florida. Sorry to those that are hearing this now but we have been working through several opportunities, many of which are still in play so we wanted to keep our options open until we were forced to make a decision. Back on point....... She scored a ton of gear, from bathing suits to sun dresses, sandals and sun hats. She also received a blow up pool, floaties, shovels and pails..... Let's just say she did well. We'll add pictures before we hit the road for Florida tomorrow night. For the time being, we will be staying with her brother in St. Pete.

Today, we took Mikaila to see her doctor for her one year/9 months adjusted visit. As always, he was very pleased with her progress and noted that her growth curve, although uniquely hers, mirrors the slope of the normal curves. She posted a weight of 14 lbs 12 ounces and her length is well within the normal range. Two shots were administered to her leg. She was a real trooper but she has been very cranky this evening, likely a consequence of the shots. The vigor I referred to in the opening moments of the very first post has never waned.

Mikaila had her 9 month developmental assessment about week ago. In virtually every regard, Mikaila meets or exceeds her developmental milestones. She does lag a bit in one area; gross motor skills, manifested most obviously in Mikaila's inability to crawl. It seems that Mikaila is content to dive and roll for objects she desires, with little concern for how long it takes. She never feels compelled to expedite her quest by attempting to crawl. We are working on it and will work even harder now that we have a cool and cushy play mat, complements of cousins Chrissy, Jay and Elise.

I apologize for the brevity of this post but we are leaving tomorrow and I have yet to pack any clothes. I'll try to do a follow up post in the next week. Cheers.

Tribute

2009-02-24T21:27:00.017-05:00

It's been an emotional week for us. Kim's grandfather David Jutton, affectionately known as Grampie, passed away last Tuesday morning. He truly was the patriarch of the family and his absence in the short week since his passing, is already palpable. Kim's mother Davia officiated a wonderful yet tear-filled service on Sunday and the equally emotional burial on Monday. Gramp faithfully served our country during WWII and as such was honored with a soldiers burial. The Honor Guard presented Davia and her sister Sandy with folded flags as Taps played in the background: A ceremony befitting an exemplary member of the greatest generation .

During the service, I had a moment of clarity; something told me that I had to update the blog with new content. I can't quite put my finger on it. Perhaps it was the fifteen or so followers of the blog not so subtly hinting that they still check the site regularly to find nary an update. No, that's not it. I wonder what it was. Anyway, I shall attempt to remedy that today. This post will be a tribute to Gramp. Sadly, we don't have many pictures of Grampie and Mikaila but we will post what we do have intermingled with the content that follows. We will also post several more recent pictures of Mikaila as there isn't a ton of news to report.

Mikaila is up to 14 lbs. Although she is still well below the curve for even a baby of 8 months (her adjusted age, she has actually been with us for 11 months) her curve seems to be following the slope of the typical curves. We tend to not worry to much anymore about how much she is taking in and now have redirected our efforts toward increasing the percentage of her intake that comes from solids.

A few weeks ago, we moved Mikaila from the bassinet to her crib. That move coincided with our move back to our bedrooms. I may have mentioned that I did some work on our floors over the holidays and as such we had to move our bed down to the living room area. We finally moved our bed back to our bedroom which necessitated moving Mikaila upstairs. She was roughly 11 months old at that point so it was long overdue. For the last few months Mikaila has kept us up at night. Kim and I take turns getting up to comfort her back to sleep. She seemed to have turned the corner a few weeks ago only to regress in the last several days. We've heard that sleep issues may be a recurring theme. I hope they're wrong.

Babbling

From the get go, Mikaila has been both communicative and expressive. Through a series of screams, grunts, facial expressions and arm movements, Mikaila has always been very effective at getting her point across. Mikaila has taken her communication skills to a new level in the recent months as she has proven to be quite the babbler.... just like her mommy.

Pardon me folks. I had to tend to a nose bleed administered by my loving wife. Back on point, babbling is a precursor to speaking. Mikaila has said both Dada and Mama although we aren't sure she really knows what they mean; at least I'm not sure. She seems to be on the brink of speaking. At times, she attempts to mimic the words we speak by manipulating her lips as we do. We'll let you know when she actually strings words to together and knows of what she speaks.

Crawling

She is in a similar spot as it relates to crawling. Although she really doesn't crawl yet she is very close. She can hold herself in position without a problem and her hips now allow her to keep her legs from splaying. At this point she tends to rock herself forward. She does struggle, however, with shifting her weight. The Physical Therapist worked with us on how best to help Mikaila and we will continue working with her. Frankly, I think Mikaila would rather walk than crawl.

Teething Still

It doesn't seem possible and I wouldn't believe it if I weren't living it but Mikaila has yet to have a tooth pop through. Most avid followers of this blog know that Mikaila has been teething for months. By months, I don't mean two months. I'm talking many months. Her gums are white so we know they are coming but when they actually break through is anyone's guess.

Quick Study

In recent months she has also taken to studying everything she touches or sees. I think she is less interested in what things do than how they do it. That explains her preference to mimic our facial expressions when we talk rather than creating the sounds that come out of our mouths. These tendencies show in her interaction with toys. When given a block for instance, she tend to study each side. The same can be said for Mikaila's hands. She finds her hands fascinating and stares at them while flexing her fingers and shifting her wrists. Perhaps she'll be an engineer or maybe an inventor? I'm just happy that she's intellectually curious.

Birthday

We will be celebrating the one year anniversary of Mikaila's birth on the 24th. It's hard to believe we've been at this for a year. She really has had a remarkable course and we feel blessed every day by her health and progress. We don't have any elaborate plans for her birthday- we have lived like hermits for the last year fending off invaders with germs- but we will probably do something. We will be sure to post pictures.

This post has been sitting for a while unposted. Kim and I have had our hands full so we haven't been able to cobble together the pictures of Grampie and Mikaila. However, I want to get this post up to appease the followers. We will add pics shortly. Enjoy.

Happy New Year

2009-01-01T21:13:00.041-05:00

Well, pull up a chair.... we're gonna be a while. Kim has given me a blog-related honey-do list, the likes of which... I'm gonna stop with the hyperbole before I get in trouble. So, let's just say Happy New Year!

To catch up, Mikaila had her Developmental Pediatric evaluation at a corrected age of 16 weeks-it must have been in October. Her Cognitive/Adaptive skills were solidly at 18 weeks. Her Gross Motor Skills were solidly at 18 weeks and her Fine Motor Skills were at 20 weeks. At that point, her language skills were comparable to that of a 24 week old and her Personal-Social skills measured between the 18 and 20 week level. The doctor's only concern was understandably Mikaila's issues related to her feeds. She recommended increasing the frequency of the visits by the feeding specialist. We will do a follow up visit with the developmental folks 6 months from the October appointment.

You're going to notice a bunch of pictures that do a much better job of capturing Mikaila's beauty. No, I haven't been practicing my photography. Rather, Kim's sister Kelly brought in a photographer as a Christmas present and she did a great job. We took a ton of shots in several outfits- my Study resembled backstage at a variety show- but the results were clearly amazing.

Halloween was interesting. She had no less than 3 costumes to wear- Exhibit A, the Pumpkin thing below.

We slowly began introducing solids into Mikaila's diet in the fall and she seems to be making slow but steady progress. You may recall that we began with a very exciting blend of rice cereal and breast milk. That just sounds scrumptious, doesn't it. Say it out loud, rice cereal. Yum. We moved from there to bananas and then avocado. She really enjoyed the bananas and seemed to be liking the avocado until she developed an allergic reaction. So, unfortunately, avocado is out. At this point, although her diet is still primarily comprised of breast milk, she does take in solids 2-4 times each day. Likes: Butternut Squash, sweet potatoes, bananas, applesauce, long walks and sunsets. Dislikes: Chicken, peas, mean people and war. She has also had carrots, green beans and prunes.

I mentioned Mikaila's feeding issues. She certainly has progressed a bit but her issues persist. She has been on Zantac for most of her life to counteract the effects of acid reflux. A few months ago we began exploring other options with her pediatrician in an attempt to advance her progress. Dr. Miller prescribed Prevacid. Initially Mikaila actually regressed so Dr. Miller upped her dosage. In parallel, Mikaila continued to see the feeding specialist (Gina) assigned by Schenectady County Early Intervention. Gina believes Mikaila's feeding issues are related to some underlying medical condition causing discomfort and recommended we see a specialist. We were referred to Pediatric GI Specialist, Dr. Qualia, and paid him a visit in November. He was happy with Mikaila's weight gain and didn't think invasive tests were warranted at this point. Dr. Qualia did express some concern with Mikaila's recently upped dosage of Prevacid and mentioned evidence in studies of bone cancer with extended over usage. Fortunately, Mikaila was only on the high dosage for a week so we really aren't concerned. After the visit, we severely reduced her Prevacid intake and her symptoms returned so we ended up going back to Zantac. Got that all? We'll be following up with Dr. Qualia again later this month.

Baby Tricks

Mikaila has developed physically quite a bit since my last post. She has been rolling from front to back for a while and recently began rolling back to front. She can sit up unsupported for stretches while playing with a toy but falls over if she looks up. She isn't quite mobile as of yet but she is making an effort to crawl. We'll continue to work on that but I think she may be more comfortable on her feet than on her hands and knees; frankly, I think she is frustrated that she can't walk now. Just this week I was holding Mikaila on the floor on her activity mat. She was sitting but decided to use the arms of the mat to pull herself up to a standing position. She held the position for a while unassisted. Occasionally, Mikaila will reach for a hand that is held up to her simulating a high five. Kim and Kelly insist she is completing a high five, others are skeptical.

Misc

Mikaila's Physical Therapy occurs monthly. Her PT, Karen, has been very pleased with her progress and indicated on several occasions that Mikaila is developing normally on her own so there is no need to focus on development of any particular muscle group. She has been teething for months now but to this point, nothing has popped through. Her gums are very bumpy but then again, they have been bumpy for months. Perhaps she'll skip the baby teeth and go straight to adult teeth? I'm on board; it will save us a few bucks in quarters under the pillow.

The visiting nurse still comes to the house monthly but the nurse has changed. Her original nurse was transferred to another position. Since November, Mikaila has been given an RSV shot to reduce the chances of contracting respiratory syncytial virus, a debilitating respiratory virus that is particularly troubling for premature babies. The visiting nurse administers Synagis at her visits and will do so through March. Mikaila doesn't care for these shots. Neither does her mother.

In the last few weeks, Mikaila has begun waking up often at night. A few times each night, we'll hear Mikaila screaming and have to go pick her up and walk her for a while. I should add that we have moved our bed and Mikaila's bassinet downstairs to the living room as we complete refinishing about 700 sqft of our hardwood floors. So, when she yells, we hear it. Actually, when she moves we hear it. Last night, I had to walk her from 11:30pm to midnight and 1:30-3:00 am. Kim got up with her at 5:30 and stayed up. The night before, I was up with her from 3:30 am on. Let's hope these events are anomalies and do not constitute a trend.

Mikaila's eyes are currently green although that may not last long. Kim has big blue eyes and I have brown eyes so where they end up is anyone's guess. Kim seems to think the shape of her eyes come from me. Perhaps so but I think the size clearly comes from Kim.

Christmas

Mikaila celebrated her 9 month birthday on Christmas Eve by opening presents with my mother and step-father. She actively participated in the opening of presents particularly excelling and reveling in the tearing of wrapping paper. It seems she enjoyed crinkling the tissue paper in the gift bags far more than the presents themselves. Mikaila scored a pretty impressive haul between Christmas Eve and Christmas Day with Kim's family. Among the presents under the tree; her first pony (pictured), a dozen or so outfits, swaddles, blankets, toys and stuffed animals.

Mikaila had her 9 Month Pediatrician visit this week. Dr. Miller was pleased with her progress and indicated that her weight gain was within the acceptable range. She currently stands at 12 lbs 14 ounces. Although she is still significantly below the curve, the slope of her curve very much mimics that of the ones above her. Translation, her weight is still very low but her growth is very much in line with that of a typical infant. Kim and I were quite amazed with where Mikaila now stands with some of the other metrics. It seems Mikaila's growth curve for both her height and head circumference has intersected with the traditional curves for 9-month olds. She caught up. I guess she's just lean. You should see her abs!

That's about it for now. I'll try to do a better job of keeping up with the blog. Translation, Kim vows to step up the badgering until I comply.

I hope everyone had a enjoyable and safe New Year's Eve and that 2009 brings you all of the successes you covet.

2008-09-24T15:48:00.008-04:00

It has been a while but I'll do a quick update for those of you that are still with us..... Radio silence................................

Mikaila continues to give us troubles with her feeds. Each day is a struggle and unlike the previous days. We have yet to see a pattern emerge. One day, she will shun breast feeding. The next, she will fight the bottle yet embrace the breast. Smart girl. We do have a feeding specialist through early intervention that will visit every 4 weeks. She is well intentioned but I'm not sure we have learned anything substantive. We'll keep at it. Her growth has been ok. She gained 5 1/2 ounces in the past week. At this point, anything more than half an ounce per day is acceptable so 5 1/2 ounces in 7 days is pretty good.

We had our second eye exam today for little miss Mikaila. They were looking for development with the blood vessles in the eye. As was the case during her original visit her eyes were perfect. We didn't get any indication of the strength of her vision.

Last week, the folks at Anthem finally came to take away the oxygen canisters and monitor. About freakin time! She had been off of oxygen for months yet we couldn't rid our lives of the monitor. We hope the lack of monitor will eventually translate into more sleep.

We added a few pics and a short video. You will see or should I say hear on the clip that Mikaila is very vocal. Enjoy.

Update

2008-09-14T13:08:00.003-04:00

The feeding specialist paid Mikaila a visit mid-week to assess her feeding issues. We have been able to get Mikaila's feeds back into the acceptable range but she still fights us more often than not. My hope was that the specialist (through early intervention, Schenectady County) would arm us with tools and techniques to re-train Mikaila to welcome and enjoy her bottle. The specialist observed Mikaila take a bottle and of course she took it without issue. She did push the nipple out at one point mid-feed but she took it back in after a burp without too much of a fight. This is not typical behavior. We generally have to coax the nipple into her mouth and constantly reassure her along the way. If Kim administers the feed, I have to be at the ready holding Mikaila's hands to avoid her knocking the bottle out of her mouth. I also generally move my mouth as if I were taking a bottle as Mikaila often will mimic what she sees. Back to the specialist. After observing her feed the specialist came to the conclusion that Mikaila's issues are likely not medical. The far more likely cause is an aversion resulting from negative feeding experiences; her formula and milk allergy that led to very uncomfortable reflux and substantial spit ups.

We really didn't get any techniques from the specialist. She did recommend that we change up our patterns. Mikaila often will get upset and sometimes hysterical when we put her in position to eat but before we even introduce the bottle. The specialist mentioned that we might change her position. Also, we have noticed that when Mikaila gets very upset often the only thing that will calm her down is swaddling her. When she gets hysterical she will not eat so we need to be more proactive to avoid her reaching that state. She generally eats without issue when she eats moments after awaking from a nap. We have been using that to our advantage as well and she validated that thesis. The take away is that we have to keep her calm and only introduce the bottle when she is calm.

When Mikaila went to the doctor last, she weighed 9 lbs 9 ounces. Some five days later, she still weighed 9 lbs 9oz. However, her feeds following the doctors visit had been very difficult and at the same time we were trying to get her re-aclimated to breast feeding so her lack of weight gain is not surprising. Two days later she had gained 2 more ounces placing her at 9 lbs 11 ounces on 9/11. Her feeds have gotten better since then so we do expect her to begin gaining weight again. Getting back to her doctor's visit, the doctor wasn't concerned with her weight. The trend was still acceptable so we will continue our current course of pure breast milk. At this point, 1/2 ounce per day is more realistic

I think that is about it. We'll add a few pics in a bit.

Quick Update

2008-09-03T19:57:00.002-04:00

We took Mikaila to see Dr. Miller today to get a check on her weight. She has been on breast milk sans formula for two weeks now. Although she posted only moderate gains (she is now 9 lbs 9 oz), the doctor was still pleased with her progress and assuaged our fears related to the reduction in calories. The latest research indicates that developmental vulnerability of very low birth weight babies is far greater pre-due date. Since Mikaila is 2 1/2 months past her due date, this is likely not a concern. Dr. Miller gave us the go ahead to continue her on pure breast milk.

If you will recall, we took her off of the formula for a number of reasons: She was struggling with her feeds often at once showing indications of hunger but not wanting to eat. She also was projectile vomiting several times each day. We eliminated the formula from the mix and eventually added it back. When we did, she showed classic signs of a milk allergy. Yada, Yada, Yada, she went back on pure breast milk and the spit ups virtually stopped.

We have a feeding specialist coming next week to assess Mikaila's problems taking the bottle. She comes next Wednesday. We'll post an update if she is helpful.

I should note that Mikaila decided that she would put a halt to her aversion to breast feeding today taking four feeds directly from the source. We hope this is not merely an anomaly but rather indicative of a trend in the right direction. She hadn't breast fed in over two weeks so this is very good news.

That's about it for now.

It's been a while

2008-08-23T21:08:00.009-04:00

Mikaila has had an interesting journey of late. Her feeding issues persist though they have improved considerably. She has seen the wife of our primary pediatrician (she claims to be a doctor as well although I see no evidence)and we have come away unsatisfied. Per her instructions, we put her on another formula- one that essentially predigested. They refer to it as being hypoallergenic. Well, Mikaila couldn't stand the taste (or smell for that matter) of the new formula. Frankly, we smelled it and it is none to pleasing. I don't blame her. She wouldn't take more than an ounce of that crap at a time. We discontinued use of that garbage within a few feeds. When we called the doctor, we were told to switch back to the original, milk-based formula. We were not in support of this idea but we decided to give it a try. At this point, Mikaila had been off of the milk-based formula for four days (we had a several days of straight breast milk mixed in there). When we reintroduced the milk-based formula, she showed signs of a red, blotchy rash on her cheeks and chin. Classic sign of an aversion to milk. It seems our milk allergy theory has some credence. We called the doctor yet again and they suggested we go back to the hypoallergenic formula.

Wow. Take a breath. I'm sure I missed something there but I'll keep going. In the eight days in between doctors appointments, Mikaila gained only 2 ounces. She had been gaining an ounce/day so 7 grams/day just doesn't cut it. Not only was she struggling with her feeds but she was spitting up a ton, further compounding her issues. The visiting nurse showed up on Thursday and we showed her Mikaila in action. Although she is taking her bottle quite a bit better than she had, she still is struggling and did so as the nurse looked on. As a collective, we made a decision. We decided to stick with breast milk for a few days to calm down her tummy. Although the calories are reduced with the absence of the extra calories, we were confident that she would at least keep her feeds down. Soon we will slowly reintroduce the disgusting, I mean hypoallergenic formula- maybe start with a fraction of the prescribed amount to acclimate her to the taste.

Kim's sister Kelly mentioned that Early Intervention, a program we benefit from, has a feeding specialist. After consulting the visiting nurse we decided to inquire as to availability. We spoke with Ellen, our Early Intervention coordinator, and scheduled an appointment for September 10.

Her recent diet of pure breast milk has really improved her feedings. Mikaila hasn't had a spitup in two days and has slowly improved her acceptance of the bottle. She still will fight the nipple but we well past the instances of 45-60 minute feeds. However, we recognise that she really needs the extra calories as she is now roughly 9 lbs and she will be 5 months old tomorrow.

We did the second overnight oxymetry on Tuesday night and we think it went much better. That is to say, the machine seemed to perform as it should, unlike its predicessor. We expect that the data will support a decision to get rid of that fricken monitor; the bane of our collective existence.

I think that's about it. I'll add a few pics later.

A little better

2008-08-16T19:40:00.002-04:00

We visited the doctor on Thursday to get a diagnosis of Mikaila's issue. Unfortunately, Dr. Miller was not on duty so we had to settle for his wife. Fortunatly for us, his wife is in fact a doctor. Or so we are told. After a semi-thorough evaluation, Dr. Elmer detected what she thought was some redness in her throat. Her diagnosis was Coxsackie Virus. We disagree. Among the symptoms of Coxsackie other than an irritated throat are fever,blisters on the extremeties and in the mouth. She has none of these. There is no antidote for Coxsackie; you simply have to let it run its course. She mentioned Tylenol to help with the uncomforable throat.

The theory we currently subscribe to is quite simple. We think her reflux manifests in frequent and often substantial spit ups/throw ups. Throwing up can lead to an uncomfortable throat. I remember from my college days. The stomach acids that assist in the digestion process can do a number on the throat. She has figured out that pain comes during and shortly after taking a bottle. Although less glamorous than Coxsackie, this diagnosis seems more plausable given the symptoms.

She has been slightly better today taking her bottle. After taking only 13 ounces on Thursday and 15 on Friday, she is on pace to fall within the acceptable range of 18-27 ounces today. We still have to fight her to get the nipple into her mouth but the battle typicaly lasts only 10-15 minutes or so. Still less than ideal but much better.

In support of our theory (admitedly proffered by both grandmothers) we have decided to try her on straight breast milk. One characteristic of many members of Kim's family is lactose intelerance. They don't care for lactose and they won't stand for it. The formula is milk based so she may be reacting poorly to the dairy in the formula additive. Although she is taking only 50-70 mls at a time she hasn't had what we consider to be reflux related spit ups today. Her two spitups were a direct result of her fussing with the nipple in her mouth and gagging. Before this episode, she was getting 80-100 mls every 2.5-3 hours (although we would let her sleep as long as she wanted overnight). Today, we have been feeding her whenever she will take it. She is getting less at each feed so occassionally, we feed her an hour after the last feed.

I failed to mention that she was weighed at the doctor's office. She weighed 8 lbs 15 ounces. She gained a scant 2 ounces in 8 days. Although upsetting, the number isn't surprising given her reduction in intake and frequent spit ups.

So, we are still somewhat confused and a bit concerned but encouraged that she is at least showing some progress.

We'll post an update when we have more to say.

Problems with the Bottle

2008-08-11T17:40:00.003-04:00

We have run into a bit of an issue with Mikaila related to her feeds. For some reason, she shows no interest in her bottle while at the same time exhibiting gestures indicating that she is hungry. Quite the conundrum. She will show clear signs of hunger- mimicking nursing, nibbling on our clothing (or occasionally on my nose)- but when presented with a bottle, she pushes it away. She'll push the bottle away with her hands, turn her head or once the nipple is in, she push back with her tongue. Often times she will cause herself to gag and eventually spit up. Eventually, we are able to get her to take the bottle and she is without exception pissed at us when we stop her feed to burp her. Her feeds now take 30-45 minutes when they had always taken 15 minutes. We have no idea what is going on. She has never had a problem with taking a bottle. This occured somewhat out of nowhere.

I should add that she did have her 4 month shots a few days before the issues occurred. These shots can often lead to grumpiness and fever but these symptoms seem different. When I called the doctor and spoke with the nurse they concluded that she was either suffering the effects of a stomach bug or reeling from the shots. We don't buy it. She isn't feverish at all and her diapers have been consistently wet. So, I will be calling tomorrow and I will not be speaking with a nurse. If we learn anything, I will post it in the next few days.

Last week the physical therapist made a cameo. I was way off. There were no squat thrusts and nary a flab jiggling machine to be found. She instead focused on baby massage. Him was taught the various techniques that will aid in her muscle development. After she gets a rub down, Kim puts her in the hot tub for a soak and then a quick steam followed by a fruity umbrella drink to keep her hydrated. The massage should also help to desensitize her to touch. She no longer kicks if her feet are touched.

Someone had asked if Mikaila was beginning to take to her baths. She actually has. I'm not sure she loves bathing yet but it no longer causes her distress. She seems to have accepted baths as a part of her routine.

Mikaila has been making some very cute noises. She seems to be finding her voice. Kim took a few short video clips so enjoy. Beleive me when I say that they don't quite capture the real thing but for now will have to serve as a proxy for the real thing.

We are still doing the due diligence on her feeding problems. If you have any suggestions we are willing to entertain theories.

Last thing, other than her displeasure with her current bottle, she seems very content and exceedingly cute. Off the charts cute.

Long overdue update.

2008-08-04T19:35:00.009-04:00

I know, I know. It's been a while. We may have lost our audience. Let's see if we can lure a few of you back. Mikaila has been doing very well. She has been off of oxygen for 4 weeks now (I think)and really hasn't had any respiratory issues. Frankly, I'm not sure where precisely the canula is so let's hope her good fortune continues. We spoke with Dr. Schroader about her overnight oxymetry. If you will recall, the first attempt didn't go very well. Understand that the issues were technological. Each time she moved, the sensor failed to register an accurate reading. Dr. Schroader insisted that we should redo the overnight test in 3 weeks. Add the almost 2 weeks to get results and we are looking at another month with the monitor.

Mikaila was weighed last Thursday and she registered 8 1/2 lbs. We haven't weighed her since but she is likely approaching 9 lbs. At this point, Mikaila is getting 80mls every three hours. We tend to give her extra in the evening; for example, we fed her at 5:45 this evening and she eagerly gobbled up 100 mls. At night, we tend to give her a bit less (from 50-70mls) and let her sleep 4-4 1/2 hours. She still tends to spit up from time to time but that didn't slow down her recent, although admittedly brief, growth spurt.

Although our energy levels are at close to all time lows (we still average about 4 hours each night) we have ramped up our home improvement efforts. There is a significant project in the offing, one that requires immediate attention given Mikaila's pending mobility. Some time in the next few months I will be soliciting the help of my step-father Bill, and will pull out the carpet in the family room/dining room/living room area, leveling the subfloor and laying hardwood flooring- 1000 square feet of it. That is some project but the carpet is simply unacceptable. Thirty years of filth looms deep in the dark recesses of that carpet. We can't have Mikaila crawling on that disaster of a carpet. It has to go.

The physical therapist will make an appearance tomorrow. She will put Mikaila on a strict regimen of calisthenics comprised mostly of squat thrusts and that flab jiggling machine from the 1940's. Actually I'm not sure what she will do but I guess I will find out.

I hope this little fix appeased your Mikaila jones. More later.

BTW - we tried to upload pictures but the site is apparently having technical difficulties. We'll try again tomorrow.

Overnight Oxymetry and Hearing Screen results

2008-07-22T19:53:00.002-04:00

I guess we owe you a few updates. We did an overnight oxymetry on Saturday night. The machine employs a flawed technology. Each time she moved, wiggled or scooted, the machine registered a false reading. Unfortunately, Mikaila is a very wiggly sleeper so the data is a bit messy. If they are unable to affectively scrub the data, we may have to do it again. We kept the other monitor going simultaneously and of course she was satting in the high 90's the entire time. The reality is she has been off of oxygen for almost 2 weeks now. We just want the monitor to go away so that we might get a bit of sleep.

The other nugget of info you may be anxiously awaiting word on relates to Mikaila's hearing screen. If you will recall, Mikaila flagged her hearing screen at the NICU. She had a scheduled re-screening today at 3 back at Albany Med. Her left ear passed very quickly. The right ear was a bit more of a challenge. The monitor had gone through roughly 7500 iterations when the person admistering the test went to find the audiologist. Before she left she indicated that Mikaila was likely to fail the test with her right ear and that she wanted the audiologist present to explain the implications. However, while she was gone, Mikiala passed the test. It took over 10,000 iterations (she passed on her left with just 1000) but she passed. One more worry to cross off of the list.

Before we left we decided to pay a visit to our friends at the NICU. Nurse Amy had just left but we did get a chance say hello to Dr. Rios. He was very please with Mikaila's progress and had no doubt that she would continue on what he said was a remarkable course. Nurse Lanette, one of our favorite nurses, was there as was Katherine. They were excited to see little Mikaila and couldn't believe her size. We will have to make another appearance to allow Amy to get a peek at Mikaila.

That's about it. There is a scheduled outage in a few minutes so I will have to end this post.

No more Oxygen... I think.

2008-07-18T11:09:00.003-04:00

Sorry again for yet another lapse in posts. I often find it difficult to find the time and energy to collect my thoughts and recount her recent activity. I will again vow to TRY to do a better job of updating this blog. I know that Mikaila has many fans that like to know what is going on with her day to day.

Mikaila has been off of oxygen for 9 days now. I’ll take a moment for you to internalize that information, disseminate to those within earshot, and engage in whatever celebration ritual endemic to your heritage. I’ve always been partial to the Jig but the Icky Shuffle is a close second. Ok, we’re back. Dr. Schroeder, her pulmonologist, ordered an overnight oxymetry. If all goes well, and we fully expect it will, her oxygen tanks and monitor will be a thing of the past. The folks that provide the equipment should arrive at the house in the next hour or so to deliver the special oxymeter.

The early intervention people paid a visit this morning to plan a course of action for the next 6 months. They were astounded by some of Mikaila’s abilities and accomplishments. For instance, Mikaila, when placed on her activity mat, will try to crawl toward, and reach for some of the objects attached to the mat. The reaching apparently is a 6 month skill. For the record, Mikaila’s corrected age is one month as her due date was exactly one month ago. They were very please with her overall progress and indicated that there really wasn’t anything that needed monitoring. However, given her birth and medical history, all aspects of her development should be systematically reviewed. We will have a monthly visit from a physical therapist and have access to specialists should any issues arise. They won’t.

About 20 minutes after the early intervention folks left the house, Mikaila executed another maneuver that is truly remarkable. Kim had placed Mikaila in her pack and play on her stomach. Moments later, Kim heard Mikaila fussing and looked over only to see Mikaila now lying on her back. Again, she is not supposed to be able to do this.

That’s about all I have for now. Kim uploaded a few pictures for your viewing pleasure.

2008-07-14T20:31:00.002-04:00

Mikaila has been off of oxygen for five days now. We haven't placed the canula in her nose for even a moment since mid day on Wednesday. I spoke with the lung doctor and he was quite pleased. He suggested we do an overnight oxymetry and ordered the device. We should have it either tomorrow or Wednesday. If successful, the monitor and oxygen tank should be out of the house in short order.

Quick Update

2008-07-10T09:39:00.002-04:00

Mikaila is progressing well. Her canula remains off for most of the day- we keep the oxygen tank on at its lowest setting and have the canula at the ready to avoid severe desats. At this point, Mikaila really only desats during a diaper change. However, even in those instances, she recovers very quickly. I have a call in to the lung specialist to see when we can get rid of the oximeter, canula and tank.

Mikaila has had a number of split-ups of late but her growth remains fairly consistent so we are chalking it up to what we know to be an immutable fact: sometimes, babies spit up.

That’s all I have for now. I will try to get back on the horse and post more frequently.

7 lbs 1 ounce

2008-07-04T22:07:00.002-04:00

We weighed Mikaila prior to her 8pm feed and she registered 7 lbs 1 ounce. Her pace slowed in the last 10 days or so creating a close contest. Congratulations to Diane. When I have the bottle in hand, I can either send it or bring it with me on my next trip to Rochester. I tend to come to town at least once a month. Enjoy.

Happy 4th of July!

2008-07-04T09:39:00.000-04:00

Happy 4th of July everyone! Mikaila may get a chance to see her very first Alplaus 4th of July Parade as it proceeds at a snails pace past our house; the route is not at all surprising given Alplaus’ designation as the smallest population in a zip code within the continental US. It is hard to get around Alplaus without passing our house at some point.

Today we celebrate our declaration of independence from the Kingdom of Great Britain. However, from this point forward, for the folks that frequent this blog, the 4th of July will hold another, perhaps less important significance. This evening, we will weigh Mikaila to conclude our little contest. We haven’t weighed her in a number of days so at this point, at least as far as we know, the winning number is still up in the air. We will weigh her in the buff after a diaper change and before her meal at 8pm.

I’ll do a quick update on Mikaila’s oxygen requirements. At this point, we can keep the oxygen off when she is sleeping comfortably. To be specific, if she is fairly comfortable following a feed, we can turn the oxygen off until she needs to be changed prior to her next feed. She always desats during changing; even when the oxygen is on. She doesn’t care for it. Frankly, it isn’t my favorite pastime either. She has gotten to the point where we can feed her without the need for supplemental oxygen fairly frequently. We are close. I can’t imagine her needing the oxygen beyond next week but I should reiterate that progress in this regard is far from linear.

I broke out the camcorder this morning that we bought for our wedding 2 ½ years ago. We bought this device in the place of hiring a videographer thinking we would use it later in life. To this point, it has been collecting dust in the hutch. The short videos we have posted on the blog have come from our camera. Our camcorder was fairly bleeding edge when we bought it; I believe it was the first camcorder to feature a hard drive as its storage format. I took a short clip this morning of Mikaila sleeping on my mother but before I post it, I will have to figure out how to convert it into a usable format. It records to a .pgi file- a format I have never come across.

More later. Enjoy your day.

Quick Update

2008-06-30T21:27:00.002-04:00

The early intervention team made a cameo this morning to get a baseline for Mikaila's development. Given her low birth weight, she automatically qualifies for this service through Schenectady County. Not surprisingly, Mikaila scored remarkably well in her evaluation. Although Mikaila is more than 3 months old, developmentally she is evaluated using 6/18, her due date, as her birth date. Again, no one that frequents this blog would be surprised to hear that Mikaila fared extraordinarily well for a baby of 12 days old. She has always been very advanced. However, we were very happy to learn that she compared favorably with the average 3-month old as well. They will continue to monitor her progress monthly in part to assuage our fears but mostly to catch any potential issues early.

My mom is now in town helping out. As you would suspect, she was in utter shock when she saw Mikaila again after 6 weeks or so. Mikaila has probably doubled her weight since then. She was in agreement that Mikaila's true cuteness can not be captured on film. We are giving her the crash course on Mikaila care. She will be here helping out for the remainder of the week so hopefully, Kim and I can get a little sleep. We are definitely on fumes.

Sorry for the delay

2008-06-28T19:56:00.006-04:00

I have taken a bit of heat of late for my failure to post an update since Monday. Well, let's remedy that, shall we. Mikaila's oxygen requirements are fading by the day. Last night, when I returned from my long day in Pennsylvania, while holding Mikaila I took her off of oxygen for more than 90 minutes. She was in fact still satting in the mid-90's when I had to turn it on for her diaper change and bottle. She should be off of the oxygen completely in short order; perhaps in the next week or so.

We weighed Mikaila this evening; she posted a modest gain from Monday tipping the scales at roughly 6 lbs 10 ounces. Her weight gain is anything but predictible. She continues to be a voracious eater so I really have no explanation for her modest gains in the past few days.

Mikaila is on a different monitor now; one that tracks her oxygen saturation and heart rate through a probe that we attach to her foot. The chest probes are a thing of the past. Two wires down one (and one tube) to go. We have had problems with the new monitor as it often fails to pick up a signal. Mikaila will be satting in the high 90's and all of a sudden, the monitor will give off its brutally annoying sound. Fortunately, or unfortunately for us affected by the sound, it typically is indicative of nothing related to Mikaila. It simply doesn't work propperly. We get preciously little sleep as it is. We certainly don't need electronic monitors exascerbating our sleep deprivation. We're doing quite alright with that ourselves. The very strange man from the respiratory company stopped by today with a replacement cord. Let's hope the cord was the culprit.

That's about it for tonight. I really didn't sleep last night other than quick snoozes in between the monitor alarms so I might go up stairs for a quick nap. Kim will hopefully post a few pics later this evening.

I'm up so why not post an update

2008-06-23T23:33:00.003-04:00

Well, it is 11:45pm and I have a ways to go before I am relieved of duty so I figured I would post an update on young Mikaila's progress. We had a routine visit today with her pediatrician, Dr. Miller. We are very fond of Dr. Miller. He has a very pleasant way about him and he comes highly recommended from friends of friends and the team at the NICU. Dr. Miller was quite pleased with Mikaila's development and did his best to assuage all of our recent, somewhat ill-advised fears; are her legs a bit bowlegged, stuff like that. She was weighed at her visit today in the buff after a timely and significant bowel movement. Mikaila tipped the scales at a robust 6 lbs 6 ounces. Keep in mind, this is an unofficial weight for our purposes but significant none the less as she has gained 18 1/2 ounces in the last 14 days.

Mikaila's gifts continue to pour in; just today, she received a very cool motion glider from my aunt Cheryl. She seems to really enjoy it. Last week we received a personalized book from some friends. Yes, Mikaila's name is actually integrated into the book. How cool. Frankly, I shouldn't name any of the gifts as we have survived by the good graces of the friends and family that had the kind of foresight we clearly lacked. We have purchased very little at this point. Other than her crib and an air purifier, I think all of the items we use to care for Mikaila have been gifts. Thanks to all.

I will name one other very cool gift. The Boyle clan led by Grandpa Mike made it their life's mission (at least for the day) to source and purchase the ultimate jogging stroller. Perhaps they are trying to tell me something? Well, they found it. A Jeep jogger with all of the amenities. I mean, all of the amenities. This thing has it all- 18 inch tires, a roll cage and a built in mp3 interface with integrated speakers. No, I'm not joking. This thing is bad ass. Pardon the profanity. Call it a shout out to the recently late great George Carlin. We have had to make modifications to accommodate Mikaila's stature (or lack there of) but it really works quite well. When I say modifications, I'm talking breaking out the sewing kit to temporarily shorten a strap, a blanket to sit on to raise her to the appropriate height etc. I can't wait to take her out on the bike trail later this summer. I can tell you, I need the exercise.

I'll leave it at that for now. Good night all.

6 lbs

2008-06-20T22:02:00.006-04:00

Mikaila was 6 lbs when the visited nurse weighed her this morning. Her added girth now has her in new born diapers. Two milestones in one day. Pictures to follow later this evening.

Quick thought

2008-06-19T15:57:00.003-04:00

Diane and Breida, your little contest of one-on-one begins once you have both submitted your guesses (by midnight tonight please) and ends on July 4th per Bill's comment of a week or go. So, keep in mind while formulating your guess that you have slightly more than 2 weeks. Diane, feel free to re-post a guess as I think you were under the impression the new contest ended July 2nd.

And the winner is...............

2008-06-18T21:13:00.002-04:00

Ok, this will have to be quick as I am in holding Mikaila right now and will be in charge of her for the bulk of the overnight. At the final weigh in, Mikaila weighed...

Wait for it.......

Wait for it............

5 lbs 13 1/2 ounces.

So, we do not have a winner. We have a new contest per the ruling by Bill. Diane & Breida, please submit your guesses for a new final weigh in in two weeks. Look through the comments for detail on the tiebreaking contest.

Last Day!

2008-06-17T23:14:00.003-04:00

Well, we have less than 24 hours to go in our little contest. Tomorrow night at about 8 will weigh Mikaila. Let's set the parameters; she will be weighed in the buff after a diaper change. To avoid excess wiggling, we will weigh her about an hour before her scheduled feed. We want a definitive number. When she wiggles, it is very difficult to get an accurate reading. That's about it. Good luck all.

2 days to go.

2008-06-16T20:42:00.006-04:00

Quick update for now; we weighed Mikaila just a moment ago sans clothes and wires but with a diaper. For the record, when we weighed the diaper, it did not register. That implies that the diaper weighs less than 10 grams. With two days to go in the contest, Mikaila weighed 5 lbs 11 1/2 ounces. I don't know who has 5 lbs 14 ounces but whoever you are, you are in good shape. I may add to this post later this evening but for now her weight will have to hold you over.

OK, I checked the earlier post and here are the front-runners with odds attached. Feel free to place a friendly wager or two. If it gets interesting, the house may cover all bets although I may lay some of the action off to another book.

Odds
Breida 5 lbs 13 oz 3-1
Diane Levin 5 lbs 14 oz 2-1
Mike Boyle Sr. 5 lbs 14 1/2 oz 5-2
Davia Boyle 5 lbs 15 oz 4-1

Tuesday afternoon edit; Given my mother's comment I feel compelled to explain my post. I was just funnin' with the Bookie talk. Feel free to use these odds if you fancy a wager but we won't be covering any bets. I'm sure most of you (at least the healthy among you) have no idea what I was talking about. Don't worry; that's a good thing.

Happy Fathers Day!

2008-06-15T17:09:00.002-04:00

Happy Fathers Day to my father, step-father, Kim's father, grandfather and all dads out there.

Four days to go

2008-06-14T21:52:00.003-04:00

We in the Shareef household are absolutely exhausted and thus the lack of posts. Although we each have shifts, there is very little sleep happening. For example, I am on duty until 3am and then I get to go to sleep. Frankly, I'm pretty excited about it as I actually get a chance to go up to my bed; haven't done that in a while. Slight digression, did Tiger just one-hop from off the green on 17? Amazing. Digression over.

Mikaila is still taking oxygen although her room air trials are going well. I took her off the oxygen for 20 minutes today. Her sats stayed very strong for the first half of the trial and hovered around the mid-80's for the balance. Her feeds are going very well although reflux is still an issue. We weighed her this evening with her onzie on and she tipped the scale at 5 lbs 9 ounces. With four days to go in the contest those in the 5 lb 13 ounce range are looking pretty good.

Because of Mikaila's prematurity and low birth weight, she qualifies for several governmental programs. For example, both visiting nurses and early intervention made appearances in the last week or so. Both will be mainstays in the months that follow.

Kim had a list of things for me to cover but I can't think of any of them right now and she is taking her sleeping shift. I'll try to post tomorrow and cover the topics I missed.

To avoid further confusion

2008-06-11T09:00:00.003-04:00

Bill, can you clarify your proposal as it relates to the date our contest concludes? Remember that we are ending the contest on 6/18 and NOT 6/28.

The contest

2008-06-10T13:43:00.003-04:00

Just a quick note to clarify the contest. We offered our guesses as to Mikaila's weight at what was her due date; 6/18. So, I will weigh her next Wednesday evening (one week from tomorrow) and the person with the guess that is closest to her actual weight that evening wins the bottle. We still have 8 full days remaining before the final weigh-in.

I will ask Bill to settle the following issue as he was the originator of the contest and will be the one to supply the spoils to the victor. How do we settle the winner in the following scenario? At the final weigh-in, Mikaila weighs 5 lbs 15 1/2 ounces. Davia offered 5 lbs 15 oz as her guess and I settled on 6 lbs. Who wins? We never added the "Price is Right" caveat- closest without going over- so I don't think it would be fair to add that now. Perhaps we should offer a tie breaking question for each participant to answer long before the conclusion of the contest. Thoughts?

We'll weigh her in a few hours

2008-06-09T22:19:00.005-04:00

Unfortunately, we didn't get a chance to weigh Mikaila prior to her 9pm feed. We will do it prior to her midnight feed. Mikaila did have another visit to the pediatrician today. He was very please with her progress and weight gain. As I mentioned, the doctor's scale, for the purposes of the contest, is unofficial. For your edification and nothing more, I will now tell you her weight at the doctor's office; 5 lbs 4 ounces. Keep in mind, this is unofficial. I will post her official weight in a few hours.

And now for something completely different; a picture of Mikaila. This particular piece features our young hero wrapped in a blanky after her first bath at home. Enjoy.

I just weighed her after a diaper change but before her third dinner. Keep in mind that we weighed her with her new, clean diaper on to avoid catastrophe (Kim is catching a rare nap and I don't want to have to deal with the potential fallout of a diaperless Mikaila.) Mikaila weighed 5 lbs 5 ounces. An empty diaper weighs far less than half an ounce so keep that in mind. Her true weight is probably pretty close to that number.

Guess Mikaila's Weight

2008-06-08T18:49:00.003-04:00

There are roughly 5 hours left to post a guess for our little contest. I pulled the following from an Excel Spreadsheet. The formatting didn't hold but you can get the picture. Good luck all. We will weigh her tomorrow night and post an update.

Atiya 5 lbs 5 1/2 oz
Mrs. H 5 lbs 7 oz
Kathy Boyle 5 lbs 9 oz
Mariam 5 lbs 9 oz
Mindy 5 lbs 10 oz
Charlene V 5 lbs 11 oz
Chad & Wndy 5 lbs 12 1/2 oz
Breida 5 lbs 13 oz
Diane Levin 5 lbs 14 oz
Mike Boyle Sr. 5 lbs 14 1/2 oz
Davia Boyle 5 lbs 15 oz
Dara 6 lbs
Kim 6 lbs 1 oz
Kelly Boyle 6 lbs 1 1/2 oz
John C. 6 lbs 2 oz
Bill V. 6 lbs 8 oz

Very Quick

2008-06-07T21:16:00.003-04:00

We have a very intriguing contest shaping up here. Keep in mind that the scale we use (and in fact the one they use in the NICU) rounds to the nearest half ounce. So please limit your guesses to increments of 1/2 ounce. If you have given us a fraction/decimal other than the aforementioned, please repost your new guess. By the way, to keep it fair for all participants, we will not be weighing her until all of the guesses are in.

Mikaila had a good day today. She really has had a rough time of late dealing with the harshness of the formula supplement. However, today was quite a bit better. We hope that signals progress and isn't simply a random occurrence.

I'm In!

2008-06-06T13:12:00.007-04:00

Ok, we have a proposition on the table. This may seem redundant to those that know me but I’m in. We weighed her just a moment ago to establish a baseline. This weigh in will be official. The scale, by proxy has been certified by the department of weights and measures. I should elaborate, the visiting nurse weighed her with a scale that had been calibrated that very day (it’s done yearly, it just happened to be on Wednesday.) Our scale corresponded precisely to their number and thus the designation. We weighed her naked this time. She weighed 5 lbs this afternoon so use that number when calculating your guess. I’ll be dusting off the old regression analysis from grad school to determine my guess. I want that bottle. Rest assured, I won’t be gaming the wager by altering her formula. You may enter your guesses in the comment section of this post. I don’t know if there is a limitation on the number of comments on a single post. If you are unable, simply comment on a subsequent post.

Here are a few pics of her nursery. Unfortunately the limitations of the space make capturing the room in all of it’s splendor an impossibility. I happen to think that the room, although not very photogenic, is magazine-worthy.

3pm Edit: A few things, I'm going to add a ground rule to break ties. If two people share the winning guess, the first person to post their guess wins the bottle; some incentive to post early. Perhaps we'll put together a second prize in that instance; say a nice box of blush or a bottle of Mad Dog 20/20?

Also, to avoid controversy, I will present my guess right now. Dara's educated guess==> 6 lbs! She will gain one pound in the next 12 days. Mark it down in pen.

One guess per contestant. No purchase necessary.

Changing the Formula

2008-06-04T22:01:00.002-04:00

Mikaila was very uncomfortable today with reflux. The formula that we mix with breast milk to create the Mikaila Special (her own proprietary elixir)really does a number on her tummy. We asked Dr. Miller if it was ok to scale back on the amount of formula in her blend and he consented to moving her to what is essentially a 27 calorie blend. It seemed to help a little bit. We hope over time to ween her off of the formula and to 100% breast milk. Her system seems to handle pure breast milk without issue.

A visiting nurse from Schenectady County paid Mikaila a visit today. Given Mikaila's low birth weight and prematurity she qualifies for this service. She took a baseline and will return in 2 weeks.

That is about all I have for tonight. I may scale back a bit on the posts reserving them for items of note.

Eyes A OK

2008-06-03T21:54:00.002-04:00

Mikaila had her scheduled second eye exam today. Unfortunately the appointment was back at the Albany Medical Center. You see, we have been instructed to avoid malls, churches and crowds of any sort. However, the same folks offering this advice are scheduling appointments at a place that by definition attracts sick people. Yeah, that makes sense. Ya feeling me here?

Back to the eye exam, Mikaila really didn't enjoy her visit with the opthalmologist. The eye drops aren't so bad. They simply dilate her eyes. However, the next step is to shine a bright light into eyes. She really didn't care for that. She screamed like a frightened cat (in fact, her scream sounds very cat-like) for a few seconds but as is her way, she quickly bounced back. The results were very favorable. Her eyes are fully developed. She has no issues with her eyes.

We did weigh her tonight although she was weighing a onsie. With wires and onsie, Mikaila weighed 5 lbs 2 ounces. We have been feeding her 50 mls every three hours and she had no problem. We may include a few feedings of pure breast milk to help her with the reflux. Also, at the doctor's office yesterday they measured her length. She is currently 17 inches long. That's it for tonight.

First Visit with her Pediatrician

2008-06-02T22:10:00.002-04:00

Mikaila had her first visit with her pediatrician. We were very pleased to meet Dr. Miller last week, a referral from another family with a preemie, and he was terrific with her today. Dr. Miller was very impressed with Mikaila's remarkable progress. His words were very comforting to her parents. He did mention one thing related to Mikaila's next few months; we must take great care in determining who enters Mikaila's space. Specifically, he said that we can never be too careful. Getting sick at this point would be our biggest concern. Not only would her getting sick derail her progress but it would likely be very dangerous. We will be vigilant in adhering to his words. Please understand that we will not be hosting any visitors in the near term. We love our friends and family and appreciate all of the thoughts, prayers, gifts and love we have received throughout this ordeal. However, the health of our baby trumps all and I'll ask that all of Mikaila's friends respect our wishes. I know that our friends want to help. That is precisely why they are our friends; they are good and caring people. We do need help but we are definitely getting it from our immediate family. Kim's family has been very helpful thus far and my Mother will be taking a shift in a few weeks. So fear not, Mikaila is in good hands.

Mikaila was weighed at the doctors office today. She weighed 4 lbs 13 ounces. She is up about 4 ounces since her final NICU weigh-in at 5 am on Saturday.

First Night at Home

2008-06-01T20:43:00.002-04:00

We have learned that Mikaila much prefers to be held. She did not do well last night when we tried to put her down. Kim and I tried everything; we tried the sleeper area of her pack n play with a home-made incline, we tried the pack n play without the incline, her bassinet with an incline, we tried swaddling her.... Nothing seemed to work. Laying in bed she spent all of her time fidgeting, squirming and crawling and inevitably de-satted. Eventually Kim and I (mostly Kim) decided that we had to hold her all night. I probably got a hair over an hour of sleep last night and I don't think Kim got any. We both were able to take a quick nap today which helped a bit. We are fortunate to have Kim's family here to help. Grandpa Mike flew in from Florida and has been very helpful as the chief cook, principal chauffeur and in other supplemental roles. Davia and Kelly, Kim's mother and sister respectively have been equally helpful. Mikaila has not seen the inside of her bassinet today being held at all times by one of the aforementioned folk. Kim decided that she will hold Mikaila all night. She has, in short order, proven herself to be an extraordinarily committed and loving mother.

We have our first visit with her pediatrician tomorrow afternoon so it's back to the car seat for little Mikaila.

We will probably weigh her at 11.

She's Home!

2008-05-31T21:17:00.005-04:00

OK, this is the first post with Mikaila home. We were able to take her home late morning after spending the night in the Rooming In Suite. I'm assuming having experienced their accommodations in all it's splendor that they are using the word "suite" literally. Yes, there were two adjoining "rooms" but the accouterments were far from plush. We did manage to grab a few hours of sleep between 5am and 8am but it certainly wasn't a sound sleep.

Mikaila was released on oxygen so we are forced to deal with variables seldom experienced with term babies. As in the hospital, her oxygen saturation, breaths per minute and heart rate are constantly monitored. Unfortunately, the portable monitor we have at the house is far less elegant than the one at the NICU. Some of the technological limitations of this mobile unit contributed to us not getting any sleep last night. A little tape to the sensors and it's all good (a little street for the youngins.)

She seems to be getting acclimated to her new surroundings. Most of her day was spent laying on chests; the chest of her mother, father, aunt, grandma and grandpa. She seems to prefer that to laying in her new bed. Mikaila's bottle feeds went well today. In fact, we were told that we can try more than 40mls as tolerated. We gave her 50 mls at 2 and she gladly gulped it all down.

We will weigh her on our new scale prior to her 11 pm feed. We haven't established a baseline with this scale so don't be disturbed if the number seems out of whack. We won't be having the department of weights and measures come in to calibrate the scale so the number she posts today will only serve as a baseline to compare against going forward.

Ok, we weighed her on our new scale. She was wearing a diaper, a little sun dress and the probes and wires that monitor her vitals. So, understand that we have no idea what all of that stuff weighs. With all of that stuff on her, she weighed 2170 grams or 4 lbs 12 1/2 ounces. Again this is merely a new starting point; nothing more.

Last Night at the NICU

2008-05-30T19:03:00.000-04:00

Well, this will be our last post with Mikaila residing at the NICU at Albany Med. We are "Rooming In" tonight, staying in a little room just off of the NICU with our daughter at our side. I believe I've referred to the Intermediate Care area as the baby half-way house. Well, I think the Rooming In area effectively serves as the half-way house for parents. She still has a nurse assigned to her so we certainly have backup should we encounter any issues.

As I write this I am sitting at the shared computer in the Ronald McDonald Family Room just one door down from the NICU. I'll have to get off of this machine soon as other families deserve equal time. There really isn't much to report at this point. She won't be weighed for quite a while. I'll do a post at some point tomorrow but don't hold your breath. We probably won't sleep at all tonight and tomorrow will be action packed. I'll do my best to keep everyone apprised but understand that we will have our hands full.

Quick update on weight gain.

2008-05-30T12:02:00.001-04:00

Mikaila gained another 40 grams bringing her to 2030 grams or 10 grams shy of 4 1/2 lbs.

Still on track

2008-05-29T21:24:00.005-04:00

I did the drive out to Rochester at the crack of dawn and return the same evening trip so I will be a bit on the brief side; kind of have that floating feeling balancing extreme fatigue with the jitters associated with mainlining caffeine all day. Mikaila is still on track to go home on Saturday. She handled her feeds and maintained her temperature all day. She failed her first car seat test but passed it when it was re-administered this afternoon. The one concern is that she failed her hearing test. I wasn't there but from what I understand it is sort of a screen to get a baseline. Her results can mean any one of the following things; she has issues related to hearing, she has fluid in her ears or her hearing is still impacted by her prematurity. Let's hope that scenario one is not in play.

That's about all I have at this point. She was not weighed at 8. It's unlikely that I will be blogging at 11 this evening but we'll see.

I have been instructed to add Mikaila's updated length. She is now a hair over 15 inches. She has gained 20% in length while gaining 200% in weight.

We are close

2008-05-28T21:29:00.003-04:00

Mikaila continued to feed exclusively by bottle effortlessly today. In fact, her intake was bumped up to 40 mls every three hours. She used the incremental calories to grow an additional 40 grams today. She currently stands at 1990 grams or a hair over 4 lbs 6 ounces.

The Peanut passed a major test today showing significant weight gain while concurrently bottle feeding and living in an isolette free of additional heat. Her team turned off the heat this morning and she had no trouble maintaining her temp. She is on course to go home on oxygen Saturday morning.

Speaking of her oxygen requirements, we have set appointments for Thursday and Friday to have her set up to travel on oxygen and have the house set up with the appropriate equipment. We will also be "rooming in" on Friday night, staying the night in a special room in the NICU with Mikaila at our side. If we are unsure about any event that comes up we will have the nurses at our disposal. Think of it as sort of a parenting half-way house.

That's all I have for tonight.

Up 40 Grams

2008-05-28T09:40:00.001-04:00

Mikaila gained 40 grams yesterday bringing to 1950 grams or 4 lbs 5 ounces. She should cross the 2 KG threshold in a few days.

Lots of stuff

2008-05-27T20:09:00.004-04:00

Mikaila's feeds were bumped up to 38 mls every 3 hours. She took the increased amount by bottle at each of her feeds. In fact, Nurse Amy was so confident in Mikaila's ability too master the bottle that she took out her feeding tube. She has now taken 13 consecutive bottles.

Mary Jane, Mikaila's nurse practitioner, decided it was time for another room air trial and unfortunately it didn't go well. Mikaila began to de-sat almost immediately. When bumped back to her .03 liters of oxygen, Mikaila quickly bounced back into form. It appears she isn't ready to free herself from this final entanglement.

She has now shown evidence of prowess in all of the areas that drive the discharge decision; she has no trouble maintaining her temp and she has been taking all of her feeds without the aid of a feeding tube and pump. If she continues along this course her team will probably send Mikaila home within a week or so. However, it is very likely that she will be coming home on oxygen. Although this is far from ideal and certainly not the scenario we envisioned, if she is meant to go home with supplemental oxygen then we are on board. We just want her to come home.

She will be weighed at 11 so if I am up I will update.

Up 35 grams

2008-05-27T09:04:00.002-04:00

Mikaila gained 35 grams yesterday bringing her to 1910 grams or 4 lbs 3 1/2 ounces. Nurse Amy, who has just returned from a long respite, indicated a room air trial was in the works. Mikaila's canula will come out during the day and will go back in during her feeds. Please send her good energy. This really is her last true hurdle as she has been stellar with the bottle. In fact, she has taken her last 8 feeds by bottle. Amy may also take her feeding tube out today.

No Changes

2008-05-26T20:47:00.002-04:00

Mikaila took 4 bottles consecutively today. I'm not sure she has managed that feat to this point so that is a very positive sign. She is likely capable at this point of taking all of her feeds by bottle. The only thing holding Mikaila back a bit is her slight oxygen requirement. Her doctors would really like to send Mikaila home sans oxygen; her parents concur.

That's about it for today. Hopefully her nurse will weigh her at 11. If she does and I am conscious I will update this post. If not, I will update tomorrow morning.

Up 35 Grams

2008-05-26T08:06:00.002-04:00

Mikaila gained 35 grams yesterday. She is up to 1875 grams or a hair over 4 lbs 2 ounces.

Sam I am

2008-05-25T21:20:00.003-04:00

I truly have nothing to say today related to Mikaila's day. She took several bottles but that isn't news. She is taking a trickle of oxygen but again, that territory has been covered. I did read her, "Green Eggs and Ham" today. We have heard that we should read 10 books each day to our daughter; that for her to fully realize her developmental potential she needs that level of interaction. That seems a bit excessive to me but I guess there is research out there that supports the theory. Kim ordered 8 books for Mikaila last night. I guess we have some reading to do.

She will likely be weighed at 11 so I will follow up soon thereafter with an update on her weight.

4 lbs Plus

2008-05-25T08:36:00.002-04:00

Well Mikaila was weighed late last night prior to her 2am feed. She gained another 70 grams bringing her to 1840 grams or 4 lbs 1 ounce. She blew past the 4 lb barrier clearly implying she holds no esteem for the artificial milestone. Save your presents please. She will soon be out of preemie clothes.

Hitting the bottle with Daddy

2008-05-24T22:04:00.006-04:00

Today is Mikaila's 2 month birthday! Happy Birthday Mikaila!

I tried to give Mikaila a bottle today for the first time and it really didn't go very well. Within minutes she was completely zonked. Was it my technique? Perhaps. It's more likely that she was very wiggly leading up to her 11 am feed and was simply tired. Yeah, we'll go with that.

She seemed to have a good day today, handling her feeds without issue. She is still taking Zantac to rid her system of reflux and we think it's going well. They didn't weigh her at 8 and may not at 11. If they do, I will post an update. She is only about 45 grams from 4 lbs.

Back to the Breast.

2008-05-23T21:23:00.003-04:00

It appears I forgot to post Mikaila's weight gain yesterday. She gained 60 grams yesterday and another 35 grams today. She currently stands at 3 lbs 14 1/3 ounces. She is just 45 grams shy of 4 lbs! The real news today is that she made an attempt at breast feeding. During rounds, her team decided to test her breast feeding prowess once each day. Mikaila performed admirably today locking on immediately. After about 15 minutes we decided to give her a rest and fed her by tube. The nurse gave her the entire 35 mls (that's news as well as she had been at 32) by tube. Kim thinks she actually was able to summon a bit of milk during her breast feeding session implying that she had a healthy feast during her 2pm feed. That's about it. Kim may be posting a picture or short video.

Zantac

2008-05-22T22:06:00.002-04:00

I will apologize again in advance for the brevity of the update that follows. I hope you don't think me terse; I'm simply tired from my trip. Tomorrow is another day and I promise to go into detail on some aspect of Mikaila's development. As you know, Mikaila had her final course of Lasix yesterday. It appears she wasn't carrying excess fluid in her lungs. Her oxygen sats are typically very strong. When she is uncomfortable, distracted or refluxing, she tends to de-sat. Invariably, she bounces back in short order. The prevailing theory, created and propagated by Kim and nurse Lynette, is that Mikaila slows down or (for very brief moments) stops her breathing as she tends to issues of more immediate concern. For example, when Mikaila bottle feeds, she occasionally holds her breath for a moment as she sucks down and swallows the contents of her bottle. Similarly, when she refluxes a bit she is uncomfortable and holds her breath for a second. Under normal circumstances, she sats in the 90's.

In an effort to rid her of her reflux issues, her team decided to begin treatment with Zantac. She will receive two doses per day for a few days to determine if they can get her refluxing under control.

That's all I have. If I make it to 11, I will call for her weight and update.

Solid

2008-05-21T22:31:00.002-04:00

Mikaila had a solid day today. She received her third course of lasix and as you might suspect, she lost 15 grams. Sbe is down to roughly 3 lbs 11 ounces. Other than that she had a solid day.

She gained weight

2008-05-20T21:17:00.002-04:00

Forgive the brevity of this post. I just checked in to the hotel and am about to head down for dinner. Mikaila had three consecutive bottles today, the second of which contained her second course of lasix. Remarkably, she still gained 70 grams today. She now stands at 1690 grams or 3 lbs 11 1/2 ounces. Her respiratory status hasn't changed so they may decide to continue her lasix treatments. That's it for tonight.

A+

2008-05-19T21:21:00.003-04:00

Mikaila's doctors today formulated a tactical plan to get her off of the trickle of oxygen she is getting. The course they chose, three consecutive days of lasix (diuretic) was supported by Kim and I. Although it isn't critical in the decision to release her, we would very much like her to come home wireless (read, not tethered to a nasal canula.) She took the lasix with one of her bottles today (Kim fed her by bottle at 11, 2 and 5) and we think it showed evidence of working. You see, Mikaila lost 20 grams which is not at all unexpected. Now, we aren't sure the lost weight was a result of fluid leaving her system because she spit up much of the feed that contained her treatment. I guess we will learn more in the next few days.

The developmental specialist administered a test today to establish a baseline to test against in the months that follow. Of course, Mikaila rocked this test (a technical term.) Because of her gestational age at birth and low birth weight, Mikaila is at risk for developmental limitations. However, Mikaila wowed the doctor with her prowess and received an A+. Her risk of developmental issues was reduced today by significantly more than 50%.

That's about it for tonight. I'm heading out of town for 3 days on business. I will do my best to maintain my evening posts.

Another 40 grams

2008-05-18T20:21:00.002-04:00

Mikaila gained another 40 grams today bringing her to a robust 1640 grams or a hair under 3 lbs 10 ounces. She has gained 3 1/2 ounces in the last two days! She will likely cross the 4 lb threshold in less than a week.

When we went to visit Mikaila today she looked very uncomfortable. For the entirty of our time with her, roughly 2 1/2 hours, she just didn't seem like herself. Her heart rate was elevated quite a bit, she was very fussy and squirmy and she de-satted a bit. After asking the PA to come look at her we discovered that her issues was related to her GI system. Apparently, for the bulk of our time with her, she was trying to poop. Her nurse noticed late in our stay that Mikaila had a wet diaper. She wasn't due for a check up and diaper change for another 90 minutes. However, when she took a look at her diaper she saw that Mikaila had solved her GI issue. She was now uncomfortable because the mess in her diaper had penetrated her forward perimeter and was migrating up her belly. Ick! When the nurse cleaned her up, she settled right down.

That's it for tonight.

3 1/2 Pounds

2008-05-17T20:40:00.003-04:00

Mikaila had a very good day today. She gained 55 grams today or roughly 2 ounces. She currently stands at 1600 grams or 3 lbs 8 1/2 ounces. She is still taking a bottle every other feed although that may be increased in the next few days. She has shown a tendency to overheat of late. It appears, at least from our perspective that Mikaila really should be taken out of heat. We understand that her calories should be diverted away from maintaining her temperature and toward growth. However, she also burns additional calories keeping herself cool when she is overheated. We will bring this issue up with her team tomorrow. Other than that she is doing very well.

Good day

2008-05-16T21:20:00.003-04:00

As I write this post, Mikaila's blog has roughly 6700 hits. The VC in me wants to think of an effective way to monetize those eyeballs. I'm sure if we did the analysis we'd find that this site has achieved, admittedly on a very small scale, what all sites aspire to; stickiness. We get a ton of return visitors on here. Mikaila has many fans.

Let's get to something you actually care about, Mikaila's day. Mikaila looked much pinker than she did prior to her transfusion. We see her so often that it is very difficult to notice subtle changes in her skin tone. The IV from the transfusion is long gone. A small mark on her foot serves as the only reminder of her ordeal of a day prior. This day was a fine day for young Mikaila. She took several bottles today without issue with an incremental volume of 2 mls. She is up to 32mls. Her vitals remain strong. Her nurse hadn't weighed her when I called after the 8pm feed but will likely do so at 11. I will make an effort to post her weight tonight so that the night owls among us might have that info in close to real time.

I called at 11. Mikaila gained another 25 grams. She now stands at 1545 grams or roughly 3 lbs 6 1/2 ounces.

Quick Update

2008-05-16T09:24:00.001-04:00

Just a quick update; Mikaila had a stable night. She actually gained 30 grams and now standsa to 1520 grams or 3 lbs 5 1/2 ounces. I say actually because she was given a course of lasix with the transfusion to eliminate any incremental fluid so there was a chance she would either lose weight or maintain. That's it for this morning. I will do the typical evening post later.

Another Transfusion

2008-05-15T19:12:00.003-04:00

Mikaila had a rough day. Her hematocrit (red blood cells) number had crept down over the past few weeks and her attending decided it was time to transfuse her again. For Mikaila, the rough part was the insertion of the IV but, as always, she bounced back quickly and looked relatively comfortable when we left this evening. With the transfusion, Mikaila was given a course of diuretic to eliminate any resulting excess fluid. As a result, Mikaila may not gain weight when they weigh her this evening so be prepared. We have been through the transfusions before. Her growth has been tremendous. However, she isn’t capable at this point of producing blood on her own to keep pace. It stands to reason that at some point she may require an additional unit.

Other than that, Mikaila’s day was quite normal. Her vital signs were strong, oxygen saturation levels were good and she continues to fully absorb her feeds. In fact her feeds were bumped up to 30 mls every three hours.

I’ll be posting this on the early side today. If we get her weight at either 8 or 11I will update this post with her new weight.

Back on heat

2008-05-14T22:18:00.003-04:00

Well, Mikaila is back in heat. Yes, I know you heard from me a scant 24 hours ago that her heat was turned off. Well, apparently the attending was not on board with the prior decision. She had no problem in the intervening 48 hours maintaining her own temp but the doctor wisely decided that her calories were best directed toward growth. She is on 27 degrees C or roughly 80 degrees F which frankly isn't a whole lot warmer than room temperature.

She had a solid day; no aspirates, strong vital signs and temperature and successful bottle feeds. She will likely be weighed with her 11 pm feed. As always, if I know her weight before I head to bed I will update.

An American Idol

2008-05-13T21:12:00.000-04:00

Mikaila had a rather pedestrian (read good) day today. She had several bottle feeds that went well. Her temperature was solid all day. Understand that one of the critical factors in determining whether a baby is ready to be released is their ability to maintain their own temperature. She is no longer in heat so that is a very good thing. She gained another 20 grams today. She currently tips the scales at 1465 grams or roughly 3 lbs 3 ½ ounces. Soon they will have to bring in a cattle scale to weigh our little porker.

That’s really it for an update. Kinda skimpy, I know. Maybe I’ll take a second to tell you a bit about my evolving relationship with my little girl.

You know, they say that Mikaila has her maternal grandfather’s hair (actually, she currently shares his hairline-sorry Mike,) Kim’s big eyes and my chin. That’s the way it works, right. Her genetic composition is a function of that of her parents. But, I ask, can it work the other way? Can parents assume the qualities of their progeny? I certainly hope they can.

You see, my daughter is my hero. Yes, I looked it up; a 7 week old can be revered by a soon to be 35 year old. Mikaila has virtues I can only admire from afar. Yes, perhaps I have each of them in small doses; but they permeate every fiber of Mikaila’s being and resonate within her essence. The qualities to which I speak, courage, resolve and an irrepressible spirit were obvious from the moment she arrived. Just ask the NICU doctor who tried, to no avail, to ventilate a one-minute old Mikaila. The now famous wedding band on her wrist picture fortunately was captured directly as she sent my band flying from her wrist within seconds. Her tenacity is tested daily and she always seems to emerge unscathed. Yes she is a miracle but she is much, much more than that; she is what I aspire to be. She is my hero.

Heating up

2008-05-12T20:29:00.002-04:00

Mikaila is out of heat as I believe I mentioned in a previous post. Although she still maintains residence in her isolette, she does so without the assistance of supplemental heat. In fact, today when she cuddled with her mommy, her heart rate climbed to scary (for me at least) levels; purely a function of her temperature which was quite high. Kim, you see is quite the furnace. I can certainly attest to her ability to raise the body temp of those in her immediate vicinity. Her heart rate and temp came down to appropriate levels when she was returned to her isolette. Needless to say, she is maintaining her temp without issue.

Mikaila's feedings continue to alternate between tube and bottle. She didn't have any aspirates today and handled her bottles with great aplomb. Her dexterity with the bottle and GI improvements yielded an incremental growth of 35 grams. She now stands at 1445 grams or 3 lbs 3 ounces.

That's about it for this evening.

Not much to report

2008-05-11T21:36:00.007-04:00

I really don't have much to report tonight. Mikaila had a few bottles today and was able to finish each of them. Her vital signs are good. She is still getting a small amount of oxygen through her canula. Her breathing is steady and unlabored. She will likely be weighed at 11. If I call to get her weight, I will update this post. I expect she will regain the weight she lost yesterday.

Kim will be sprucing up this rather bland post with several pictures. Enjoy.

She did gain back the weight she lost plus 5 grams. She is up to 1410 grams or 3 lbs 1 1/2 ounces.

Her lungs are getting there but...

2008-05-10T23:38:00.000-04:00

Mikaila had a good day after a difficult evening. She had accumulated excess fluid in her chest again and had to work a bit harder to breath. As was the case a few weeks ago when the fluid crept up her team gave her a dose of lasix, a diuretic designed to rid her system of the excess fluid. They were in fact hoping to see a dip in weight after the treatment and she answered the call losing 25 grams. She is back down to 1380 grams. Like virtually all premies Mikaila's lungs are lagging a bit, struggling to keep up with her spectacular growth. No worries here. She is doing very well. Sorry for both the brevity and tardiness of the post this evening. I spent the day and night working on getting the house ready for her arrival.

We're not alone

2008-05-09T21:41:00.000-04:00

Kim administered two consecutive bottles to Mikaila today, the first at 2 and the second at 5. She handled the 2pm feed without issue and managed roughly 24 of the 28 mls in the second bottle. Did I say 28mls? I did. During rounds, her team bumped her up to 28mls every 3 hours. Essentially, Mikaila gets 20 mls per feed for every kg of body weight.

An old friend from High School came across my Facebook profile and noticed a picture of Mikaila that I had posted. Seeing the nasal canula in her nostrils, Kevin inquired as to Mikaila's status at birth. When I confirmed to him that Mikaila was in fact a premie he responded with some interesting information. Kevin has two boys, both of whom were premature at birth. One in fact was 26 weeks and 2 lbs at birth. Although Mikaila was quite a bit smaller, she was actually almost two weeks older gestationally. The nugget that this readership may find interesting is that Kevin is authoring a book giving a fathers perspective on the experience of having a premature baby. Some folks on this blog have suggested I seek publication; that a sequential diary of this sort may be of some value to others especially considering the author is the father. Well, Kevin, having gone through the process more than once, is eminently qualified to take on the project. I will be sure to post the information as soon as his book is commercially available. I look forward to reading it.

That's it for now. They will weigh her at 11 so I will follow up with an update soon thereafter.

They ended up weighing her at 2am. I am far too old to be up at that hour so I called this morning. Mikaila gained another 40 grams bringing her to 1405 grams or 3 lbs 1 1/2 ounces.

3 lbs

2008-05-08T20:37:00.000-04:00

Mikaila's day was unremarkable yet solid. She was bottle fed several times and for the most part handled it without issue. She gained the 10 grams she needed to cross the 3 lb threshold. Let's hope she kicks her weight gaining machine into high gear in the days that follow. I don't think they will release her if she is much under 4 lbs although they were quite emphatic telling us that there is no weight requirement for release.

That's it for tonight.

From Untitled to Titled

2008-05-07T20:36:00.000-04:00

Mikaila was a bit tired today after her ordeal yesterday. If you will recall Mikaila was put through a rigorous and traumatic eye exam. Immediately following her exam, she downed bottles on consecutive feeds; quite remarkable actually. Typically, babies are exhausted after these exams. Well, it appears Mikaila had a delayed reaction. During her 2pm feed she was only able to manage 12 mls by bottle. She was given the balance through the tube. Kim believes that her struggle was more a function of the nurse using the more difficult nipple than Mikaila being tired. When the correct nipple was used at 5pm she managed to imbibe the entire 26 mls without issue.

She was weighed this evening at 8. She put on an additional 25 grams bringing her to 1355 grams. She is less than 10 grams short of 3 lbs. That's about it for this evening.

I can see clearly now.........

2008-05-06T20:59:00.001-04:00

Mikaila’s feedings continue to produce results. Kim bottle-fed Mikaila at her 11am, 2pm and 5pm feeds. Nurse Cliff (save the cracks) remarked that she sucked down her 2pm bottle in 3 minutes flat. That may have been a slight exaggeration but she did devour her bottle’s entire contents in each instance. Well done. Mikaila’s successes during feedings have continued to yield results. She gained another 35 grams today bringing her to the brink of the 3 lb mark. She currently stands at 1330 grams or a shade under 2 lbs 15 ounces. She is roughly 35 grams from 3 lbs. Oh, also related to her feeds, I failed to mention that her team bumped up her volume to 26 mls every three hours.

Mikaila’s isolette temperature was reduced to 27.5 C or 81.5 F. She really hasn’t had any issues with maintaining her temperature. Assuming she handles this reduction, and she will, they will move her to 27 C. The next step is room temperature so she really is close in this regard.

The last little nugget to report relates to Mikaila’s eyes. She had her first eye test today. Although the event was rather traumatic for our little peanut, she emerged relatively unscathed and passed her examination with flying colors. She didn’t even study. This was a routine test and will be re-administered in a month.

That’s all I have for today. Kim will be posting a picture or two momentarily.

Here are the pics and I have been instructed to introduce them with some detail. As a rule, I try to avoid accommodating specific requests. I mentioned in an earlier post that entertaining these requests can be dangerous; my lawyer friends know well the slippery slope argument. However, we had a suggestion that I thought was worthy enough to consider breaking my rule; to capture Mikaila in a picture with my wedding band. If you will recall, I took a picture of Mikaila with my wedding band on her wrist when she was only a few hours old. Well, fortunately, that same band would have no chance of fitting on her wrist at this point. So, we decided to post a picture of Mikaila with my wedding band next to her arm.

She Loves that Bottle

2008-05-05T20:58:00.000-04:00

Mikaila hit the bottle early and often today. She was fed by bottle by Kim at both her 2pm and 5pm feeds. Fear not, she has been authorized to be fed by bottle once a shift. Mikaila has really mastered manipulating her bottle. In fact, she took both feeds entirely by bottle! Now, that's progress. Her nurse weighed her before her 8pm feed and she gained another 25 grams. She currently stands at 1295 grams or a little more than 2 lbs 13 1/2 ounces. Everything else is stable. That's about it for tonight.

Slow and steady

2008-05-04T20:42:00.000-04:00

Quick Monday morning update- I didn't start a new post as I thought the pics were too cute to bump. Mikaila gained 60 grams last night. She now weighs 1270 grams or a little under 2 lbs 13 ounces. She has now more than doubled her weight at birth.

Mikaila was fed by bottle three times in a 22 hours span despite the directive on her chart prescribing one bottle feed every 24 hours. She is beginning to master manipulating the bottle and actually took her entire 2am feed by bottle. Bottle feeding is hard work for little Mikaila. She expends a great deal of energy that might be redirected toward growth. However, as previously stated, for her to be discharged to the custody of her parents, that's us, she must be comfortable feeding by either bottle or breast. So, we have two competing forces here, both critical, that must be accommodated; growth and non-tube feeding. The solution seemed easy to Kim and I; bump up Mikiala's blend from 27 calories to 30. I pitched it to her dietitian and thankfully she agreed. Mikaila will be getting extra calories starting tomorrow. She gained 20 grams yesterday which is ok but we would like to see her consistently gaining 30-35 grams daily. The extra calories should help.

They should be weighing her at her 11 pm feed. I may not post the update until tomorrow.

Not Much to Report so..........

2008-05-03T22:36:00.000-04:00

My apologies for my tardiness this evening keeping you apprised of Mikaila’s progress. I have spent the preponderance of the day refinishing the floor in her nursery. Perhaps I should explore the impact of her early arrival a bit as I have very little to report otherwise. Mikaila arrived on March 24th, roughly 12 ½ weeks premature. So, essentially, we lost 12 ½ weeks of preparation; preparation related to the house, Kim’s professional future, the stuff Mikaila will require and our competency as parents. Kelly and co didn’t even have time to plan and host a shower for Kim. There is a chance, although slight, that Mikaila will be in attendance at her own baby shower some time this month or next. So, as you might imagine we have been thrown into scramble mode. I’m not complaining at all; I’m simply enlightening you by giving you a glimpse of our current reality. The nursery is looking great by the way. We put up crown molding in her room. I don’t have crown in my bedroom! I gutted that room, taking it down to the lath. When Mikaila enters her room for the first time she will be greeted by kangaroos and koala bears. An Australian theme was selected among hundreds of options. She will see small replicas of creatures indigenous to the region adorning her shelves, furniture and walls. I’m sure she will love them unless of course they freak her out.

Not much to report.

2008-05-02T20:36:00.000-04:00

There really isn't much to report today. Mikaila's feeds were bumped up to 24 mls every three hours. She didn't have any aspirates today but wasn't able to manage any gain in weight; Not surprising given her astounding 50 gram gain yesterday. All of her vitals are stable.

Kim wanted me to report to Mikaila's public that she now has the beginnings of a butt. You may have noticed, especially in the early going, that Mikaila was all torso. Well, it appears that her bottom half is beginning to catch up. I now feel like a tabloid reporter. Thanks Kim. That's all the news that is fit to print (and a bit that really isn't.)

Good Day

2008-05-01T19:47:00.000-04:00

Mikaila's day was solid yet non-descript. She did very well with her bottle feed at 2pm sucking down 18 mls of the 22 in the bottle (she was given the balance through her tube.) She had a little de-satting during the bottle feeding but not much. Understand that nursing on the bottle and swallowing its contents is no easy task for a baby of Mikaila's size. She did very well.

One of the critical elements doctors evaluate in determining whether or not to discharge a NICU patient is body temperature; is the baby able to maintain her own body temperature. Let's take a step back for a moment. Soon after birth, Mikaila was placed in her temporary home; a controlled environment known as an isolette or incubator. The temperature in the isolette at that time was 37 degrees C or 98.6 F. At that point Mikaila was unable to regulate and maintain her own temperature. Over time, her team has weaned her isolette down to it's current temperature of 29.2 C or roughly 84.5 F. She is making tremendous progress in this regard.

Of course, the second of the two determining factors is the willingness to take to either breast or bottle. Frankly I prefer breasts but that’s me. As we have seen, she has made remarkable progress with both breast and bottle feeding so I would say discharge is in her not too distant future. Perhaps 2 weeks? Stay tuned.

Quick update, she was weighed at 11 last night and gained 50 grams. I know, that's a lot. They checked it three times. She now weighs 2 lbs 10 ounces or 1190 grams. Sweet!

Mikaila's Hitting the Bottle Already! I didn't start until I was 10.....

2008-04-30T21:33:00.000-04:00

Ok, I am tired. Very tired. Just got back from a trip to Rochester a minute ago that began with my drive west more than 16 hours ago. I almost didn't do a post tonight but I wanted to keep my Ripkenesque (you have to be a baseball fan to get the reference) streak going and there really is news to report. My mind is very mushy so please lower your expectations. This morning Mikaila's feeds were increased to 22 mls. She handled the additional calories without issue. The real news is that Mikaila was bottle fed for the first time with her 2pm feed. Nurse Amy was astounded by both her instincts and her progress. Mikaila was able to take 16 mls from the bottle! Remarkable. She was given the balance through the tube. Amy made everyone that entered the room aware of Mikaila's feat. Of course, I wasn't there to see it. Luckily, Kim had Amy snap a few pictures of this epic event. Enjoy. Quick addition Thursday morning, Mikaila gained 35 grams and now stans at 1140 grams or 2 lbs 8 ounces.

Back on O2 but that's OK

2008-04-29T21:26:00.000-04:00

Last night Mikaila had a few more episodes of de-satting so her team put her back on the trickle of oxygen. Again, she is taking the slightest amount possible and it has helped her immensely. Her sats are stable in the high 90's. In short, the supplemental oxygen allows Mikaila to direct her energy toward growth rather than breathing. This focus on growth spearheaded another tremendous growth day. Mikaila added 40 grams to her slight frame and currently stands at 1105 grams or 2 lbs 7 ounces. She is now up almost 500 grams from birth.

We've included a little video of Mikaila taking her binky to school. It's a short clip that was recorded on our camera (not our camcorder) that only caught the tail end of her session. Enjoy.

I'd like to ask everyone to add Mikaila's little friend Maddy to your prayers. Maddy is a former resident of the Albany Med NICU and has progressed very well since her release. She had a little episode and had to spend the day next door in the PICU. Little Maddy looked great when we saw her and will be going home very soon. Mikaila asked me to pass this along.

Productive Day

2008-04-28T21:11:00.000-04:00

Mikaila gained another 20 grams today. At present, she stands at 1065 grams or 2 lbs 5 1/2 ounces. Today Mikaila attempted to breast feed for the first time. This was a practice session really but Mikaila displayed outstanding instincts. Breast feeding is great deal of work for her at this point so they limited the session to just 10 or 15 minutes. They will probably wait a few days before they try again. She really needs to direct her calories to growth.

She was taken off of caffeine today. Apparently, she is beyond the point of concern as it relates to apneas. She had a little de-satting today but as is her way, she bounced back nicely. She did have a slight episode during breast feeding and required a little blow by oxygen but had no problems after that. They will be adding iron tomorrow to her supplementation regimen.

That's about it. All told it was a productive day for our little peanut.

Very Strong Day

2008-04-27T20:50:00.000-04:00

Mikaila had a very good day today. Early this morning, her team decided to try her on room air again. She had been satting in the high 90's so their decision was completely supported by her parents. She has performed like a star today. Her satts have consistently stood in the mid to high 90's. Initially, they left the canula in during the test. After a few successful hours, they decided to take the canula out completely. This is a very good sign related to her BPD.

She was weighed prior to her 8pm feed. She is up another 35 grams to 1045 grams or slightly under 2 lbs 5 ounces.

Kim will be attaching pictures any second now (that's her job in this process.) Enjoy.

Very Quick Update

2008-04-27T08:26:00.001-04:00

As expected, Mikaila bounced back nicely gaining 30 grams yesterday. She now stands at 1010 grams. Note to the Milestone Crew and you know who you are, she has already passed this threshold and you have rewarded her appropriately with gifts; no need to celebrate this again.

She had a very strong night; no aspirates, apneas or de-satting. They will likely try her on room air again today.

Quick Update

2008-04-26T21:15:00.000-04:00

Mikaila’s feeds were bumped up to 21 mls every 3 hours. I will save you the math to avoid condemnation from my friends in teaching (apparently I’m a much better practitioner than I am a teacher) but I will say that she is up to roughly 150 calories per day. They started her at 8 calories/day a scant 33 days ago. She had no problem fully absorbing her additional calories. I failed to mention yesterday that her team added a multivitamin to her daily regimen to help her to better absorb the calcium and phosphorous.

We don’t have any news to report on her BPD. It appears that they will hold off x-raying her again if they can to minimize her exposure to radiation. They will instead monitor her vitals to ascertain her bronchial status. She had a strong day respiratory-wise. We spent 2 ½ hours with her today and she consistently satted in the 99-100% range. Her heart rate was back to it’s typical 158-162 bpm. She is still on the slightest amount of oxygen. From our perspective, she really doesn’t need it.

I kangaroo’d her today for 90 minutes. Other than requiring a bit of suction to eliminate a little congestion in her nose (she can’t blow her nose on her own), she had a very comfortable session.

They didn’t weigh her at 8 so I will have to update later with her weight. I expect a nice little bounce back

BPD

2008-04-25T20:39:00.000-04:00

Today, for the first time in quite a while, Mikaila had an issue that caused us a bit of concern. This morning her team took a chest x-ray to further explore the de-satting issue. When they examined the film they noticed that Mikaila had extra fluid in her chest likely indicating a condition known as bronchial pulmonary dysplasia. Essentially, BPD is an abnormality in the lungs caused by the ventilators, sipap and canulas that are designed to serve her. Her attending sees Mikaila’s case as being very mild and expects she will bounce back after a course of diuretic. The diuretic should help to rid her lungs of the excess fluid. Only through growth will Mikaila actually correct the underlying issue. She was given the diuretic today and as you might expect, she gave back the gains she made yesterday. She is back down to 980 grams.

Independent of her need for a diuretic, her team, during rounds decided to bump up the calories. As of this morning she is on the 27 calorie blend. Once she has passed the BPD, she should resume her tremendous growth spurt. She had no problems today with aspirates.

One last thought on the BPD. More than half of low weight preemies experience some form of respiratory issues. Fortunately, Mikaila’s issue is considered mild and shouldn’t cause any issues down the road.

That's it for tonight.

Happy 1 month Birthday!

2008-04-24T20:32:00.000-04:00

Today marks Mikaila’s one month birthday. I’ll pause while you in sequence break out in a round of “Happy Birthday.”

Ok, we’re back. Mikaila had some more bouts of de-satting so her team bumped up her oxygen intake a smidge. Again, that isn’t at all a big deal. She simply needs a few days to allow her lungs to catch up with the rest of her body. Keep in mind, she has grown 60% (in body weight) in one month.

I do have some significant news to report. During rounds, her team determined that Mikaila’s system was strong enough to accommodate additional volume during feeds. She was bumped up to 20 mls every 3 hours. She handled the incremental amount during her 2pm and 5pm feeds without issue.

They will likely weigh her at 11 so stay tuned.

Here are a few pics of the peanut for your viewing pleasure. Fashions conceived and paid for by Davia and Kelly and Mike Sr.

Quick Update: We called just a moment ago to check on her weight. Mikaila gained 35grams today. She has blown passed the 1 kg mark and stands at 1015 grams or a hair under 2 lbs 4 ounces.

Exhale

2008-04-23T22:43:00.000-04:00

As we have all seen, Mikaila has made tremendous progress over the course of her month of existence. She has met with great success it seems each and every day. It has been my great pleasure to report those successes. That said, there was a day and procedure that was looming; her third and final ultrasound- the 30 day ultra sound. In this procedure they are looking for specific evidence of trauma resulting from the restricted flow of blood from her umbilical cord. This trauma often manifests in the form of cysts. Mikaila had her ultrasound done this morning and thankfully, the results were favorable; no abnormalities were present. Exhale.

When we called at 8:30 to check on her status, we learned that she had gained 25 grams. She is now tipping the scales at a beefy 980 grams or roughly 2 lbs 2 ½ ounces. Progress, sweet progress.

We had a chance to speak with her new Attending doctor this afternoon. It just so happens that we purchased a treadmill that she had listed on Craigslist.org about 6 months ago. Small world. The treadmill is going strong by the way; likely from lack of use. Her new Attending had a few nuggets of news for us. If Mikaila continues to progress at her current stellar rate, she will probably be able to come home in 3-4 weeks. Keep in mind that Mikaila is gestationally only 32 weeks right now. Her due date was June 18. Dr. Khalac also asked if we had considered moving her to Bellevue Hospital. The notion was pitched to us earlier in the week but we really hadn’t given it much thought. You see, if the pregnancy had gone as planned, Kim would have delivered at Bellevue. We were only transferred to Albany Med when problems arose. It is hard for us to fathom making the move back to Bellevue when by their own admission, they lack the resources, infrastructure and expertise to accommodate the needs of micro preemies. However, if space at the NICU becomes an issue, we may not have a choice. Stay tuned.

That’s all for now.

Up 15 Grams

2008-04-22T21:43:00.000-04:00

Mikaila gained another 15 grams today so at present she tips the scales at 955 grams or slightly more than 2 lbs 1 1/2 ounces.

High Rent District

2008-04-22T19:20:00.001-04:00

When Kim called this morning to check on our little girl, she learned that Mikaila was moved from her customary position in Nursery 1 to Nursery 6, aka Intermediate Care. Although we thought their decision a bit hasty at first, we were assured that she was more than qualified for the upgrade. Typically, babies are moved to Intermediate Care when they are off of the Sipap and they are no longer in need of an IV. Nurse Amy remarked that she was surprised Mikaila lasted as long as she did in Nursery 1. Apparently, there are other babies that are in need of more care than our Mikaila. I guess it is a graduation of sorts. Don’t worry, Mikaila’s chair remains at the ready at her new bedside in the high rent district.

Despite her upgrade, Mikaila had several bouts of de-satting. As such, Nurse Amy suggested and her team agreed that her canula be reapplied. She is getting the slightest measure of oxygen but it really has helped her maintain her numbers.

As I was leaving the hospital this morning, I bumped into the good doctor Rios. Dr. Rios was the Attending NICU doctor in the delivery room when Mikaila was born. We are big fans of Dr. Rios. He has a terrific way about him. He assuaged my fears related to Mikaila’s episodes of de-sating. Most preemies, especially those of Mikaila’s size, almost without fail have episodes of de-satting as they grow. Apparently, her lungs at this point simply can’t keep pace with the rest of her system. Dr. Rios was VERY excited about her progress and added that it is only a matter of time before her lungs catch up.

When they weighed Mikaila last night she was up another 25 grams to 940 grams (roughly 2 lbs 1 ounce.) She has now gained weight for seven consecutive days. It appears we are in the aforementioned “grow like a cute little weed” stage. We are excited about this stage.

That’s about it for tonight.

She is doing very well... De-Satting explained... Change of scenery

2008-04-22T11:15:00.001-04:00

No time to elaborate during the day. We have news to report but you will have to wait until this evening. She's doing well so no worries.

Perspective

2008-04-21T21:19:00.000-04:00

Mikaila had quite a few episodes of de-satting today. She tends to drop below the line for just a moment or two before quickly recovering to resume her rightful place in the high 90%s. Twice today, they gave her what they call blow-by oxygen (think of it as supplemental ambient oxygen.) I was fortunate to be present as the rounding doctors discussed Mikaila. I posed the obvious question to her team prompting the Attending to take a closer look at her respiratory trend. Apparently, momentary lapses are quite common with preemies of her size and vintage and although they will monitor this tendency, he assured me that we should not be alarmed. In fact, the Attending was very pleased with her respiratory prowess.

This afternoon, Mikaila’s favorite nurse shared with Kim and I a photo album of one of her former primaries. The lad in the album is now roughly 7 months old and is really thriving. However, he was still on supplemental oxygen at discharge and in fact was just taken off of oxygen within the last month or so. Gazing at a photo of this little guy with a high flow canula in his nostrils at 7 lbs really offered us perspective. It is not at all abnormal for these little guys and gals to need respiratory assistance for several months. Mikaila has consistently over achieved and we have to understand just how remarkable her progress has been. If they decide to offer her a bit of assistance for her breathing, we really should view it as a side-step along the path rather than a setback.

Mikaila’s counts were slightly low and as such, her team decided that a third transfusion was in order. Again, consider this small transfusion as the third act of what is likely at least a three act play (transfusion). One unit of blood is good for roughly a month. Knowing that she would need blood at some point in the next week or so and also understanding that the unit of blood ordered initially would “expire” in the next several days, her team decided that the time was right to build back her levels. The transfusion may help with her de-satting. Remember that red blood cells serve as the primary oxygen delivery mechanism in the body.

That’s about all there is to report. Her transfusion (a three hour process) should be wrapping up right about now so they were not able to weigh her early. Perhaps they will weigh her at the 11 pm feed. If they do, I will post her weight tonight. If not, I will wait until tomorrow.

She's a Two Pounder!!!

2008-04-20T21:22:00.000-04:00

As I’m sure you can surmise from the clever title, Mikaila passed a major milestone today surpassing the 2 pound mark. She is officially 915 grams, or slightly more than 2lbs. I know I went on and on about artificial milestones but this one feels more substantive. This is a very exciting day.

I had a chance to Kangaroo Care Mikaila for 90 minutes this afternoon. The session went very well for both father and daughter. I’m sure there was a period of adjustment for her as my chest is slightly hairier than is Kim’s but she forged ahead without complaint. I have attached a few pictures of our time together. It appears from the picture on the left that Mikaila isn’t the only one to put on a few grams. Daddy is still carrying a bit of pregnancy weight.

As is her way, Mikaila had no problems today with her feeds. Her ability to completely absorb her feeds has fueled her impressively consistent growth this week. We expect she will keep it up.

Mikaila will be 4 weeks old tomorrow evening at 8:19. Wednesday, she should have her third and final head ultrasound. Assuming all goes well, and it will, there are no further scheduled examinations of her head.

That is all I have for this evening.

Solid

2008-04-19T20:45:00.000-04:00

Mikaila, for the most part, had a very solid day. They weighed her on the early side again today and we learned that she gained another 15 grams. Although the number itself is far from noteworthy, the recent trend certainly is. She has experienced five consecutive days of gains. And, when you consider her substantial gain from the day prior, you really have to be pleased.

During the day, Mikaila did have brief periods where her oxygen saturation levels fell slightly below the desired level (known as de-satting). Typically, Mikaila's numbers are in the high 90's. If her level fall below 85%, her monitor alarms, alerting the nurse. During her Kangaroo Care session with Kim, she fell slightly below 85%. She had a few other instances throughout the day. The likely explanation is reflux. You will recall that her team bumped up her feeds to 18 mls every three hours. 16 to 18 may seem inconsequential but imagine how your GI tract would react to raising your daily intake by 12.5%; now think of the impact on a 1 lb 15 ounce baby. We have been assured that reflux is quite typical and that we have no reason to be alarmed. She had no problems today fully digesting her new allocation so it appears all is well.

We haven't posted a picture in a little while so enjoy.

Quick Update

2008-04-19T09:47:00.000-04:00

Doctors rounded early this morning and decided, in an attempt to fuel and maintain her explosive growth pattern, to bump up her feedings to 18 mls every three hours. Atta Girl!

Update

2008-04-18T20:54:00.001-04:00

Well, we just called to see how she did with her 5pm feeding. As is her way, she handled the full 16 mls without issue. The real news is that they weighed her early tonight and she gained 40 grams. She is up to 880 grams. Woo Hoo!

OK. I know that most of us are metrically-challenged. I’m certainly not well versed but we have had enough questions on the topic that I think it is worth exploring. I’m a math guy so this should be fun…. at least it will be for me. Ok, a mathematical exposition: There are 1000 grams in a kilogram. There are 2.2 lbs in a kilogram and there are 16 ounces in a pound. As such, there are 35.2 ounces in a kilogram. If you divide 1000 grams by 35.2 ounces in a KG, the result is roughly 28.5. So, there are 28.5 grams per ounce. Translating grams to pounds is actually pretty simple. Think of Mikaila’s 880 grams as being 88% of a kilogram. Again, a kilogram is 2.2 lbs so, at 88% of 2.2lbs, she is 1.94 lbs. To convert the .94 lbs to ounces, simply multiply by the 16 ounces in a pound and you get just shy of 15 ounces. Mikaila is now 1 lb 15 ounces. I hope that was clear. I’m sure there is a Wikipedia entry that does a much better job.

Not much to report

2008-04-18T19:02:00.000-04:00

We really don’t have much to report tonight. Mikaila tolerated her feeds very well throughout the night and all day. She didn’t have any aspirates. Despite my silent protestations, a rare event for me for sure, her team has not budged from their position. She will be getting the 24 calorie blend at least through the weekend. I would really like to see them bump up her calories. For now, we’ll leave it to the experts. To stay on track at her current weight, Mikaila must now gain an average of 17 grams each day. She gained 15 grams yesterday and as such, is up to 840 grams.

Today, Kim Kangaroo Cared her little girl for almost three hours. Mikaila really thrives during these sessions and today was no different. Her vitals remained stable as she settled in for a long nap.

I should add that visual inspection of little Mikaila speaks volumes. She simply looks better each day. That’s about it. If they weigh her tonight before we go to sleep, I will do an update post.

Free At Last!

2008-04-17T20:50:00.000-04:00

We had some big news today. We no longer need worry about distracted nurses ignoring the status of Mikaila’s canula. This morning, much to our surprise, her doctors, deciding she no longer needed the supplemental pressure provided by the canula, yanked it out. Sweet! The only thing left distracting us from her facial cuteness is her feeding tube. Sadly, she’ll still need that for a little while although we have heard rumors that they may put her to breast (note to my friends, Stop It!) some time in the next few weeks.

Ho hum, another day of Mikaila tolerating her feeds all day without issue. Actually, we take that seriously and we are quite pleased. We spoke with her personal dietitian this afternoon. It appears they will stick to the 24 calorie blend for at least the remainder of the week. Her team will determine next week if a more aggressive posture is necessary. Essentially growth, both body weight and cranial, will determine their course of action. Mikaila is up to 825 grams or 1 lb 13 ounces after gaining 15 grams yesterday. She needs to average about 15 grams gained per day to stay on track. If she deviates from that trend line, I’m sure they will kick up her calories to 27 per ml.

That’s about it for me. Enjoy the pictures.

One final thought. We would like to think that this is an environment where you, the audience, feel engaged and compelled to post comments freely. This blog is a living, breathing thing. That’s the beauty of blogs. We have created a little community here where you need not be simply a reader. You can be an active participant. I would love to see additional content. A single voice can get tiresome. It takes the pressure off of me as well. Post away.

Pretty in Pink

2008-04-16T20:34:00.000-04:00

Mikaila had a rather uneventful day. She continues to respond well to her feedings and has shown little resistance to the 24 calorie breast milk & formula mix. During rounds, her team reflected on their earlier decision to keep her at 24 calories for a few days to determine if a more aggressive course is necessary. If she grows at an appropriate rate, they may never need to explore the heavier caloric blend. They achieved consensus determining that the current course was still prudent. If her growth lags, I’m sure they will reevaluate their decision.

Did I say uneventful? Well, she was quite feisty although that is hardly news. She pulled her feeding tube out more than once. We learned that she also pulled the canula (the two-pronged device that lives in her nostrils and provides pressure to her lungs) out of her nose. In fact, she had no problem living on room air and breathed freely for roughly an hour before the nurse noticed and replaced it. That she went that long unobserved is a bit scary but I’ll move on.

This may be a very slippery slope but we took several pictures to accommodate a few specific requests. The first picture is of the now legendary chair. As you can plainly see in the second photo, Nurse Amy crafted a very artistic sign laying claim, by proxy, for young Mikaila to her chair. Apparently, Mikaila’s chair is to remain at her bedside at all times. Who knew?

We also were asked to dress her in something pink and capture the results. Well Kelly, here they are. Enjoy.

That’s about it for now. As always, if there is any news to report, we will be sure to do so.

Mikaila on the Catwalk

2008-04-15T19:46:00.000-04:00

Mikaila was a sight to see today, resplendent in her new digs (sans hat unfortunately- she is very efficient maintaining her body temperature and thus overheats with the hat.) She of course was very cute as you can see in the pictures.

Mikaila continues to do very well with her feeds. She didn’t have any aspirates last night so her doctors, nurses and personal dietitian, henceforth referred to as her team, decided to bump her up to the 24 calorie blend. Assuming she conquers this elixir as she did her prior mix (and she did well with the 2pm feed), they will likely move her to the 27 calorie mix within a few days. That said, when they weighed her last night, she had dropped 20 grams. No big deal. Remember what I said about expectation setting and artificial milestones. She must have been extra wiggly yesterday.

We were able to drop off the chair we purchase last night during our lunchtime visit. In fact, Kim sat in said chair for 90 minutes while she Kangaroo Cared her little girl. I arrived at the NICU moments after the chairs arrival. I walked into Nursery 1 only to see Nurse Amy lounging in the chair. Needless to say, both Amy and Kim have given resounding thumbs up on the chair.

It has been suggested by someone in the comment section that this blog should be published. I can only assume that either the person commenting is a close family member of mine or that they have been drinking heavily; I should add that those two are certainly not mutually exclusive. Of course, I’m joking and flattered by the way. I do think there is merit to the general notion that learning about the experience of others going through similar, difficult times can be both educational and cathartic. Just today, I received a note from a friend of mine who had forwarded Mikaila’s blog to one of his friends. His friend delivered their child at 7 ½ months at Albany Med and he was kind enough to share his experiences. They were very helpful and I’m sure Kim and I will lean on our new friend from time to time as we continue on this journey. If we can in some way help others by relating our experiences, we are all too happy to help. We will continue to post to this blog in an effort to update our friends and family. If the results serve others in any way, we’ll view that as a wonderful little byproduct.

As always, if there is news of consequence tonight, I will repost. If not, I will wait until tomorrow.

Quick update: they weighed her early again and she regained the 20 grams she lost yesterday so she is back to 810 grams. She handled her feed well again. That's all for now.

Upward and Onward

2008-04-14T19:50:00.000-04:00

Mikaila had another great day with her feeds. I’m not aware of any aspirates. She did so well that they decided to bump her up to 16mls every three at her 2pm feed. They decided to give her another day at the 22 calorie blend but will likely go to 24 calories with tomorrow’s feeds.

The exciting news is that Mikaila will be sporting clothes the next time we see her! Preemies of her vintage are monitored constantly for body temperature. Her monitor is easily observed in the pictures already posted; it is the silver, heart shaped probe that typically lives on her stomach. When the sensor is on, she cannot wear clothes. This afternoon, at the recommendation of her favorite nurse Amy (that's her in the photo), her doctor decided that she no longer needed constant monitoring for temperature. She has been maintaining her temperature for a while now without issue. In fact, her nurses have been lowering the temp in her isolette. So, stay tuned for some excruciatingly cute pictures of Mikaila in her various outfits. I’m sure we’ll have a few tomorrow.

The other little nugget of news is that we found an appropriate chair for Kim to use during her Kangaroo Care sessions with Mikaila. I should provide the back story. The NICU at Albany Med is sorely lacking appropriate and comfortable chairs for mothers to use while spending time with their babies. At present, there are two comfortable chairs in the entire unit. That’s two chairs for seven nurseries and somewhere on the order of 50 babies. That just won’t do. Kim and I had an idea. We decided to seek out a chair to purchase for Kim to use while she is with Mikaila at the NICU. Other mothers would be free to enjoy it when Kim wasn’t using it. When we bring Mikaila home, we would happily donate it back to the NICU as a token of our appreciation for their diligence in caring for our daughter. The idea seemed so simple, but proved a much greater challenge when we put the plan to action. After countless hours, we finally found a suitable chair at Taft Furniture. We picked it up this evening and we’ll deliver it tomorrow, hopefully in time for an extended kangaroo session.

That’s about it. If they weigh her early again, I will do a quick update post. If no news, I’ll wait until tomorrow.

Back to Kangarooing!

2008-04-13T20:48:00.000-04:00

We went to see Mikaila today with the explicit purpose of having Kim kangaroo care her. Mikaila has missed out on her Kangaroo Care session for the last several days so she was very excited to resume her one on one time with her mother. During Kangaroo Care time, Mikaila had an opportunity to wear one of her new hats. This particular model (she, of course, has many) came from her friend Madison, formerly a resident of the Albany Med NICU.

Mikaila had another great day. She had no problem digesting her favorite cocktail, breast milk with a twist of formula. No aspirates today. During rounds, her doctors decided to continue her on her current course, sticking to formula over human milk fortifier. They will probably bump her up from 22 calories per feed to 24 calories in the next day or so. Soon thereafter they will try again to introduce the fortifier. In truth, it is better for her than the formula but we are happy that they are letting her advance at her own pace.

They weighed Mikaila on the early side today. Prior to her 8pm feed, Mikaila tipped the scales at a robust 810 grams, or roughly 1 lb 12 ½ ounces. That is an increase of 30 grams from a day ago and exactly 200 grams from birth. She has increased her body weight by almost a third in her three weeks! It’s time for her first of many Atta Girl's!

That’s about all I have today. Enjoy the pictures. Mikaila and I had a little photo shoot this afternoon so there’s more where that came from.

Quick Update

2008-04-13T08:51:00.000-04:00

Mikaila had no problem tolerating her feeds through the night. When they weighed her prior to her 2am feed, she was up 10 grams to 780. We are so happy that she has been able to maintain the huge gain she had a few days ago. Although her latest up-tic is somewhat modest, it is a move in the right direction. She is just 13 grams short of 30% growth (in weight) from birth. Not too shabby.

I should talk for a second about expectations. My instinct is to set milestones, monitor her progress toward achieving those milestones, and then fill everyone in on her successes and setbacks. Although I would prefer her to follow that course, that really isn't how it works. We can set artificial milestones and celebrate them as she breezed by them or we can simple enjoy the fact that she is kicking some major butt each and every day. I think I will go the second route and enjoy her continuous improvement.

She's a little Rock Star!

2008-04-12T20:24:00.000-04:00

Mikaila had another terrific day. She completely tolerated her feeds all night and morning. With her 2pm feed, her doctors decided to explore another option to get her additional calories as well as supplemental calcium and phosphorous. Instead of adding a milk fortifier, they decided to blend a little bit of formula with her breast milk. Mikaila had no problem digesting the formula with her 2 and 5pm feeds. When we call at 11:15pm we'll confirm what we already know to be fact: that she completely tolerated her 8pm feed. This is wonderful news and should allow her to continue to grow like a very cute weed. We are really looking forward to her reaching 1kg (roughly 2.2lbs). At that point, she can begin to wear clothes. Mikaila is a clothes horse and doesn't even know it. Between aunt Kelly and Grandmas Charlene and Davia, she will never be short of options. Trust me, she will be a vision of sartorial splendor.

Kim was feeling better today so she went for a visit. Mikaila is looking noticeably better each day. Today, she executed a remarkable maneuver. She was on her tummy as she often is (to be addressed later in this post) facing away when Kim walked into the nursery. When she noticed her mother in the room, she began to fidget. Eventually, she pressed herself (think push up) and turned her head 180 degrees to face mommy. I don't know how she was able to do that. Further evidence of her strength and determination. I know some people in their 30's that would struggle to accomplish that feat.

As I mentioned, Mikaila really enjoys sleeping on her belly. In fact, she mentioned it to one of her nurses, Pam, and asked that she spread the word to her other caretakers. As you can see by the picture below (left), Pam was up to the task.

When we called a little while ago to check on her, the nurse mentioned that Mikaila had just calmed down after being very fussy. The nurse couldn't figure out what was bothering her. Eventually, the nurse gave Mikaila her pacifier and she immediately began going to town on the thing. Clearly she got what she craved as she passed out in a deep sleep soon thereafter. It looks like we will have our hands full when she comes home. We can't wait. It is this will that drives her continuous progress and will serve her well as she goes through life.

That's about it for an update. They won't be weighing her until late tonight/early tomorrow morning so I probably won't post on her weight gain until tomorrow morning.

I'd like to take a second to thank everyone again for their support. Our friends and family really have come through, not only for Mikaila but for us. We have people dropping off food for us knowing that we spend a good deal of time in the evening at the hospital. We have received gift certificates for restaurants proximate to Albany Med. We really have some amazing people in our lives. Thank you.

Quick Update

2008-04-12T08:16:00.000-04:00

They didn't weigh her until her 2am feeding and we are far to old to be up at that hour so I put in the call to the NICU this morning. She had a good night tolerating her feeds. She didn't gain any weight but she didn't lose either. That is good news after her huge gain the day prior. Her vitals were strong, she's breathing comfortably and her girth is good. That's about it. If there is more news, I will do a more comprehensive post in the evening. If not, I'll just do a quick update.