AAAAAAAANNNNNNNDDDDD Home

Emma finally made it home yesterday evening.  We pulled out of the hospital around 5:30.  Her favorite nurse, who happened to be there when she was born and has been there with her every time she works, was the nurse who got to discharge her, so that was a great thing.  I'm sure Lynette will miss lil Emma, but she's so happy for her that she's big and strong enough to come home.

Emma's big sister Eden was SO excited to see her.  She keeps saying "I want to see Emma!!"

Thanks again to everyone who provided support and prayers during this difficult time.  I will continue to keep you updated as often as I can through this blog.  God bless y'all!!

Saturday: Update

Well, it turns out that today was not the day for Emma to come home.  She just hasn't been consistent with her feeds and her weight gain recently, so they did not feel comfortable sending her home.  Their best guess at this point is a few more days.  She must be enjoying her time in Chapel Hill.  As her aunt Jennifer said, she just doesn't want to leave the southern part of heaven.  And really, who can blame her?  So that's where things stand right now.  She continues to do well, just not quite well enough for them to feel 100% comfortable releasing her.  Keep the prayers coming that she can come home soon!

Saturday

Well, the news finally came down this week.  Emma is coming home on Saturday!  Everyone who has prayed for her, there is absolutely no way possible that you could ever be re-paid.  Family, friends, strangers...Emma's had quite a large number of people praying for her and rooting for her.  All of it seems to have worked.  A great big Thank You goes out to each and every one of you.  I know the posting has been sparse recently on here, and it will probably continue to be after she comes home.  But I'll try to post something every now and then just so all of you can keep up with her progress and how she's doing.

Again, thank y'all so very much.  Emma thanks you as well.

Happy Due Day!!

Today Emma officially reached the milestone of 40 weeks gestational age, meaning today is her official due date.  So happy Due Day to the big girl!  She's growing nicely still.  I realize that it has been a while since I last updated this blog, and I apologize to everyone for that.  Sometimes you just have to step away for a while.  Not only that, but like I mentioned before there just isn't a development every day like there was in the beginning.

Emma is now on the absolute lowest amount of oxygen they can have her on.  The next step would be to remove her from it completely.  They still don't know when they're going to try that.  The reasoning behind that is because they still want her to develop the ability to take 100% of her feeds from a bottle as opposed to anything from the feeding tube.  She was doing very well last week, taking everything, or nearly everything for a few days straight.  Then she developed thrush, which is a very common infection in all babies, not just preemies.  This made it painful for her to eat because there was an infection in her throat.  So they treated that and are continuing to treat it still and each day she gets back to taking more and more of her feeds from a bottle.  So hopefully she will continue that trend as well.

Once she is taking all of her feeds from a bottle they will contemplate what to do with the oxygen.  The main thing they're concerned with right now is the feeding.  They're not nearly as concerned about the breathing at this point.  As I stated above, she is on the absolute lowest level of oxygen she can get.  But some babies have a very hard time coming completely off of it, and they just don't want to push her anymore than they already are.

Another big development for Emma is the fact that she's closing in on 5 pounds.  She's not there yet, but she's very close.  She was at 4 pounds 12.8 ounces last night when they weighed her close to 11pm.  Not being able to eat from a bottle has actually HELPED her gain weight.  It seems counter intuitive, but she is not burning any calories eating if she's getting all of it through her feeding tube.  They only let her eat from a bottle for 30 minutes each time, and if she hasn't finished her feed by that time they put the rest of it in her feeding tube.  The reasoning behind that is she burns more calories than she takes in after that point.  So by not taking anything at all from a bottle for a few days, she didn't burn as many calories.  And as you all know, the more calories you take in, the more weight you gain.

This whole experience has gone much differently than anyone imagined.  Everyone figured Emma would be born now, or sometime around now.  Instead she decided she was ready 10 weeks and 1 day early.  She's been such a fighter up to this point, growing more and more and just inspiring so many people.  Happy Due Day to that beautiful little girl!!  There are so many people praying for you Emma.  To those of you who have reached out to me recently inquiring as to how she is doing, thank you very much.  I am sorry that I haven't kept the blog as updated as I was in the beginning.  But know that your words of encouragement and well wishes are well received.  Hopefully soon I'll be able to make a very exciting post here.  I'm not sure when that's coming, but hopefully soon.  I hope y'all have a great night!!

Inching Closer

Emma has had a pretty big week.  She officially blew past the 4 pound barrier, going from just under 4 pounds one night to 4 pounds 3 ounces the next.  She's still tolerating all of her feedings as well, which are now up to 33ml every 3 hours.  When she's awake and will take it, they are giving her a bottle.  They do want her to feed completely from a bottle, obviously because when she comes home she will no longer have a feeding tube.  So she has to be completely on bottles before she can come home.  She's hit or miss with those right now.  She's taking about 30% of her feeds through a bottle right now.  So she still has a long way to go before they'll even begin the discussion about her coming home, but she's making progress.

Another big development recently, today in fact, was the fact that they moved her out of her isolette and into a bassinet.  They'd previously told us that around 3 and a half pounds they try to put them into a bassinet or a crib, but they also have to have one available.  So once she hit the 4 pound mark, they went and found one and put her in it today.  She has to hold her temperature on her own completely now, and if she doesn't they'll have to put her back into the isolette.  But so far, so good.

Her breathing is still the same as it has been recently.  She's apparently reached the minimum level for her oxygen that she can tolerate at this point, as they tried a couple times to go below that and she didn't do very well.  So they're not going to push her any harder than she will let them.  But she's still on a much lower level than she was even a week ago, so everyone is definitely encouraged by her progress there.  She's not there yet, but she's getting there.

Emma turned 8 weeks old yesterday, and she is 38 weeks gestational age today.  She's been in the NICU now for 57 days.  She's received some incredible care from some of the most amazing people anyone could ever have the pleasure of meeting.  Hopefully she will continue improving and making good progress towards coming home at some point in the near future.  I know this, she's getting cuter each and every day!!  She's a lot like her big sister in that way.  But she's doing great.  Just please keep the prayers coming that she continues to improve!

Growing Steadily

So apparently, it's been a few days since I last wrote anything on Emma's progress.  I know when I started this blog I was writing every day, or almost every day at least.  But things were changing so much from day to day at that point.  Things aren't changing as much each day anymore, which is why I've gone to the ~2 times a week approach to the blog.  But in the last few days, there have been a number of positive developments for little Emma.

First of all, they have been able to reduce her air flow.  She's now back on the "low flow" nasal cannula.  She's a few steps away from being completely off of it.  Now the last time they had her this low, she had a setback and had to be put all the way back onto the high flow, but that was a few weeks ago.  She's grown and developed a good amount since that time, so hopefully this time she will continue improving every day until they're able to take her off of it completely.

Next, she has grown a good amount.  She had a little growth spurt at the end of last week, gaining 3 ounces one day and another ounce the next.  As of Saturday night (as I haven't heard what her weight was when they weighed her last night yet), she was 3 pounds, 14 ounces.  She's closing in on the next milestone, the 4 pound mark.  She's now getting 32ml of milk every 3 hours as well, which is over an ounce each feeding.  She's definitely come a long way there, from her initial feeds of 1ml 8 times a day.  It's crazy to think just how far she's come.  She's got a long way to go, but not nearly as far as when she started.

They did give her another 3 day dose of the diuretic last week.  We haven't heard anything about another regimen this week, but if they feel she needs it they will give it to her I'm sure.  Obviously we're hoping they don't have to, but if they do, they do. 

So there's the update.  See, if I wrote something every day at this point, the updates would be 2 lines each!  So it's just easier for me to do it less frequently.  I appreciate all the concern and prayers Emma gets, though.  She's getting closer to being able to come home.  We don't have a time frame yet, but she's definitely closer now than she was even 2 weeks ago.  Once we hear something about that I will definitely post that and share it with everyone.

Trucking Along

Emma has had a few good days in a row again.  She continues to feed more and more from the bottle.  She took 10ml from one yesterday morning and they're feeding her as often as she shows the interest in it.  She's up to 3 pounds 10 ounces now as of last night as well.  She continues to improve in her breathing as well.  Her oxygen level is back down to what it was before she had that setback a week or two ago.  They are still planning to give her the next round of the diuretic tomorrow through Thursday in the hopes that it will help her come down even more on the help she's getting with her breathing.  She may lose some weight again like she did last time, but she only lost an ounce last week.  And she's since gained 6 ounces, so she's doing very well.

The long process continues.  Emma continues to fight and show everyone what a handful she's going to be once she comes home!  Eden still enjoys going to visit her on the weekends as well, even if it's only for a couple minutes.  For now she loves her little sister.  We'll see how she feels about it once Emma is home and actually is living in the purple room.  Eden tells us that Emma is going to live there, but it'll be interesting to see how she reacts once Emma actually is living there!  I'm sure there are many years of bickering between those two girls in store.

O2 Coming Down

Emma has shown a good amount of improvement over the last few days.  They have been able to get her oxygen levels back down to levels we're used to seeing for her.  The diuretic they gave her really did relieve a lot of the fluid in her body.  As such, she did lose some weight.  She's down to a little under 3 pounds 4 ounces, but they expect her to gain a good amount of weight again now that she's off of the diuretic.  Not only that, but as they put it, it will be "real" weight since it won't be a lot of fluid.

Beyond that, there really haven't been a lot of updates in the last few days.  She's been trucking along, doing what they expect of her at this point.  When she moved up to Pod C, the nurse practitioner on duty that day told me that we were entering the long, boring process part of a stay in the NICU.  That's the reason I haven't posted as much in the last week or so, there just hasn't been a whole lot of developments to share.  But she's doing well this week, improving in every way she's supposed to improve.  They want her to be more alert during feeding times, and she's definitely been that way all week.

So this whole experience is far from boring, but from a standpoint of big developments, there haven't been many recently.  But hopefully things will continue on a positive trajectory.

New Update

I realize it's been a few days since I last posted anything, and I'm sorry for that.  I know you're all waiting quite impatiently for the latest news on little Emma.  Well, as of last night, she's up to 3 pounds 5 ounces.  She's gained an ounce a day for the last 3 days, so that's still right in line with where they want and expect her to be.

The breathing issues are still present though.  Today when they listened to her lungs they sounded like they were filling with fluid again.  Also, there was a little bit of swelling around her eyes.  Because of this they decided to give her another dose of the diuretic today.  This will help relieve some of the fluid build up in her little body.  As a side effect, it will more than likely cause her to lose a little weight the next time they weigh her, as some of the weight gain was probably some water weight.  So by releasing some of those fluids she will more than likely drop an ounce or so.  It was explained to us today that they plan to give her the diuretic for 3 days, take 4 days off, and then do another 3 day dose.  After that they will assess and see how she is doing.  That's the plan at this point.  As with everything else in a NICU, I'm sure it can change in a heartbeat.  But for now, that's the course of action over the next week and a half.

Her red blood cell count was a little bit low today as well, but there's another count that they check when they check the red blood cells.  This is the count of the new red blood cells that the body is producing, and it was very good.  So for that reason they did not decide to give her a transfusion at this point.  The body is a fickle thing.  It knows that it needs to do certain things, such as produce red blood cells, and hers is producing new ones.  But if they give her a transfusion, the body may stop producing them for a period of time.  They want to train her body to produce them all on her own, and as such will not give her any blood unless it's absolutely necessary.  But she's doing very well in that department as well.

She's still only had the one bottle feed last week, but she was going to town on a pacifier today when Brit was there with her.  They gave it to her while she was getting her food through her feeding tube.  So maybe she's gonna start showing the cues again and they may try another bottle soon.  She'll be 36 weeks gestation tomorrow, so they definitely want her to start taking bottles sooner rather than later.  They won't rush her if she's not ready, but they hope that she is ready pretty soon.

That's about all that's happened over the past few days.  She's growing and progressing quite well.  You never know what you're gonna hear when you call for that first update in the morning.  The whole situation is exhausting, but at the same time, it's become our routine for the last 6 weeks.  Hard to believe that she's 6 weeks old today!  It seems just like yesterday that she was born, but at the same time, it seems like an eternity ago as well.  So we're all hanging in there and doing the best we can.  Thanks again to everyone for all of the prayers.  And please, keep them coming.

Double Down

Last night we got the word that Emma was up to 3 pounds, 2 ounces, which is OFFICIALLY double her birth weight!!  Way to go Emma!!  She keeps packing on the weight at an acceptable clip to all the doctors.  They are very pleased with her progress still.  We were told recently that they expect her to be about triple her birth weight when she gets to come home, so she still has a little while before we get to that point.  But double is still really good!!

Her breathing is still an issue, but it is getting better.  They were able to reduce the flow into her nasal cannula today.  Her oxygen level is still higher than we would like, but the doctors do not seem alarmed by it at all.  It's just higher than it was in the weeks leading up to now, which is what alarms us.  But again, the doctors have seen much worse.  Her breathing rate has slowed down to acceptable levels.  The days leading up to her receiving the diuretic saw some very heavy breathing.  But they got the fluid drained out of her lungs with that medicine, so she has slowed her breathing rate for the most part.  She still has some episodes of high breathing, but not nearly as many.

So overall the last couple days have been very positive ones for Emma.  We both got to hold her today, which was just awesome.  We held her for about an hour each.  She did very well with this bonding time with each of us.  So let's hope for some continued days of good progress for Emma.  She's a tough little girl and we love her to pieces!!

Fluids

I personally like my fluids.  Water, Milk, Diet Coke, Beer(notice I put water and milk FIRST there, Mom?).  The more the better.  But for little Emma, she had some fluid building up in her lungs over the last couple days, which is the most current theory as to why she was having to struggle and work harder and harder to breathe.  So the doctors gave her a diuretic today to help relieve her of some of that excess fluid.  She responded to it pretty well.  Her breathing rate came down to a safer level and the amount of oxygen she's receiving also came down.  It was at higher levels than we'd seen at any point during her life at one point yesterday and into this morning, so apparently the diuretic worked very well pretty quickly.  She still has to come down even further on the oxygen, but she's doing better than she was the last couple days.

So other than that there haven't been a whole lot of changes over the last couple days.  She's still getting 27ml of milk every 3 hours.  They informed us today that they're going to keep her there for a while.  As she continues to grow, the amount of milk she gets will stay constant, but her milk intake per pound of body weight will go down if they don't increase the amount of milk she gets as she adds body weight.  This is because they want to cut down on the amount of fluid she's receiving.  They will also cut down on the fortification of the milk, and in doing so will decrease her calories each day.  So she'll get less fluid, which will make it less likely that fluid will build up around her lungs.  They don't want to continue having to give her a diuretic more often than they absolutely have to.  They can have some bad side effects, one example of which is kidney stones.  So they want to avoid this as best as they possibly can.

She continues to hold her own body temperature very well.  She's still had only the one bottle because of the instability of her breathing over the last few days.  Hopefully soon we'll be able to give her another bottle.  But overall, she's still doing everything they expect her to do.  If they can get her lungs cleared out they will feel very good about her condition.  So keep praying for her folks.  They're working more than you know!!

Morning Update

3 POUNDS!!

Eat Emma Eat

First of all, a big Happy Birthday to Mommy!!  Britne celebrated her birthday today.  Thanks for all that you do for our family, Brit.  We all love you very much!!

There were a couple of positive developments today with little Ms. Emma.  First of all, they increased her milk intake yet again to 27ml every 3 hours.  That's good for a total of 7.2 oz every day.  So far, so good.  She's tolerating it all very well and doing a great job.  Second, as you can see in the picture, Emma had her first meal from a bottle today.  Of the 27 total milliliters in the feeding at 2pm today with Mommy, Emma took approximately 6ml from the bottle!  Brit said that she did very well with this.  Feeding a preemie is much different than feeding any full term baby.  With a baby that's carried to term, you just tuck them into your elbow and give them a bottle.  Apparently with a preemie, you have to lay them down on your leg, on their side and feed them that way.  It's a completely different approach.  The reasoning behind this is the breathing issue.  If the baby has an apnea episode during a feed, if they're laying down in your elbow they'll get the food down into their lungs.  But if they're on their side on your leg, then the food will just come out and they won't choke on it.  But it's just different, yet another example of the quirkiness of having a preemie.  But again, Emma did very, very well with the feed.  She's quite a little trooper!

Another big development for Emma, as you can also see in the picture, is she's wearing clothes now.  They've turned off the heat in her isolette, dressed her in clothes, and she's now regulating her own body temperature.  The reason for that is that she gained weight again last night.  She's now just shy of 3 pounds, less than an ounce away.  That's as of 11pm last night, so maybe by the time they weigh her tonight she'll have crossed that next threshold. 

So other than the breathing issue, which is still not resolved but not worsening, she's doing well.  She is still on a little more oxygen than she has been before, but it's not getting worse at this point.  She's held steady the last couple of days so we're at least encouraged by that.  But you may remember a couple weeks ago that there were three criteria for her being able to come home.  First, the breathing issue.  That's not resolved, but she will outgrow it.  Second, she has to be able to regulate her own body temperature.  For the last 24 hours she's been doing that, so we're happy about that at this point.  And third, she has to take all of her feeds from a bottle.  They start them small with that one, but she had her first bottle feed today and will get more and more every day.

So for right now, we are very encouraged with Emma's progress.  The only issue, as I said, is the breathing.  Once she gets that resolved and takes more food from a bottle, she will be well on her way to coming home.  We are still taking this one day at a time.  I know that sounds like a broken record, but we cannot allow ourselves to think too far ahead.  But it's encouraging to see Emma beginning to exhibit the criteria required for discharge.  I've said it before, and I'll say it again: 21 is our lucky number.  Emma's dressed and eating from a bottle on the 21st of August. 

Happy Birthday Mommy!!  Your little girl had a pretty big day today!  :-)

Working Through It

Emma stayed pretty stable today.  They didn't have to go up on her oxygen today, which was a good thing.  They are still taking a wait and see approach with this one.  As long as nothing else goes wrong they will just kind of wait for it to resolve itself from the sounds of it.  Her temperature has held steady so that's a good sign that there's not an underlying reason for this other than what we were told yesterday, which is her lung disease of prematurity.

She gained weight again last night.  She's now up to 2 pounds, 13.8 ounces.  When they weigh her tonight if she's gained again, they're actually going to put some clothes on her.  Up to this point they've just had a diaper on her because she's been in the isolette, which is heated.  But once they reach a certain point they feel that they're a little better at holding their own body temperature and that's when they start dressing them.  I think she'll still be in her isolette for a good little while, though.  We were told that anywhere from 3.5 pounds to 4 pounds is when they take them out of there and put them in a regular crib.  But if she gains again tonight we'll post a picture of her tomorrow night with her little outfit on.

Hopefully in the next few days she'll hit that next milestone, 3 pounds.  She's gaining on a good clip here lately.  If it continues she should be to 3 pounds in the next day or two.  She's still tolerating her increased milk intake very well.  She's still getting 24ml every 3 hours, so 6.4 ounces over the course of a day.  That's a long way from her initial feeds when she was getting just over .25 ounces every day. 

We're so proud of her.  We just hope the breathing issue works itself out soon.  Hopefully it will, but if not they will do something to help her along when they feel they need to intervene.  Until then, we'll just wait and pray that it resolves itself.

Roller Coasters

When I was in the 7th grade I went on a class trip to Busch Gardens in Williamsburg, VA.  It was then that I discovered that I suffered from terrible motion sickness!  I rode the Loch Ness Monster twice at about 11am, and I was sick for the rest of the day.  On the 4 hour bus ride home, I could not help but get sicker and sicker with each and every bump from the road.  We stopped for dinner at McDonald's, and the bus driver would not let me stay on the bus.  He made me go inside the McDonald's and watch the rest of my classmates enjoy their food while I got sicker and sicker with each and every passing second.  By the time I got home, I was literally green in the face.  I remember my parents telling me that when I got off the bus.  At the time, I thought that would be the worst roller coaster experience of my life.  And for 20+ years, it was.

Then little Emma was born 10 weeks early and went to the NICU.  Ups and downs, ups and downs.  That is how it has gone for the last 33 days.  Emma will have many good days in a row followed by one or two bad ones.  Recently she's been doing well in all areas except one:  breathing.  Her oxygen level has been creeping up over the last couple days.  At this point they're not thinking it is anything serious.  She's not showing any signs of an infection, as the only symptom she's exhibiting is the need for more and more oxygen.  Her temperature is holding steady so they're not worried about that.  They told us today that instead of a fever, babies actually drop their temperature when there is an infection.  But hers is holding steady.  If the situation doesn't resolve itself soon, they will do a chest x-ray to make sure there's no pneumonia or other type of infection.  If they do find an infection they will give her antibiotics through an IV for 7 to 10 days and hopefully that will cure it.

We were told today that their best guess at this point is that it's just the latest bump in the road, another symptom of her lung disease of prematurity.  She still doesn't need a ventilator and there are a good number of kids at this point who are still using that treatment.  So we know that she's still doing better than other kids.  But we don't care how she's doing in comparison to others.  We want her condition to improve.  This is just another example of a situation where we know that the doctors are on top of it, but we are still nervous about it.  We had many good days in a row followed by this latest blip.  Again, it's frustrating, but we also know they will fix it.

Other than that she really is doing very well.  She's still on 24ml of milk every 3 hours and tolerating that very well.  She gained weight again last night to 2 pounds 12 ounces, another ounce closer to her next milestone of 3 pounds.  She continues to look better each and every day.  We are absolutely amazed by the progress she continues to make in the NICU. 

The difference in this roller coaster and the one that made me sick as a child is that I can't get off this one.  Not until Emma is home.  In the 7th grade when I got sick on that roller coaster, I woke up the next day feeling fine.  Each day we wake up now we find ourselves still stuck on this roller coaster.  We know that in the long run this is just a short term problem and we'll look back on it one day and think how short this time actually was.  But right now it feels like an eternity.  The last 33 days have aged each of us about 33 years!  If I have any hair left after this, it will all be gray.  But the reward will be bringing Emma home.  We just have to remember the doctors' advice:  take it one day at a time.

Lazy Saturday

There weren't a whole lot of changes with Emma today.  I did forget to mention yesterday that they increased her meals to 24ml of milk from 22.  And when they weighed her last night (post blog of course) she was up to 2 pounds 11 ounces.  She continues to grow at pretty much the rate they want, 1 ounce every day.  Way to go little baby!  I'll call in a little while and get her weight tonight, and post it here tomorrow night. 

She continues to be on 1.5 liters of pressure in her nasal cannula.  They didn't attempt to reduce it today, they just gave her a little break today from making any changes.  And other than that nothing else changed at all today.  She's holding steady, but growing well.

We got to visit with her today and we took Eden with us again.  Eden was very, very excited to see her baby sister.  She told her that she loves her and touched her little hands and feet.  Emma's got an oxygen sensor on her foot and it's a red light.  Eden looked at it, pointed to her foot and said "She's got a pink foot!"  But most times we take Eden to see her, she'll spend a few minutes with her and then say she's ready to leave Emma.  Today, though, she stayed with us for about 20 minutes before I had to take her out.  She had a good little visit with her little sister today.  Emma had her eyes open, and that's probably what held Eden's attention so well.  But she enjoyed it today more than any other visit we've had.

Other than that, there's really nothing new to share here tonight.  We're just trucking along, taking it one day at a time still.  Thanks again for your prayers everyone.  They seem to be working, so keep it up!!

Happy One Month Birthday!!

Today was a very exciting day for Emma, she turned 1 month old today!  Woo Hoo!!  Happy One Month Birthday little Emma!!  We love you very, very much, and we're so proud of you for all the strides you've made so far. 

Emma continues to excel in her growth.  They evaluate her every Friday for weight, length, and head circumference.  She's well above where she was last Friday in all 3 of those categories!  Her growth seems to be going along at the clip they would like to see, which is definitely a good thing.  She's still 2 pounds, 10 ounces, as she was last night.  She's approximately 14 inches long now, after being born at 12 and a half.  And her head circumference has gone up 3 or 4 centimeters since birth as well, so she's growing at a good rate.

The only minor blip, and it was very minor, was her nasal cannula pressure had to be adjusted back to the 1.5 liters.  They were able to drop her down to 1 liter yesterday, but she had a few very minor A's and B's overnight, so during rounds this morning the doctors made the decision to go back up on the pressure.  They keep thinking she's ready for less.  One of these days she is going to be ready for it and we'll all be very pleased.

Mommy and Daddy both got to hold her tonight.  Mommy did her normal kangaroo, or skin to skin.  Brit held her for about an hour and both Brit and Emma did fantastic with this time together.  Emma held her vitals up very well.  I got to swaddle her after Mommy was done.  She didn't like the swaddling as much as she liked the kangaroo time.  Her blood oxygen level kept dropping so the nurse came and put her back in her isolette.  But I did change her diaper for the first time tonight!  It was pretty exciting.  Of course, I put it on backwards at first, as if it was the first diaper I've ever changed.  I realized what I'd done and looked at the nurse and said "I've changed thousands of these things, I can't believe I just did that!"  I don't think she believed me, though.  She looked at me as if to say "Yeah, sure you have."  But nonetheless, it was still a pretty exciting experience.

That's about all the updates we have for today.  Hopefully the weekend ahead brings good developments for little Ms. Emma as she inches closer and closer to the 3 pound barrier.  She's still got a good little ways to go before she gets there, but I'm sure it'll be here before we know it.  I hope everyone has a great weekend!  We'll keep you updated on Emma's progress!

Beefer

Emma gained more weight last night.  Hopefully this one will hold, it wasn't a ridiculous gain like the one from a couple nights ago.  She's now up to 2 pounds, 10 ounces.  She's now OFFICIALLY gained more than 1 pound from her birth weight.  In celebration, I cracked open a beer in her honor when I got home this evening!  Way to go Emma!

In other news, the doctors were able to reduce her air flow today a little bit.  The high flow air is measured in liters.  Before they dropped her all the way down to the "low flow" last week Emma was getting 2 liters of pressure into her nasal cannula.  Yesterday when they reintroduced the high flow they started her on 1.5 liters of flow.  Today they reduced it to 1 liter.  She seems to be tolerating that very well, keeping her heart rate and breathing rate up, as well as her blood oxygen level.  So they're confident that she's still developing as she should be.

Remember last week when I said the doctor came by and talked to me and gave me an estimated time frame for when he thought Emma would be going home, but told me not to hold him to it?  Well, the reason I didn't post his estimate here was because he told me not to hold him to it.  He spoke with Britne today and gave her a bit of a different window.  Still a very reasonable one, but slightly longer than he'd initially told me.  But still, we were pleased with what he said.  If she keeps progressing as they think she will, our little Emma will be home with us sooner rather than later.  Again, I'm not going to post his estimate here because I don't want anyone freaking out if things change again.  But again, suffice it to say that we are OK with what we were told.

Emma had another good day today overall, with no A's and B's or anything negative at all.  She's even taken a paci when eating the last couple days, which is a positive development.  They look for cues that she's ready to start taking a bottle, and when they take a paci or put their hands to their mouth that usually means they're close to being ready to try a bottle.  So we're pretty excited about that as well! 

There's not as much to fill you in on tonight as there was last night, so I'll just keep this one relatively short.  We hope you all have a great night!

Faith

"No trial has come to you but what is human. God is faithful and will not let you be tried beyond your strength; but with the trial he will also provide a way out, so that you may be able to bear it." - 1 Corinthians 10:13

This particular bible verse was emailed to me today (thanks Dad) and it definitely fits with what we are going through.  Our faith is extremely important in getting us through this entire ordeal.  Time and time again we have to remind ourselves that the good Lord will not give us anything we cannot handle.  We also know that this is a short term problem and one day we will look back on it and realize how much stronger it has made all of us, especially Emma.  But that doesn't change the fact that it is very difficult right now.  All the good reports we get from the doctors (and we get many more positive ones than negative ones) don't change the fact that our baby is sitting in a hospital instead of in our house with the rest of us.  This isn't something you ever prepare yourself for mentally or emotionally because it's not supposed to happen like this.  But through faith, we are able to make it through this trying time, knowing that we can handle this.  Otherwise, God wouldn't have chosen this for us.  There will be an end to this, a very joyous end when Emma comes home to us.  Until then, we will continue to know that we can get through this.  We have to get through this.  If Emma can do it, so can we.

Developments today were mixed, but good overall.  About the same time I was writing last night, the doctors and nurses were making an adjustment to Emma.  They put her back on the high flow air instead of the low flow they had her on for the last 4 or 5 days.  They felt that the number of A's and B's she was having was concerning and they wanted to give her a break.  She's on lower pressure than she was the last time she was on the high flow, so that's encouraging.  They made a lot of adjustments to her last week, testing her to see what she could handle.  They removed the caffeine, they put her on low flow oxygen, they upped her feedings, and they removed her humidity.  So that was quite a bit for her to handle.  She got a little tired, so they decided to give her a little break and increase her air flow again.  She's doing very well with this new (or old, depending on how you look at it) setup.

This morning, she had her first eye exam.  At this point they want to make sure that the blood vessels in her eyes are developing as they should be.  They call it "vascularizing" (and I have no idea if I spelled that right or not, and quite frankly, I don't care).  The blood vessels in our eyes apparently start out small in the middle of our eyes and very early in life (and in most babies it happens in the womb, but with preemies it has to happen outside) they grow and stretch out across the entire eye.  They checked to make sure that she's vascularizing as she should be and determined that she is. They will check her again in a couple weeks to make sure she's still moving along at the right pace, but they were pleased with what they saw today.  The exam itself is a little traumatizing most times though.  In fact, it can cause them to have apnea during or immediately afterwards.  They have to dilate her eyes and then hold them open with prongs.  If you've ever had lasik surgery, they basically use those same things to hold her eyes open.  And then with the bright light they shine into her eyes it makes them want to close instinctively, but they're pried open.  They do this quickly and parents are encouraged NOT to be present.  We had no plans of attending as I'm sure it would have been just as traumatic for us as it was for her.  But she passed her first eye exam and she didn't even come close to any apnea episodes.

The whole deal with gaining 2 and a half ounces in one day was, in fact, false.  She "lost" half an ounce last night when they weighed her.  So in essence, she gained 2 ounces over 2 days, which is exactly the pace they want her to follow.  We were totally expecting this by now.  The first time it happened (as is often the case with most of the "firsts" we've experienced through this trial) we freaked out.  "SHE LOST WEIGHT??  WHAT????  HOW IS THAT POSSIBLE?  WHAT DOES THIS MEAN?  IS SHE GOING TO BE OK?"  But through the last month we've gotten used to this happening.  She'll have a huge gain of 60 or 70 grams one night, and then come down about 15 or 20 the next night.  That's probably one of the few things we've gotten used to, but it's something at least!  The trend there is definitely going in the right direction as she's still up roughly a pound from her birth weight, and well over a pound from her lowest weight.  There's still a long way to go but she'll get there.  And then when she gets home we'll definitely fatten her up.  Her big sister beefed up nicely once we got a hold of her!  She was 16 or 17 pounds at 6 months.  That's how we roll, we make babies fat in our house.  So look out Emma!  Once you come home, you're gonna be in for some serious weight gain.

We're sticking with the whole 1 step forward, 2 steps back theme this week.  No one other than us has been alarmed by it.  The doctors and nurses have all seen this a thousand times.  They expect it, they know how to handle it.  They are coaching us through this whole thing as well.  They've been absolutely wonderful with how they explain everything to us and make us feel comfortable (as comfortable as possible anyway).  Emma's getting spoiled with great care right now in the hospital.  And when she comes home she's going to get spoiled in a whole different way with love from every direction imaginable!  We continue to hear from different folks every day offering encouraging words.  Some folks have reached out to us more than once (and this is totally encouraged, please feel free to send well wishes whenever you feel compelled to do so) and some folks just pop up out of the blue.  But definitely more days than not we've gotten an encouraging note, phone call, email, card, or some other form of communication.  We definitely feel very fortunate and loved to be getting so many well wishes from so many folks in so many different places.  Thank you so much. We are saving everything so one day we can show Emma just how much she's been loved from birth.

Backtracking

Emma is still doing well, but she's had a couple days where she's gone in reverse a little bit.  She's still increasing her feeds and gaining weight, but her breathing is not as good as it was a few days ago.  She's had a few episodes of the old A's and B's since Saturday.  She hasn't had a large number of them on any given day, but she's had them daily.  They still coincide with her feeding, so they are almost convinced that it has to be an issue related to that.  The team there made a decision over the weekend to increase her feeds, as I said, to 22ml every 3 hours.  Now I'm not a doctor, and Britne's not a doctor, but that's when these episodes began happening.  We trust that they will figure it out and will continue to keep us updated on her condition.  If they have to make adjustments then they will do it.

Other than that there haven't been a whole lot of changes lately.  She was weighed last night and came in at 2 pounds, 9 ounces, which was a full 2 and a half ounces higher than where she was the night before.  A lot of times when she has a gain that big, the person who weighed her did something different than the person the night before, and she actually "loses" weight the next night when she's weighed again.  We've seen that happen more than once.  So we're not getting too excited about that one until we hear tonight how much she weighs.  But she definitely did gain weight, they've never been off by that much.  We are just skeptical as to whether or not she gained as much as they say she did.

So all in all, other than the breathing issues she's been exhibiting lately, she's doing rather well.  She still looks fuller and fuller every day.  She even looks like she's getting a little bit of fat building up on her frame, so that's a wonderful development.  The more fat she can develop, the more she'll be able to regulate her own body temperature, which is a hurdle to being able to bring her home.  So we are encouraged by that.  But still, the breathing issues are kind of concerning to us.  We hope they figure it out soon and get it corrected.  We are sure they will, but the sooner they can do that, the better we will feel.  And the roller coaster continues!!

March of Dimes

Emma had another good day today.  She's still tolerating her feeds well.  She did have one more apnea episode today, but it was right after she ate again.  So it could be a reflux problem.  They will keep watching her closely to make sure the frequency of those episodes doesn't increase.  She's up to 2 pounds, 6 and a half ounces today, so a slight gain over where she was yesterday.  But overall she is still doing very well.  Since there's not a whole lot of change to discuss with Emma tonight, I'd like to devote this post to the March of Dimes.

You may have noticed a link on the right hand side of this page for the March of Dimes.  They are a wonderful organization that advocates for children and does amazing research to help prevent premature birth and birth defects.  Their Mission Statement is:  "We help moms have full-term pregnancies and research the problems that threaten the health of babies."  There are many causes of premature birth, and there are many cases where the cause is not known.  A lot of times the doctor and patient will decide together that the child should be born earlier than usual due to potential health concerns of not only the child, but the mother as well.  The March of Dimes has a campaign to encourage doctors and patients to get to 39 weeks gestation, whenever possible.  Obviously there are many exceptions to this, but if it is at all possible and will not cause harm to the mother or the child, 39 weeks is best.  Their research has shown that babies born at 39 weeks or after do better developmentally and have fewer complications.

1 in 8 babies born in the United States each year is born prematurely.  1 in 8.  That's a staggering statistic!  That is 36% higher than it was 25 years ago.  So the trend is definitely going in the wrong direction.  Across the globe, 13 million babies are born early every year.  Due to this, on January 30, 2003 the March of Dimes launched the Prematurity Campaign.  This campaign has two main goals.  First, to raise public awareness of the problems of prematurity.  Second, to decrease the rate of preterm birth in the US.

This campaign does the following things:

Funds research to find the causes of premature birth

Encourages investment of public and private research dollars to identify causes and to identify and test promising interventions

Educates women about risk-reduction strategies and the signs and symptoms of preterm labor 

Provides information and emotional comfort to families affected by prematurity

Advocates to expand access to health care coverage to improve maternity care and infant health outcomes

Helps health care providers to improve risk detection and address risk factors

Generates concern and action around the problem

In 2005, the March of Dimes initiated the PREEMIE Act, which stands for Prematurity Research Expansion and Education for Mothers Who Deliver Infants Early.  It became law in 2006.  It authorized the federal government to devote money to research and education on prematurity.  As parat of the PREEMIE Act, the first Surgeon General's Conference on the prevention of premature birth was held in 2008.  This conference brought together experts on the topic from the public and private sectors.  March of Dimes staff and volunteers were key participants in each of the six work groups that developed goals for an action plan. The goals were presented to the Surgeon General at the conclusion of the conference. Achieving the goals of this plan requires both private and public resources for broad-based research, capacity building, data systems, creation of interventions, quality initiatives and a comprehensive communications strategy.

The March of Dimes has made November Prematurity Awareness Month.  This is the time that they focus the nation's attention the the problems of premature birth.  The March of Dimes and their partner organizations and alliances are asking everyone to help spread the word on the problems associated with prematurity.  These partners include The American College of Obstetricians and Gynecologists, The American Academy of Pediatrics, and The Association of Women's Health, Obstetric and Neonatal Nurses.  There are a large number of alliance members, and they can be found here.

So in short, through donations received, the March of Dimes funds research that will one day greatly reduce the number of premature births.  We've known people that have gone through this, but like I said before, until you go through it yourself, there's really no way to describe how stressful or emotionally taxing it truly is.  It is something that no one who has ever been through would ever wish on their worst enemy.  If you would like more information on exactly what the March of Dimes is and what they do, check out their website at www.marchofdimes.com. 

Old Habits

Overall, this was a pretty good weekend for Emma.  But she did have a couple episodes of the ol' A's and B's.  She had 2 of them on Saturday and then another one this afternoon.  But with all the changes they've made to her in the past week, they were completely expecting something like this to happen.  In addition to all the changes they've made, she's still only 33 weeks and 4 days gestational age at this point.  They expect babies to outgrow the A's and B's somewhere between 36 and 38 weeks.  So she's still a good amount of time away from when they expect her to totally be over them. 

She'd been 3 days since her last one so to have 3 over the weekend isn't bad at all.  It's discouraging for us, but the nurses all explained to us that they've seen this thousands of times from other babies.  Not only that, but each time she had one, she'd just finished eating and she was laying on her belly.  Normally babies aren't allowed to lay on their bellies as it's considered a SIDS risk.  But in the NICU when they're hooked up to all the monitors they can put them there because when something does happen, the alarms go off and alert the team that something's wrong.  But once she comes home, she will not be laying on her belly!  With all that said, we were told by more than one person that they feel it's a positional thing since they all occurred with her laying in the same position.

On the positive side of things, Emma is now up to 2 pounds and 6 ounces.  She's getting beefier by the day!  Not only that, but she's now up to 22ml of milk every 3 hours, up from 20 which she'd been on for the previous few days.  She's still on what they call the low flow oxygen.  When they put her on it, she was getting 50ml of oxygen.  The next step down is 25ml.  After that, the next step down is to remove it completely.  After a day on 50ml, they tried her on 25.  She tolerated it pretty well, but they do have to keep teeter tottering between the 50 and the 25.  So she's obviously not quite ready to come completely off of it and be on 100% room air.  But they are very encouraged that she's handled this low flow as well as she has.

So all in all, I'd say it was an average weekend for Emma.  Again, while we are discouraged by the return of the A's and B's the nurses are not alarmed at all.  She does continue putting on weight and tolerating more and more food whenever they give it to her.  She's still exactly where they expect her to be at this point.  It's a little bit tough for us because we thought that maybe she was getting over the A's and B's.  Everyone there keeps reminding us not to get ahead of ourselves but when we have a few good days in a row it's natural to start thinking ahead.  So while a few A's and B's isn't abnormal at this point, we got our hopes up.  We know that she will improve and continually get better.  There are many more good days ahead.

New House

Emma had another good day today.  They moved her into a new isolette that does not have any humidity option at all.  Previously they had just turned off the humidity in her old isolette, but today they moved her into a new one completely.  It's still temperature controlled so they can still provide heat to her, but since she's growing so well she's not going to need the humidity anymore.  Yaaaay Emma!!!!

Other than that, everything today remained the same as yesterday.  Her oxygen remained on what they call a low flow, her feeds held steady, she's still tolerating her feeds well.  She's doing everything that she should be doing.  In fact, that's exactly what the doctor who I spoke with today, Dr. Bose, told me.  Apparently since she moved up to Pod C she now has a new group of doctors as well.  Dr. Bose stopped by and talked to me about Emma's progress and where we go from here.  He let me know their expectations for her from here on out, as well as the requirements for her to be discharged.

I cannot tell you how many times I've heard from people a variation of the following statement:  "I'm sure as soon as Emma hits 5 pounds they'll send her home."  It's as if folks assume that when she weighs 5 pounds, she'll be completely OK, but not before that.  In all actuality, weight, while a factor, doesn't play nearly as big of a role as everyone thinks.

First, she has to be able to eat from a bottle.  Up to this point they've been feeding her through a tube that goes directly into her stomach.  They will not send her home until she can successfully eat all of her feeds from a bottle.  Second, she has to be breathing better with no assistance.  While it's not uncommon for some babies to go home on oxygen, they want Emma to have no breathing assistance when she comes home.  They're testing her now with the low flow oxygen, and if she responds well to that, they'll gradually work her down off of that completely until she is on 100% room air with no nasal cannula or any other form of assistance.  And finally, she does have to gain weight.  There's no real magic number as far as what they want for her to go home, but they would prefer her to be over 4 pounds.  Dr. Bose told me that in years past they didn't remove babies from the isolette until they hit 4 pounds, but now they start doing it when they hit 3 and a half pounds.  At that point they get them into a regular crib because they are better able to hold their body temperature.  Added body fat helps babies fight off temperature drops, and that's the final qualification for being ready to go home, holding her own temperature with no assistance from an isolette.

He gave me a time frame of how long he thinks it will be before Emma hits all of those milestones, but we'll just wait and see.  I'm hesitant to write it here because I know that once that time has passed if she's still there folks will be freaking out and asking us why she's not home, what's gone wrong, etc, etc.  Suffice it to say, we felt very encouraged by his hypothesis.  But he did say that I was not to hold him to that, because as everyone else has said, things can change in an instant.  But he indicated to me that it was very unlikely that we would be taking home a 5 pound baby.  He seems to think that she will be well under that weight with how well she's progressed up to this point.

So all in all, yet another positive day for little Emma and her parents.  We got some encouraging news on our baby girl, she got a new house for the next few weeks, she's still doing everything she's supposed to do (although we know that won't last once she's home, she's going to give us hell).  We could not be more proud of her.  She's such a good little girl.  Keep it up sweetheart!!  Mommy and Daddy (and a whole lot of other folks) love you very much!!

Many Changes

Emma has had a wonderful last couple of days, there are so many things to update everyone on.  First and foremost, Emma was baptized on Wednesday evening.  Our priest, Father Dan Oschwald, was nice enough to drive to Chapel Hill and give Emma the sacrament of baptism in the hospital.  He said it was his first ever hospital baptism in 14 years in the priesthood.  It was a very special moment, as he dipped his thumb into some sanitized water (of course it was sanitized) and let a couple drops fall down onto her head.  Emma didn't even flinch!  She was sleeping, very cozy in Mommy's arms.  The whole thing took about 5 minutes, if that.  Once Emma comes home we will have a ceremony in the church where she will wear a white gown instead of her hospital swaddling blanket and the whole ceremony will be done.  For these purposes, though, only the water and oil were applied to her head.  There was no baptismal candle or anything like that, and in the church ceremony we will get all of that.

She's getting 20ml of milk at every feeding now, so almost 5.5 ounces a day total.  She's tolerating all of that very well.  She's gained even more weight over the last couple days, and tonight when they weighed her she was 2 pounds and ALMOST 5 ounces.  The trend in the right direction continues for little Emma in that department.  She's fighting, that's for sure.  She knows she has a lot of making up to do and she's determined to do it.  We're so proud of her!!

Another change is in her isolette.  They still have her in the same one for now, but previously they were pumping some humidity into it.  They turned that off yesterday, though, so it's now just temperature controlled.  So after taking her off of caffeine on Tuesday, they took away her humidity the next day.  Then today they reduced the pressure in her nasal cannula.  There are still a couple more steps they'll have to take prior to taking her completely off of that, but assuming she tolerates this reduction well, they will contemplate reducing it again tomorrow.  Once they do make that next reduction, the next step would be to remove it altogether and have her breathing only room air.  That would be an amazing accomplishment for little Emma at this point.  But again, we're taking it one day at a time and we'll see how she tolerates this initial reduction before we get too excited.

You may also have noticed that the layout of the blog has changed as well.  The reason for that is two fold.  Even before Emma was born, we knew that she was going to have a purple room.  I painted it a couple weeks before she arrived, not even anticipating that she'd be that early.  It's a good thing I went ahead and painted it since it would be impossible to find the time to do so now!  But anyway, her room and most of the stuff in it is purple, so having a purple blog for her is more fitting.  Secondly, as you may notice in the picture above, Britne is wearing a purple wrist band (I wear one too, in case you were wondering).  These are from the March of Dimes and they are to help bring awareness to premature birth.  In the days to come I'll be doing a much more detailed posting on the March of Dimes and what it is they do.  But their main color is purple, so it's fitting that this blog should be a tribute to them as well.

I think I've hit on all the major changes that have occurred over the last 2 days.  If I have missed anything I'll be sure and add it in tomorrow night.  Sleep tight everyone!

Cold Turkey

If you recall, I stated last week that usually somewhere between 32 and 34 weeks of age, they take the babies off of caffeine in the NICU.  Emma will be 33 weeks tomorrow, and today they took her off of it.  We weren't sure if they would wean her off of it or just take it away at once.  Well, they went with the cold turkey approach.  They are going to see how she tolerates it.  They are apparently pleased with the number of apnea and bradycardia episodes she's been having, otherwise they would not take have made this move.  We haven't been told of an episode in the last few days, so we're thinking she must be doing a pretty good job with those and not having many of them.

The next step, which they apparently considered trying today but decided against, is to reduce the pressure on her nasal cannula.  They contemplated doing it, but decided that they didn't want to make too many changes in one day.  This way they'll be able to better see which change was working.  If they changed both of those things and then she had a lot of A&B episodes or something else went wrong, they wouldn't be sure if it was the caffeine or the nasal cannula reduction causing it, so they're taking it one step at a time.  But if she tolerates the caffeine suspension, sometime in the next few days they will most likely also reduce her nasal cannula pressure.

Everything else remained the same today.  But we were also told that she is now up to 2 pounds, 3 ounces!  She's growing like a little weed!!  We were definitely excited about that as well.  She's now up to one kilogram, or 1,000 grams.  She was born at 708 grams, so in 3 weeks (today is her 3 week birthday, by the way) she's put on nearly 300 grams, or 10 ounces.  But after her first week, she was down approximately 3 ounces, so she's been pretty much right on track with her gaining 1 ounce a day goal they have for her since then.  Some days she will gain a couple ounces, some days she'll lose a few grams, but the trend is definitely in the right direction.

When I called this morning for her update, the nurse told me that she was doing great.  She told me that Emma was a feisty little thing.  Apparently Emma had been trying to take her feeding tube out, so the nurse was trying to tape it to her chin a little bit better.  Emma wasn't too fond of this, and kept swatting the nurse's hands away.  So when she was telling me this story, she said "I wonder where she gets her feisty nature from."  I of course have no idea, but my parents may be able to offer some insight into that one!!  Plus Emma's big sister also has the same trait.  Just more evidence of the battle for supremacy that we are going to face in the years to come.

Another Graduation Day

Last week when Emma got her IV taken out, the nurse on duty told us that she was graduating to Preemie Preschool.  Well today, she graduated again.  There are 7 pods in the NICU in Chapel Hill, each with multiple babies.  They go from Pod A to Pod G.  Pod A is where the babies are when they're about to go home.  Pod G consists of the sickest babies.  I can't imagine what those babies are like, as when Emma was born she was teeny, teeny tiny and we couldn't imagine much worse.  But she has only required a ventilator for 24 hours of her life, so I guess we should've realized that there were sicker babies there.  But for the last 3 weeks, Emma has been in Pod D, right in the middle of the pods.  Today, she graduated to Pod C.  They informed us that she would spend the bulk of her NICU time in that room.  They told us that she's doing so well that they felt like she was ready to move on up.  They have to make room for babies that are sicker than her in Pod D, and put her with other babies who are doing better.  That was very welcome news on this Monday!  Our little over achiever keeps doing it.

Other than that everything remained constant.  Her feeds didn't change, she's still got the nasal cannula to help her breathe a little bit, the multivitamin and caffeine are still there.  Everything else stayed the same.  But still, that was pretty big news for us that she was moving up to the next pod.  Britne just asked her nurse yesterday if she would be moving anytime soon and her nurse was quite certain that she would not be.  So to hear today that she was indeed ready to move and would be moving this afternoon, we were shocked, but in a good way.  As her nurse told us yesterday, she continues to surprise us in a good way.  We could not be more proud of her.  We know there are still plenty of challenges ahead but we are ready to face them.  Most importantly, we definitely believe that Emma is ready to face them as well, thanks to all the prayers and well wishes coming from everyone.  I know I sound like a broken record, but thank you.  From the bottom of our hearts, thank you so very much.

More of the Same

As you saw from my excited post earlier today Emma hit the 2 pound mark last night.  She was 2 pounds 1 ounce when they weighed her.  Today everyone that went to see her agreed that she did indeed look beefier.  I'm not sure if it was our mental perception of her since we knew that she'd hit a big weight milestone or what, but she does continue to look bigger and bigger each and every day.  Even seeing her every day we can still tell a difference in her.  Her nurse Monika put up a picture of her by her bed that was taken a couple weeks ago and then put up another one that was taken today.  You can definitely see a marked difference.  She is without a doubt packing on some OZ's.

Eden got to visit her again today.  While Mommy was holding Emma, Eden was sitting in daddy's lap.  She reached out and touched Emma's tiny fingers again today and grinned so big and giggled!  It was pretty cute!  She gets so excited to see her.  We have to bribe Eden to take a nap lately.  We tell her that the only way she's going to go see Emma is if she takes a nap.  We say that they won't let her in if she's super tired because she'll make too much noise and wake up the babies.  It's not entirely effective, though.  Eden will fight off a nap any chance she gets.  We can already tell that these two are going to be just alike with how hard Emma is fighting and how far she's already come.  I'm telling ya, the battles that lie ahead in this family are going to be legendary!

Oh, there was one small update:  they increased Emma's milk intake again today.  After telling us that 18ml would be the norm for a while, they increased her to 19ml.  Not a big change, and it was due to the fact that she gained some weight overnight.  When they're figuring out how much to feed her, it's based on her weight.  They give her a certain amount of food per kilogram that she weighs.  She's now up to .93 kilograms, by the way.  That's another adjustment to make, they will convert her weight into pounds and ounces for us, but in the NICU, they weigh her in grams, they take her temperature in Celsius, and they feed her in milliliters.  We are used to the weight being in pounds, temperature in Fahrenheit, and milk being in ounces or half ounces.  So we've had to completely adjust our way of thinking having a baby there, even more than we thought we would.  But after a couple weeks you get used to all of that stuff being in different units and it becomes second nature.

Today was another exciting day for Emma and everyone.  The first big milestone was reached!!  Way to go baby girl.  We love you so much and are so proud of you!!

Quick Update

2 POUNDS 1 OUNCE!!!!!!!!

Our Little Rock Star

We call the NICU every morning for an update on Emma to see how her night was.  Today when I called I spoke to her nurse who told me that "Emma is doing great.  She's a little rock star."  When the doctors were doing rounds they were discussing how great Emma is doing and apparently that term was thrown out there.  Way to go little baby girl!!  Nothing changed from yesterday, not even the amount of food she's getting.  She's actually still on 18ml of milk every 3 hours and tolerating it very well.  They said she'd stay there for a while and they're actually keeping her there.  They're still adding enough to get it up to 26 calories per ounce as well.  As of now they haven't weighed her so we still don't know if she's finally hit the 2 pound barrier or not.  They weigh her at either 8pm or 11pm, and we left there around 7:30 tonight so we aren't sure if they've weighed her yet or not.  Check back tomorrow night for an update on that!

There's really nothing else to update everyone on tonight, so I'll keep this one short.  I hope you all have a great night!

So Much To Say

So, 2 or 3 days ago, I mentioned that Emma would stay at 13ml of milk for a good little while.  Then yesterday she went up to 15ml.  We were then told that she would probably increase to 16ml and stay there for a while.  Today, they increased her to 18ml.  Her night nurse told me this evening that she'll probably stay there for a while until she starts gaining more weight.  I'll believe that when I see it!  So she's now up to a total of just shy of 5 ounces of milk every day.  But she still didn't hit the 2 pound mark, she held steady at 1 pound 15 ounces tonight.  She's a little booger!!  She did lose her umbilical cord this evening, though.  It wasn't much bigger than a little booger either, so that nickname is fitting tonight.

In my very first post on this blog, I detailed how when Britne was 28 weeks pregnant we found out that Emma was a growth restricted baby.  When she was born a couple weeks later, the doctors told us that it could have been any number of things ranging from a bad placenta to a possible chromosomal problem that caused her to be small.  They informed us that it would be anywhere from a couple days to a couple weeks before we heard anything definitive as they had to run a lot of tests on a blood sample they got from Emma, as well as on the placenta itself.  We've been on pins and needles ever since, not so patiently awaiting the word.  Well, today we got the news:  the placenta was bad and that was what was restricting her growth.  The initial chromosomal screening came back normal as well.  So at this point, we feel pretty good that it was nothing more than a bad placenta restricting our little Emma from growing more.  And now that she's in the NICU getting nutrients from Mommy's milk she should start to take off soon.

Part of the effort to get her to gain weight was to add more and more milk to her diet every day.  This trend has continued every day for the last week and a half or so.  For the last 5 or 6 days they have also been fortifying her milk to add calories to it, and the fortification has increased slowly over the course of this week.  Today they added a multivitamin to her repertoire that will also help her gain some weight.  The nurse practitioner told Britne today that they want to fatten her up!  According to the book they gave us, if a baby is getting less than 5 ounces of milk every day a multivitamin supplement could be used to help add weight.  Some of the nutrients present in the multivitamin are essential, such as folic acid which helps fight anemia.  Vitamin D works along with calcium (one of the substances used to fortify the milk) to help strengthen her bones.  Vitamin K helps prevent bleeding, and both Vitamins A and E help fight tissue damage that's present in many common complications of prematurity.  So not only will the multivitamin help add some weight to her, it'll aid her in avoiding many complications.  That's not to say that she won't have those complications, but the multivitamin will help fight them off.

So all in all, today was a pretty darn good day for Emma.  We needed a good day like this.  Recently while driving through Chapel Hill, I was pulled for speeding, but luckily a very nice cop was the one who pulled me and decided to let me off with just a warning.  Then my car started acting up recently and it's now in the shop over the weekend.  Fortunately, though, they were able to provide me with a very nice loaner car, so it's not all that bad.  But we were beginning to feel like there was just a dark cloud hanging over us.  I was beginning to feel a little like Joe Pesci in this scene (Caution:  Not completely kid friendly).  So having a good day like today really helped us out a bunch!  Emma is doing very, very well overall.

Every day we hear from more and more folks who are keeping up with Emma's progress through this blog.  We can't even begin to express how grateful we are for that.  People from far away places are glued to these daily updates.  Who knew that someone so little could captivate so many people's lives?  It seems every day we hear from someone new that's praying for little Emma.  So thank you everyone!  Keep up the prayers, and may God bless each and every one of you as well.

SOOOOOOOO Close

1 pound, 15.5 ounces!!  Emma's so close to 2 pounds we can almost taste it!  Plus, after telling us last night that 13ml of milk was going to be the maximum for a while, they increased her again today.  This morning she went up to 14ml and when we left her, she was getting her 8pm feeding which was 15ml.  We've now been told that 16ml will probably be her max for a while.  But who really knows?  She seems to be exceeding expectations up to this point.  She's digesting her milk very well.  She's completely off of IV fluids so she's now getting her caffeine through her feeding tube.  So she's basically having a teeny tiny cup of coffee every day now!  We were told that they normally do that until anywhere from 32 weeks to 34 weeks, and she was 32 weeks yesterday.  So in the next couple weeks they should be able to take her off of that.  But if she's still having a good number of the brady episodes they will keep her on it for a little while longer.  We'll see.

There's not a whole lot else to report this evening, she was a good girl all day today.  Again, at this point no news is good news so we'll take it.  But everyone there keeps talking about how great she's doing and how she's right on track with most things and even above their expectations on others.  Still, cautiously optimistic is a term being thrown out there very often so as to temper our expectations for the future.  This whole thing is definitely a marathon and not a sprint.  There are still plenty of hurdles to clear so we have a long way to go.  But we know that we've got a little fighter on our hands.

Here's hoping that she clears that first one either tomorrow or sometime this weekend...hitting 2 pounds!  That would be a big one for Mommy and Daddy more than anything I think, but it is definitely important.  Everything seems to be right on track at this point.  We are definitely hoping that continues.  Sleep tight folks!!

Hanging In There

Today, Emma reached 32 weeks gestational age.  Around 9pm this evening they removed her IV from her arm so she is now on 100% Mommy's milk for nutrients.  They've upped the fortification on the milk to 26 calories per ounce and she's now receiving 13ml of milk every 3 hours.  That will remain that way for a while.  If they change anything anytime soon it will be the amount of fortification that will increase.  They don't know how long she'll be on 13ml each feeding, but they will not increase her again anytime soon.  She's tolerating everything very well, digesting her feeds great, and seems to have adjusted to life in an incubator quite nicely!  She's doing great and we're so, so happy and proud of her.  Keep it up baby!!

I've gotten a lot of questions lately about how the rest of us are doing, so the post tonight will be a little update on that.  Emma's stable so I feel maybe I should address the rest of us tonight.  Britne and I are hanging in there the best we can.  Unless you've been through something like this before then there is really no way to describe exactly how we feel.  You get the whole gamut of emotions.  Every time the nurses or doctors tell you something good, you feel euphoric and you start getting very excited thinking about the future, which we've been told not to do.  As I have said before, everyone there has told us that for a while, Emma will take 1 step forward and 2 steps back.  And as soon as we find ourselves thinking ahead, we will get the news about her taking the 2 steps back that they keep telling us are coming.  When that happens we feel devastated.  It brings us back down to earth and then some.

The highs are awesome, and the lows are terrible.  I think it's probably normal, but we get higher on the highs than the doctors and nurses want us to and we get lower on the lows than they want us to.  I would imagine that for the first few weeks most parents are probably the same.  As I said at the beginning of tonight's post, Emma's only 32 weeks gestational age.  Her older sister wasn't even here for 5 more weeks from where we are right now, and we have a baby that's now 15 days old.  So this is definitely a very different feeling than the first time around.  We are doing as well as anyone could expect us to be doing.  The team in Chapel Hill taking care of her has been just wonderful.  We know that everything happens for a reason, God is giving us this right now as part of a plan.  Our faith is getting us through this.  Our friends and our family are getting us through this.  But most of all, Emma is getting us through this.

Speaking of Emma's older sister Eden, she's adjusting about as well as anyone could expect her to adjust also.  Mommy and Daddy aren't home as much recently, including the 9 days we spent in the hospital in Chapel Hill initially.  But she loves going to her grandparents' house.  It's a big vacation for her there.  They've got tons of toys and a dog that she absolutely loves!  Thank God for Bailey!!  But it is an adjustment for her too.  I think it will end up being a good thing because it gives her a chance to get used to the idea of not only having a sister before Emma comes home, but also to the fact that Mommy and Daddy are going to have to take care of Emma when she comes home so we'll have to divide our attention between the two of them.  Until now it's been all Eden all the time.  She's going to be in for a big adjustment when Emma finally does come home, so I think this will ultimately help her with that.  Only time will tell.  But she's an amazing little girl, too.  The poor thing has also had a change in her daycare class this week to deal with on top of everything else, but other than not napping for the first 3 days in that class she's adjusting nicely.  We're as proud of her as we can possibly be, too.  She's a sweetheart and we love her so much.  She keeps us smiling!!

So that's how we're doing.  Thanks for all the messages of concern recently, it made me realize that we haven't let you guys know how we are handling everything.  Like I said, we're hanging in there the best we can, still adjusting to having a baby in the NICU.  There are good days, and there are bad days.  So far the good have out numbered the bad.  We definitely hope that trend continues!  I think that by the time we get completely used to Emma being there, she'll be on her way home to our house.  But we're hanging in there pretty well given the circumstances.

Closing In...

Emma has had a couple more good days since I last wrote on Sunday night.  I believe she was on 7.5ml of milk at that time, and as of 8pm this evening, she is now on 12ml of milk every 3 hours.  So she's now over a daily total of 3 ounces!!  Go Emma Go!!  Due to this vast increase in her food intake, she's starting to pack on some weight as well.  She's now up to 1 pound 15 ounces, a mere one ounce shy of 2 pounds.  Hopefully before the week is out she'll reach that milestone.  But again, we'll take this one day at a time.

She was having a little difficulty breathing yesterday so they had to slightly increase the pressure on her nasal cannula.  It wasn't a big increase, but pretty much instantly it helped calm her down last night and she went right to sleep.  She's still nowhere near the pressure she was receiving on the CPAP.  Her little lungs still aren't mature yet.  Tomorrow she'll be 32 weeks gestational age, which is where they say the lungs are typically viable.  But still, in 2 weeks of life she's been on a ventilator for only 24 hours.  That's pretty darn good for someone her size.

This whole adventure is definitely a learning experience.  We learn more and more every day.  Her heart rate was a little elevated at times tonight when we were there with her and the nurse said it could have been a little reflux.  The increase in her feeds is a good thing but again, it's just another example of a necessary evil.  They have to increase her feeds to help her gain weight and also to help her get off the IV fluids (which she's still on track for tomorrow at 6pm for that) but she may be having a little discomfort in the form of reflux.  Her big sister had reflux as well when she was a baby, so we already know that it's totally normal.  But she's still digesting her feeds very well so they're going to continue to increase them per the feeding protocol that she's on.  Increasing her intake will help her gain weight, which will help her put some fat on her frame, which will help her regulate her own body temperature.  That's the long term goal.  Each day increasing the feeds is the short term goal.  So we're taking it one day at a time, but we know that the doctors and nurses have the big picture in mind as well.

So the reflux and the slight increase in the nasal cannula pressure are just minor setbacks and we're very encouraged with the progress she's made up to this point.  We are sticking strong to our stance of being cautiously optimistic.  I don't think any baby has ever had a completely positive experience in the NICU, not one born at Emma's size and age anyway.  We are very aware of that, and because of that we are able to keep the positive attitude we have.  Knowing that Emma is in a world class facility getting care from some of the smartest people on the planet helps give us peace of mind.  And I'm not just saying that because she's at UNC and I'm a UNC grad!  These people really are geniuses.  They do this each and every day of their life. They're very passionate about their work and it shows in the care that Emma receives there.  We couldn't say enough nice things about the folks there.

Finally, we want to say thank you to everyone reading this for the prayers, but especially to our families.  You guys have bent over backwards to help us out recently.  There is absolutely no way we would make it through this ordeal without you.  You've kept us positive, you've kept us sane, and you've been absolutely amazing every step of the way.  Emma is definitely going to be spoiled with the love of her entire family when she comes home.  So thank you guys so much.  We love all of you!!

Status Quo

Uneventful is good, as I said last night.  Today Emma was a good patient again for the doctors and nurses at the NICU.  She kept up her trend of increasing her feedings.  She's up to 7.5ml per feeding today and tomorrow morning the plan is to increase her again to at least 8ml.  Also, as planned, they began fortifying her feeds today to add more nutrients to it.  The average caloric intake for an ounce of Mommy's milk is 20 calories.  They are starting off slowly with the fortification, making each ounce 22 calories.  I believe the plan is to slowly increase that as they also decrease the amount of IV fluids she take each day.  As previously stated, she should be completely off of IV fluids by Wednesday of this week.  She gained another ounce today, so she's now up to 1 pound 12 ounces, 6 ounces higher than her low weight.  That's right in line with their goal of adding an ounce to her frame every day.  So all in all, another good day for Emma today.

This was a big weekend for Emma.  She got to see all 4 of her grandparents, her aunt, and her sister twice!  Not to mention Mommy and Daddy.  All agreed that she seems to be filling out her tiny frame nicely as she packs on the "OZ's"...a phrase properly coined by the one and only Mommy.  Her chest and stomach definitely look to be beefier and her little arms and legs, and even her face appear to be plumping some as the days go on.  Britne and I see her every day, but even we can tell a difference.  We're so proud of our little fighter!!

I'm keeping this one short tonight, it's been a long week and the thought of having to face a Monday morning tomorrow is making me even more exhausted.  I hope all of you folks have a great night!  Thanks again for all your prayers.  I can't state enough how appreciated and important they are to us.

First Contact

At this stage in the game, an uneventful day is a good day.  Emma behaved herself wonderfully today.  Following her blood transfusion yesterday, she followed that up today with having zero A's and B's.  In terms of Emma alone, the big event today was the increase in her feedings both this morning and this evening.  This morning they increased her to 6.5ml of milk and tonight they upped it again to 7ml.  She's up to almost 2 ounces a day at that pace, a far cry from her initial pace of 1 ounce every 4 days.  The increase in her feedings is already paying dividends.  Little Emma has packed on a few ounces and is now up to 1 pound 11 ounces!!  After being born at 1 pound 9 ounces, she dipped all the way down to 1 pound 6 ounces last weekend.  Since then she's definitely trended in the right direction.  Here's hoping that trend continues!

As I mentioned a few days ago, they will begin fortifying her milk tomorrow.  That is, they are going to add calories to it to help her gain a few more ounces.  They've informed us that if she keeps tolerating her increased feedings, they expect her to be completely off of IV fluids by Wednesday and she will be getting all of her nutrients from her milk, so fortifying it will help even more.  The substance they use to fortify the milk will contain extra protein, fat, and carbohydrates, all the building blocks for gaining weight!  This little girl is going to be on the anti-Atkins diet.  It will also contain other essential nutrients such as calcium to help develop her bones better and grow even more.

She got some good time again with Mommy today.  The two spent an hour and fifteen minutes cuddled together in a recliner for what they call kangaroo time, which is what I've described before as the skin to skin contact.  This contact is beneficial for both Emma and Britne as it helps develop the bond between mother and daughter.  I've also gotten to do it a couple times myself, and it is amazing.

So through all that today with no A's and B's, the increased feedings, the weight gain, and the kangaroo time with Mommy, the absolutely thrilling highlight of the day was Emma and her big sister Eden holding hands for the first time ever.  The nurse who is in charge of taking care of Emma tonight was nice enough to allow Eden to sanitize her hands and reach into the isolette and touch little Emma's tiny hand.  It was one of the most touching moments of my life.  Eden put her finger on Emma's hand and Emma wrapped her tiny little fingers around Eden's finger.  It was brief, but she definitely grabbed her big sister's finger.  Eden grinned from ear to ear.  She loves her little sister so much.

Emma continues to fight hard.  It amazes us every day just how hard this little girl is working.  As Dwight D. Eisenhower said, “What counts is not necessarily the size of the dog in the fight – it’s the size of the fight in the dog.”  She's going to be one tough cookie, Eden better watch out!  Eden's pretty tough herself though, so we are in for some battles over the years to come.  Thanks again to all of you folks out there who are praying for not only Emma, but our whole family.  We wouldn't have the strength to go through this without you guys.

Harmful Benefits

You might recall the other day I posted about Emma's CPAP.  It was great for providing support to her little lungs, but was also pushing air into her stomach, making it difficult for her to be regular.  Well, another such situation reared its ugly head this morning.  They have to test Emma's blood daily to make sure everything is looking good and make adjustments in her IV fluids when things get a little off.  All of these blood tests are great at letting the doctors know what adjustments need to be made, but they also deplete her blood supply.  Our red blood cells are made in the bone marrow.  When we lose some blood, the bone marrow simply makes more to replenish our supply.  In a preemie this is just another example of something that is immature.  The bone marrow hasn't fully matured to the point of being able to create enough red blood cells to make up for the amount they withdraw every day, so she will need a little boost to help her with this.  And this morning, Emma received a blood transfusion.

The doctors briefly talked to me about this yesterday, but did not indicate that anything was this imminent.  So when Britne received a phone call this morning asking for her consent to give Emma this transfusion, we were a little shocked and scared.  But due to the big bad book on preemies they gave us yesterday, and a good friend who has gone through this exact same thing with his oldest child being born premature, our fears were quickly resolved.  Thanks J!  It's very common for preemies to have to get blood transfusions due to the fact that they have immature bone marrow, as I mentioned above.  There is a medicine they can give instead, but transfusions are faster acting.  They solve the problem pretty much immediately.  The red blood cells are responsible for delivering oxygen to the body, so this should also help reduce the amount of apnea spells she has.  There was apparently an increase in those episodes over the 24 hours leading up to her transfusion, so that coupled with the low count they received when they tested her blood led to the decision to go ahead and go forward with the procedure.

This is just another example of things that we had no idea we were getting into.  Each day is more and more of a learning experience and we hear more stuff from the doctors and nurses every day.  We know they've been through this a million times and for them to sit down and tell us everything to expect would not only take too long, but it would scare us even more because some of the things they've seen with other kids will not happen to Emma.  All kids are different and move along at their own pace.  We wish there was a cheat sheet, but unfortunately there isn't.  We just have to keep learning on the fly with the understanding that the doctors and nurses are NOT learning as they go.  They have seen it before, they know how to handle it, and they have everything under control.  It's a difficult thing for a parent to do to place your child's life in someone else's hands.  But in this situation, we simply have no other choice.

Emma was in great spirits when we got there early this evening, though.  The nurse told us that since the transfusion she had zero apnea and bradycardia episodes, so it seems that the transfusion did indeed help with that as they indicated it should.  Both Britne and I got to hold her tonight, which was downright awesome.  Britne held her for about an hour and a half and then I held her for about an hour.  She was getting a little uncomfortable near the end of that, as I'm pretty sure that's the longest she's ever been out of her isolette.  But it was great that they let both of us hold her.  And as soon as they put her back in her isolette she calmed right back down and was doing great.

Both Britne and I looked at her today and agreed that she seems to really be starting to fill out some.  She gained another 20 grams this evening, so maybe there is something to our perception.  They upped her feeds again this morning to 4.5ml each feeding and then at the 8pm feeding tonight they increased it again to 5ml.  This gradual increase will continue every day for quite a while as long as Emma tolerates it and continues digesting her milk well.

So a day that got off to a rocky start quickly calmed down and turned out to be another good day.  Brit and I both thought that she looked better today than she did yesterday.  Her eyes were open very wide, the widest I've ever seen them open.  Even though we were a bit concerned when they mentioned a blood transfusion, it seems to really have perked her up.  She reacted well to it and had a great day afterwards!  Hopefully she'll enjoy seeing her big sister again tomorrow.  I know Eden will be excited to see her.  Thanks for the concern and the continued prayers!  We all appreciate it, especially little Emma.  Goodnight everyone!

The ABC's of Preemies

Emma's older sister Eden is so excited that she's learned her ABC's.  She sings them all the time and ecourages Britne and myself, and frankly anyone else who is around her, to sing with her.  She's so proud of herself for learning them, and we must say that we are proud of her as well.  Emma, being a preemie, is working on a different kind.  Instead of the ABC's, it's just the A's and B's.  That stands for apnea (when the baby stops breathing) and bradycardia (a decreased heart rate), which is very, very common in premature babies.  In fact, 80% of babies born before 30 weeks of gestation have this problem.  In most cases it gradually becomes better and resolves itself prior to 36 to 38 weeks gestational age.  It's considered mild if the following criteria are met:  the baby doesn't stop breathing for 20 seconds (try holding your breath for 20 seconds and see how tough that is), her heart rate doesn't dip below 60 beats per minute, she resolves it on her own by beginning to breathe again, and she has fewer than 10 to 12 a day.  So far, Emma meets all the criteria for mild A's and B's.  She's having about 4 to 6 episodes a day and each time she's resolved it on her own without any intervention.

It is very nerve wracking to be in the NICU spending time with her and look up at the beeping monitor and realize that her respiratory rate is 0 and her heart rate is dropping.  You're looking around wondering why all the nurses are just sitting at their computers charting or doing whatever it is they're doing instead of rushing to help your child come out of one of these episodes.  But the reason they have that job and the parents don't is because they have years and years of not only training, but dealing with this on a daily basis.  One such occurrence happened to me this afternoon when I went to visit Emma.  I was just standing there watching her when all of a sudden one of the alarms on her monitor started to beep.  I looked up to realize that she had stopped breathing and her heart rate was dropping...117, 102, 85.  Finally, 2 nurses who were covering for Emma's nurse, who happened to be on her lunch break at the time, came casually walking over, one of them saying to the other "She's bradying."  The second they made it over to Emma's isolette, she resolved this herself and started breathing again, and I watched as her heart rate climbed back up to its normal 140 to 150 rate (yes, that does seem high as the normal adult heart rate is about 60 - 90 beats per minute, I believe, but it's totally normal for young babies).  The nurses wait to intervene not only because they realize better than the parents when it's time to be alarmed, but because it's good for the baby to learn how to come out of these episodes on their own.

About 5 minutes later, the doctors were making their rounds and were so excited to report that since the increase in her caffeine the day before she'd had no more bradies.  I was a little disappointed to have to tell them that she'd just had one.  But that was the first one she'd had all day, and the first she'd had since 4pm the day before.  She did have a few more after that a little later in the afternoon, but she was still under the 10 per day that raises an alarm from the doctors.  Britne was with her later in the afternoon and said her heart rate didn't even drop below 100 on any of the ones she observed.  So Emma is still going along as expected.

Dr. Price, the chief in charge of the NICU, was one of the doctors who was making rounds when I was there this afternoon.  After he'd gotten the full update from the nurse practitioner on Emma's overall condition, he turned to me and said "We are still cautiously optimistic.  As you know things can change in an instant in premature babies, but up to this point, she's done exceedingly well."  That was a big boost for me, and it put a smile on my face about as wide as I can possibly imagine!  Still, he prefaced everything by saying that he and the entire team remain cautiously optimistic.  Emma's Mother and I share that same stance.  We know that at the drop of a hat anything can happen, but we cherish each and every good report we get from the doctors.  We know that we haven't had our last bad report, but that doesn't make the good ones any less enjoyable.

As I mentioned last night, they increased Emma from 1ml of milk every 3 hours to 2ml.  Well this morning they increased her again to 2.5ml.  She tolerated that increase very well, and the plan, as it was told to Britne, was to increase her again this evening at her 8pm feeding to 3ml.  I called for an update at around 8:45 and her nurse told me that they had indeed increased her feeds again, but it was to 3.5ml, even more than they'd told Britne they would give her. 

They weigh Emma every night, sometimes they weigh her prior to her 8pm feeding, sometimes prior to her 11pm feeding.  It all depends on which nurse she has that night.  Last night when they weighed her she was up to 710 grams, up 40 grams from the day before.  That's a little over an ounce gained, and more importantly, it's 2 grams more than her birth weight of 708 grams.  There are approximately 450 grams in a pound, so there's about 28 grams in an ounce.  So a gain of 40 grams is nearly an ounce and a half.  At this point they want the babies to average a weight gain of around an ounce a day, because that's the average gain they would have in Mommy's womb at this gestational age.  So they have a protocol they follow for increasing her milk intake that coincides with their goals of increasing her weight.  In the next few days, definitely before the weekend is out, they will begin fortifying her milk with a supplement to add a few calories to it.  They've told us that Mommy's milk usually averages 20 calories per ounce (again, an ounce is 30 ml, so Emma's still well shy of that volume every feeding) and the substance they add to it will increase that count to 24 to 26 calories per ounce.  This will all aid Emma in adding some weight to her tiny little frame.  It's completely normal, they do it in all babies in the NICU.  They reassured Brit and myself of that yesterday afternoon.

I know that was a lot of information for one post, but the hospital gave us a book yesterday called "Preemies:  The Essential Guide for Parents of Premature Babies."  It's basically an encyclopedia of everything that can happen during a stay in the NICU.  They have encouraged us to read only the parts of the book that pertain to our current situation.  It's got a lot of information in it, and much like googling stuff, if you look up everything, you're going to find stuff that scares the daylights out of you.  But since Emma's been having some episodes of apnea and bradycardia, I looked that up in this book tonight, hence the extraordinarily long post.  All in all, it was another positive day for Emma.  We remain, as they tell us to, cautiously optimistic.  Taking this experience one day at a time is the only way to do it.  I sometimes find myself thinking ahead, then I have to remind myself not to do that.  We never know what's just around the corner.  But so far we're 9 days in, and we're very, very proud of the strides Emma has made.  Keep fighting little girl!!  Your strength is what is keeping us going.  We love you!