The Dilemma

Day of Life: 77

Six pounds! Tera has officially started gaining weight again and is now six pounds!

I never thought she would get this big this fast. I thought that I would be lucky to bring home a five pound baby, much less a 6+ pound one. I still get email updates from thebump.com telling me how my pregnancy should be going. (Uh, thanks, but my pregnancy is happening in a glass box right in front of me). According to the website, my 37-week baby should now be the size of a watermelon (check) and gaining about 1/2 ounce each day (check) and practicing skills like blinking, sucking, breathing, and gripping (check, check, check, check). Sounds like a pretty reliable source.

Today's goal seems to be the same as yesterday - regulate body temperature. The Air Temp in her Isolette is still higher than it should be, but somehow it seems like she's doing better. I don't have any basis for that statement, just a hunch. Just to be sure, I put an extra layer on her feet and head before taking her out this morning.


Tera's pediatrician wasn't here today, but a Nurse Practioner came around to check on her before making rounds with the Neonatologist. If you remember, Tera went ad lib on her feeds yesterday. This means that she can take as much or as little as she wants with each feed. Her nurse yesterday suggested that I keep her at 50cc for the first few days. No need to push her too hard too fast. When the Nurse Practioner came in this morning, I learned that Tera had taken 70cc at two different feedings and 62cc during a third one. This scared me a little for a couple of reasons. First, Tera had a follow-up echo yesterday (that I forgot to mention), and it shows that the PDA is still there. Small, but there. Until the whole IV incident last week, Tera was considered "fluid restricted" because of it. I was worried that her taking in too much milk too quickly could cause the PDA to act up. Second, the nurse yesterday suggested that I not increase her feeds so quickly. I discussed this with the Neonatologist when he came in to check on Tera, and he said not to worry. The PDA is still not a problem, and if extra milk is going to cause it to become a problem, we'd rather it happen at the hospital than after we get home. His suggestion was to let her eat as much as she wanted.

After looking at Tera and her history, he reported very enthusiastically that she really looked great. In fact, he went on and on about it. I couldn't help but agree. I asked that we wait at least one more day before working on a crib, and he said that would be fine. Whenever I was ready is fine with him.

I know that yesterday I felt very comfortable with the Slow and Steady mentality of Tera's development, and I'm still on board with that. But today, it feels more complicated. I feel like I am in the position to make decisions for Tera, but sometimes I don't know what decisions to make. Some nurses and doctors say to push; others say to hold back. Some say that I should wait to let Tera regulate her temperature in the Box; others say I should get her in a crib to see if she can do it on her own. Some say to regulate her feeds; others say to give her as much as she wants. Two conflicting philosophies on every decision. As a parent (not a doctor) it seems to come down not to what philosophy do I trust (How would I know? This is my first preemie.), but what person do I trust? Then the problem becomes that I trust them all. They've all seen hundreds of babies succeed under both sets of circumstances. How do I know what's right for Tera? I know there's a time to push and a time to wait, but which do I choose and when? As tough as it is to admit, I think part of the problem also lies in the fact that I am trying not to let my eagerness to be home get in the way of making good decisions for my daughter.

As I think about all of this tonight, I can't help but make a connection between my dilemma and my newest Soapbox - NICU parents that smoke. I walk through the garage on my way in and out of the hospital each day. There is a small glass hut - it looks like a bus stop bench - where all of the parents go to smoke. I know it shouldn't, and I don't mean to judge, but it irritates the fire out of me. With everything that is known about second-hand smoke, why do people smoke when they have babies? Especially when those babies are in the hospital? It just seems so selfish, giving in to your own personal desires when that lack of restraint could cause harm to an innocent baby.

It hit me tonight that, in a way, I currently share this addiction. Well, not this addiction to smoking, but I share the addict mentality right now. Sometimes - not all the time, but sometimes I want to do the really selfish thing and just push her right on out of here. Put her in a crib. Dress her in five layers of onesies, socks, and hats and just force her to stay warm enough. Then my conscience kicks in, and I know how selfish it would be, but somehow I still want to do it. I want my needs met, and I momentarily forget that meeting these needs could mean neglecting hers. This must be how the smokers feels. They have a strong personal desire, and they have to decide whether fulfilling that desire will be harmful to the needs of their children. I know this metaphor may seem a little far-fetched, but I can't help but feel like a smoker today.

As it has for the last eleven weeks, I know this will all work out and, in the end, Tera will make the final decisions. Not her Basket Case of a mother (thank God!). So for today, we will just continue to wait, and we'll make the next decision when the time comes.

Tera's nurse today was the type that let me do everything. I wrapped her up, got her out of her bed, fixed her bottles. Everything. It helped me relax about all of my indecisiveness and just enjoy being her mom. I said earlier that Tera had been taking extra amounts of milk during the night. It seemed that it all caught up with her during her 11:30 bottle. She was very tired and only took 25cc. Because she had had so much before then, we didn't worry about giving her the extra milk. She hasn't had a feeding tube in several days, and it didn't seem necessary to give it to her today. By 2:30, she was alert again and ready to eat. She took 80cc - that's almost 3 ounces - in one bottle. The Speech Therapists were there to watch her eat. They were so impressed with how well she did. While this feed was next to perfect, I did have to tell them about her recent choking issues. I think I mentioned these a few days ago, and they are still going on now.

I'll have to watch more closely over the next few days, but her choking seems to occur either at the beginning of a meal or at the very end. And it seems to occur when she's overly tired. This makes sense because when she's tired, she's not as organized and doesn't always remember to follow her suck-swallow-breathe pattern. The Speech Therapists said that if she doesn't grow out of it in the next few days, we can look into doing a Swallow Test to see if there is a problem with how she swallows. They don't think this will be needed, mostly because she's shown that she can do it really well. But it's an option if we need it.

Soon after her massive bottle, MyGoo came for her weekly visit today. She spent some personal time with Tera during her stay.

I love this picture of Tera!

MyGoo brought a beautiful dress that she made for Tera to wear home. I haven't taken any pictures yet. I'm saving them for when that day actually comes.

MyGoo left just after Rush Hour traffic calmed down. Lydia came to visit, and Nonna and Poppa came by soon after. I told them last weekend that they would be able to hold Tera on their next visit, and they were eager to get their turn. Before they held her, I fed Tera a bottle. Because she had taken so much in her last bottle, we let her sleep for four hours instead of her usual three. When I got her ready to eat at 6:30, she was very alert and eager. I started with a 60cc bottle (2 ounces), and she took it down very easily. The nurse had brought in 70cc, so I got the last 10 because she was still very alert. She was a little hesitant to take the bottle back, but she eventually started sucking again. She hadn't gotten much down when . . . she choked again. This one was pretty dramatic, at least from my end. She was definitely a little purple, and it seemed to take longer than usual for her to take deep breaths. I just beat her back and tried to startle her back into high oxygen saturation. It got down to 12 at one point. When she finally came out of it, the nurse and I agreed not to give her anymore to eat. Tera seemed satisfied, and I didn't want to go through that again.

Nonna and Poppa finally got their turn with Tera. She stayed awake for a few extra minutes while Nonna held her.

I know she's not really smiling, but Tera smiles a lot. I like to think it's because she's so happy.

Poppa still had on his clothes from work, so he wanted to wear one of the Isolation aprons to protect Tera from any germs he might have brought with him.


There's something about Granddads making a perfect cradle.

When we finally put Tera back in her Isolette, we found that Nonna and Poppa had kept her very warm, even though she had been out for over an hour. We all headed back home after this. I tried to go to bed early, but thinking about my Smoker metaphor is keeping me up longer than I had hoped.

What About Barry and Canon?
Canon had to leave school early today because, according to his diapers, he's having some stomach issues. Sharon picked him up from school, and Barry has gotten our baby-sitter, Brittney, to keep him tomorrow. He won't be able to return to school until Thursday, assuming that everything clears up before then. I told Barry to stop feeding him so many chicken nuggets, but he seems to think that this is not the problem and that a little Gatorade will fix it all. He agreed to at least swap the Gatorade for Pedialyte. Knowing Canon, he's probably not acting sick at all and will love the one-on-one attention he'll get from Brittney tomorrow.

Before Bath Time, Barry called me using FaceTime to show me one of Canon's newest tricks. I don't know if you've ever heard of a Slurpie (that's what I call them). It's when someone blows on your belly or cheek and makes the bubbly sound (also called the Fart sound!). Canon is really into doing this now. When I could see them on the screen, Canon walked right up to Barry and gave him a Slurpie on the cheek. Then, without warning and without being prompted, he leaned into the phone to try to give me a Slurpie, too! It was hilarious and sweet all at the same time. You can understand the severity of my previously mentioned dilemma. Who wouldn't want to be at home with that?