Follow-up appointment

Hanging out with Daddy on the couch

Camo overalls from Nana

From a little home photo-shoot Auntie Bri and I rigged up

'T' is for Truck and Tractor :)

Standing up like a big boy!

This snow suit from Grandpa Smith and Rita is a bit big, but he looks so cute and it's sooo warm!

Eli's follow-up appointment with Dr. Ekanem went very well. He said it sounded like his bronchiolitis was all cleared up and he was happy that he had started to put some weight back on. He was 14 lbs when he was admitted to the hospital, and yesterday he was 14 lbs 6 oz. I was pleased.

He has been doing great sitting up. I've started to count how long he sits unassisted, Mississippi-style. He has made it to 15-mississippi. Also, he rolled over last night like it was nothing. It's been a while since he's done it on his own. I usually have to "bait" him with a toy like you do when you're teaching a dog to roll over, and then he still gets angry and gives up most of the time. I was so excited to see him enjoying tummy time!

Playin' cards and sittin' up

It's been pretty darn cold around here lately--in the negatives. I had to cancel two of Eli's doctor's appointments. One was a follow-up with his regular pediatrician so he could see how Eli's been recovering. The other was actually two separate appointments in Columbus at Children's Hospital: a visit with the urologist and a developmental check-up with the folks at the BPD Clinic (the clinic that will be checking in on him until he is two). I was really looking forward to the BPD Clinic appointment where they would have shown me where he is on the growth chart and compared his development to other babies his corrected age. The test they were going to give him was designed for babies up to a corrected age of 4 1/2 months, and he has now passed that, so there was no point to reschedule. He'll be going for the 6-month test in March.

I'm not concerned with Eli's development so far. In some ways, he seems to be ahead of an almost-5-month-old, and in some ways behind, but I don't think he needs any intervention. For example, he is still not really rolling over, but he's almost able to sit up unassisted (can for as long as 10 seconds or so). He grabs at toys, but doesn't really handle them other than to hit them or shake a rattle. I guess I'll have to wait until March to see what they think.

We've discovered that Eli enjoys playing cards. He likes looking at them and tries to throw them and put them in his mouth. He's pretty good too. Whoever is on Eli's "team" always seems to end up winning.

Now I lay me down to sleep

Eli has been falling asleep like this lately. Isn't it sweet?

Bubble Boy

Sunday
Eli had been pooping more than usual since Thursday, the 1st, but he started to have aweful diarrhea. He also had a cough and a runny nose.

Monday
The cough and the congestion gets worse and he starts to sound wheezy. I debate about bringing him to the ER that evening, but I assume they will tell me it's just a cold and send us home. He didn't have a temperature, so I decide to wait it out and call Dr. E., his pediatrician, the next morning.
Tuesday
Eli is no better or worse. There was no answer at Dr. E.'s office. I call the BPD clinic in Columbus and talk to the nurse clinician. She says, yes, it's probably a cold and give him some pedialyte for the diarrhea. Later, I give him a bath in some Vicks-type soothing bubble bath and he goes to sleep. Around 9, he wakes up and sounds aweful. Seth described it as "he sounds like he's been smoking for 20 years." At this point he can't even cry. The only sound he can manage to let out is a whine tha sounds like something you'd hear in Jurassic Park.

I decided to take him to the ER. Eli's Grandma Jody went with us. He was running a low-grade temperature when we arrived. When the doctor came in to listen, Eli didn't like the coldness of the stethoscope. I'm not sure whether he was merely trying to get away or if he wanted me for comfort, but he appeared to be reaching for me. It was the first time he'd done that and I can't describe how it made me feel. I've never felt so needed.

The doctor ordered a chest x-ray and bloodwork. Blood analysis showed elevated white blood cells, indicating that he was fighting an infection (no, really?). The doctor said that he didn't see anything on the x-ray, but after it had been read by the specialist in the morning, someone would call me if anything was wrong. He couldn't diagnose Eli, but he prescribed an antibiotic, just in case. We went home, and a cranky Eli stayed up until 5 a.m.

Wednesday
I had a dentist appointment for a toothache at 9:00. I left Eli with Grandma Jody, because Seth was working. While I was in the waiting room, I got a phone call from Eli's pediatrician. He asked about Eli's visit to the ER. I told him about it, and said that I had been concerned because of the wheezy breathing, that I thought it might be a respiratory virus. "That's why I'm calling," he said. And my stomach dropped. "I think Eli might have RSV, the very thing we've been trying to prevent. We'll need to see him today because he might have to be admitted."













Right after my appointment, I drove 30 minutes home, packed up some diapers and pj's, and brought Eli to see Dr. E. He concluded that he needed to be admitted so he could be monitored and receive breathing treatments. We went to Wetzel County Hospital, a small hospital near our hometown, where Dr. E. would still be his physician.

When we got to the room, some nurses checked Eli's oxygen saturation. It was 85%. He was going to need to be put on oxygen. Because he was so congested, he would be put under a tent that would be filled with humidified oxygen. This tent was to be put over a crib. For those of you who don't know, we co-sleep with Eli at home, and he's not been in a crib since he was in the NICU. We tried a pack 'n' play and a bassinet when he first came home, but that last all of 2 weeks. I did not like the thought of Eli having to transition to a crib when he was sick and afraid. I wouldn't even be able to hold him close to me, because he needed the oxygen in the tent. And how was I supposed to breastfeed him? Get into the crib? After voicing my concerns to the nurses, they allowed Eli to stay in a bed with me, something that isn't usually done for safety reasons. I was very pleased.
Thursday
Eli was getting breathing treatments every 4 hours, an antibiotic and hydration through IV, Zyrtec for congestion, and his temperature and sats were checked regularly. When awake, his sats were in the high 90's, and asleep, in the low 90's.

Friday
Eli started to feel much better. He no longer sounded like a pterodactyl, and he was starting to play and smile again. That evening, Dr. E. wanted him to be taken out of the tent for the evening, as long as he could keep his sats up. If all went well, he'd go home in the morning. The nurses checked Eli's sats an hour later, when he was asleep, and he was at 85%. He went back into the tent. Later, we tried again to take him out, but he was at 85% again when they checked him (also sleeping). He stayed in the tent for the rest of the night.


Saturday
Dr. E. came in the morning and wanted him out of the tent and wanted his sats checked while he was awake. An hour later, he was at 95%. He took a nap, and when he woke up, he was at 99%! We were able to go home late that afternoon, and we were sent with a portable nebulizer for breathing treatments, and 5 days worth of antibiotic. We've been home for 2 days and all is good. Eli still has a cough and some congestion, but it's not nearly as bad, and you can tell he is feeling much better.

I am still not really clear on what he had. The chest x-ray showed pneumonia, which is what rsv looks like on an x-ray. A mucous swab tested negative for RSV, but Dr. E. said that didn't mean he definitely didn't have it. His diagnosis was acute bronchiolitis, which, according to wikipedia (not the most scientific resource, I know, but useful for understanding things in everyday language) is a common virus in infancy caused by RSV, the flu, rhinovirus, etc. Just to note, here is the reason RSV and the like affect Eli so badly. A virus can not be warded off by an antibiotic; it can only be left to run its course and the immune system gradually does its thing. Being a preemie, his immune system is at a disadvantage. It's also a respiratory illness, and as you know, Eli's lungs are not as developed as other babies his age. The moral of the story is: if you think your child is sick, it's better to be safe than sorry, especially if he was a preemie.

Here are two pictures of Eli in the hospital. In the first, he is a few days shy of 7 months, and in the second, he's in the NICU and is a few days shy of 2 months. Think he's changed much?

Welcome

Hello all, and thank you for visiting Eli's new blog! If you are a regular reader, I appreciate your interest and your concern for Eli. If this is your first time, welcome! Since this is the first post here, I will provide a short history.

My name is Courtney and I am Eli's mother. I have been keeping a blog--for personal record, to update family, to educate and entertain--since shortly after Eli was born. He was due on August 27, 2008, but my water broke on March 9th (15 weeks in). This early breaking of water is referred to as pPROM: preterm premature rupture of membranes. My fiance, Seth, and I were told that I would most likely go into labor too early for the baby to be viable; they expected within the week. If that didn't happen, they said, I would probably not make it to term and even if I did, the baby would be born with very immature lungs (babies need amniotic fluid for their lungs to develop, and mine was leaking about as fast as my body could make it) and there would be nothing that could be done for it. The baby would also probably be born deformed, because with no fluid, the uterus is like a deflated balloon, and the baby has little room. Along with these risks were a terribly long list of complications that come along with being premature, which they assured me, he would be.

Despite the odds, Seth and I decided to take our chances, and pray; we continued the pregnancy. I couldn't imagine giving up on my baby...my baby... a part of me and the man the I love. I would have wondered my whole life, "what if?" I went about the pregnancy with an optimistic attitude, keeping in mind that it could still end in heartache.

Until 23 weeks, I was placed on strict bed rest at home. For the most part, I was cared for by Seth and his mother, but I had a lot of help from many other people as well, and I'm incredibly grateful. At 23 weeks, the baby is considered able to survive outside of the womb. It was then that I was admitted to Ohio State University Medical Center in Columbus, 3 hours away from home and my family. Since there is nothing that can be done about pPROM, I was there for monitoring and close access to hospitals capable of caring for a very premature baby.

At 28 weeks, I started to have some heavy bleeding. An ultrasound indicated that the placenta was beginning to tear away from the uterine wall, something that would be very dangerous to Eli and to me. At the advice of the obstetricians and a neonatologist (NICU doctor) I had been talking to throughout my stay at OSU, we decided I would be induced. Because my body was far from ready for labor, it took a while, but I successfully delivered vaginally and Eli Richard arrived at 12:53 a.m. on June 11th--exactly 29 weeks. He even let out a small cry, which gave us hope for his tiny lungs.

I wasn't able to see him up close right away, but the NICU team did pause at my bed side for a moment before wheeling him away in the incubator. A few hours later, Seth and I were allowed to enter the NICU and meet our son. He weighed in at 2 lbs 12 ounces at 15 inches long, and although curled in a ball, he was roughly the size of my hand, he looked remarkably big and absolutely perfect and beautiful to me. At first sight, I knew everything would be ok. Of course I was still scared, but I just had a good feeling.

For the next few weeks, I spent as much time as I could with Eli, and when I went home, I called the NICU every day for updates and learned as much as I could about what was going on with my little miracle. I learned about bilirubin, the incubators and alarms, meconium, PICs, bradycardias, and sats. Boy, did we hear a lot about sats. Oxygen saturation in the blood, or sats, are measured by pulse oximeter (or pulse-ox, the little red light they put on your finger). The goal was to keep Eli's sats above 85%. Anything below was considered a de-sat, and anything in the 70's or below was a pretty bad one. The level of respiratory assistance was adjusted according to his needs. Eli started out on the ventilator, or breathing tube, which pumped air into his lungs and "breathed" for him. At about 1 week old, Eli moved to a CPAP, which blows air into his nose with pressure to keep his lungs expanded, but he took each breath on his own.

When he was 3 weeks old, Eli was transferred from OSU to Nationwide Children's Hospital because we had a scare with a condition known as NEC in which parts of the bowels die and need to be removed via surgery. Thankfully, Eli didn't end up needing surgery, and the move ended up being a blessing. The day before the move, there was an opening at the Ronald McDonald House which is practically in the parking lot of Children's Hospital. I was able to be by Eli's side for the rest of his NICU stay.

Around 8 weeks or so, Eli was able to move from the CPAP to the nasal cannula (which gives him a tiny whiff of pure oxygen), and shortly after, he was able to begin bottle and breastfeeding. On August 19th, 8 days before Eli's original due date, he was released and sent home on oxygen. He came home at 5 1/2 pounds, which is exactly double his birthweight.

At home, things went pretty smoothly. We were still living at Seth's parents' which ended up being a huge help. There were many people who enjoyed meeting Eli for the first time or being able to see him more often, including his Daddy. He gained weight and adapted well to being home. He was able to become cannula-free on October 1st, after being home for 6 weeks.

Today, Eli is 7 months old, 23.5 inches long, and 14 lbs. His adjusted age is 4 1/2 months. We often think about the things we were told about terminating the pregnancy and about Eli never being able to take a breath. I used to be angry at the doctors for leaving us feeling hopeless, and I'll admit that I was angry that this happened to us. I no longer feel that way, though. The doctors were just stating the facts, and I soon realized it wasn't them I needed for support and strength. And other than the pain this journey may have caused Eli, I wouldn't trade the experience for a normal pregnancy. I learned so much about myself and about prematurity, and Eli and I have created a very special bond. I know it sounds cliche, but Eli is a strong little boy and I know he is going to do extraordinary things. I thank God for him every day.

Here is a picture of Eli at birth and recently: