Gavin Comes Home!

Gavin was discharged from the NICU today and we were finally able to bring our little boy home! I couldn't ask for a better birthday present than having all my boys home with me tomorrow!

Daddy, Mommy, and Ryan spent a special morning together making cinammon buns, snuggling on the couch watching morning cartoons, assembling brownie trays for the NICU staff, and enjoying lunch at Chick-fil-A. We then piled into the car around 1 p.m. for the hour-long trek down to Shady Grove Hospital.

Once we arrived at the NICU, we presented the nurses with homemade brownies (as well as hugs) to express our gratitude and heartfelt appreciation for the care and support our family received during Gavin's stay. We then changed Gavin's diaper (naturally, he peed everywhere once the diaper was off!), dressed him in his blue and white gingham sail boat "going home" outfit, signed all the necessary paperwork, strapped him into his infant carrier, loaded him into the car, and headed for home!

Ryan, who had never been in the NICU and had only seen Gavin once or twice through a small window next to Gavin's bed, was excited to finally meet his new little brother. As you can see in the photos below, Ryan was all grins and dimples during the entire visit! The first thing he did when he saw Gavin was to reach out to gently "pet" him and smell his feet for "stinky feet." He then proudly helped Daddy carry the carseat through the hospital lobby, waited with Gavin while Daddy pulled the car around to the front entrance, and helped load the infant carrier into the car. Ryan then entertained Gavin during the ride home by reading books and singing "Twinkle Twinkle Little Star" and the "ABC's" (despite the entertaintment, Gavin was only awake for the first half of the trip). Daddy was so proud of the way Ryan behaved at the hospital that he treated Ryan to ice cream with rainbow sprinkles at Jimmy Cone in Damascus. Once we arrived home and were greeted by Guinness, Ryan insisted on playing with Gavin. Although he quickly realized that Gavin isn't able to play quite yet, Ryan kept running over to Gavin throughout the afternoon to hug and kiss him. And at bedtime, Ryan, without prompting, hugged Gavin and said, "I love you." We couldn't ask for a sweeter, more loving big brother for baby Gavin!

Mommy preparing for the first of many diaper changes. This was also the first time we saw Gavin without any monitors, wires, or leads attached to him.


All dressed up in his going home outfit and looking much healthier than he did 9 days ago!

Ryan's assessment: "Pee-eww! Stinky Feet!"

The first family photo; we look tired from the stress of the past 9 days but relieved and thrilled to be bringing Gavin home.

Ryan proudly poses with his new baby brother as he waits for Daddy to return with the car.

Daddy's little helper helps lift the car seat into the car and inspects the installation to make sure it's safe and secure enough for Gavin to travel. Gavin is already exhausted from all the excitement and ready to nap on the ride home.

Gavin, Mommy, and Ryan anxiously await chauffeur Daddy to drive us home.

Mommy squeezes between the two boys, ready to run interference if necessary.

Gavin was alert for the first 15 minutes of the ride, but soon fell asleep despite Ryan's boisterous singing.

Ryan was disappointed to discover that, given the position of the two carseats, he couldn't see or reach Gavin during the ride home. Once we arrived home, he was excited to see how Gavin fared during the hour-long drive.

Ryan offers Gavin the first of many kisses before helping Daddy unload the carseat and carry it inside.

Daddy finally gets to hold Gavin in the comfort of our own home and without all the wires and beeping monitors!

Ryan compares foot sizes with Gavin. Although Gavin has long, skinny toes and big feet, Ryan's feet are still bigger (and probably stinkier!).

Mommy holding her sleepy little boy. Let's hope he sleeps this well at night!

NICU Days

As we prepare to finally bring Gavin home from the hospital tomorrow (Monday, June 29), I wanted to take a look back at the 9 days he spent in the NICU. The photos below show his progression from when he was really sick until now. Although he's a healthy little boy now, the early photos are a reminder of just how sick he was at the beginning. And, his recovery over the past week and a half is a testament to the amazing work of the NICU staff at Shady Grove Adventist Hospital. The nurses and neonatologists are truly angels here on earth - they were exceptionally caring, supportive, patient, accessible, and honest and forthcoming with information. We will be forever indebted to them for ensuring Gavin a healthy future.

The First Few Days
The days immediately following his delivery, Gavin was on CPAP (continuous positive airway pressure) to help keep his lungs inflated so the excess fluid in his lungs could be reabsorbed into his system. The nurses and doctors had to frequently adjust the air pressure as well as the amount of oxygen he received via the CPAP device based on his breathing rate and oxygen saturation. As Mike explained in one of his email updates, Gavin developed a pneumomediastineum (air in the space between the lungs) and subcutaneous emphysema (air in his chest) caused by the pressure from the CPAP. Although he needed the CPAP, he had to be briefly removed from it and placed in an oxygen tent to dissolve the stray air pockets. Also, since his lungs were not fully developed and he had respiratory distress syndrome, he was given two doses of surfactant to help keep his lungs open and improve his breathing.

These two photos were taken during Gavin's first 24 hours in the NICU. The second photo shows the first time I was able to hold Gavin (about 20 hours after delivery!).



Improving, but still a ways to go
After a few days, Gavin graduated from the CPAP to a nasal cannula, which is considered a step down from the CPAP, but still delivers oxygen and positive pressure to assist in breathing. Gavin was slowly weaned off of the oxygen over a period of days. Once he was on room air only, the NICU staff gradually decreased the air flow until he was breathing completely on his own. He also had a tube in his mouth, and later his nose, that they fed him through until he was strong and stable enough to be bottle or breast fed.

Although seeing him hooked up to so many tubes and wires was unsettling, around this time he began to open his eyes and respond to us, which made things much easier, especially since this was around the time I was discharged.

Breathing on his own
On Saturday, June 27, we walked into the NICU and were surprised to discover that Gavin was tube and wire free! The nurses and neonatologist had weaned him off the air from the nasal cannula overnight and he was able to maintain an acceptable breathing rate and oxygen saturation level on his own. Once he was completely off of air, the staff had to monitor him for 48 hours to be sure he was stable before discharging him. The end was finally in sight! As an added bonus, we could finally see our little boy's handsome face and hold him without getting tangled in the wires or ripping off his leads and sending the monitors into alarm mode!

As you can see in several of the photos posted here, Gavin has a birthmark on his forehead between his eyes. The nurses explained that when this type of birthmark appears on the back of the head, it is called a storkbite, but those that appear on the face are typically referred to as an angel's kiss. We thought that was particularly approps since our faith as well as prayers from family, friends, and complete strangers helped get us through this ordeal.

Baby Poll – Share Your Predictions!

Since Baby Mann’s expected arrival is less than 2 weeks away, we thought it would be fun to create a poll to gather family and friends’ predictions about the impending birth of Baby Mann. To help you complete the survey questions, I’ve included a brief update from yesterday’s doctor’s appointment as well as a summary of old wives’ tales about gender prediction.

UPDATE FROM OB/GYN APPOINTMENT ON 6/18/2009

As many of you know, the perinatologist prescribed weekly 17-alpha hydroxyprogesterone injections beginning around week 19 of this pregnancy to reduce the chance of preterm labor or birth. Mike had to administer this intramuscular injection every Wednesday night for more than 3 months. My last injection was on 6/10/2009.

In addition to the 17 HP injections, I have been taking oral terbutaline since week 22 to help control pre-term labor contractions. My OB/GYN and perinatologist recommended I stop taking the medicine around weeks 36-37 since at that point the baby is considered full-term. I took my last dose of terbutaline around midnight on Tuesday, June 16. The next evening (6/17) I started experiencing contractions (some more painful than others) lasting about 30 seconds and occurring about every 8-11 minutes.

Since I had fairly regular contractions throughout the night (and got very little sleep!), we assumed we were in the early stages of labor. We decided against going to the hospital in the middle of the night since I had a doctor’s appointment scheduled for 10 a.m. the next morning. Around 1 a.m. I decided it would probably be wise to pack my hospital overnight bag in the event that the doctor sent me straight to the hospital.

During the doctor’s appointment, they did a sonogram to check my amniotic fluid levels, which have been unusually high since about week 32. Although my fluid levels had dropped slightly from the previous week (33 cm vs. 29 cm), they are still considered abnormally high and are likely contributing to my contractions. The sonogram technician was unable to estimate that baby’s size since we’re so close to delivery, but was able to determine that s/he is big for his or her gestational age. During previous sonograms, we learned that the baby’s size is measuring almost 2.5 weeks ahead of schedule!

Given my history of preterm labor, the estimated size of the baby, and my complaints of fairly regular contractions, the doctor decided to check for cervical changes to see if labor was imminent. He was surprised to discover that I am 75% effaced and 2 cm dilated. Given the unpredictable nature of labor, he could not definitively say whether he thought I’d make it to the scheduled c-section date. However, he did say that the cervical changes were evidence that my body was preparing for labor and that the contractions were causing the effacement and dilation.

OLD WIVES’ TALES ABOUT GENDER PREDICTION

Myth 1: Cravings – Expectant moms are believed to crave sweets if they’re having a girl and salty foods if they’re carrying a boy.

I am craving sweets, although I have always been a sugar addict and sweets are even more attractive to me now that they’re on my gestational diabetes restricted foods list.

Myth 2: Baby’s heart rate – It is thought that girls have a heart rate of 140 or faster while boys’ heart rates are typically below 140.

At yesterday’s appointment, Baby Mann’s heart rate was estimated at 158 beats per minute.

Myth 3: Acne – Expectant moms who have acne during their pregnancy are thought to be carrying girls. Those who do not experience breakouts or acne flare-ups during pregnancy are thought to be having a boy.

I have not noticed any difference in my skin since becoming pregnant.

Myth 5: Morning sickness – According to legend, expectant moms who suffered from morning sickness during their first trimester are likely having a girl. Those who did not experience any nausea or vomiting are having a boy.

Thankfully, I did not have a problem with morning sickness with either pregnancy.

Myth 4: Mom’s weight – The belief is that if a woman is carrying low and all out in front, she’s having a boy. If she is carrying high and the extra weight is primarily in the hips and thighs, then she must be having a girl.

I’ve included a recent photo so you can judge for yourself. I think I’m carrying the extra weight high and all out in front.

On what day will Baby Mann be born?

What time of day will Baby Mann be born?

What gender will Baby Mann be?

How much will Baby Mann weigh?

How long will Baby Mann be?

A Big Boy Room For Ryan

When planning Ryan’s transition from his nursery to a big boy room, we debated whether it would be best to move him to new room entirely and maintain the current nursery for the new baby or convert his existing nursery to a big boy room and set up a new nursery in another room. Ultimately, we decided to keep Ryan in the same physical space but redecorate it to better reflect his changing interests. Our hope was that by officially designating the room at the end of the upstairs hallway as “Ryan’s,” the familiar location and routine would lessen the disruption, make the adjustment easier, and increase his comfort with and acceptance of his new room as well as his new role as big brother.

Given the amount of work involved in creating the perfect big boy room as well as our hectic schedules and general fatigue, the task of converting Ryan’s nursery to a big boy room required a phased approach that spanned several weeks. The photos and accompanying descriptions below document the room transformation process to date.

Phase 1: Ceiling Fan Installation

Since Ryan’s room is consistently much warmer than the rest of the house during the summer months (and significantly colder in the winter), we decided to install a ceiling fan to make the hot summer nights more comfortable. Ryan desperately wanted to help install the fan, but admitted he wasn’t quite “tall ‘nuff” to reach the ceiling and begrudgingly agreed to let Daddy handle the electrical work. Instead, his contribution was to use Handy Manny’s tools to help cut up the Styrofoam packaging, hold the ladder steady while Daddy installed the fan, and perform the final inspection before approving the installation.



Phase 2: Painting the Room

Even before we had picked the theme and bedding for his big boy room, Ryan insisted that the walls were to be painted “dark blue.” He was so resolute in his description of the paint color that we often liked to tease him by casually saying in conversation that we were going to paint Ryan’s room green (or any other non-blue color). He would adamantly correct us and specify that it was to be painted “dark blue.” If we confirmed he wanted a blue room, he would again specify “dark blue.”

We taped numerous paint samples on the wall of his nursery and slowly narrowed it down to a handful of dark blue shades we could all agree on. Luckily, Ryan approved of the color we selected. Several weeks earlier I had painted his big boy bathroom a shade of light blue to match the ocean / sea life theme of the shower curtain. Apparently the color blue I chose wasn’t dark enough because he immediately walked in looked at the color and announced, “Me no like this, Mommy!”

To increase the likelihood that Ryan would accept, and ideally embrace, his new room (and to avoid the same mistake of not involving him in the bathroom transformation), we decided to heed one of the fundamental principles of business – a person’s satisfaction with an outcome is directly related to his or her level of involvement in a project. Therefore, much to Ryan’s delight, we allowed him to help us with the first coat of paint. Daddy fashioned a smock out of an old dress shirt while Mommy prepped the room by covering every square inch of carpet with plastic. Then, Ryan did the honors of splashing the first strokes of blue paint on the previously yellow walls. Naturally, Ryan bored quickly with it and decided that Daddy and Mommy (who was more than 8 months pregnant at the time) could finish the dirty work!

Phase 3: Moving Day

We decided to make the big move over Memorial Day Weekend since it was a 3-day weekend and Daddy didn’t have paramedic class that Saturday and would be available all weekend. Early Saturday morning, Daddy and Ryan began moving the nursery room furniture out of Ryan’s room while Mommy washed the mattress pad and sheets for the first time. Since, in Ryan’s words, “Mommy has a baby in her belly” the two men handled the hard work and heavy lifting themselves. Luckily for Daddy, he was able to slip coasters under the heavy pieces of furniture so he could manage most of the weight on his own. Ryan soon decided that having crib mattress races up and down the hallway, compliments of Daddy, was much more fun than moving furniture!

Once the crib, dresser, bookcase, and glider had been removed from Ryan’s room, we put Ryan to work vacuuming the carpet, woodwork, and baseboard. We figured it best to take advantage of his desire to help clean (particularly vacuum) while it lasts since I’m sure his fondness for household chores will be short-lived! Once the room had been thoroughly vacuumed, Ryan and Daddy carried or, in Ryan’s case, pushed, the pieces of his big boy furniture into the empty room and started assembling the bookcase, trundle bed, and case pieces (i.e., dresser and side storage unit that flank the bed). Although we consider ourselves fairly laid-back parents, we did draw the line at allowing Ryan to operate power tools! So, while Daddy used the power drill to put together the furniture, Ryan once again resorted to using his Handy Manny tools to cut up the furniture boxes and “fix” the Styrofoam packaging.

Once everything was assembled and positioned in the room to our satisfaction, it was Mommy’s job to dust all of the furniture and make the bed. Then the three of us scrambled up onto the bed to relax, admire our hard work, and snuggle and read the first of hopefully many books in Ryan’s big boy bed.

The First Night

Saturday, May 23, 2009, was Ryan’s first night in his new big boy room. Not only was this Ryan’s first time to sleep in a real bed, but it was also his first night to sleep without a pacifier. Looking back, I don’t know if we were crazy to tackle both at once or whether it was wise to address them both in one fell swoop. We had been preparing him for weeks that he’d have to give up the binky once the room transformation was complete. Whenever we asked him, “what happens when Ryan starts sleeping in his big boy room” he’d gleefully (at the time) reply, “No more binky!”

To increase our chances of actually catching some shut eye that first night, we took Ryan to his first fire department carnival of the season. To wear him out, we purchased two all-you-can-ride wristbands for Ryan and Daddy and the two of them rode every age appropriate ride at least once. By the time we got him home, bathed, and ready for bed, it was nearly 10 p.m. Exhausted, we climbed into his new bed, read several books and told him a couple of bedtime stories. It was at that point that he realized his beloved binky was missing. As it began to dawn on him that the pacifier was gone for good, the crocodile tears then began to flow and he repeatedly cried, “Oh no, I miss binky.” As a parent, it was difficult to watch this genuine display of grief from a 2-year-old, especially knowing that he’ll likely experience many losses in his life and we can’t always protect or shield him from sorrow.

As an emotional late third trimester pregnant lady and a complete sucker for cute little boy tears, I had to leave the room before I succumbed to his desperate pleas for help and returned the binky. Luckily Daddy, who I affectionately refer to as the “baby whisperer” since he has always had the innate ability to coax Ryan to sleep, was able to calm Ryan down, stop the torrent of tears, and gently persuade him to close his eye and drift off to sleep. Daddy then spent the entire night in bed with Ryan, partly because he was so exhausted from his demanding schedule, but mostly because he wanted to be there should Ryan wake up scared in the middle of the night. I tiptoed quietly into the room several times throughout the night to check on them, but they both slept soundly and peacefully all night. I’m happy to report that ever since that first night, Ryan has slept in his big boy bed, without a binky, and without any protest or tears! And, even though he is able to climb in and out of his bed now at will, he still wakes up in the morning (at the crack of dawn to be exact), greets his 17 “friends” that share the bed with him (including, but not limited to “Puzzle Duck,” “Spot,” “Ruff,” “Peep,” and a collection of Guinness’ dog toys), sings to himself (either the ABCs or “Are You Sleeping”), and then excitedly calls out to us, “Mommy, Daddy, Morning yet?”