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.