What's Charlotte Up to?


Charlotte is 2 weeks old now and has made tremendous progress. She loves to grab any tubes attached to her and pulled off her canulla in the night, but her oxygen saturation didn't go down, so it was decided she didn't need it anymore. 

Charlotte with her mittens taped to her arms because she loves to pull on all her tubes.

She moved out of the isolette (her "condo" as the neonatologist fondly referred to it) because she can now regulate her body temperature. 


Charlott'es vacated "condo"

She is now in a regular crib and wears clothes.  In order to take her home she has to be breathing without help, able to regulate her own temperature and getting all her nutrition orally.  So, she's good on the first two and now we just work on eating.  She still gets most of her nutrition through her feeding tube.  Being a preemie, she just doesn't have the muscle for sucking yet, and she doesn't have the coordination of sucking, swallowing and breathing.  We work on nursing a few times each day.  At first, she would just suck and swallow and forget to breathe (and one time turned blue).  Then she was able to nurse for a few minutes before she fell into a deep sleep.  Now we go for about 10 minutes before she is worn out and she is getting more efficient.  She gained about 8 ounces since she was born and has increased her feedings.  Everyday, we are closer to bringing her home.

As parents, Mike and I also made tremendous progress.  We gave her a bath for the first time (there is a video somewhere.....).  I had my first freak-out as a mom - about baby poop.  I didn't read the last chapters of the baby books and I don't know what's normal for a newborn.  I may have babysat a lot as a teen, but never newborns.  Anyway, the very patient neonatology nurse practitioner assured me that Charlotte and her poo were totally normal.  Well, that's a relief.  I swore I would never be one of if those people whose facebook status updates are about baby poo.  I think this is the appropriate venue, if there is one, for such information.

For Archival Purposes

Here are email updates that Mike sent to our families during Charlotte's first days (before we started this blog).  I pasted them together here for archival purposes.

_______________________________________________
From:  Michael Nawrocki
To:  halfdrunkcanofpop
Date:  October 5, 2010 3:09 PM
Subject:  Happy Birthday

Charlotte James Nawrocki
5 lbs 3 ounces, 18 1/2 inches
12:23 p.m.

Emily did great.  C-section birth ordered by the doctor around 9 a.m. Ben was with us and got some beautiful pictures.  Emily is recovering nicely and Charlotte is in the Special Care Nursery on a CPAP machine to keep her lung pressure at a level where the alveoli can stay inflated, but otherwise she is breathing on her own.  So she is having a tad difficulty breathing but this is pretty standard stuff for a baby born at 33 weeks, 6 days.

Pictures to follow.

So Charlotte won the race against her cousins, which we really wanted her to lose but, who cares?  She is beautiful and in the hands of some of the best medical practitioners in the world. And I almost lost a race myself.  On the way over I thought I'd take Shepard Road as a shortcut to get to Crosstown.  But at 35E and Shepard Road traffic was a at a standstill.  I was pinned with an 18 wheeler behind me and to the left of me and a Schwann's delivery guy in front of me.  I waited there for 45 minutes.  I got out and walked up to what was going on. Joe Biden was on his way to the airport and no one could pass until he went by.  He was in town to stump for So there we sat.  I thought, "If Joe Biden makes it so I miss my baby's birth, I am definitely voting for Tom Horner this fall!!!"

_______________________________________________
From:  Michael Nawrocki
To:  halfdrunkcanofpop
Date:  October 5, 2010 3:16 PM
Subject:  Re:  Happy Birthday

p.s.
Full head of black hair.  Long toes.  Allegedly she has her father's eyes, but we can't confirm that because they are always closed. I miss her.  Think I'll ditch Emily for awhile and see how Charlotte is doing.  Feels weird and great actually calling her by a real name.

_______________________________________________
From:  Michael Nawrocki
To:  halfdrunkcanofpop
Date:  October 7, 2010 12;25 PM
Subject:  Charlotte Update

Charlotte is doing GREAT!!!!!!!!  After a trial run of taking her of the CPAP yesterday (and replacing it with a cannula)  failed, last night was spent getting her back to equilibrium.  She did great through the night and they tried again this morning right as we walked in late this morning.  They took out the CPAP and put in a cannula. And this time it took.  She stayed calm and her breathing and blood O2 sats stayed well over 90% (the goal), so they let us hold her.  Highlights:

1. We saw her open her eyes for the first time and she looked right as us when we talked to her.
2. We both got to hold her.
3. I changed my first diaper ever with a lot of help form the nurse.
4. She took her first feeding of Emily's breast milk.  Emily has been pumping every three hours and they have been storing it up for this moment. And they feed through a tube.

Video and pics to follow sometime between now and when Charlotte turns 18.

_______________________________________________
From:  Michael Nawrocki
To:  halfdrunkcanofpop
Date:  October 7, 2010 2:34 PM
Subject:  Emily Update

Both Ben and Beth have asked for updates on Emily.  Emily is doing awesome.  We have ditched the wheelchair and she walks to and from the nursery slowly but easily.  Her husband needs to be retrained because he keeps walking at normal speed.  Then I'll hear this "okay bye" and I turn around and she's ten yards back.

Physically there is still pain but nothing unusual.  For someone who whines about people on the radio in the morning (or any time of day, she would like me to correct), she sure is one tough lady. Emotionally, she is super happy.  So am I.

_______________________________________________
From:  Michael Nawrocki
To:  halfdrunkcanofpop
Date: October 9, 2010 9:13 PM
Subject: Re:  Cottage conference thought

Just as a heads up, I am not sure how many visitors Charlotte would be able to see.  Charlotte's immunity will not be up to snuff when we take her home.  Exactly what that means in terms of who can visit and how often remains to be seen.  We are taking this one day at a time and will keep everyone posted on that.  The possibilities range from no restrictions to a lot of restrictions.

I hope it's okay if I hijack this thread to briefly say Charlotte is doing great.  She is breathing on her own and off the IV.  She still needs the light for jaundice prevention and she still needs support to maintain her body temperature.  She now only has one tube in her, an NG tube for feeding.  Two days ago they gave Charlotte 5 cc of Emily's milk to see if she could tolerate it.  When I left tonight after her last feeding, she took 35 cc. Emily is getting to the point where she can keep up with the the demand, in tems of what she can supply.

Emily is kicking ass too,  She had a good day today.  Her soreness post-surgery persists and she is not overly fond of living at Fairview Southdale.  But we both agree it is worth it.

No word on when Charlotte comes home,  She has to be nursing independently and pass a carseat test.  So we are on her schedule.  Like I said, we go one day at a time.

_______________________________________________
From:  Michael Nawrocki
To:  halfdrunkcanofpop
Date: October 10, 2010 2:00 PM
Subject: Re:  Charlotte Update

Update #3
Things continue to progress nicely for both Emily and Charlotte.

Beginning with Charlotte,
1. Her biliruben (or however you spell it) count is back to normal so
no more blue light for now and hopefully forever.
2. She and Emily worked on learning how to nurse for the first time this morning.  Charlotte latched a few times which exceeded expectations for a first time trial.  The two ladies will have their second practice this evening.  We used to two-a-days in college for track and cross country.  Quite frankly, those workouts seem a lot easier than the work Emily and Charlotte go through.

Emily...
1. Has a swollen ankle which she researched thoroughly and learned is normal post-pregnancy. But it was pretty painful and stiff through the night and improving today.
2. Had some issues with expressing milk but thanks in part to Jessie's nurse and mostly to a nurse we had here, Emily learned a few tricks of the trade to make things work and now she is doing a great job.  This is a huge relief both mentally and physically (literally) for Emily. And that is really the most I want to talk about my wife's mammary glands with everyone.  Bottom line is she is 100% happier today than she was 24 hours ago.

Charlotte's Birth Story

On Monday October 4, I had an ultrasound to measure the amniotic fluid and it was low.  My doctor said that she'd repeat the next day and if it was still low we'd deliver.  Well, she said that a bunch of times and it didn't happen so I didn't take her seriously.  I didn't even mention it to Mike that night.  The next morning, my doctor came in at 5am on her rounds and told me again that if the fluid was low this would be the day and she told me not to eat breakfast. Well, we'd been through this before, so I didn't bother to call Mike.  At about 9 am, I had the ultrasound and the fluid was still low.  The nurse said that they could get me in the OR for a c-section at 11:30am.  I was not prepared - I had some loose ends to tie up!  I wasn't completely mentally prepared either. I knew we would be having her early, but not >6 weeks early!  So, I called Mike and hastily emailed a few people at work.  The nurse kept coming in to start prepping me for surgery, and I'd say, "I need ten more minutes!"  Then, Mike called and he was stuck in traffic.  Joe Biden was at Macalester giving a talk and the road was closed for his safety.  He was worried that he wouldn't get there in time, but the nurse said they wouldn't start without him.  I called my sister.  My brother-in-law, Ben, had offered to come take pictures so he was on his way.  The nurse started prepping me for surgery and packing up my stuff since I would be moving from an antepartum (my home the last two weeks) room to a postpartum room. 

Ben got there before Mike since he didn't have to deal with the Joe Biden traffic.  Mike arrived and put on his scrubs.  He looked so cute!  Then the nurse said we would walk down to the OR.  What!?  After 2 weeks being confined to bedrest, I was going to walk down the hall!?!  As we were walking down the hall, I had to ask them to slow down because I couldn't keep up.  Even though the childbirth class instructor came and talked to us for almost 2 hours one night, and we knew what to expect, I was really nervous.  I mean, holy crap!  We were going to have a baby in 20 minutes! 

I went in the OR without them and they gave me the epidural and strapped my arms to the table (did you know they do that?  It's instinct to reach out to grab the baby and that would compromise the sterile field) and the guys came in. It didn't hurt, but I felt lots of pulling and tugging. After <15 minutes the doctor pulled Charlotte out.  I heard her cry and it was the most amazing moment.  She was here!  And she was OK!  Crying meant she was breathing!  My doctor said, "say hi!" and lifted her up to the curtain for a split second and all I saw was the top of her head.  Mike could see everything and he just kept saying, "she's so beautiful, she's so beautiful." 

Because Charlotte was a preemie, I knew that I wouldn't get to hold her right away since the neonatologists would take her away for assessment.  During this part, Ben came over and showed me the pictures on his camera, the first time I got to get a good look at her.  Charlotte was breathing on her own, but then she stopped and was in respiratory distress.  Ben had to leave and Mike was with Charlotte. I don't know what was happening while they finished stitching me up, Mike can tell that part of the story.  While I was in recovery, Mike and Ben were in the Special Care Nursery with Charlotte and took more pictures and came back to show me. 

Having Ben come to take pictures was so wonderful.  The nurse had told Ben that he wasn't allowed in the OR, but he would not take no for an answer and kept asking until she said it was up to the anesthesiologist and he was fine with it.  So, Ben got some scrubs.  It was really cool to share such an important day with him.  It also allowed me to see what was going on throughout the whole thing.

Once I was recovered I was wheeled through the nursery to see her for the first time and I put my finger in her hand she grabbed my finger.  She is amazing and beautiful and we are in love.

our first family photo

Our Babymoon

I was thinking about starting a blog to document Charlotte's coming into the world.  In fact, I had planned on doing it the week she was born, as I was not even 34 weeks pregnant and felt I had plenty of time.  Then, on October 5, 2010 at 12:23 pm, she was delivered and it's been busy ever since!  Before I can tell her birth story, some background is in order.

A little background:

Aside from feeling like I was 500 degrees all summer, I was enjoying a rather normal pregnancy until about 27 weeks.  At my appointment that week, my doctor was concerned that the amniotic fluid was so low and ordered me on bedrest.  I wasn't overly worried.  In fact, we had plans to go to a Twins game that night with friends and went anyway because I happen to find baseball very relaxing and that complies with bedrest, right?  So, I was on bedrest at home for a couple weeks.  I worked at home during the day on one couch, and then spent the evening on the other couch with Mike.  Then August 30, I was diagnosed with severe oligohydramnios*  and the fluid was so low that my doctor sent me to the hospital to be admitted and assessed by the perinatologist.  She gave me a shot of steroids to help the baby's lungs develop faster and put her hand on my arm and said, "Emily, I don't know what they are going to say.  You might be admitted, you might have to deliver, or they might send you home."  That was scary!  So, off we went to the hospital, had an assessment with the perinatologist.  Our baby girl wasn't moving very much, which concerned her, but she didn't want me to eat anything to try and wake her up just in case I had to have a c-section that night.  She wasn't born that night, although everyone kept reassuring us that 29 week old babies do fine. After a couple days, I was discharged.   When I asked about bedrest, the perinatologist said he didn't see any benefit. Woo hoo!  I got to go home in time to attend my cousin Cait's wedding, where Mike had the honor of officiating and I was heartbroken that I might have to miss it. 

Mike doing his thing

Mike and the newlyweds, Cait and Zach

I continued to go about my business, but taking it extremely easy.  Then on September 20th, it was the same thing again.  I was wheeled over to the hospital.  We thought we might have a baby that night or the next day.  After a night of being pumped with IV fluids, my fluid went back up to a level my doctor was comfortable with, but she wanted me to stay in the hospital for constant monitoring and IV fluids for as long as possible so that the baby could be more of a "chub head" (her words).  It was balance between the baby being best off in the womb until the situation in the womb became too stressful due to the low fluid.  She couldn't say when exactly this would be, but she wanted it to be past 34 weeks.  After eight days being confined to room 211, the fluid was the highest it had been since this whole low fluid thing started. I was discharged from the hospital, but I didn't tell everyone because I knew that I would be back as soon as I saw my doctor again. Sure enough two days later, September 30, I was back.  Same deal as before. 

Let me tell you, being on bedrest in the hospital is not easy. Being away from Mike for so long sucked. I missed our dog (but not the cats, in fact, I forgot I had cats). I was only allowed to walk as far as the bathroom and my doctor only wanted me to shower once a week, but I negotiated showers on IV changing days (every three days).  I left my room one time, to go on a wheelchair ride with Mike pushing me. It was a beautiful, perfect September day and we did a lap around the hospital.  Mike said, "this is our babymoon" and we laughed.  Mike came every night after work to spend time with me, and sometimes bring me food that was edible.  I had zero appetite from being so sedentary, plus being horizontal all the time just gave me a stomach ache and wicked heartburn.  I had no idea what day it was most of the time. Most people won't understand this, but I actually did not get enough alone time in the hospital and that makes me crabby.  People were always coming in my room so I never had any stretches of peace and quiet to myself.  I continued to work remotely because it made me feel like a normal person and made the days go faster.  The weekend before Charlotte was born was a low point for me.  It was really getting to me and I didn't think I could do it any longer. 

Mike was incredible through it all.  He had to do everything around the house that usually takes two people to do and at the same time take care of me.  We got to spend a lot of time together over the summer, but not as we had envisioned.  No trips to the cottage, or the State Fair, or going out to enjoy our last months of just the two of us. Even though it was really scary, stressful and frustrating at times, I would do it all over again and I wouldn't change a thing because now we have Charlotte. 

And that is the end of the background section.


* Do you really want to know?  Oligohydramnios is a pregnancy condition where there is less amniotic fluid than there should be.  The fluid is measured by ultrasound where they measure the largest pocket of fluid in each quadrant and add them up.  Normal is between about 8-21 centimeters.  Below 5 is considered oligohydramnios and may be an indication for delivery.  My fluid was hovering between 5-7 for a while and was below 5 each time I was sent to the hospital.  Oligohyndramnios can be caused by a number of things:  a baby without kidneys or a bladder will have low fluid because the fluid is basically peed out of the baby; a placental insufficiency issue may not make enough fluid; a tear in the amniotic sac; pre-eclampsia and some other conditions that the mother may have.  My case was idiopathic.  Low amniotic fluid can be a very stressful environment for a baby and can result in immature lungs since the baby uses the fluid to practice breathing and inflating her lungs.  It can also result in restricted growth.  A baby needs room to move her limbs for development of muscles and bones.  It can also result in compression of the umbilical cord, which would mean the baby wouldn't get enough oxygen and nutrients.  So, plenty to worry about.