Paci...

Ava - September 29th

A few pictures from yesterday....Ava lovin' her paci!

baby girl has some long skinny feet...

Ava was still at 3 liters and 21% when we went to see her first thing this morning.  We feed her the little bit that I was able to pump and got to talk with Dr. Lightburn.  The plan was for them to gradually decrease her flow from 3 liters to 1.5 liters with the goal of trying to breast feed her once she reached 1.5 liters and was stable.  We were so excited!

They also let me change her diaper for the first time!  I never thought I would be so excited to change a diaper...it's definitely the little things!!

They also gave her a new premie paci that she absolutely loves!  She can actually keep this one in on her own...at least for a short bit!

One of the nurses made her a little lovey that she really seems to like.  We'll definitely be bring her some of own lovies as well....

Ava had her largest meal to date around 11 this morning...a whole 9 cc's!  It was quite a bit for such a little tummy so she only had 6 cc's at her 2:00 feed.  

When Josh and Gigi went in for her 2:00 feed, they got some really exciting news!  Her oxygen flow had been lowered to 1.5 liters and she was doing good!  Praise the Lord....prayers have been answered!    They are planning to pull her UAC lines around 3:15 and then we'll get to hold our baby girl!!!!  AND if everything goes well....I get to try and breastfeed her at her 4:30 feed!!  Please pray for normal respiration rates and O2 sats!

We are so excited!!!

Ava - September 28th

Josh and I got a good nights sleep last night and woke up feeling much better today....sleep was definitely needed!  We went to see Ava first thing this morning and the nurses reported that she had a good night and that they had decreased her oxygen to 35%!

talkin' with daddy...

 Sweet baby girl is loving her hands....

 It's hard to tell how small she is in these pictures, but the diaper she's wearing (that looks extra large) is a premie diaper!

A picture of the monitor showing a good heart rate, respiratory rate, and O2!  It's exciting to go in for a visit without alarms going off...she definitely making progress!

 I've been pumping and they decided that she was ready for her first feed today.  She's still not able to breast feed or bottle feed because she needs to save all her energy for breathing...so we fed her through the tube in her mouth that goes all the to her tummy.  It's only a little bit, but she tolerated 3 feeds well.  The first one was 3 cc, the second was 7 cc, and the last was only 2 cc.  They said we could feed her up to 9 cc every three hours, but I haven't been able to pump that much yet.  Hopefully my supply will increase and we can start feeding her more.  For now, they are still feeding her through one of her umbilical lines, but if she continues to tolerate her feeds they'll be able to remove one of her umbilical lines!

One of the NICU nurses called us around 5:00 to tell us that Ava was wide awake...so of course we jumped at the opportunity to see our baby girl awake!  We practically ran to the NICU!  It was so sweet...she just laid there staring at us as we talked to her and loved on her.  It was definitely the next best thing to actually getting to hold her!

She was trying really hard to suck on her hands so the nurse told us we could try a paci.  She absolutely loved it!!!  It was difficult for her to keep it in because of the tube in her mouth, her tongue thrust, and the fact that she kept pulling it out....but with a little help she kept it in and loved every minute of it! Looks like we have a paci girl on our hands...

Once again they gradually decreased her oxygen today.  She moved from 35% to 28% and down to 25% at our last visit around 11pm tonight.  The goal is to be at 21% (which is what everyone breaths at) by morning and then they'll start decreasing the flow.

Ava also had her first bowel movement today!  (I never thought I would be so excited about poop...Ha)  

All in all it was a good day....decreased O2, 3 successful feeds, 1 poop, improved respiration rate, and a successful paci trial!!!

Ava - September 27th

Yesterday was the longest day ever...Josh and I managed to get about 2 hours of sleep sometime after the delivery but spent the rest of the day visiting Ava.

I got to hold Ava for about 2 minutes after delivery before they took her the nursery for monitoring.  Little did I know that would be my only opportunity to hold her.  She started out in the "front" nursery (where everyone could admire her through the window) on room air.  After an hour or so they decided that she needed supplemental oxygen and an IV of D10, which also meant she would be moving to the "back" nursery...as Josh and I like to call it.  The hope was that her respiration rate would slow to normal with a little extra oxygen....

getting checked out by her nurse and Dr. Lightburn (her neonatologist).... 

Around noon, Dr. Lightburn decided that a UAC line (umbilical arterial catheter) needed to be placed.  This would allow them to monitor her more closely, feed her lipids, proteins, etc, and draw blood without sticking her over and over.  Obviously Josh and I agreed to the procedure....whatever it takes to help Ava get better! 

When the UAC line was placed, Ava was on a 3 liter per minute flow of oxygen at 100%.  Throughout the day, they gradually decreased the percentage and by the end of the day she was at 40%.  Josh and I went to visit her again around 9:00pm and her respiration rate stayed closer to normal and she seemed to be a lot more relaxed....which was great end to a stressful day!

I had planned for Owen and Ava to give each other a present when they met for the first time....but there was a change of plans since Ava was in the NICU.  Owen brought his gift for Ava and we just told him we would give it to her later.  Luckily I had gotten him a few things, so we let him open a couple and saved the rest for the day they actually get to meet.  

He was so cute opening the presents!  He showed everyone and loved telling them that they were from ABA...aka "Ava"!  

Owen and Josh also surprised me with a gift...mothers rings!  One with Owen Peyton and the other with Ava Kate engraved on it!  I absolutely love them!!

We took a few videos of Ava to share with Owen. I'm not sure he really understands, but he was very curious about them.  There's one video that Ava cries in and he wasn't a big fan....he told me " I not want baby cry"! Ha!  He's definitely going to have some adjusting to do when Miss Ava comes home!

A few more pictures of Ava...

Because she is being feed through the UAC lines now, they were able to remove her IV.  Yay, one less line/tube!!

Ava's Arrival...

Monday, September 26th started out like every other Monday.  Josh and I both went to work and Owen to daycare.  I had my 36 week appointment at 8:50 so Josh and I just meet at the doctor's office.  We went through all the normal "weekly" appointment stuff...I was 2 cm dilated, 70% effaced, and measured right at 36 weeks.  Ava was being super active during Dr. Birch's exam...to the point that we were all laughing because she kept kicking the HR monitor.  She had an elevated heart rate because she was so active...which was not really concerning, but Dr. Birch wanted me to be monitor for a short period just to make sure her HR went back to normal when Ava calmed down.  So off we went to be monitored....

After about 20 minutes of being on the monitor, Dr. Birch came in and said she was not liking what she was seeing.  Ava's heart rate was staying elevated...so she wanted us to go upstairs to labor and delivery triage for further monitoring.  We had done the same thing with Owen and everything was fine, so we weren't to concerned at this point.  About thirty minutes later, Dr. B sent us for a biophysical ultrasound (something we had also done with Owen).  Ava scored a 6/8 and back to the monitor we went...

Ava's heart rate had leveled out and we were just waiting on Dr. Birch to come and access everything.  I had been having contractions all day, but by this point my contractions were 2-4 minutes apart and getting stronger. I was only 36 weeks, so Dr. Birch decided to give me some medication to try and stop the contractions.  An hour or so later I was still having contractions but only 2.5 cm dilated and 80% effaced.  So now they were trying to decide if I was in active labor or if they should send me home.  The decision:  go walk the halls for an hour and then we'll re-assess.... 

A visit from Owen....

The first words out of his mouth were.... "what are you wearing mommy?" Apparently he didn't like the gown/moo moo I was wearing, Ha!

Danielle and Holly arrived just in time to walk the halls with me...

After a little exercise, I had progressed to 3 cm and my contractions were a lot stronger.  At this point the decided I was in active labor and needed to be admitted to labor and delivery and get my epidural started...

Owen with his big brother pin...

Gigi and Papa Bart arrived around the time I was being moved into a room.

Aunt Anna and Papa Bart

I hadn't eaten since breakfast and popsicles and ice were the only things on the menu.  Owen was really excited about the popsicles...Ha!

Aunt Amanda and Owen...

Aunt Anna and Danielle...

My contraction were getting stronger and stronger so an epidural was the first thing on my agenda after getting settled into the room.  It took a little while because there were so many deliveries going on, but I finally got an anesthesiologist to my room around 9:30....

The night got a little crazy shortly after I got my epidural... About 5 minutes after my epidural, I started having trouble breathing, experiencing blurred vision, and tingling/heaviness in my arms.   My blood pressure also dropped to 110/40.  It was pretty scary, but with some oxygen and different positioning I started feeling better.  We're still not exactly sure why I had that reaction, but the anesthesiologist seemed to think it was some kind of vagal nerve reaction.  At this point, Josh and I thought everything was back to normal....but we were wrong.  Apparently, Ava's heart rate had dropped into the 70's (normal is 130-160's).  The entire nursing staff as well as the doctor and anesthesiologist were in the room trying everything to get Ava's HR back to normal.  We tried oxygen, different positioning, a more direct HR monitor, etc...but nothing seemed to be working.  So they decided an emergency c-section was necessary...but just as they started rolling me to the OR, Ava's heart rate went back to normal.  They watched me closely for a period and then decided we would proceed with a vaginal delivery.

Gigi watching the monitors...

Danielle and I...

Mom and I...

After the epidural my contractions slowed to 4-6 minutes apart so we started a little pitocin to move things along.  And that's exactly what it did....my contraction intensified and I moved from 5 cm to 10 cm in record time.  With the intense contractions, Ava's HR dropped back into the 70's so we stopped pitocin.  At this point, they were going to put in a new monitor, but as it turns out...I was already at a 10.  So with just 3 pushes...Miss Ava Kate arrived at 3:43 am weighing 5 lbs 8 oz!

While we were waiting on Ava Kate, we made a few bets!  We all guessed the weight and arrival time...and Aunt Anna was the winner!

Ava's Here!!!

After a very long day (more on this later), Ava finally made her debut!  She looks just like her big brother!

She arrived at 3:43 am....weighing 5 lbs 8 oz and was 19 and 1/8th inches long.

 We were only able to hold her for a few minutes before they took her to the nursery for monitoring.  Josh stayed with her and was able to talk with the doctor about all the precautions....

After a few hours of monitoring, they decided to put her on oxygen.  Since she was born at 36 weeks, her lungs are a little under developed and the oxygen will help with her labored breathing.  Her respiration rate is suppose to be around 40-60, and without the oxygen Ava's is around 80-90.

Her blood sugar is also a little low, so they are starting an IV of D10.  She is unable to eat right now because of her breathing issues so the D10 will also provide the fluids she needs...especially if she has VLCAD like her brother.  

These issues are not uncommon for premature babies...but please pray for fast healing and strength for our baby girl!