Post Op

Thomas is recovering well. They are keeping him on the ventilator one more night, but will take him off tomorrow. Its probably skewed by the IV fluids, but right now he weighs 6 pounds, 3 ounces. Sadly, mom is not recovering as well. She has a cold and is laid up wishing there was a team of nurses taking care of her, or at least one. Since I'm out of town, I'm failing miserably as a husband and a nurse.

Hopefully we will begin the feeding frenzy anew, in a day or two. Hey, that rhymes!

Deja Vu all over agian

Here I am again, sitting in the waiting room with Rebecca, waiting for Thomas to come up from Surgery. It gave me time to think up alternate titles for the blog. Here they are:

Sixth time is the charm

If its Tuesday, it must be surgery day

Why is it that nothing good ends up happening when I'm laying in my bed without any clothes on

I guess a little explaining would make these titles make sense. Or I could move on and wonder why anyone would want to watch a show like House while sitting in a hospital waiting room. Kind of like making the in flight movie "Concorde 79". But yet here I sit, and the show is on. Anyway, back to the titles and explanations:

Sixth time is the charm: This one is fairly easy. This is Thomas' sixth surgery. Pretty crazy when you think about it. We're definitely not used to it, but I don't know if its hitting quite the same as the last couple times. The first surgeries were all about survival, so there wasn't much to consider or think about. The next ones came after we'd gotten really attached to Thomas and it was a little more scary and real, if that makes sense. This one is hopefully a means to an end, getting him home. They say this procedure is no big deal, so we were not nervous really walking into this one. Still didn't want Thomas to go through it, but we were cool, calm and collected.

***Spoiler Alert***
Since I'm trying to write this real time, the doctor just came in and told us that everything went well. So if you're reading this, then you already know how things turn out. Don't spoil it for everyone else. And now back to your regularly scheduled programming.

If its Tuesday, it must be Surgery Day: Just a bunch of surgeries going on today. Three in Thomas' room alone. Based on the headcount, that's 50% of the population, but then again, maybe his room is throwing off the curve. It gave me pause to think what kind of lifestyle it must be for a surgeon, bouncing from procedure to procedure, where some one's life is in your hands. It must be very exhilarating, but then again, its probably somewhat common place for them after a while. I know I got that way when I worked at Wendy's in high school. It stopped even looking like food to me. Probably not the best comparison, but there's a correlation there somewhere (yes, I just compared surgery to making a double with cheese and I'm going to stand by it).

Why is it that nothing good ends up happening when I'm laying in my bed without any clothes on: Maybe I'll just leave this one unexplained...

Well no, I won't. Prepping for surgery in the NICU involves starving Thomas, which he really didn't care for, putting lines into both arms for IV drips, which he really, really doesn't care for, and just hanging out in a diaper for easier access I guess. Since he's been wearing clothes for a few weeks, it was weird seeing him hang out shirtless.

I guess I should tell you what the surgery is for. Thomas has 2 hernias in his lower abdomen. They are about the size of golf balls now, so they are probably uncomfortable, I'm guessing. Way too many sit ups and crunches. The doctor (Dr. Hermann for those tracking with their Baylor playing cards) has decided to go ahead and repair both at the same time. The hope is that this may help with Thomas' feeding. We'll see.

Since I'm blogging away and I told you the outcome of the surgery (its in the spoiler alert above, if you didn't read it) and we're waiting to go see Thomas, I will throw in another addition of Mike's Observation Corner. While we were waiting with Thomas to go down for surgery, Rebecca revealed something that I hadn't noticed before. Thomas' ear lobes are attached to his head, as are Rebecca's. Mine are not. Rebecca's dad's are not, but her mom's are. I have determined that this is the Calhoun curse (Me Ann's maiden name. I'm waiting on confirmation of ear lobe attachment/detachment from Leigh and Uncle Bill). This horrible affliction may haunt Thomas forever. Probably not, since I had never noticed Rebecca's ear lobes. She has either kept it hidden all these years through the clever use of hair, shadows and positioning, or I'm just not that observant (ironic since its my "observation" corner). Either way I feel tricked. :)

Weekend clean up

Sunday morning and I made an early morning milk delivery for Thomas' 8 am feeding. Since Wednesday, feedings for Thomas have been up and down. He was struggling with it most of Thursday and Friday, but yesterday was a bit better. They've switched from the original formula combined with milk to Ellicare combined with milk, which Thomas seems to be taking better. Part of the issue may be that Thomas has a diaper rash. That combined with the hernias and the potential for acid reflux may be making things uncomfortable all the way around for him.

The other issue is that Thomas is a little A.D.D. I do not in any way mean that in the literal sense. Thomas doesn't have any disorder. He's a new born boy that easily gets distracted, especially in the NICU unit that he's in now. Most of the babies in there are similar to Thomas in that they are on there way out the door or resolving an issue to be out the door. A great many of them are also feeding from the bottle, so there is always activity and noise and things to turn your head towards. Thomas is also working on his communication skills. Right now he appears to be on the chapter pertaining to using your hands to gesture, because they are always flying about akimbo.

Swaddling helps the arm issue temporarily, but Thomas looks alot like Harry Houdini working his way out of straight jacket. He can almost always work one hand loose and, more times than not, both. Just a matter of time. To his credit, he does not get frustrated by this process, just keeps at it.

Anyway, the long and the short of it, is we haven't found the right combination to get him to take his bottle every time. He seems to be doing bette rthough. He's still gaining weight though, 5 pounds, 11 ounces and he seems to be filling in. His legs are starting to get a little chunky.

And now its time for another installment of Mike's Observation Corner. In today's corner, I'll be observing myself. I've noticed that any time anyone asks about Thomas, I tend to give a vague answer, that he's fine, things are going well. Its not for the reason that some might think. Its not that I don't want to talk about Thomas, quite the opposite. Its actually that I don't want to spoil the blog. If there's something interesting that I plan to write on the blog, I find myself subconsciously holding back information so that I don't scoop myself. I think that's a little weird and I'm working on not being so secretive.

Eviction Notice?

Everyone seems to want Thomas to go home. Rebecca really wants Thomas to go home. The nurses would like Thomas to go home. The insurance company seems especially anxious for Thomas to go home. Thomas appears to be fairly bored with the limited scenery in his current surroundings.

How are we going to get across that finish line? Well its all about the feeding. Today, Rebecca met with the occupational therapist and the pediatric doctor who will be taking care of Thomas, post NICU. They tested Thomas' swallow capability this morning, which is done by giving him a syrup like substance with dye in it, and then they x ray it as he takes it from a bottle. Of course during this test, Thomas was more than willing to take the bottle and gobbled down 20 ccs. Unlike his normal feedings. The results were very good. He has a very strong swallowing mechanism.

The strongest possibility that is left is acid reflux, which is very common when you have a ventilation tube down your throat for an extended period of time. They are putting him on Prilosec to see how that does through next week. Depending on what happens, they may postpone the hernia surgery. The reason being, if the Prilosec does not work, they will insert a G tube into his stomach and they would like to do that at the same time as the hernia.

The G tube would be used to feed Thomas at night whatever he doesn't eat during the day, when he comes home. Basically, one way or another, Thomas will be home in a couple weeks. This part of the journey is almost over. There would be an added bonus of the G tube, although we'd like Thomas to get fully comfortable and at ease with the bottle, the G tube would be used at night to feed Thomas. So, no night feedings! I jinxed us on purpose by telling you this so that Thomas gets better sooner.

One other note. Rebecca met the pediatric doctor Monday. When she did, he told her that he had never had a boy who was born under 500 grams. Thomas would be the first. When she told me that, I thought it was weird and quietly wondered if maybe we had an inexperienced doctor or something. I knew this wasn't true and Thomas' nurse told us how great he is. Today, Rebecca found out from the occupational therapist that the reason why the doctor had not taken care of a boy who was born less than 500 grams is that very few boys that weigh that little survive. She told Rebecca that Thomas was a miracle. I don't really like that sort of description. I think it puts a little undue pressure on him to really make a difference or be special. Maybe say that the situation was miraculous and we're all just along for the ride.

I'm just not that hungry

Quick update. After really good initial strides feeding, Thomas has become less and less interested in taking the bottle over the past few days. He's only taken a portion of the milk each time, if at all. Fortunately, they do not choose to wait him out. If he doesn't want to eat, they give it to him through the feeding tube. We're not sure what's going on. He seems to want to eat, but the act of eating is either making him tired or uncomfortable. Possibly from being on ventilation for so long. The doctor and the occupational therapist are putting their heads together to figure out what is going on. I'll let you know.

They've scheduled his hernia surgery for Tuesday.

That's all for now.

We're real parents now, or...

How Rebecca almost failed discharge class...

Provocative title, no? So Rebecca and I are taking the last steps toward bringing Thomas home. One of those steps was this morning, the dreaded and feared baby CPR and Discharge class. I wasn't really sure what we were going to cover exactly in 2 hours that would properly prepare us to be qualified to be parents. I remember taking CPR years ago and it taking many hours, so I was a little skeptical that we would be taught enough to really be effective, especially in an hour.

Class started at 10, of course society's rules and timelines don't apply to super parents like Rebecca and me. We were approaching the hospital from 2 different directions, Rebecca fitting this class into her work schedule. At 5 til 10, we were on the phone to each other, telling the other that we might be late and to get started without the other. At 10:15, we both arrived in the parking lot. At 10:20, we were met at the reception desk by the CPR instructor and escorted to the class room, where 5 other people and 7 plastic CPR babies were waiting patiently. Very good start.

The approach to cramming 8 hours of CPR knowledge into 1 is fairly sound. They don't ask you to memorize anything. They have a very simple step by step sheet that they want you to keep with you to refer to in a time of need. The specific instruction is to actually thumb tack the sheet to the wall in the nursery. I'm not sure the instructor understands or cares about nursery decoration and presentation. Given the wide audience that goes through the course, its taken to a very basic level. Since I'd taken CPR before, I knew what was going on and was sitting back thinking how easy this is. To get us all involved, the instructor had each of us read a step title or description. I went first, nailed it, perfect diction. Then Rebecca's turn. We're going to be the star couple, parents of the year, they're going to totally forget that we made the whole class late. Then Rebecca reads the wrong step, then tries to correct herself and reads another wrong step. Crushing defeat. Rebecca was lost after step 1. Actually, she got a little confused with the layout of the sheet, but it cracked me up.

That's ok, we can rally. As we were reading the steps, we also were practicing with our CPR babies. Rebecca, all dressed up for work, was wearing lipstick. This made the baby look like it had very haphazardly applied lipstick. I made a very humorous observation to Rebecca, which made her laugh, which in turn drew a disapproving stare from the instructor. Strike 3! As it turns out, there was no test, just a couple run throughs and our xerox copies.

The second part of the class, the discharge, was also fairly innocuous. I guess the hospital is in an awkward position. They can't really tell you what to do, they can only suggest and recommend. Once you leave the hospital, you're left to your own devices. So there was a lot of that, general advice and non-specific instructions. I think I was really looking for more of a "these are the steps you will take to leave, this is what you can expect in the first 24 hours, the first week, etc." I know every baby is different, but there is a commonality that I would think should be pretty standard by now. In consulting, every business that we deal with claims ultimate uniqueness. There are always a set of core processes that can be identified. Then you're left with quirks and nuances that are much easier to deal with in isolation. Anyway, that's the way I'd do it, but nobody likes a know-it-all consultant.

In the end, there was no gauge of our comprehension or our ability to parent. Not even a certificate I can frame for my wall. Despite Rebecca's attempts to get us disqualified, we were all given the thumbs up and a notation was made in Thomas' medical chart. You'll just all have to check back in 18 years to see whether the hospital made the right choice or not.

First Mother's Day!

Another crazy week, started out slow while I was out of town Tuesday thru Thursday (not much to write about), but just non-stop since then. Friday was all about getting ready for and executing the hand print party, Saturday, Rebecca's parents came into town and we spent the day with grandparent quality time for Thomas and Nursery prep. Today was Rebecca's first mother's day and I did all of the things you're supposed to do as a husband and father; I slept in, watched golf and basketball and then went drinking with the guys.

Thomas has made amazing strides in the last 3 days. He drank 50 ccs from the bottle the last 4 times today. So he's taking from the bottle more than from the feeding tube. He's completely off TPNs and Lipids and they've removed the central line from his chest. They're also only monitoring his breathing and heart beat now, and there is talk of moving off of all monitoring (still something we're a little uneasy about, but they know best).

So clearly all of this is leading to something, I just can't place my finger on what it could be. Well hopefully they will give me a hint when we go to our discharge class tomorrow (I think that will give me some decent material for a blog, but we'll see).

It is late, so I will make up for this abbreviated blog, and the lack of updates, with many forced jokes and run on sentences tomorrow. Until then, here's a video of Thomas staring intently at the camera, or is he looking into your soul?

Happy Mother's Day, to Rebecca, my mom, Rebecca's mom, my sister, Jennifer, Aunt Susan, Dede, Cynthia, Leigh Ann, Pat...and every other mother who might be reading this.

Three Days, Three Updates

It was a very busy weekend all the way around. Today I will cover the events of Saturday, Sunday and Monday. I'm in Belton and forgot to load the pictures onto my laptop, so there will be no pictures at this time, you'll just have to use your imagination, consider it a theater of the mind.

Lower the lights,
Cue the orchestra,
Draw the Curtain:

Act 1: A Birthday and a Wedding.

Saturday was the big 4 months for Thomas. Really crazy to think that he has been in the hospital for 4 months. I really cannot get my head around that. Just doesn't feel like it, but it feels like forever all at the same time. Happy Birthday Thomas!

As I mentioned before (although not quite enough for Leigh's liking), Rebecca's sister got married Saturday. It was a day of hectic activity for Rebecca and her mom. I wisely snuck away and did a race. I found myself to be not as focused and thought about Thomas, especially during the swim when I realized I wasn't in that great of shape ("Didn't get to train as much as I wanted" goes on Thomas' list). Although there were many phone calls to Thomas' nurses, including at least one at the reception, we both were able to relax and step out of our current responsibilities and pressures for a while. Of course there were many people that came up to us during the weekend to inquire and wish Thomas well. Its always really cool and uplifting to hear that people are following Thomas through this blog, especially when its someone that I may not have met before. So it was a really nice evening for both of us...oh , and Leigh got married and wore ivory. (It was a really wonderful ceremony and reception and Thomas got a new uncle, which he's totally stoked about)

Act 2: Revolving Door at the NICU

Sunday was a big caravan back to Dallas for Rebecca and I, my parents and Leigh and Carlton, who were flying out of Dallas for their honeymoon. So when we got to Dallas, we all headed to the hospital. Where over about 3 hour period Thomas was visited by 3 ghosts, wait, no, different story. Thomas was visited by mom and dad, nana and papa and Aunt Wee and Uncle CaCa. Those aren't official names, I'm just trying them out here to see how they read. I'm going to take this opportunity to bring in a guest author, Thomas' mom. Rebecca has been hesitant to jump on this blog since I'm so eloquent with my wordy phrases and stuff, but she happened to respond to some one's email today and I thought it was a nice summary of the weekend, so I'm going to cut and paste it here. Please enjoy Rebecca's debut:

"Hi Laurie,

It's ALWAYS good to hear from you. I enjoy everything you write. The wedding was absolutely wonderful and everything went according to plan. Thank you for asking. We were definitely able to enjoy ourselves since Thomas was doing so well and our favorite nurse, "Aunt" Tina, was there Friday and Saturday to take care of him. Fortunately, he did not give us the silent treatment upon our return. He greeted us with smiles and a poopie diaper for my sister while she held him. Carlton, my sister's husband got to see Thomas for the first time Sunday night. My sister cried because Thomas looks like a baby that you would take home from the hospital (size wise). She loves his little hands. I sent the pics of Thomas from the past week to you and pics from Leigh's, my sister, Rehearsal Dinner and Wedding. That way you could see her white gown! Hope you are doing well.

Love,
Rebecca :)"

Act 3: Public Awkwardness

Monday evening, it was finally just Rebecca and I after a whirlwind weekend. We went up to the hospital and Thomas was looking as cute as ever. I will dance around this and get to the point as best I can. There are things you do in the privacy of your own home that in the NICU you're not afforded the same alone time. I think I've mentioned before that a NICU has all of the solitude and privacy of Melrose Place (its an old tv show reference, look it up, you'll think I'm funny). Everybody is all up in everybody's business. So there are things that happen that a mother is required to do. You basically have to deal with all that sort of thing cribside. There's no private room. All you get is a folding screen, a blanket and strategic positioning of your chair. Rebecca is very shy and modest and I'm not much different. I will just say, she was not really excited about this, hated it actually. Rebecca wasn't into it and really, neither was Thomas. In typical manliness, I pulled out my MP3 player and went to my happy place. I share this in the interest of giving you all the full experience.

And Scene

Update on Thomas, he's at 5 pounds, 7 ounces. They're adding some stuff to his milk with extra calories (kind of like muscle milk if I can make another training parallel). It also makes the milk a little thicker, like a milkshake. It seems to be working a little better. He's able to drink a little better. They are still taking turns with the bottle and the feeding line.

A good start, but...

OK, it looks like we’re in the home stretch, so we’re going to have a second hand print party this Friday, May 8th. Same deal as last time, doors open at 6pm. We will provide hors devoirs and drinks, you will provide a hand. Even if you’ve already put your hand on the wall, please feel free to come by and have a drink. This may be the last time anyone sees us for a while.

If you can’t make it, or are not in within a reasonable driving distance, please send us a trace of your hand. Even if you don’t necessarily know Rebecca and me that well, but you do feel like you know Thomas, we really would love you to participate.

We’d love to see each of you there, but if you can say no to this face, I completely understand.

The address is:
6715 Inverness Lane
Dallas, TX
75214
214-370-0292

Absentee Parents

Rebecca and I have abandoned our son because her sister is so self-centered that she insisted that we go to Shreveport, shower her with gifts and tell her how great she looks in white (I’m assuming she chose white, but she is a little weird, so it could be purple. I’ll let you know after she walks down the aisle). Leigh is getting married tomorrow. Rebecca left yesterday and my parents and I have just left Thomas and our on our way.

We visited Thomas last night and this morning. Last night, my mom and I attempted to feed Thomas, with limited success. In bottle feeding Thomas, they have been going back and forth on which size nipple to use. When he uses a normal size nipple, it gives him more milk than he can handle, so some of it doesn’t make it to its intended destination (his stomach), lots of dribbling and spillage. So they tried a smaller nipple, which does not dispense as much, but Thomas has to work harder to feed. This wears him out a lot.

My mom initially tried to feed Thomas last night and Thomas basically sat there with the nipple in his mouth, not doing anything but smiling occasionally. Clearly he was amused at My mom, the nurse and I trying to coax him to eat. I took over without much more success. Thomas was so tired that, despite the fact that he was sitting straight up, he fell asleep with the nipple in his mouth. I couldn’t wake him at all. I am convinced that he does better with the regular nipple and that much like his dad, he’s just a sloppy eater.

We went by today before we went out of town and the nurse said he’d done a little better with the larger nipple, but an occupational therapist is going to come in at 2 to feed him and I guess determine what kind of career he’s going to have? Seems a little early for that sort conversation, but I’m not the expert here. My money’s on either fireman or a truck.