Wednesday, January 31st

Lauren continues to enjoy her 'private bedroom' (see above.) You can barely see her in the isolette. The equipment to the left is her Bubble CPap, which is connected to the green squares on the wall (Oxygen source.) The blanket on top of the isolette is large, fuzzy and perfect for shading her tender eyes from the light. It was given to us by our dry cleaner!! Thank you!

Wednesday, January 31st - Kaia's comments

Break out the champagne and celebrate a few mini-milestones! Today Lauren is 31 weeks (adjusted gestational age) and she is over 3lbs!!! In her short life she has already increased her weight by 150%!

This week we are beginning to see Lauren learn some new tricks. First of all, she can suck on a pacifier (yes, very impressive.) In the next week or two, she will begin mastering the art of nursing. For Connor, this was a challenging skill to learn, and since Lauren is so small, it will probably be challenging for her as well. Over the next few weeks, Lauren will also begin weaning off of her Bubble CPap and just using oxygen from a nasal canula. It will be great to get all of the head gear off of her and enjoy just gazing at her darling face. (Sorry for the fuzzy photo, but we try to shield her eyes and limit any flashes because they startle her. As you can see, the bubble CPAP really obscures her face.)

Another skill that we both began learning today was baby massage. Lauren's nervous system is developing well, and the occupational therapists now encourage parental touch as a positive counter to the 'negative' touch she's used to receiving (heel sticks, blood draws, diaper changes, ventilator changes, xrays.....few of which are welcome or enjoyable.) During our Kangaroo session today, an OT helped teach me how to gently touch her back, arms and legs. Although eventually this may be a very soothing experience, it was quite stimulating to her today. But she tolerated the massage quite well and we'll continue this pattern as a part of our daily Kangaroo'ing.

Lauren continues to be quite the enthusiastic eater. She's up to 24 cc's of breastmilk every 3 hours, which is considered a 'full feed' for her weight. This is almost double the amount of breastmilk she was getting just a week ago! She no longer has any IV's, and the only additional nutrition she's receiving is an iron supplement and a little caffeine (her morning Starbuck's.)

January 29th, 2007 11:15 a.m.

There is lots of good news to share with all of you. First, Lauren turned 1 month old on Sunday, which is a huge milestone in any preemies' life, as the first month is always the hardest. Second, and more importantly, she was upgraded from "critical condition" to a "feeder- grower" - NICU speak for all she needs to do...Feeder' and she will grow, I guess... (At least that is what we are doing with her big brother, so it must work...) We are elated with her progress. She is up to 1286 grams, but her weight fluctuates by 40-60 grams a day. Some days she gains, and others she loses. So, we are trying not to focus on the day to day changes, but more week to week. They are fortifying the breast milk with iron and extra calories.

The only speed bump in the road has come from the medical team's efforts to ween her from her bubble Cpap breathing machine, which is taking longer than expected. This really is not a problem, but something they are trying to accomplish soon. She remains on about 30-40% oxygen (room air is about 21% oxygen here in Colorado.) So, ideally they want to get her down to about that room air level before she goes home. (But, if she doesn't want to cooperate then she will be on oxygen at home, which used to scare us, but not really any more, as it seems par for the course with most preemies.)

I was able to hold her for the first time on Saturday, which was very exciting but also stressful because of her extreme fragility. I think the blankets they used to cover her weighed more than she does, as I could not distinguish between the two. Needless to say, it was about time... Connor still isn't all that impressed with his baby sister, but really likes the monitors and machines which surround her. For now, the 'zamboni' that cleans the hall floors of the hospital is by far more exciting than Lauren, but we are sure that will change in time.

We continue to appreciate your well wishes.

Grant and Kaia

Saturday, January 27th

Gram by gram, ounce by ounce, our little Lauren is growing bigger every day! Each day that we visit her in the NICU, it looks like she has a little more baby fat on her body. It's been amazing to see how quickly she has ramped up on her feedings, and it's been very satisfying to watch her quickly wean off of her IV fluids. She's now up to 19cc breastmilk every 3 h0urs and continuing to increase. She gained another ounce yesterday - just packin' on the weight!

We're still probably 2 months away from taking Lauren home, but she's making great progress toward the three criteria required for her to be dicharged from the NICU: 1) She must be able to maintain her own body temp, 2) She must be able to breathe on her own and go at least 5 days without any apnea or bradies, (although it's almost guaranteed that she will be on oxygen for a few weeks at home), and 3) She must be able to eat well and regularly on her own. Apparently the complex skill of sucking, swallowing and breathing is something babies can't do until they're at least 34 weeks old.

We continue our daily kangaroo sessions, and it feels like Lauren is beginning to expect them and enjoy them, as am I! She sleeps well and her stats remain very stable when I hold her, and even after I put her back in her isolette, she continues to sleep comfortably for many hours afterward.

We're beginning to establish a daily routine of hospital time, Connor time and work toward moving (we close on our new house next week!) But just as we get comfortable with that routine, it will soon change again. Grant is already back to work full time (gotta get that real estate biz going again for 2007!) I will be going back to work 1/2 time from mid-Feb until Lauren comes home, at which time I will hopefully have the opportunity to take a few months off again to be home with her for a proper maternity leave. Of course I'm a little nervous about how we will care for her properly without the help of our fabulous team of NICU nurses and monitors, but we will learn!

January 25th, 2007 10:45 am

"Steady as she goes," says Lauren's doctors. And steady she is... Lauren continues on this remarkably stable path, and is growing by leaps and bounds, so to speak...
She is now up to 17 ccs of breast milk every 3 hours, which is providing the vast majority of her nutrition and fluids - like a full term baby. (Yeah, it feels good to say that...) She is now pooping and peeing regularly, indicating that her digestive system is fully up and running.

The only hiccup has been a blood clot that developed in her central IV line yesterday afternoon. Rather than flushing the line and depositing the blood clot back into her body where it could potentially cause a blockage, they removed the entire line. So, she only has a small Piv line in her ankle. Because she is getting most of her feedings by mouth now (through the G-tube), the central line wasn't really necessary.

We are starting to see some big changes in her, as most of the support is being scaled back for now. As Kaia says, "our little girl is growing up." The kangaroo sessions are incredibly important to both Kaia and Lauren, and seem to be going well... We are told by the doctors that these sessions of skin to skin contact become expected by the baby. So, Kaia has made an effort to at the same time each day to hold Lauren. We continue to hope and pray that she continues to grow and thrive, and that we will be able to bring her home this spring...

Thanks for all of your support,

Grant and Kaia

January 24th, 2007 10:30 am

Today, Lauren is 30 weeks gestation, which is another big milestone for her. It feels nice to be done with the '20s'. We are happy to report that Lauren continues to improve, and that we have found some much needed rest.

Her doctors have rapidly increased her feedings, and she is now up to 13ccs every two hours. They are still 'pushing' her feeds, meaning that they trickle them into her stomach via a feeding tube. It seems to be doing the job, as she gained a whopping 74 grams today, which is about 2.5 ounces. Her digestive system seems to be working just fine. They will continue on this path of increasing her feedings as long as she can handle it until she is up to full feedings. Once she can handle full feedings, they will pull out her last remaining IV, and she will be one step closer to a full term baby.

It sounds a bit funny, but I don't have any 'bad' news to report. She is doing very well (knock on wood), and the nurses even dressed her up for her 30 week birthday today.

January 22nd, 2007 7:45 p.m.

With most of the serious complications of last week behind her, Lauren continues to progress slowly, but much faster than anyone anticipated, including her doctors. Freed of the infection, she can now dedicate most of our energy into increasing her feedings so that she start growing. The early feedings were successful in starting up her digestive system, which apparently is very slow to crank back up. She has been remarkably stable over the last four or five days, which has allowed our medical staff to rapidly increase her feedings, and she is now up to 9 ccs every 2 hours. (Just a few days ago she was at 2 ccs every 4 hours. So, she has come along way.) She put on 20 grams yesterday, and now weighs in at 1178 grams, which is about 2.4 lbs. (We keep thinking she is closer to 3 lbs - maybe it is wishful thinking...) Her heart rate and vitals remain "rock solid" as one of her nurses likes to say. She is slowly coming off the bubble cpap, but that will take several weeks if not months to complete. We are confident that she is now on a good path that will ultimately lead to a happy homecoming sometime in mid March or early April. Many thanks for your continued thoughts and prayers (and food).

Grant and Kaia

January 21st, 2007 10:45 a.m.

Happy 3-week birthday, Lauren!

We finally feel like we can just relax and enjoy each other this weekend. On the doctors' rounds this morning, the neonatologist declared that Lauren was doing 'beautifully!" She has been unbelievably stable over the last few days - her heart rate, blood pressure, blood gas levels, and feedings are all in a normal range with very few aberrations. She's now getting about 1/2 her nutrition from her IV fluids, and 1/2 from breast milk, which is great progress! She's been gaining 1/2 oz per day over the past few days and on her way to being a 'big' 3-pounder. (yes, it's all relative!)

Grant's mom (Pat Carney) has been spending the weekend with us, which makes life so much easier. We've enjoyed many delicious dinners brought over by friends, Kaia has had a chance to 'kangaroo' with Lauren for 2-3 hours every morning, and Connor has been showered with love and kisses by us all. This morning Grant and Connor rough-housed and played so hard that Connor literally asked for a nap by grabbing his pacifier, blankey and pointing to his crib. The only hitch we've experienced this weekend was YET ANOTHER SNOW STORM! Can you believe it? What a winter! Pat is stuck with us for another night, so we ordered pizza and we're all just about to watch a little football together.

January 20th, - Kaia's Comment

That Lauren had better increase her appetite soon or we'll have to purchase a second freezer!!! I've been pumping every 3 hours, but she's still only eating a small amount. Come on, girl! Work with me!

Connor continues to be a high energy little boy. This morning he emptied his whole bookcase in search of his favorite book "Wheels on the Bus." Of course, "A-Wuh" (as he calls it) is also his favorite song. When he hears the song on a CD or on his "Things that Go" Baby Einstein DVD, he starts bouncing up and down with a huge grin on his face. Toddlers are crazy!

January 19th - Kaia's comment

Our sweetest little Lauren is on a great track this week. She is healing from her infection (docs think she had pneumonia and they seem to have nipped it in the bud!) and she's getting back to the all-important work of growing and developing!

She and I had a great morning together. Now that she's off her ventilator, has all but one of her IV's out, and has very stable stats, we restarted our morning 'Kangaroo' ritual. It felt great to hold my little daughter again, as she snuggled up on my chest and quickly fell asleep. It's amazing how such normal baby sounds, like her sneezes and cries can sound like music to my heart! As we snuggled together on a reclining chair, I told her all about the new house our family is moving into next month and all of the little girls her age who will be living on our street. I also told her about her amazing Dad and her crazy little brother, both of whom just love her with all their hearts. It will be so great to have our whole family under one roof. I just can't wait! I also told her about how many friends she already has - this blog seems to have stimulated quite a Lauren Fan Club!

Because we started this blog after Lauren was born, some of you may have some questions as to why this all happened so early. Honestly, most of our questions remain unanswered, and may always remain unanswered. First, why did I go into labor so early? No one knows. On the night of December 26th, I began feeling contractions. They subsided and I slept well that night. But when I went into my doctor's office to be checked on the 27th, I found out that my cervix was beginning to dilate and efface - I was going into labor!!! I was immediately checked into the hospital and put on a series of strong anti-contraction drugs. I was also given a series of steroids to help Lauren's lungs develop in case she was delivered. For the next 4 days, I was on strict bed rest in the hospital and monitored rigorously. We all hoped that the contractions were gone and I might still carry Lauren to term. Unfortunately, on Sunday the 31st at 4am, my contractions began again. The docs tried but were unable to stop the inevitable. Lauren was ready to greet the world, whether the world was ready for her or not!! Sometimes premature births happen because there is an infection somewhere or a tear that leaks amniotic fluid. I went through multiple tests looking for a reason that my contractions came so early and everything came back negative! We must accept that we may never know the reason this all happened.

Why did I have an emergency C-section? When the docs did an ultrasound right before Lauren was born, the images showed that she was in a breech position (her head was not down.) Also, her umbilical cord was gathered near the cervix....all things that made a normal birth dangerous. C-section was the only safe option. My contractions were coming rapidly and I was 100% effaced and 8cm dilated. Lauren was on her way out and the c-section was the best option to minimize her trauma.

So, we may never know why my body was ready to give birth so soon. One friend has told us that perhaps Lauren has some amazing things to do in her life and she just couldn't wait to get started! No matter what, she has already taught us many lessons about love, patience, celebrating the littlest victories, and being comfortable with the unknown and the uncontrollable. She sure is a special little girl and we are so thankful for all that she is and all that she will be.

January 19th, 2007 9:11 a.m.

We are headed to the hospital now to see Lauren, but wanted to drop a quick note to let you know the latest news.

She continues to breathe on her own with the aid of the bubble Cpap machine, and the amount of oxygen she is breathing is slowly decreasing, proving her lungs are strong enough to oxygenate her blood - all good news. We understand that all of her vitals remain good.

The one bump in the road is that she is not digesting her milk. She has a feeding tube (G-Tube) that delivers the breast milk directly to her stomach. Typically the medical team checks the contents of her stomach before next feeding, and they have discovered that the milk is not making its way down in the intestines. There are many potential reasons for this, and we hope to find a solution to it today. Meanwhile, all of her nutrition is supplied through her IVs, so don't worry - she won't starve.

We will keep you posted...

Grant and Kaia

January 18th, 2007 11:02 a.m.

We were pleasantly surprised this morning when we walked into Lauren's room to find that she was no longer on the ventilator!! So, she is now breathing on her own, with only minimal support from the bubble Cpap machine. (In the NICU world, this is a huge step because it means that she is strong and mentally coordinated enough to handle the big job of breathing.) We do, however, realize that she may have to go back on the 'vent' if she isn't fully capable of keeping her lungs completely inflated. (It is normal for preemies to bounce between the two machines at first.) We will know more this afternoon about how she is processing the oxygen she is breathing on her own when we get the results of the latest blood gas test. For now anyway, it is a welcomed return to some sense of "normalcy" if such a state exists at this time.

They have increased the volume and frequency of the feedings as well. And, we did receive the results of the latest brain scan, which was clear of any bleeds. (Ventilators tend to elevate a preemies' blood pressure, which can burst the tiny blood vessels in the brain causing damage.)
So, needless to say it is a good day.

We are not out of the woods by any stretch, but we remain confident that this episode is behind us. I was able to touch her hand this morning for the first time (partly because I have been a bit scared of all the wires and IVs). She wrapped her small fingers about half way around my index finger and shook it a little bit, sort of like a hand shake. So, we've now been formally introduced. We hope she is stable enough on the Cpap for Kaia to hold her today...

Thanks for hanging with us through all of this...

Grant and Kaia

January 17th, 2007 11:25 a.m.

We just returned from our morning visit with Lauren, and I am happy to report her condition is stable and improving. We are truly blessed to have her doing so well, as we are only beginning to realize from the docs how close to the edge she really was...

She has improved enough that they will most likely switch her to a conventional ventilator this afternoon. (This is a big step towards breathing on her own.) She is currently breathing "over" the ventilator now, which shows that she wants to breathe on her own. She has handled the draw down on the meds and pain killers, which gives our medical team confidence that she is ready for the next step. Her vitals have remained consistent, with much lower heart rates and perfect blood pressure and gases. They even started feeding her again yesterday. Her last chest x-ray showed some improvement in the lung congestion, but this mysterious infection is still with her. She will remain on the antibiotics (which apparently can "peel paint off the wall," as our doctor says) until we are completely sure that she has in fact conquered the infection.

So, we continue to rejoice in her miraculous recovery, and try not to worry about another trip down this terrifying path. Although we are back to square-one, we now know she is tough and battle tested. Our hope is that she can start breathing on her own and regularly feeding soon. We are both worn out emotionally, but your thoughts and prayers for our family keep us going. We appreciate all of your support.

We will try to update the blog this afternoon after the switch to the new ventilator...

Keep the faith,

Grant and Kaia

January 16th, 2007 9:50 a.m. - She's a fighter

I just wanted to let all of you know that Lauren's condition continues to improve. In fact, she is recovering quite well. We can't thank all of you enough for your heartfelt concern, prayers and thoughts. Clearly, Lauren could feel all the love.

Her heart rate this morning was in the 130's, lower than it has been since she was born. (Compared to 230's bpm a day or so ago.) This is a great sign of her overall health, as preemies exhibit signs of stress, infection, etc...through their heart rates. Her vitals remain strong, and she is receiving much less support than she was even 24 hours ago. So, we believe that she has the infection on the run. (Our medical team believes the infection was probably pneumonia, due to her cloudy lungs, but we don't have any positive test results to confirm that.) They continue to ween her off the vent, and hope to put her back on bubble Cpap breathing soon (which means she will be breathing on her own, essentially). Kaia says she looks comfortable, despite her bruised and swollen arms and legs from all of the IVs and her scars from her multiple procedures, spinal taps, and surgery.

We still don't know the cause of her serious deterioration, and the docs are still searching for it. We hope and pray it won't return. I suppose this is part of the NICU roller coaster that we have heard so much about. We still have many many hurdles to overcome, but things are moving in the right direction. We certainly believe that all of your positive energy, prayers, and concern gave her the strength to push on...She is a seriously tough little girl.

Keep the faith, and much love to you all....

Grant and Kaia

January 15th, 2007 - 9:51 a.m

After much worry and tears yesterday, the medical team did get Lauren stabilized yesterday afternoon, and she had a calm night. They are concerned that some sort of infection has taken hold, but finding it remains a big mystery. So, the search continues, which most likely will include a spinal tap today, unfortunately. Meanwhile she remains on a long list of drugs and antibiotics. Your thoughts and prayers mean everything to us right now.

Keep the faith,

Grant

January 14th, 2007 - Kaia's comment

We received our first middle-of-the-night phone call from the NICU last night. When I heard the phone ring at 3am, I knew who it was and I knew it wasn't good. Through my groggy sleepy haze, I listened to the doctor tell me that he was concerned about Lauren. She had been rather unstable over the last few hours and he was concerned that she may have an infection. She was retaining fluids, her blood gases weren't good and her heart rate was very high (over 200bpm, although she had been in the safer 170-180bpm range right after the surgery.) Her blood pressure was low and CO2 was high. Basically, her heart was working hard and it seemed like she wasn't getting enough oxygen throughout her body or ridding herself of the waste gas CO2. The doctors planned to switch her to a different type of ventilator (high frequency oscillating ventilator), put her on a high powered antibiotic and begin to diagnose the problem. We knew that the PDA surgery recovery would likely be rocky and sure enough it has been.

Grant and I headed into the hospital this morning knowing that Lauren was fighting a good fight. We have tried to keep a strong and positive outlook, but there have been a lot of tears today. We have been told that she may not make it through this infection, which is impossible for us to swallow. We have been by her side constantly and hoping for the best. The team of respiratory experts, NICU doctors and nurses were very focused on Lauren all morning. So far, test results have not shown a specific infection, but they think she is shunting some blood through another duct near her heart and she may have a sepsis (infection in her blood.)

Grant's brother Matt braved the snow (yes, we had MORE snow last night!) and has been by our side in the hospital today, providing positive encouragement. Fortunately, Connor seems to have recovered today, and we think his 'illness' last night was due to more molars coming in. Poor little guy!! Early this morning, it seemed like our whole family was falling apart. The cat was the only one who didn't seem out of sorts. This afternoon Connor's energy and spark have returned, and he's been playing with his GranD (my mom) who is here to care for us all and help us get through the weekend. With his giggles and smiles, once again our son is the embodiment of hope that we need in such a difficult time.

January 13th, 5:52 p.m.

Happy Birthday to Kaia and my Brother Matt!!!

We visited Lauren this morning, and her condition continues to be stable. They are slowly reducing the pain meds, and she seems to be tolerating it. She remains on the vent until her blood gases improve, however. All other vitals are stable and good...So, no real news. She is doing what she should be doing, which is sleeping and healing.

Unfortunately, Connor seems to have come down with the flu and Kaia pulled a stitch and has been layed up all day. Fortunately, Kaia's mom is here today to help take the pressure off of me.

Grant

January 12th, 2007 - 6:35 p.m.

Hello family and friends - We both want to express to all of you our sincerest appreciation for your loving support, thoughts and prayers. We feel like your positive thoughts and energy helped Lauren turn the corner. How could she not feel the love? Today was a good day.

Lauren remains somewhat sedated, and she has been slowly waking up today. Because of the narcotics used to control her pain, Lauren still needs the help of a ventilator. (The drugs relax so many functions including her ability to breathe.) We hope to have her back on regular oxygen soon. Her blood pressure is amazingly stable, which is a marked changed prior to the PDA ligation. She is producing lots of urine, which indicates that her kidneys are working fine and she is flushing her body of the drugs. Her color is good, and she is comfortably stable. They moved her out of the super station neonatal ICU post-op room and back to her isolette, where they can better control the humidity necessary to keep her skin from drying out. (Her skin was becoming fairly chapped, and flaky due to the dry heat lamps she was under in post-op.)

As with any surgery, there have been some recovery challenges. Her body is retaining some fluid, which she is starting to flush out with the help of a diuretic. However, that process takes a few days. So, some of that fluid remains in her lungs. When they moved her this afternoon, they completed a chest x-ray that revealed some congestion in her lungs. So, they will continue to monitor that to ensure it clears up over the next few days. There is also a continued murmur in her heart, but our medical team doesn't seem too concerned about it. However, they did indicate that it could be a sign that maybe the clip isn't holding. It's too early to tell, but something they will also continue to monitor. Tomorrow, they hope to start some small feedings to get her digestive track back up and running. (Kaia has completely filled our freezer with milk for what we hope will be a very hungry little girl!)

We're not out of the woods yet, but feel confident Lauren now has a chance to start thriving, and putting on the necessary weight. We slept great last night, and woke up this morning with a renewed sense of optimism and hope. We haven't cried today, so that is also a nice change.

Your thoughts and comments have made all the difference in the world, and we are glad to share her journey with all you despite how difficult it is to write these blogs some days. We must admit that sharing her life with you is incredibly cathartic, and in some way brings us closer to Lauren, as we can't really touch or feel her, and sometimes can't see her face. Anything to feel close to her.

Much love,

Grant and Kaia

January 11th, 2007 - kaia's comment

Perhaps my birthday wish has been answered early! Lauren's surgery this morning was quick and successful. We have just returned from the hospital and we're so excited to share the good news.

We received a call at 10 am saying that surgery would begin within the next 2 hours, so of course Grant, Pat and I packed up and rushed over to the hospital. Connor was left in good hands with his nanny Katie. We left him happy as a clam, riding around our basement in his brand new wagon - I think he would sleep in it if we let him.

At the hospital we were greeted by Bobbi, the NNP who has primary care of Lauren. (an NNP is a neonatal nurse practitioner who has advanced training in newborn special care) Lauren had been moved to a more private room within the NICU and in the process of surgery preparation. "She's been feisty all morning, " Bobbi told us, "I think she feels gypped because we wouldn't let her have her breastmilk this morning. We need to keep her tummy empty in preparation for her surgery" When we arrived, Lauren had already been intubated and sedated (general anesthesia.) It was heart wrenching to see our little daughter splayed out and prepared for surgery. No one should have to endure this, especially one so little. But doctors have assured us that this surgery is routine and although it will take her awhile to recover, her pain will be managed and she won't remember a thing.

After the surgeon and anesthesiologist thoroughly scared us with all of the consent forms and descriptions of all potential risks, we went to the family waiting room and tried to keep the most positive of thoughts in our minds. About 45 minutes later, Dr. Max Mitchell (cardiac surgeon from Children's Hospital) walked in with a smile - the ligation was a success! He sealed the ductus with a very small titanium clip and she was already showing signs of improved stability. "The ductus was very large," he told us. "Her heart may have been working 2-5 times harder than necessary due to this PDA. I can tell that her lungs are already beginning to clear and she is very stable. She hardly lost any blood in the process and everything went smoothly." We were elated with the positive news.

Of course once the surgeon left, we all broke down with tears of joy and relief. We went in to see her and she looked great. She really looked no different than when we had left her an hour earlier, other than a new small bandage under her arm. But eventually the only sign left of this surgery will be a small fine line on her skin. Plus, she now has her first permanent piece of jewelry - a titanium clip near her heart. We are so hopeful that her recovery will be smooth and she is now set to really start growing and THRIVING!!!! Great job, girlfriend! We are SO PROUD OF YOU!!!!!

January 10th - Kaia's comments

As we had feared, Lauren's PDA has not closed. Her surgical team: cardiac surgeon, anesthesiologist, etc are currently forming and we've been told that her surgery (a PDA ligation) will happen early tomorrow morning. This news is both good and bad - bad because of course we wish the medication had closed the duct in her heart. But good because the surgery will guarantee 100% closure of the duct. It's been an emotional day, to say the least. We're concerned for Lauren's stability but know that this surgery is necessary for her condition.

This surgery is very common and rather routine for preemies, which is somewhat comforting. The Dr. will make a small incision under her arm between her ribs and seal the open valve in a surgery lasting less than 20 minutes. Then comes the tough part - recovery. Lauren will be intubated and completely anesthetized for the surgery. It will likely take a few days (hopefuly not too long) for her to get back to breathing on her own and she will be on a number of medications for awhile to maintain her fluid/breathing/digestive balance and avoid any infection.

Our parents have been wonderfully responsive in these critical situations. Grant's mom is headed down from Ft. Collins now to care for Connor over the next 2 days and my parents will be here through the weekend. This all allows Grant and me to leave for the hospital and attend the surgery at a moment's notice, which is reassuring. For Connor, it's a blast having his grandparents here to dote on him. Connor has a brand new red wagon waiting for him in the basement tonight, so I'm sure that his look of surprise and absolute excitement will help to counterbalance the tears I have experienced today.

Please keep Lauren in your thoughts and prayers over the next few days as we do our best to help her get over this PDA hurdle. We have strong faith that once she recovers from this issue, she will really begin to grow and thrive!!! You're a strong little punkin, Lauren! We know you can do it!!!!!

January 10th, 2007 - 2:05 p.m.

We've been by Lauren's bedside for most of the morning.

Upon our arrival, we learned that her red blood cell count was way down, and she was very pale in color. Her stomach and intestines were bloated, and most likely the result of an incorrectly placed feeding tube, which allowed too much air to pass down into her digestive track. They quickly did a chest x-ray on her this morning, which didn't reveal much, which was good. They transfused her this morning to bring up her red blood cell count, which is common in preemies. So, hopefully those two minor problems will be corrected by tonight. She continues to gain weight, and now up to 997 grams - which is great.

Unfortunately, it appears that her PDA is not closing, and that the second round of medication didn't work as well as we had hoped. An echo cardiogram was performed to see if there was any progress, and we should have those results back this afternoon. We believe that she will most likely undergo heart surgery on the duct either tonight or early in the morning. We will have a consultation with a cardiac surgeon this afternoon from Children's Hospital. We've worked so hard to avoid this result, and it pains us to see her go through more trauma. In many respects, it doesn't hardly seem fair for someone so small to have to endure all of this. Yet, we understand this to be a necessary and routine procedure, common in many preemies, and will most likely result in a healthier child. However, we just feel so sad and so very scared, but confident too...

Your thoughts and prayers have meant so much to us. We read them every night, and they remind us that we are not alone. Thank you for keeping Lauren close to you today.

Much love to you all,

Grant, Kaia, and Connor

PS - today is her gestational birthday of 28 weeks, only 12 more weeks to go.

january 9th, 2007 - Kaia's comment

Two steps forward, one step back....that's the way it seems to go in the NICU. We try to celebrate each little progressive milestone, but each little setback hurts my heart (and probably also gives both Grant and me a few new gray hairs!)

The big 'win' today was a normal brain scan. Whew!!! We know there's still a chance for some brain bleeding, but we've been told that a normal scan after almost 2 weeks in the NICU is a very good sign. The setbacks today were an increase in Lauren's oxygen level and a slight increase in A/B's. It takes a lot of effort for her to breathe with her underdeveloped lungs, so although she was breathing room air (aprox 20% oxygen) by her second day in the NICU, she now needs about 30%. This is a sign that she needs a little more help breathing, which may lead to the need for intubation again. But hopefully she'll hold her own. We've been told that A/B's are very common for little preemies and they will continue for many weeks. She will not go home until she goes for at least 5 days without an A/B, although many babies do go home on some oxygen. This is due to our thin high altitude air. Perhaps we all could use a little more O2 here in CO!

The highlight in my day was a second opportunity to 'Kangaroo' with Lauren this morning. I will try to routinely practice some 'skin-to-skin' with her over the next few weeks, as it seems to be very good for both Lauren and for me. The NICU nurses say that babies come to expect it. "After awhile she will wake up and seem to be waiting for you to arrive at your typical kangaroo time," says her primary nurse Bobbi (who we absolutely LOVE!)

The nurses at St Joseph's NICU are just phenomenal. Of course we have our favorites, but they are all so generous, gentle, knowledgable and caring. I love to hear them describe Lauren's little quirks - it makes me feel like they know her well, like adoptive aunts. They say: "She's always more comfortable on this side," or "She loves it when I give her a little breastmilk on a qtip in her mouth to taste - watch how she seems to lick her lips, Kaia!" "Oh, she often gets a little fiesty when we change her diaper. Just watch those long arms and legs kicking!" We have learned so much from them all and we owe them so much for their wonderful care.

I can forsee that it will be exciting but scary to take Lauren home, where we won't have the nurses and doctors at our backs or the monitors to assure us that she's doing fine. But still, I'm just so excited for the day when she can come join our family at home!

January 9th, 2007 10:15 a.m.

I just returned from our morning visit to the hospital to see Lauren, and to find out the results of the tests we have been so anxiously awaiting. Today, is a good day.

The IVH unltrasound (which is scan of her brain to see if there has been any bleeding) came back NORMAL, so we feel like a huge weight has been lifted from our shoulders. Typically, preemies experience brain bleeds in the first two weeks of life, and after that the chances of bleeding decline. So, we are not out of the woods yet, but feel encouraged by this great news. We've been so worried about this potentially serious complication because the outcomes are rather grim and there is virtually no treatment. We remain confident that her neurologic system is maturing normally and is in fact intact. They will do another IVH ultrasound before she is discharged just to make sure there has not been any changes.

We are also encouraged by her continued weight gain. She now tips the scales at 970 grams or 2.165 lbs (from a low of 810 grams). So, she surpassed her birth weight in about a week. Her feedings will continue at the current rate and volume until we get past the PDA issue. Her vitals were normal this morning, and we noticed that her heart rate was down into the 170's. Her lung congestion seems to have cleared, and no more chest x-rays... All good news.

We remain concerned about her heart condition, aka the "PDA." The valve has not closed yet, and it was louder this morning. We hope that the louder the flow through the valve means that it is closing, as turbulent blood flow being pushed through a smaller opening tends to produce a much louder sound than a much larger and less turbulent flow. So, they will do two more rounds of medication to see if they can close it. If they can't close it with these two rounds, we will begin the process of considering heart surgery, unfortunately. She also had several more A/B spells last night - still normal, but concerning nonetheless.

Kaia remains with Lauren this morning at the hospital. She is very much looking forward to holding her this morning, as Lauren seems to really respond to Kaia's touch. Kaia will probably update the blog tonight after we get home.

Thanks for all of your support. We feel very lucky at this point to have such wonderful family and friends. Your notes and comments are an encouraging lifeline.

Keep the faith,

Grant

january 8th, 2007 3pm - Kaia's Comment

It has been difficult to feel so detached from Lauren throughout this process. First in the C-section delivery, when she was whisked away to the NICU instead of placed on my chest - I had just a few seconds to glance at her sweet little face! Then leaving the hospital without her - one of the greatest emotional challenges I have experienced. And daily, to feel like although I am her mother, my ability to 'mother' her has been reduced to pumping breast milk and speaking soothing words to her through the isolette walls. It doesn't feel normal. But I know she has great care and my job to mother her will increase with time.

But today was a good day in the mothering sense. Now that Lauren is more stable in the NICU, we have been encouraged to try 'Kangaroo Care' which Grant defined in his last blog entry. As I lay, shirt open, in a recliner chair near the isolette this morning, Lauren's nurse took her out of her 'sauna' and placed her on my chest. Of course I had tears in my eyes as my tiny 2 lbs daughter snuggled close and seemed to immediately relax as her heart rate reduced to a calm level and her other stats were very stable. For almost 2 hours, I enjoyed the simple pleasure of holding my baby daughter....something I don't think I'll ever take for granted.

Although this is my first blog entry, I have read each and every one of your encouraging comments. Thank you all so very much for your loving and hopeful words. When I feel stressed and concerned about the emotional roller coaster we have been on for the past 2 weeks, I often read your notes and they cheer me up and warm my heart. One thing I do NOT feel is ALONE in this process. As Grant and I cling to each other for strength in these challenging times, we feel your love and your support with us every day - thank you!

January 8th, 2007 9:47 a.m.

We made it through the night, and Lauren continues to fight with everything she has.

We visited her last night, and received good news that her PDA is slowly closing. The valve opening is smaller than before, and her heart rate has come down as a result. We've decided to go another round of the medication to see if that will fully close the valve, which will greatly improve the efficiency of her heart and lungs. So, another echo cardiogram is scheduled for Tuesday night to see if the second round of meds will completely shut the valve. The congestion in her lung was less last night, but still present. Her digestion seems stable, and for the most part she is improving.

Kaia is planning on spending a good deal of time with her at the hospital today. She will most likely start "kangarooing" her, which is delicately holding her skin to skin. Many studies show the positive effects of parental touch, including reduced A/B spells, faster weight gain, and overall better health. We've been resistant to holding her because of the risk of infection, and because it was nearly impossible with all of her IV lines, breathing tubes, and electrodes. However, I think Kaia is in an emotional place to begin this process. We should have the results of the brain scan this afternoon, and hopefully some news on her weight.

Emotionally, we remain positive, and encouraged by all of your well wishes. Thanks for keeping Lauren in your thoughts today.

Grant and Kaia

PS: I know some people are interested in knowing about "A/B" spells or episodes. The A/B stands for "apnea and bradycardia" - which are short periods where she forgets to breathe, and her heart rate and pressure go into steep decline. When she goes through one of these, the alarms go off, and the medical team wakes her up with light touching and rubbing...They are fairly normal, but absolutely terrifying.

January 7th, 3:45 p.m.

Today is Lauren's week birthday. Unfortunately, her condition has deteriorated slightly today, and for the first time we really feel like we are on the NICU rollercoaster.

During our evening visit last night, we learned that one of her lungs is congested with fluid, and this fluid buildup was confirmed with a chest x-ray. Consequently, her heart is working hard to keep her body oxygenated, which concerns us greatly. The medical team believes this is the result of her heart condition (the "PDA"). The PDA, while normal in most preemies, can greatly decrease pulmonary efficiency, and give other potential problems a foothold. So, closing the PDA (which is essentially a small valve necessary for life in the womb that is suppose to close when the baby makes the transition to breathing oxygen) is critical at this point. Over the last few days, the medical team gave her drugs to help close the valve. An echo cardiogram was performed today to see if the valve closure is smaller. We will head back to the hospital this afternoon when they receive the results of the test. Regardless, Kaia and I feel strongly that we must get the valve closed to keep her on the right track.

Lauren also quit "bubbling" (part of her breathing equipment) this afternoon during our visit, which scared us beyond belief. It was just a mechanical problem relating to Lauren's position, fortunately, but terrifying nonetheless. As we are painfully learning, these little setbacks are very hard to swallow.

Fortunately, there was some good news on this visit. She continues to gain more weight, and she is up to 922 grams, so she continues to close in on her birth weight. Most preemies take 2 weeks to get back to their birth weight, but she will most likely do it in one week. She also has been accepting all of the increased feedings, and producing bigger fuller diapers. (I never really thought that would be a good thing.) They will most likely increase the volume of the feedings once we can get the PDA under control.

Again, we can't express to you all how much we appreciate hearing your words of encouragement and HOPE. They keep us up, and remind us how lucky we are to have such great friends and family. Please keep them coming.

Keep the faith,

Grant

January 6th, 1:25 p.m.

We just returned from our morning visit with Lauren, and there is lots of good news to report. First, Kaia was able to change her diaper for the first time, which doesn't sound all that fun, but is to us because it means that her digestive track is "waking up," and represents another small step towards a normal life. Her diapers are about the half the size of your hand. The Docs also want to start increasing the frequency of her feedings because she has proven she can handle it. If all goes well they will also increase the volume of the feedings to 3cc's. (She currently gets all of her nutrition through her IV lines, so the feedings are more to stimulate her digestive track than actually provide nutrition to her. Eventually, the feedings will provide all of her nutritional needs, but that is still many weeks away.)

We also were excited to learn that her weight is also up to 894 grams, which is about 2 lbs - only 51 grams to go before she is back to her birth weight. In terms of her breathing, she only experienced two A/B episodes last night (where she stops breathing for more than 20 seconds), which gives her a total of 6 in the last 3 days - a massive improvement, and ahead of most preemies her age. She continues her caffeine drips (her "Starbucks lattes") to further stimulate her respiratory and circulatory systems.

Unfortunately, her heart condition (the "PDA") continues to cause us some concern. The cardiologist will be doing an echo cardiogram tomorrow to determine if the medication is working to close the valve. If it hasn't shown signs of improvement, we may try another round, or consider a surgical option. However, she is doing so well that we don't want to go the surgical route unless it is absolutely necessary. There is a chance that the PDA will close and resolve itself in time. Her blood gases were low, so she they turned up her oxygen and pressure.

On the horizon is the IVH ultrasound (IVH = Intraventricular Hemorrhage), which essentially is a test to check for bleeding in the brain. It is fairly common for preemies to have some bleeding, but not a lot, as that is a sign of significant brain damage. She doesn't have any of the symptoms that would be associated with a high grade hemorrhage (level 3 or level 4), so we remain hopeful that the scan goes well. I am sure that will be a tough and anxiety filled day.

We can't thank everyone enough for the emails and for the encouraging comments left on the blog. We read them every night, and they always leave us with a comforting sense of hope. Connor is doing great - a little confused by all of this, but for the most part he is enjoying being completely spoiled by both sets of his grandparents.

Keep the faith,

Grant

January 5th, 2007 3:56 p.m.

Amid all of the snow, we made it to the NICU for lunch with Lauren. Her condition continues to be stable, so nothing new to report. We are encouraged by some new tests results that suggest her heart condition (called a "PDA") maybe improving, although we will not have any confirmation of that until tomorrow. She didn't "tan" today, meaning her b/r count was good. They will put in the central IV line tomorrow, and remove her main arterial line which is running through her stomach. This will lessen the risk of infection, which is our biggest fear at the moment. We will visit her this evening around the time she is weighed. C'mon 900 grams!!!

We are really encouraged by many of your stories of friends and relatives with preemies, especially a call from a friend of mine in Arizona. He called just to let me know that he was a preemie himself, and told us to watch out because "they are a feisty lot." We also learned that Winston Churchill, Albert Einstein, Mark Twain, and Renoir were all preemies, so we feel she is in good company.

Kaia is feeling much better today, and walked from the car to the NICU without a wheelchair. It seems as if our life now is a series of tiny milestones, as we look forward to the day when we can bring Lauren home. Thanks for all of the good vibes.

Grant

January 5th, 2007 9:15 a.m.

I shared all of your comments, emails and kind notes with Kaia this morning, and it put a big smile on her face. She arrived home last night, and was promptly greeted by a very happy little boy, who clearly missed his mother...She is feeling better, and enjoying time with Connor. Our family feels incomplete, however. The strong gravitational pull of the hospital, and Lauren is always present it now seems...

We visited Lauren last night, and she continues to improve. Her increasing weight is the biggest improvement to date. At birth she weighed 945 grams (all measurements in the NICU are metric, which takes a little getting used to), and dipped to a low of 810 grams on Wednesday. However, last night she was back up to 877 grams, which means that she is adequately absorbing Kaia's breast milk - another small, but important milestone. So, we remain confident that her weight is headed in the right direction. One of her doctors said to us last night that "we couldn't ask for a better condition at this time." Of course, we hang on every encouraging word, as we are painfully aware of the fragility of her life.

We sincerely appreciate all of the emails, voicemails, and cards...We certainly can feel your support.

Keep the faith,

Grant

January 4th, 2007 4:00 p.m.

Kaia is now home from the hospital, and relaxing comfortably, albeit with a touch of sadness as we had always expected the baby would come with us. She already wants to head back to the hospital this evening.

Lauren's condition this afternoon was stable. The good news is that she is absorbing the breast milk, and peeing like a champ. She continues to breath on her own, with less A/B's. We will know more about her heart condition in the next few days, and we remain confident that we will see some improvement in her blood pressure.

We continue to be amazed at all of the technology being utilized to help keep her alive. It all looks very scary at first, but we have come to embrace all of the machines as de-facto caregivers for us while we are not there.

Again, thanks for all of your thoughts and prayers. It really helps to keep our spirits up...

Keep the faith,

Grant

January 4th, 2007 - 9:32am

Lauren had a good night, according to Kaia. Her breathing is strong, and everything is status quo, which is good. We did learn unfortunately that the echo-cardiogram revealed a hole in her heart, which is normal for preemies. Yet, it is something that will need to be treated. The standard frontline treatment is some fast acting drugs, which they have already started. She will have another "echo" done in a few days to determine how effective the treatment is working to close the hole. If they can't close the hole with drugs, we are looking at open heart surgery, unfortunately, which has its own risks. The amount of the feedings will not change due to the new medicine. Her a "A/B" episodes (these are where she does not breath for 20 seconds or more) were few and far between last night, which is good. She is back under the sun lamps today to help her liver break down certain chemicals...

We took Connor to meet his baby sister last night, and he was a bit confused of course. He was more interested in Kaia's wheelchair, which wasn't all that surprising. We spent a few minutes outside watching a front end loader load semi with tons of snow...Needless to say, it was the highlight of his day.

Some people have asked to see pictures of Lauren, and I would love to, but she is covered in tubes, wires, electrodes, and bandages...So, there isn't really much to show you. In fact, we have only seen her face briefly because it is covered with her CPap breathing mask and "sunglasses" to keep the light out...I'll post a few pics when the time comes.

Kaia will be home this afternoon, and we are very much looking forward to regaining some sense of normalcy.

Thanks for your thoughts and prayers today. Both Kaia and I can't thank all of you enough.

Today is Jan. 3rd, 2007 -


WEDNESDAY!!!! We are very excited about our spunky new addition Lauren Reece Nesbitt! Like her mother, she already lacks patience, and decided to join our family 3 months early. (She was due on April 4th, 2007) Surprisingly, she is 2.1 lbs, and almost 14" long, which is big for her age if you can believe that. She is currently in the Neonatal Intensive Care Unit (NICU) at St. Josephs Hospital, and being watched over by a fantastic team of doctors and nurses. Kaia is also in the hospital recovering from her C-section. We hope to have her home tomorrow.

We look forward to Wednesdays, as that is Lauren's weekly "birthday." (When your life is measured in weeks, each new week is an important day - and represents a new milestone in her development.) Today, she is 27 weeks old!

Today, Lauren is doing quite well. She continues to breath on her own, with the help of a bubble Cpap machine, which is great. Her heart rate remains strong, but there is some concern about the a tiny hole in her heart, which most newborns have...An echo cardiagram was taken to get a better idea of the size of the hole, and how it might be affecting her. She had her first poop today, which shows that her digestive system is starting to work. (Kaia's milk arrived, and she's been pumping and storing the milk for future use.) The docs removed one of her arterial lines, and they will most likely put in a central line in the next few days. (Hopefully, they can find a vein in her small little arm...) She has lost a few more grams in body weight, but much less that the previous day, which is encouraging. Finally, her "A/B" episodes are much less today, which is also encouraging..

Kaia seems to have more energy today, and walked to the NICU this morning and then again at lunch. She will stay at the hospital tonight, we will bring her home tomorrow (Thursday). Connor continues to eat us out of house and home, and seems to be in his normal groove of playing with everything in the house, including our cat. I've noticed that he is now taller than our dining room table. (He did take a dive down three stairs, and landed on his forehead, which produced a rather large blue/green shiner...He's fine...)

I'll do my best to keep you updated...Grant