One Month Down

Dear Charlie Bird,

I'm writing this letter to you on day 33 of your time in the NICU. On Tuesday, May 18, you were officially four weeks old. On Thursday, May 20, you turned one month old! Like I've told you before, your mom and I say that the days in the NICU are long, but the weeks in the NICU fly by. A lot has happened since I last did a daily update, so here's what's been going on.

Day 20: 5/10/21 - Remember that cold that I had that forced me to stay home for a few days? Probably not... But I wrote you about it. Anyways, your mom was mad at me on this day because I gave her the cold that I had. Your mom was able to get ahead of it with some meds, which allowed her to still come in each day she wasn't feeling great, but she decided not to hold you out of precaution. On this day, you had another low blood sugar measurement after your feeds were moved to 1.5 hour compressions, so the doctors moved you back to a 2 hour compression. Even though we had to kind of keep our distance, Nurse Holly was here with you taking amazing care of you.

Day 21: 5/11/21 - On this day, your mom and I celebrated our 3-year wedding anniversary. We had been planning to spend it in one of our favorite places, Seaside Florida (where we got married) until, you know, you were born way early! But it was still special spending that day with you. We came to see how you were doing, and the nurses said you had a great day. We still didn't hold you because of our colds.

Day 22: 5/12/21 - Mom and I both finally felt better on this day. You did have some more alarms on this day, but your doctors weren't too worried about you. You have a tendency to be a bit dramatic with your alarms at times. (I wonder who you get that from?) You had a physical therapy session today as well. The therapists asked Mom and I if you were "always this feisty." The answer, of course, was yes. I was able to hold you for the first time in about a week and you were so happy (meaning your numbers were good). It was an excellent snuggle session. Mom and Grandma K went out to drink this special drink called "Prosecco" (you will most definitely have some with them approximately 21 years from now) and they started planning your baby shower. Now, most baby showers happen before babies are born, but with you, we don't go by the script.

Day 23: 5/13/21 - You had a quiet day on the "bubbles" (your CPAP machine). You didn't gain as much weight as the doctors would have liked you to gain but you were still doing well. This was a pretty easy-going day, overall.

Day 24: 5/14/21 - As we've told you before, you have "primary" nurses who will take care of you when they are working. Your primaries have been Holly, Kate, Brooke, and Megan. You are usually well-behaved for your primaries. Yet, there are days when none of your primaries are working, and these are the days when you decide to be naughty. Mom came to hold you today, but it was clear you were getting a little tired on your CPAP. Mom tried to hold you twice, and both times, you "de-satted" (blood oxygen level went below the desired 89-93% range) really low. Often, when you "de-sat," you have some air in your tummy. On this day, you had a bunch of air, which made you really uncomfortable. You did have a good poop which helped a bit. Later on, though, you had a big "Brady." These Brady alarms (short for bradycardia) are when your heart rate drops below the desired rate. Usually, your heart rate measures between 150-180, but the Brady alarms go off when you go below 80. Anyways, while we were gone, you had a big Brady alarm, and the nurses had to use "the bag" to give you breaths. We do not like when you have Brady alarms, and like I said, you usually decide to have them when you have a new nurse. That is so uncool, Charlie Bird.

Day 25: 5/15/21 - The difficulties from Day 25 continued into this Day 26. You were still on CPAP, but you were visibly tired. You had quite a few more "de-sats" and "Bradys." You still had a lot of air in your belly, and the doctors and nurses started to wonder if you needed to be moved back to the NIPPV machine, the breathing machine that gives you a minimum lung pressure, as well as a certain number of breaths per minute.

Day 26: 5/16/21 - Today, you had to be "bagged" again, meaning the nurses had to supply breaths for you. We always hate getting calls telling us stuff like that. It was official: you were tired of CPAP, so the doctors moved you back to the NIPPV. To make sure your fatigue wasn't being caused by an infection, you had a bunch of labs done, and they even took an X-Ray of you. The labs came back clean, which allowed the doctors to be extremely confident that you did not have an infection of any kind. However, the X-Ray showed you had a lot of air in your intestines. Basically, you needed to fart, but your body doesn't quite understand how to do that on it's own quite yet. Because you had quite a bit of irritation in your bowels, you had a slightly bloody poop. (I am SO sorry I am writing this down, but all I'm trying to do is keep track of everything that happens to you... You'll hate me someday, and then you'll thank me on a later day.)

Day 27: 5/17/21 - You had a quieter day on this day, thankfully. There were fewer alarms, but they did another set of labs and another X-Ray, and still, you had no infection (much to the liking of your mom and me). Because your mom and I were sick last week for our anniversary, we tried to go out to dinner to celebrate on this night (since you were having a relatively uneventful day). Remember how I said that life in the NICU is a time warp? Well, we forgot that it was Monday, and on Mondays in Grand Rapids (apparently), every good restaurant is closed. We drove around the city looking for a place, and struck out seven or eight times. We finally found a place that was open, but we decided that this would not be our anniversary celebration. I don't want to put 100% of the blame on you for our brains being mush... But I have to give credit where credit is due. You deserve at least 90% of the blame.

Day 28: 5/18/21 - You turned four weeks old on this day. This was a big day for a few reasons (literally and figuratively). In a literal sense, this was a big day because you gained 68 grams, which is over 2oz., in a single day. This was a big gain, and one that was welcomed by the doctors because you had been somewhat dropping off of your growth curve. In a figurative sense, this was a big day because you got a "NICView," which is basically a webcam that we can use to check in on you at anytime throughout the day. Mom especially loves the "NICView." It is a bit grainy and a bit slow, but we still love tuning in and seeing you (usually) peacefully sleeping, but sometimes we get lucky and catch you with your eyes open, your hands moving, or with a pacifier in your mouth. I wish it was more like a Furbo (the camera we have for your dog-brother Archie) so I could throw treats to you! Doesn't that sound fun?

Day 29: 5/19/21 - You gained 20 more grams on this day, and your feeds increased by 3mL per syringe. You are still on a continuous drip feed, so this basically means you are now getting an extra mL of breastmilk every hour. Hopefully, this increase in feeding will help you gain more weight as you continue to get closer to passing the 3lb. mark! Nurse Megan called us to let us know you were being super cute on the NICView, so we tuned in to see you.

Day 30: 5/20/21 - One month ago, you were born! We celebrated with you in the NICU. PT said you were doing GREAT. In the morning, you got the Hepatitis B vaccine. Mom tried to hold you, but the session only lasted 30 minutes before you had some de-sats and Bradys. Nurse Brooke thinks you were acting up a bit because you weren't feeling well from the vaccine. You were placed back in your bed and you took a MASSIVE dump. This got you feeling much better. By the way, now that you are one month old, you get to sleep in a Dandle Roo. When you are in your Dandle Roo, which is basically a type of swaddle, you are about as big as a football. It takes everything in my power to not tuck you under my arm and run.

If you didn't need the breathing machine, I'd actually consider it, but we need you breathing. We decided to let you rest and recover from the vaccine for the day. On a more positive note, your Gigi was in town for a few days to help us decorate your nursery. Your crib arrived today, and Mom and Gigi finished wall-papering your room. Check it out! We hope you like it.

Day 31: 5/21/21 - This was a special day, because it was the first day that Mom and I both held you on the same day. Mom held you before lunch and I held you after lunch. We have started reading you more books during skin-to-skin time, and you especially like Chicka Chicka Boom Boom. I've read it to you five times in the past few days!

You still had a few alarms here and there, but they didn't seem to be as frequent (at least to your mom and me). During rounds, Dr. Claudia said you were a "rock star." The only change that was made was that you were getting sodium supplements only three times per day instead of four. However, the more "fun" change since you turned one month was that you get to sleep on non-sterile sheets that aren't the boring white ones. Nurse Megan made sure to hoard some of the cutest designs in your drawer (shhh.... don't tell anyone!), so in the past few days, we've been able to take some adorable pictures.

Day 32: 5/22/21 - Your nurse from last night (Kacie) and your nurse from today (Abby) both said you were wonderful. You only had one alarm last night. You had a Brady this morning, but again, that was because you were pooping. If only you could learn to poop and keep your heart rate at the same time! Life is so difficult. Overall, though, as of the time that I'm writing this to you, you've had a great day. Mom just got done holding you for 2+ hours, and the nurses continue saying how cute and calm you are. I can only hope that you remain calm when you come home. Wishful thinking, perhaps? Most definitely.

Charlie, keep up the amazing work. We are letting you go at your own pace, but it won't be long until you weigh more than 3 lbs., and it won't be long until you are back on the CPAP machine. You have some big milestones coming up this week. First, on Tuesday, you have your first eye exam. From what we have heard, this procedure is NOT fun for you or your parents. We are going to come and sing songs to you while this happens, but we know you're probably not going to love it. Sorry in advance. Then, on Friday, you have another heart echocardiogram to check your PDA (Patent Ductus Arteriosus) in your heart to see if it's closed at all. Your mom and I will be praying for positive results from these procedures! But like Dr. Claudia said, you are a ROCK STAR, and we know you're going to do great.

We love you so much, Charlie Bird! Keep growing, eating, pooping, and being happy!

Love,

Dad