Friday, July 28, 2006

The $171,000 baby

Actually it's more....all I can say is thank God we're not one of the thousands in Texas with no health insurance (the state with the highest rate of uninsured or under-insured). The hospital sent us a summary of charges - of which insurance should pay almost 100%. Yup US$171,000! Ouch. And that's not even for the delivery, my stay, OR for any of the MDs' fees! Much of that is the machines used, and the 24/7 1-on-1 nursing care she was getting, the daily x-rays, the drugs....

An interesting twist I guess, as the insurance company, though they claimed to cover homebirth 100%, in fact didn't and we just paid for that in cash. So we were going to save them loads of money but in the end are costing them a lot.

She is of course worth every penny. But I shudder to think what would have happened if we didn't have insurance (and recall the few months I didn't have insurance in grad school and lived in constant fear of having an accident).

I know, I know, you want pictures

update - pics added according to date so scroll down

They will come soon. Frederic has them all and has been too busy to copy them to me, but soon!

Angelina is doing great! She's finally taken to breastfeeding with a vengeance. She's in her 3 week growth spurt and eating non-stop. I'll be curious to see how much weight she's gained next week. She gained 73g in the 4 days between hospital discharge and doc's visit, so that means the feeding is working! I'm in a rare extended sleep break right now...tho it's about to end soon.

Wednesday, July 26, 2006

Tuesday, July 25, 2006

Boobs and Poops..... Feeding Challenges

On Thursday, July 13, she had been doing well for a few days and there hadn't been any changes to her treatments. Her regular doc was away so we asked the doc on call what was up. We were getting impatient at that point. He said all she needs to do is mouth feed. Great! So when can we start that? How about tomorrow? he says. We realised that had we not asked, things would have continued as usual until her regular doc returned.

So we tell the nurse and she's not too thrilled, but doc said so so she agreed, only she said "no" to breastfeeding, claimed they had to be able to measure how much she took, so had to be bottle. That made some sense to us, so we didn't argue. By Sunday, July 16, however, Angelina still wasn't taking more than 20-30mls (1oz) via bottle of the 60mls 'required' and we started to get worried. Her suck was fine, she just didn't like the bottle. Her Saturday nurse suggested next time I try putting her to the breast, just to see. So on Sunday night, we asked the nurse when I could start breastfeeding. "Not til she takes 60mls via bottle 2x/day for a couple of days, then 3x/day, then 4x/day." WTH?! That'd be more than a week before I could even put her to breast! It made no sense, esp given the whole point was breastfeeding, not bottle feeding! But this nurse was no-nonsense, no deviation from standard protocol. That was the one time I finally gave in to despair. The thought of our Angelina being there another week or more, when she was clearly doing much better made me lose it.

On Monday morning I called the hospital's lactation consultant. Smart move. The above was a load of rubbish! They could weigh her before and after if they wanted to know how much she took. So she talked to the nurse and the doctor. By the time I came in at 11am, the nurse said "you can feed her!" Thankfully Holly, my midwife was with me that day, as the LC was away and though I was told 'there are plenty of people around to help with breastfeeding', no one was there and I was on my own. Holly guided me through it, And amazingly, Angelina took to it like a champ.

However, the next few times were rough. Fortunately the LC came by each time to work with us. By Tuesday afternoon, the doc decided it was better to just breastfeed on demand, skip the tube and bottle feedings entirely! Woohoo!!! So beginning Wed am I just stayed at the hospital and fed her whenever she wanted. One nurse commented that I was feeding too frequently (every 2 hrs or less). By now I was more confident of my knowledge and said rubbish! She eats when she's hungry, not on a schedule. And she gained 30g that day! So Thursday her doc said "take her home!"

Moral of the story - Question! Listen to your instincts and trust yourself. Though overall the staff at the hospital were great, for some the idea of going against the status quo was too much. I think they're also not used to parents who 1)are there constantly, 2)are knowledgeable and 3)are willing to question their procedures. I can appreciate their need for a schedule - it's not practical to feed every baby in the nursery on demand. Fortunately her neonatalogist trusted us and let us follow our instincts, else she'd still be there now learning to bottle feed.

Breastfeeding at home was still a challenge. It took us a few more days to get it down right, consistently. But we have, and now she's at it non-stop....

Monday, July 24, 2006

Napping with mommy

The co-sleeper is great! Thanks Angeline and Nico! Though she may outgrow it allows us to see her and touch her without getting up out of bed, but no worries about anyone rolling too far.

Saturday, July 22, 2006

Thursday, July 20, 2006

Home where she belongs!

Not only is she totally wireless

our Angelina is now home!!!!!

Pulling off those last tubes and wires was a wondrous occassion!

At 17 days old, her doctors and nurses decided they could part with her
bright shining eyes, pug nose and huge smile and it was time to share
her with the rest of the world, though her proud parents may
keep her all to themselves for a little while.

She's almost completely recovered. Her lungs will take awhile to repair
the damage done by the ventilator, but otherwise she's in excellent
shape. Everything else is perfect. Thank you so much to all for your
kind words, thoughts, and prayers.

Wednesday, July 19, 2006

Almost wireless!

Just a quickie update. Fredo has loads more photos but hasn't gotten them to me yet. I've been staying at the hospital all day and will be sleeping there tonight with Angelina. She's got ALL her tubes out now, for good! only thing left is the heart/breathing monitor. I can't wait til she's fully wireless. We're just trying to get her feeding well - she's breastfeeding better now, which is why I'm staying there so I can feed on demand. Doc agreed that the nurses' 3hr schedule wasn't working for her. But she's not taking enough (she latches well, but about 50% of the time gives up after a few minutes, the other 50% she stays on and does well for 15 min, so she *can* do it), so I'm adding in some breastmilk via syringe to make sure she gets sufficient amounts. Doc says we just need her feeding enough to send her home, then we can watch her closely. We're hoping the going home day will be Friday, cross your fingers!

Her lungs are as good as they're going to get for now. It'll take awhile for them to fully heal, but she's breathing fine and is alert and active as ever.

Pictures to come soon!

Monday, July 17, 2006

Slowly becoming wireless

They had to put the nasal tube back in, just because no one had ordered it taken out (except for Angelina, who decided herself is was time...). But they did make that decision the next day!

And now with the nasal canula removed! She looks rather peaceful but don't be fooled. Her next order of business was pulling out the NG tube, which she did nearly every day til they finally gave up for good.

July 17, With her Papa

Saturday, July 15, 2006

Look! No Tubes!!! 15 July 06

Ok, so it was only temporary. She pulled out the nasal canula and the feeding tube, and the nurse noticed her saturation levels were looking even better (consistently 100), so left it out til we came in so we could finally see her face! She checked with the Nurse Practitioner though, who agreed she was doing ok but said to put it back in, but bring the pressure down to 1L (it had been at 3L in the am, brought to 2L in the afternoon, 1L is basically nothing) for one more day. So today it may be removed entirely! She still needs the feeding tube though, as she hasn't quite got the knack of feeding. She again managed a quick 10mls, so she *can* suck, but she doesn't seem to get past that easily. With effort from myself and the nurse, we got her to take in ~33mls at the evening feed, so there's progress. I'll try nursing her a bit as well, maybe that will encourage her (tho they're still insistent we can't rely on that entirely yet because they need to make sure she's taking something in). It's frustrating as that is basically all that will keep her there longer, otherwise she's nearly good to go.

I think that's a smile!

The hat is a gift from our friend Sara in Geneva/France (she lives in France and works in Geneva). It was one of her first knitting projects and looks perfect.

Friday, July 14, 2006

Learning to feed, 14 July 06: 11 days old

That's breastmilk in there, but she has to learn to take it by bottle for awhile so they can measure how much she takes before she can be trusted to go solely to breast. She managed 20mls in her first two feedings (out of a total 60 mls), so that's a start. She starts off ok, but gets lazy. No wonder, she had tubes stuck down her throat for a week, she doesn't really like things in her mouth now. But we're working at it.

And giving up after 20 mls and going to the NG feed for the rest. At least she gets used to being next to mommy.

Her Papa has a fascination with her big feet!

Not so sure she's happy about being all bundled up, but it prevents her from ripping out her tubes.

Thursday, July 13, 2006

10 Days Old, 13 July. Sleeping Peacefully

because she doesn't always sleep peacefully....that star-thing is a kind of weight to hold her in place a bit - she wiggles too much and tries to tear out her tubes. The pacifier, as much as I hate them, is useful when she feeds so she can associate sucking with food. After a week with tubes down her throat, she has a bit of an oral aversion we're trying to overcome.

Angelina Update 13 July 06
I just wanted to update you on Angelina's progress. She's now 10 days
old, and showing a strength of spirit one can hardly imagine.

On Monday evening she was extubated and has been breathing completely on
her own. We finally got to hear her cry, and though surely that sound
won't always be so beautiful, it was the most beautiful sound in the
world Monday night. On Tuesday we were able to hold her for the first
time. As of Wednesday she's still got an IV, her feeding tube and the
nasal tubes for regulating flow, although that should be removed soon.
Her chest xrays show her lungs are not totally in the clear, but are
improving every day. She's being fed almost entirely breastmilk now
through the NG tube, so the IV should come out soon. She's graduated
from the 'sickest baby' position to the 'almost out the door' position
in the NICU. On Monday her doctor told us to plan for her to be there
another 2 weeks still, but we're crossing our fingers for sooner. She's
very alert and active. She recognizes our voices, and responds to our
touch and movement. She is strong too - she managed to push herself up!

As for us we're exhausted but doing well. Frederic goes in every morning
at 5am, for his special daddy time, while I stay home and pump. Then we
head in the afternoon for a few hours and again in the evening. It's
tiring but worth every second we spend with her. I guess our lives
really did change, but not how everyone expected....that's ok, she's
giving us her first challenge.

Thanks to all for your words, thoughts and prayers. They have
surely helped.

Wednesday, July 12, 2006

Tuesday, July 11, 2006

Can't believe it's only been a week!

8 days old, looking up at Papa

Those piercing eyes! 8 days old

8 days old

holding her for the first time, 11 July 06, 8 days old

Monday, July 10, 2006

Getting better everyday!

10 July 06 She knows her mommy!

10 July 06

9 July 06

Saturday, July 08, 2006

Our Beautiful New Addition

Day 5, 8 July 06

Day 4

Day 3

Day 2

14 hours old, 12pm, 4 July 2006

Angelina Gisèle Allegrini was born on Monday, July 3, 2006 at 21:56. She
weighed 7lbs12oz (3.525kg) and is 21.25in (54cm)long. She's got loads of
dark black hair, her dad's long legs and arms, and my clown nose. She is
cute as ever.

Her first few days on earth have been a bit rough however. During labor,
she aspirated meconium which filled her lungs. Though she never stopped
breathing and her heart was beating well, the meconium in her lungs
posed a big problem for her and she was whisked off to NICU immediately.
The first 12 hours were harrowing (and we now know her condition worsened and her docs didn't think she'd make it), but from that point on she started to
improve rapidly, amazing all her caregivers but not her parents who know
how tough she is! She was started off on an oscillating ventilator which
basically pushes oxygen through at really high frequency, while they
heavily sedate her so she doesn't try to work too much on her own. While
her lungs are fully formed and she should be able to breathe fine,
because they're so filled they use the machine to breathe for her while
she works at clearing out all the gunk. She was able to come off that
yesterday (July 6), was moved to a normal ventilator and by last night at 72
hours old, though still on the ventilator, was down to 50% oxygen, which
means she was doing half her breathing on her own! Each chest x-ray
looks clearer and clearer, and literally every hour brings improvement.
She's less sedated now and very alert - too much so at times because she
starts squirming and pulling at her wires. She clearly wants out of
there! Her docs thought they may be able to remove the vent entirely
today. She still has a long ways to go, she's got to finish clearing
those lungs, hold off infection and stay healthy. All her other organs
are working very well. She's amazingly strong and fighting like crazy!

Her doctors said to plan her being there for 3 weeks. An eternity when
we want to have her home, but given that in the first day they wouldn't
even hope that much, we'll take 3 weeks and hope for sooner.

We hadn't planned for any hospital stay as we had
planned a homebirth and did labor mostly at home, but once her heart
showed irregular beats we immediately transfered to the hospital which
is only 5 minutes away and has the best NICU around. Laboring at home
really was excellent, I had fabulous midwives and Frederic gave
incredible support, working nearly as hard as I did (and much more since
then!). Fortunately Angelina had her way of telling us
that she was going to need some extra help once she was born and we
listened! We also got very lucky with the OB on call at the hospital,
as she is renown as one of the best in the area. The entire team there
was incredible as well.

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