Reclaiming Ava

I'm sure I don't have to go on about how happy I am that Ava is home. I feel like a new mom again, finally. It's such a weird feeling to have your baby in the NICU and only get to spend a certain amount of time with her. Sure, you get to participate, but really it's the nurses that call the shots. I wouldn't say it's harder for a parent to already have a child that had a normal delivery, but in some ways you know what you are missing. I missed having her in my hospital room while we were both recovering from the traumatic experience of delivery. I missed that photo opportunity where Sophia comes to visit and gets to take a picture on the hospital bed snuggled up to her mom and new sister. I can go on about all that I missed, but one thing I did get--although delayed--was the wheelchair escort out to our car the day we brought her home. I don't know why this is such a big deal. The first time I saw a baby from the NICU go home and found out that the mom got the wheelchair ride out to the parking lot like all the other normal moms that get to take their baby home after a brief hospital stay, I got excited that I would have that experience. But that first time seeing those parents take their baby home from the NICU was rough for me. Each time got a little better. Each time I knew we were also closer to the door. When that day came, I was really overwhelmed with emotion. I could finally cry. I could let go.


So here we are. Ava is home. I thought I'd be freaked out not having the monitors tell me everything that was going on with her. But in reality, it's nice to have my instincts start to take over again. The first day of her home was filled with some doubt that I could really handle it. After her first few bottle feedings, I started feeling more confident in my ability. I had joked with the nurse when she took off the monitors and cut the hospital security bracelet off Ava that she initialized the "cry baby" feature because all of a sudden Ava started to cry. But it was really no joke. Ava cried the whole night through her first night home. But why wouldn't she? She went from a place that was always 75 degrees and 24/7 filled with lights and activity to a place that was lucky to get up to 68 degrees and the lights went off at night and the only noise heard was Rick and the dog taking turns snoring. So we got through the first night, and the next night got better. And Ava stopped feeling so foreign and more permanent in my arms. And she had her first bath to finally wash off any last bit of hospital smell. So here we are. Ava is home and she is ours for good.

Ava came home today

Our "rent to own" baby is finally ours to take home! After lots of paperwork and lots of instructions, we left the NICU at 10:30 AM. More details later, but for now I'll just leave you with a picture of her.

Notice anything different?!?

Her feeding tube is out! Apparently I had to write about my frustration in order to turn that corner. Doesn't she look happy? I sure am. So now she's onto the next stage of feeding where she's ad lib, meaning that she determines when she wants to eat and how much she wants to eat. You know, like a real baby does. The nurses told me they heard a rumor that she may be coming home before Christmas. Keep your fingers crossed!

Ready, set...stall

No matter how many times a nurse has told me that the most frustrating part of the whole NICU experience will be waiting for Ava to get the feeding down, I brushed it off. Until now. Because here we are. And it's a painfully slow process. And I'm frustrated. The great news is that Ava is now 5 pounds and 13 ounces. She is obviously gaining weight. However, they have a system in place to teach premature babies how to breathe, suck and swallow at the same time. This comes naturally for full term babies, but not preemies.
Everything started out great, but during the week it seemed like Ava said enough was enough, and she tired out. It could also be that last week we seemed to have a lot going on in her world. She had her last heart echo, which showed that everything is functioning perfectly. She had her vaccines the next day, and usually that makes babies tired. And then she had her head ultrasound the following day, which showed no brain bleeds or cysts. All in all, very good progress and very good results. But it probably made her tired. And she needs energy to be able to take a bottle or to nurse. So while we were told that she may be able to come home for Christmas, she won't if she can't take at least 75% of all her bottle feedings in a 24 hour period. If they have to hook her up to the gavage feeding for the rest, the clock is reset and we start the whole process over. She's made it through 5 straight feedings without the need to gavage, but those last 3 feedings have been challenging. We've all given her pep talks, but I'm afraid it's going to happen on her own time. Until then, we are in a holding pattern.

Overachievers

Ava took half a bottle yesterday! Last week I met with a speech therapist to discuss transition from gavage feeding (feeding tube through her nose and to her stomach) to nipple feeding (nursing and bottle). Why a speech therapist? Well they look at all the signs a baby is ready to feed herself, like rooting, sucking, waking up when she's hungry. Ava started doing this last week, so we had an initial test run. I was excited to see what she would do, and it was pretty anticlimactic when the therapist presented Ava with a bottle and she only sucked 4 times before the therapist took it out and told me she wanted to wait a few more days. Ava had the sucking down, just not the breathing during the sucking. So yesterday she tried again and Ava took 22 mL of milk, which is half her feeding. She's really young to do this, and everyone was impressed. The goal is to get her to complete a whole feeding by bottle, and then they will increase her bottles until she is completely bottle fed. It could take awhile to do this, but this is a big step for her and one step closer to going home.

She's really changed in appearance the last few days. Now that she's 4 pounds and 10 ounces, she looks like a real baby. She's also doing super cute baby things instead of super scary preemie things.

My other overachiever, Sophia, is into the "let me do it myself" stage. She does everything really well all by herself, I might add. It's incredibly frustrating when I'd like her to do certain things within a time frame. But with Sophia, it's on her own time. She's stubborn. Boy is she stubborn. And you know what? So am I and so is Rick. And Sophia is super smart, too smart for her own good. She has a memory like an elephant. I can't believe she's only 2.5 years old and remembers the coffee mugs from last Christmas. She knew there was a picture inside each coffee mug and asked to look at them before I washed them. That's just one of many examples. Lately, to get her to go to bed, I've been telling her what she can look forward to when she wakes up the next morning. And when she wakes up, the first thing out of her mouth is a reminder of what I've promised her. Nothing gets past her.

It's been a challenge to juggle time with Sophia and time at the NICU with Ava. I feel like I never get enough time with them and am not doing a great job with either. I have to remind myself that it's only temporary and that Ava will be home soon. And then it'll be a feeling of guilt that every normal mother feels about dividing their time between the newborn's needs and the other child. I just hope during this whole process I don't completely screw up with Sophia.