31 October 2010

Doctor Appointments

David's 2 year check up was this week.  I had scheduled it last month and didn't think we were going to make it.  I'm glad I didn't cancel it because Kayla was able to have her newborn check up scheduled right afterwards.  

Height 33.75" 
Weight 25 lb 1 oz. 
Head Circumference 48 cm

His weight is a little low.  Doctor said we could give him Pediasure or Carnation Instant Breakfast drink.  We've tried Pediasure, but he doesn't really drink it.  The doctor gave us a free sample of the Carnation mix and some Kid Essentials chocolate milk, so we'll try it.

Height 18.5" 
Weight 6 lb 7.5 oz. 
Head Circumference 32 cm

We pretty much just talked about her heart defects and the doctor recommended giving her Synagis which is a shot for RSV.  Appeared to be a lot of paperwork because after the appointment I got 3 different phone calls about it needing a lot of info about her.  

29 October 2010

Our Days at the Arkansas Children's Hospital

Day 1 - October 22 - Transported to ACH
Kayla was transported by ambulance to the Arkansas Children's Hospital about 2 hours after she was born.  When she was there the doctors did another echo to get a better look at her heart to determine her diagnosis.

Kayla's Diagnosis:
Tricuspid Atresia
D-Transposition of Great Arteries
Unrestrictive ASD
Large Perimembranous VSD
Mild Pulmonary Stenosis

It looked like the heart tried to work around some of the problems to compensate for the heart defect.  This meant Kayla's heart was okay for now and we could let her grow more before having surgery.  They took Kayla off the prostaglandin that was supposed to keep the ductus open.  It normally closes after a baby is born.  If she was stable, then it would confirm that we could wait to have surgery.

Day 2 - October 23 - Monitoring Kayla
I was discharged from UAMS in the morning and immediately went to the children's hospital to go see Kayla.  We were told that if her ductus was closed and she was still doing okay then I could probably start breastfeeding.  A doctor did another echo, but we didn't hear the results until that night.  When the doctor came around, she said the ductus was closed and Kayla was doing great but she wanted to wait another night before trying to breastfeed because the tube going to her umbilical cord was only about 4 cm when it's normally about 10 cm.  If she was still doing well the next day, then the tube could come out and I could breastfeed.  Meanwhile, we were able to go ahead and give her some formula.

Chris feeding Kayla her first bottle at 3pm.

Day 3 - October 24 - Began Breastfeeding
The next morning Chris and I got to the hospital around 5:30am, so that we could give her the 6am bottle.  Kayla was doing great, so they took the tube out of her umbilical cord and allowed me to breastfeed her for the rest of the day.  I was quite excited about this because I had been trying to pump every couple hours, but was never able to get a drop.  Kayla latched on perfectly the first time like she'd been doing it forever.  I was glad about this since David had some problems in the beginning.

Kayla was stable enough to be moved to a different room, but they kept her in this room for another day.  Now all they wanted to do was make sure she was eating good and having good diapers.  They also were going to do another ultrasound to check her kidneys and brain.  I slept in the waiting area that night, so that I could get up every 2-3 hours to feed Kayla.
Chris changing one of Kayla's diapers for the first time.
Holding Kayla for the first time so I can breastfeed.
Day 4 - October 25 - Moved to Private Room
The next day they did the ultrasound and everything was good, so we were moved to a private room.  Kayla wasn't having many wet diapers, so they wanted me to supplement with formula.  My milk hadn't came in yet because I'd only been breastfeeding for a day.  She was just getting the colustrum which is usually enough for newborns.  I didn't think the doctors were being very supportive.  I think they need some breastfeeding training as they didn't really seem to know much about it.    I wanted whatever was best for Kayla and wanted us to go home as soon as possible, so I gave her formula each time after I breastfed her.
Kayla's private room.
Removed everything from her head.  She had red spots where all the tape was.
David got to visit
David and Nana visiting
Day 5 - October 26 - Discharged!
I was glad that I got to stay in the room all day and night with Kayla.  My milk still hadn't come in, so I started pumping again to see if I was getting anything.  I also went and talked to a lactation consultant because the doctors were making me feel like a failure.  She said she was worried that they were going to make me supplement with formula when she heard I was going to start breastfeeding.  She recommended staying off formula, but said sometimes milk doesn't come in for up to a week.  I felt better after talking to her.    

The only thing left to do was give Kayla a carseat test.  This is where the baby has to sit in the carseat for the duration that it takes to go home.  In our case, this was 3 hours.  They monitor her on the machines, and she passed.  We were all set to go home.  The doctors just wanted me to keep supplementing with formula until my milk came in.  They also scheduled an appointment with our pediatrician and an appointment to see the cardiologist again in Little Rock.  She got to home without any medications.  Yay!
My 15 minutes worth of pumping produced a whopping 5 ml of colustrum.  That container holds about an ounce.  The bottle on the right is 2 ounces of formula.
Carseat test.  Kayla slept the entire time.

27 October 2010

Kayla's Birthday - Friday, October 22

When I went to my doctor's appointment on Thursday afternoon, the doctor said I was 4cm dilated and 75% effaced.  He said he wanted to strip my membranes and send me to the hospital to deliver.  However, the nurse said it might not be such a great idea to deliver in the middle of the night, so he told me to go to the hospital around 4-5 in the morning and say I was having contractions.  

Chris's mom drove down to Little Rock, so that she could watch David.  Since it's flu season, anyone under the age of 4 is not allowed to visit.  Chris and I went to the hospital around 5am.  After all the paperwork and getting us settled in the room, around 6am they started giving me pitocin to induce me.  They had to stick me twice for an IV.  They did an ultrasound to see how the baby was positioned and told me the baby was 4lbs 13 oz.  This made us a little worried since a few weeks ago when they did the ultrasound they said she was around 5 lbs.  I was 6 cm dilated when I arrived.  I think this might not have been correct because 4 hours later I was 6.5 cm dilated.  It just depends on who is checking it. 

They also had to give me an epidural twice because the first time didn't work.  That was probably the most painful part of the whole delivery.  They gave that to me at 8am and it took about an hour for them to finish.  The second time they gave me the epidural I was shaking just from the anxiety of having to get it again.  I think they had to do just about everything twice for me that day.  

Around 2pm, I was completely dilated.  The nurse wanted to wait until I was ready to push.  After about 30-45 minutes, I could feel lots of pressure and the need to push.  They started to get everyone in the room and around 3:00, I started pushing.  It only took about 15 minutes and at 3:16, Kayla was born.  Since I delivered at UAMS, the experience was a lot different because it was a learning hospital.  The room was filled with nurses and doctors.  There were nurses that were excited to see their first vaginal delivery.  Chris didn't get to hold my leg or help me hardly any because the nurses wanted to do it all.  This was delivery was lot easier than David's because I didn't have to push as long and I got the epidural before I started feeling any contractions.  After Kayla was born, the doctor snipped the umbilical cord and they took Kayla to get her ready to be transported to the children's hospital.  The whole day I was tired.  Chris says I took several 5 minute naps that day.  After pushing Kayla out, I had a lot of energy.  I was really sad that I couldn't hold her and breastfeed like I was able to with David.  However, they did push her into the room before transporting her so I could see her and take a few pictures.

Chris stayed with me for a bit, then left to go to the ACH to see what the results of her echo was.  The epidural didn't wear off for about 6 hours after I delivered.  I couldn't lift my right leg for the longest time.  It was so uncomfortable.  I spent most of the time wanting to pump but they didn't give me the pump until around 8pm.  I pumped several times that night, but wasn't able to get a drop of anything.

Having contractions.  They had me sit up so gravity could help out a little.  I had to have them position my  legs because the epidural made my legs numb and I couldn't move them.
Preparing Kayla to go to the Arkansas Children's Hospital (ACH).
Kayla was 6 lbs 7 oz and 19 inches
Getting to see Kayla before she gets transported to ACH.

Kayla's room at at the CVICU.  There is a nurse dedicated to monitoring her at all times in this room.
Chris getting to hold Kayla for the first time.

02 October 2010

New Due Date

We went to Little Rock again this week to get another echo and ultrasound.  Our appointment was at 9:30, but we got there at 8:50 and they actually had us in the room at 9:00!  We were glad we didn't have to wait too long, but then they took 1.5 hours doing the echo.  Then another 30 minutes doing the ultrasound.  They didn't really find much different this time.  Instead of pulmonary atresia the doctor said it was pulmonary stenosis.  Which is where a tiny amount of blood flows out instead of nothing.  However, she still has tricuspid atresia.  I don't think they'll really have a good idea until she is born.  Since she is bigger now, there appeared to be shadows and stuff that made it hard to see.  The ultrasound went well in that her other parts seem fine.  They have scheduled me to be induced on October 25th, so I'll have another October baby.  After the ultrasounds, we went to the children's hospital for a tour of the parts that we'll most likely be spending a lot of time in.  We got to see the CVICU, NICU, waiting room, and lactation room.

We plan on moving to Little Rock next week just in case I go into labor earlier.  David was born at 37 weeks because my water broke.  If that happened here, they said they'd probably have to send a helicopter for me to deliver in Little Rock.  I have started my leave of absence from work and Chris plans on working remotely.  David's last day of daycare and my last day of work were on Thursday.  I'll probably be on leave until after she has her 2nd surgery which is probably at least 6 months.  However, I think David will probably go back to daycare when we're back home again.
Family photo before we leave