Nolan's Top Gets Popped

We were happy to discover that Nolan's isolette (incubator) top was raised when Kolleen showed up in the NICU Wednesday morning. What this means is that he's doing most of the work to keep warm on his own; he gets a little boost from the radiant element in the raised hood, but not a lot. This is one of the prerequisites for him to be discharged from the NICU.

It also means that the isolette is more like a crib than a George Foreman Grille (ha ha). Seriously though, it's so much more natural and comforting to look down on him than it was to look through the plastic "windows" of his incubator. Praise God for the little victories in Nolan's daily challenges!

Dave

Nolan's Weight Progress Update

Weight Length* Date Lbs Oz In Sat, Dec 09 2 15 16 Sun, Dec 10 3 1 Mon, Dec 11 2 15 Tue, Dec 12 2 15 Wed, Dec 13 2 15 Thu, Dec 14 2 15 Fri, Dec 15 3 0 Sat, Dec 16 3 1 Sun, Dec 17 3 4 17 Mon, Dec 18 3 5 Tue, Dec 19 3 5 Wed, Dec 20 3 6 Thu, Dec 21 3 9 * Length measured on Sundays As you can see our little peanut, Nolan, is gaining weight consistently. The 2oz. per day weight gain is roughly the same at which a fetus will grow in the womb at the same gestational age as Nolan (roughly 37-1/2 weeks). We were also delighted to find that he had grown about 2 inches in length in his first week of life. Also, his head circumference had increased by about 1-1/2. We are so pleased by how well he's developing and so proud of our feisty little boy. His will to thrive is truly amazing. Kolleen is working hard to stay ahead of Nolan's breast milk needs. She puts him "to breast" once or twice per day to get him familiar with what will be his normal feeding method. However, the neonatalogist is wanting him to be on fortified milk for the majority of his feedings. This means that he needs to be fed by bottle or gavage (feeding tube). Consistent bottle or breast feeding is a condition of his discharge so we are doing what we can to support this accomplishment. As you can imagine, Kolleen's discouraged because she wanted to be his "natural" source of food. We are accepting, though, that if it takes consistent bottle feeding to get him home from the NICU then that's what has to happen. I like to say that we have been afforded an extra 4-1/2 weeks getting to know Nolan because of his premature birth. If things don't go exactly as we had planned during these few weeks we are still blessed by his wonderful, miraculous birth! Thanks again for all your prayers, support and love! Dave

Santa Visits the NICU

Santa at the NICU (click picture to view album)

Santa Claus took time out of his busy schedule getting ready for his big night to visit the NICU today. I told him how much we were looking forward to his visit and how much we appreciated his benevolent presence. With a genuine tear in the corner of his eye whispered in my ear that it was he that was most blessed to be able to be there for the babies and their families. Before he left us I told him to give all his reindeer and extra carrot and say "Hi" to Rudolph.

Dave

Legacy Emanuel NICU Information

I just posted a link to the Legacy Emanuel Hospital Neonatal Intensive Care Unit (NICU) under the Links Section in the left hand column of this blog (or click on the photo above).

12/21 Update: I forgot to mention that this is a good source of information about the rules of visiting the NICU if you are considering a visit.

Dave

Nolan's Weight Progress

Yay! Nolan is one week old!

He and his mom are proving to be a great team and both are working hard to get some fat on his skinny little body. We are still hopeful for a Christmas release but we know that he may not be able to grow enough to get to that benchmark. The neonatologist sounded pretty confident that he would be out of the NICU by New Year's but we'll see if we can't surprise her, right Nolan?

As mom was nursing today (yay!) I reviewed Nolan's medical chart and transcribed his weight progress over the last 6 days. It's my intent to continually update this but it may be several days or a week between postings.

Keep up the great work, everyone and keep those prayers coming! Thanks.
Dave

New Photos Posted

Yay, Nolan's six days old today!!!

I have posted new photos to the Picasa Web Album. The photos without captions are new and there are some duplicates at this point so I've got some editing and organizing to do.

Yay! Nolan's Here!!!

I'll be back later today or tomorrow with an update on how we're all doing.

Dave

So, What Happened?

Kolleen and I have been trying to piece together the circustances that lead up to Nolan's premature birth from what we've heard from the doctors and nurses that were involved. It seems to us that Nolan is, in fact, a very fortunate baby whose birth was a miracle.

Nolan suffered from a condition called Intrauterine Growth Restriction (IUGR) -- his birth weight and size are in the 3rd percentile (97 percent of babies of the same gestational age will be larger). We believe that this was caused, mostly, by Kolleen's high blood pressure which caused the placenta to function at a much reduced level. Nutrients and oxygen were not passed onto baby in the womb and the amniotic fluid was not replenished sufficiently.

Ultimately, this restricted plancental function began to stress Nolan more and more. He seemed to be pinching his umbilical cord because he just didn't have the amount of fluid needed to function as a cushion like it would in a normal pregnancy. This caused precipitous plunges in his heart rate that were the first obvious alarm that something was seriously wrong with the pregnancy. He became so stressed that he would eventually pass his first stool in utero. He "inhaled" the toxic meconium, as this first bowel movement is called, which would ultimately delay his first breaths after delivery. He had to be intibated prior to taking his first breath. What a way to enter the world, huh?

All of this conspired to result in a less than auspicious delivery. APGAR tests are administered to newborns at 1, 5 and 10 minutes after birth and are a measure of a baby's "adaptability" after birth. As I understand it, APGAR measures breathing, heart rate, reflexes, muscle tone, color and probably something else... Nolan barely scored a 1 out of 10 in his first minute, a 4 at 5 minutes, and (phew) a 9 at 10 minutes.

All I can say is that I'm glad that we found this out 3 days after the fact when we could tangibly see that Nolan was doing well for his circumstances. I believe Nolan is here with us partly because of the sheer determination and skill of the Legacy Emanuel birth team that we were blessed with. But he is partly here, too, because God wanted him to be with us. Nolan is NOT out of the woods yet, we know but we are hopeful and prayerful that he will continue to grow stronger every day.

We have fallen deeply in love with our beautiful little baby and pray that God will take care of him and guide that hands of the wonderful NICU medical staff. Keep up the good work!

Humbly,
Dave

Hopeful News

Today was a really good day for Kolleen and Nolan which means it was a good day for me too. It appears that Nolan's weight has stablized. Although he didn't gain any mass, he didn't lose any either which is a good sign for our little Peanut (thanks to Gaila for graciously letting us use that nickname).

Nolan's feedings are constantly improving and Kolleen has made a concentrated effort to bond with him as he feeds. Though he is still is being fed primarily through his feeding tube or bottle, Nolan seems to take to his mother's breast very naturally which pleases both of his parents very much. His vital signs have been stable and reasurring and we look forward to the point at which he can maintain his own body temperature without the aid of his Isolette (incubator).

Kolleen's recovery is on track and she seems to be healing very quickly. Numerous people have complemented her on how good she looks. Even better, she tells me that she is as happy as can be knowing that her dreams of motherhood are coming true, even if not in the exact manner she would have predicted (C-section, NICU, etc.). I am truly proud of her in this trying time and I am falling in love with her all over again!

And with that public display of yuckiness I'll sign off.

Dave

Welcome to Nolan David's blog

Yay! Nolan's Here!!!

Nolan David Couch was born 4-1/2 weeks premature at Portland, Oregon's Legacy Emanuel Hospital by emergency C-section on December 9, 2006 at 4:57 in the afternoon. He was delivered 1 ounce shy of 3 pounds but was a relatively long 15-1/2" inches. He, of course, is the most beautiful baby ever! We got the N-Scale version of a baby instead of HO-Scale, as my cousin's husband quipped.

Both mom and baby are doing great and Kolleen will be discharged from Emanuel on Wednesday the 13th. As long as Nolan cooperates with the NICU nursing staff we think he should be headed home around December 23rd, just in time for Christmas. In order to go home Nolan needs to bulk up, maintain his body temperature outside the Isolette (aka incubator, giraffe, "broiler") and continue to breathe well.

Keep checking back for photos, video, audio and, of course, more postings. I'm new to the blogging universe so I'd love to hear how I can make this blog as useful, entertaining and informative as I can. I'm learning a ton of information about fatherhood, premature birth, breast pumps, burrito-wrapping and humility and I invite you all to add your wisdom, questions, comments and words of encouragement to this blog. Or, send me an email if you aren't so inclined to share with the "blogosphere".

Love to all,
Dave Couch - aka "Dad"