Tuesday, August 18, 2015

Eliza's first week {part one!}

Oh goodness, friends! My little love is a whole week old!
And we've been so busy in the last week that I've totally failed at keeping folks as up to date as I promised! It seems like we'd be sitting around bored all day in the hospital. And while there's a fair share of that, because we have a baby in the NICU, things are constantly changing and needing our attention.

So let's catch up:

Wednesday, August 12th

Our sweet Eliza was born on Wednesday, August 12th at 10:36 a.m. via c-section. This was always the intended plan with Vanderbilt so we dealt with zero surprises (like a crazy car ride or emergency surgery). A c-section was a better delivery option for her since it was the easiest way to protect the open spot on her back. 
 Delivery-wise, everything went well. J.B. and I were able to lay eyes on Eliza just as she was delivered, and before she went on her trek over to the NICU. J.B. headed off with her to make sure no baby swapping shenanigans went down and I headed off to recovery. One of the hardest things about this set up was knowing that Eliza and I would actually be in different hospitals. She was delivered (and I recovered) at Vanderbilt Hospital, but as soon as she was okayed in the delivery room, they headed off to the Vanderbilt Children's Hospital NICU. The two hospitals are side by side so you can technically take a long walk down some back hallways that will eventually get you from point A to point B, but the distance of around 2/3 of a mile isn't something to scoff at. Especially for a recovering mom. I knew this ahead of time and one of my biggest anxieties was wondering when I'd ever get to really see my baby. I tried to prepare myself mentally to not see her for a day or two (that wasn't going over well in my head...)

So I was super surprised when my room nurse bopped only six hours after I'd had her and asked if I'd like to go over to the NICU. 
Heck yes!
I spent several hours the day she was born sitting by her little layette in the NICU. Since the surgery on her back was intended for the next day, much of the afternoon and evening was spent running tests on her to make sure she was fit for the procedure. There was also an ultrasound done to check the ventricle levels in her brain. This would give the neurosurgeons an idea of what the baseline was for those ventricles.

And we just soaked her in. She's a chunky little thing, with fat rolls that Jake never had! We watched intently on her movement levels to see if or how she was moving her legs. The neurosurgeons felt like she was displaying definitive hip movement along with some movement in the lower legs. And her muscle tone looks wonderful all over, as if she's been squirming up a storm. What I loved doing was tickling the bottom of her feet, because when I did that, she jerked them away! Considering that she wasn't supposed to have any movement or feeling below her belly button, we were thrilled. 

All of this indicates some great promise, but the real question is if she'll retain that movement level after her back surgery.

Day 2 - Thursday, August 13th 
Thursday morning, she went into surgery bright and early. J.B. and I went with her through all of the prep work and met with each of the different surgeons that would work on her. The goal for the procedure was to close the opening on her back with as much precision as possible. The neurosurgeons basically rebuild the spinal column and nerves of the spine, then they pass the torch to plastics, who brings together all the muscle and tissue and skin along the back.
We've known all along that Eliza's spina bifida was severe and that the lesion on her back was large. The plastic surgeons prepared us for several different intense strategies of how they might work on her, not knowing exactly what the situation would be until they got into the operating room. 

It was a long surgery, about 5 hours. Not such a fun feeling when it's your little one.
As it turned out, the opening wasn't quite as bad as they thought.
Neuro was totally satisfied with their part, and plastics was able to do a little less evasive procedure than expected. Basically she has four sites of healing. First, a major incision along her spine. Second, two smaller, but still large, incisions on her sides. Those were created to able to properly close all the muscle and tissue at the spine. Then lastly, in order to cover those side incisions, they did a skin graft from the back of her thigh. That skin was grafted onto her sides to help close those two areas. 
So, major back incision, side incisions with skin grafts, and her graft site. 

She has to lay on her belly at all times to give each of these areas plenty of time to heal properly. No movement, no holding her, even diaper changes are tricky. Just flat on her belly in the bed. 

I was on day one of c-section recovery, which was less that fun. The distance between the two hospitals was incredibly taxing since I had to return to my own room for meals, pain medication, doctor's rounds, and rest. Major kudos to J.B. for wheeling me all over the place and just staying with Eliza by himself when I couldn't be there. 

Day 3 - Friday August 14th

Friday was a major day of healing. She was on some oxygen for awhile and pain meds to help her recover from the surgery. She still hadn't had a single thing to eat and was only on IV liquids for the most part. Since SB patients will typically have bladder/bowel issues, they started by cathing her once every three hours just to check for any volume in her bladder. She's had great diapers so far, but they'd much rather be safe than sorry.

As it turned out, she was controlling her bladder and bowel just fine so far. So the cathing was quickly moved up from every three hours to every six, every eight, and then every twelve hours. Fantastic news!

Day 4 - Saturday, August 15th

By Saturday, they started her on a very small amount of breast milk that she took through a tube marvelously. They they began to quickly double the amount she was drinking and within a few days we had gone from giving her 8 mL to 60 mL. The doctors couldn't believe how easily she was handling it all while laying on her belly.

Saturday was also the day that I was discharged from the hospital! Yay! While I wasn't feeling just amazing, I was glad to be done with the trips back and forth. I was super thankful for my OB with the Fetal Medicine Clinic at Vanderbilt. They saw us through every stage of pregnancy with Eliza and my favorite OB was the one to deliver her. She came by Saturday and was so kind and encouraging about our sweet girl. I might have cried. 
(let's blame it on the hormones...) 

J.B. and I were able to discharge from the hospital and immediately get a room at the Nashville Ronald McDonald House. That was such an answer to prayer. We'd been told that the RMH often had a long waiting list and took a few days to get into, so no wait was amazing! For a super low cost, the RMH provides a room for us to stay in just three blocks from the hospital.

And if that wasn't enough, on Saturday my parents also came up with Jake! Oh my goodness, four days without my first baby was hard and we were so excited to see him. My parents got to meet Eliza and dote on her while J.B. and I got to dote on Jake. He stayed with us our first night at the RMH and thought the place was just so cool.
Unfortunately, he's too young to visit Eliza in the NICU so he'll be meeting her when we get home. 

Whew! So much to type! Stay tuned for part two!

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