WE HAVE A BABY!!!!

Normally, I will post all of Ava's updates daily. However, I will post a series of them today in order to get caught up. It's been a little busy over the weekend!

So, back to Saturday. We got to the hospital around 5am and contractions started to pick up. I hadn't had any before my water broke, but they started up on the way to the hospital. Ava had been in the breech position for the last couple weeks so we already knew we were likely to need a c-section. Once we got to the hospital, they set me up on monitors, confirmed she was still breech, and things moved quickly at that point.

One thing I forgot to mention in my last post. There is a steriod called beta methazone (sp?) that can be given to mom if it is likely that the baby will be born early. This is to help the lungs develop. You need two doses of the shot, 24 hours apart, and then an additional 24 hours for the second shot to metabolize. I got my first shot on Friday. So, didn't even have the first one in for 24 hours before she was born...bummer.

Back to Saturday...I went into the OR around 7:45, things moved very quickly, and Ava was born at 8:08am. Because of her positioning, the doc really had to work to get her out. Her head was way up by my ribs on my right side and feet down. Since it took her a few extra minutes to get her out and a lot of wrestling (not fun for me!), Ava was a little stunned when she came out. They handed her immediately to the NICU team that was waiting in the OR room next door. We didn't get to see her because they were in a hurry. At that point, the NICU team intibated her (put her on a ventilator) to help her breathe, put some IVs in her umbilical artery (belly button), and got her stabilized. She was doing great. Jason was able to go next door and take a picture of her so I could see her. Then, he headed over to Children's Hospital with the NICU team and Ava while I was sent to recovery. They needed me to be able to move my feet before they would wheel me over to see her.

AVA ELIZABETH GEHRMAN
3 lbs, 3 ounces
15.75 inches long
11 inch head

DAY 1-NICU: Ava was doing great right away once they got her to the NICU. The ventilator is able to show how much a baby is breathing on their own versus needing the vent for support. She was breathing on her own with no oxygen almost right away. They did a chest x-ray to check maturity of her lungs and some other tests throughout the day. It was determined by Saturday evening that they could extabate (take the ventilator out) because she was not needing it. The shorter you need one, the better! She is getting antibiotics and also TPN (fats, lipids, nutrients) through her umbilical IV. By Saturday night, things were good. She was MILES ahead of her brother on his first day and we couldn't be happier. The part that is so weird about all of this is that is seems so normal to us. Everyone was commenting on how calm we were, but again, this is all we know...unfortunately.

Things we expect over the next few days based on what we already know:
-Ava's weight will drop (Typically up to 20% of birth weight)
-She is likely to need phototherapy lights
-They will try to establish feedings (through a feeding tube)
-She might need oxygen, might not
-Things are up and down in the NICU...some good days, some bad days...hopefully we stick to the good days ;-)

DAY 2-NICU (Sunday): Ava is still doing great. Over night, they put her on a high flow nasal cannula to help with her breathing. They can adjust her oxygen levels but she didn't require any. The flow in her nose is just to give her a little extra help breathing. Certainly don't want to tire her out after only one day!! She lost some weight and is down to 3 lbs. We are starting her on feedings today as well. She will get 1ml of breast milk through her feeding tube every four hours. Then, we will see how she tolerates it. She hasn't really pooped yet, which is a HUGE step for getting feedings established. It might not work the first time, we'll see. FYI, the reason she needs a feeding tube is because babies do not know how to do the "suck-swallow-breathe" thing until around 36 weeks. So, she's got some learning to do.

Justin got to see his sister today. He took one look at her and said "done". He was more interested in all the lights and sounds! Hilarious!

DAY3- NICU (Monday): Today, the doctor decided to take out one (she has two) of Ava's umbilical IVs. She is not requiring both. When things like that are not neccesary, they try to get them out as soon as possible to avoid infection. She is also not needing any flow any more so they got rid of the nasal cannula and she is breathing all on her own! Doing great!! She lost some more weight today, down to 2 lbs, 12 ounces. That is the weight that Justin was born at. Weird. Her bilirubin (jaundice) levels are a little high so she will go under phototherapy lights today. Also, since she hasn't really started pooping yet, her feedings aren't going the best. We have stopped them completely to give her tummy some time to get going and will try again soon.

DAY 4-NICU (Tuesday): Really nothing new today. She did lose a little weight but is still 2 lbs 12 ounces. They measure in grams (she lost 10 grams) because of how small these little ones are. We have been able to hold her a couple times. When they are this little and fragile you really don't want to take them out of the isolette too many times. Plus, she is under phototherapy lights which is where she needs to be. Still no feedings today. However, they have ordered suppositories (sups) every 12 hours to get her pooping. Once she is pooping, feedings will go better, and which means her jaunidice levels will improve and then we can get rid of the lights. The sups are working. Huge poop today! Way to go!