Attachment Parenting

As I sat day in and day out watching Walter in his fishbowl incubator, unable to hold him, I became paranoid that he would suffer psychological trauma from the disruption of the mother-child bond. I came across Dr. Sear's book Attachment Parenting for the premature infant and I was transformed. I went from feeling helpless to feeling empowered. I knew that while I couldn't do the things I wanted to do and was not able to foster a typical mothering role for the first four months of Walter's life, I could still impact his psychological well-being in a positive way.

I remember in nursing school learning about attachment theory, and read about Dr. Prescott's primate research that showed that disrupting the mother-baby bond in primates and aboriginal groups led to violence and fear in the society. My fear for Walter was not having the ability to feel his world was a safe and secure place, especially when he was put through painful procedures every day. There were times when I was so anxiety ridden about leaving him at night that I thought I may need "help", but managed to get through the nights.

Bowlby's attachment parenting theory states that infants have an inate tendancy to bond and feel close to one person, and feels secure when that person is around. Without this bond the child tends to be depressed, hostile, and unable to form healthy relationships in adult life. Dr. Sears book gave me some ideas and tools to use to empower me to feel like I could reverse the negative effects of losing that 4 months of womb-bonding.

7 BABY B's

Baby bonding- we were able to sit at his incubator, touching him gently, reading to him, singing to him, etc for as much time as we wanted. Sometimes this was 6 hours a day, usually it was 12 hours or more a day. I was determined that when the opportunity arose, we would have marathon cuddle times- at least 3-4 hours per session (regardless of numb/broken butt syndrome)

Breastfeeding- helps to develop a bond between the baby and mom- make the mom more easily able to read baby's cues. I pumped by milk every three hours for four months not only to give him my breast milk but to prepare for this intimate and bonding experience. He is a breastfeeding champ and it is time that I cherish with Walter. This is something that only I can do for him and feel so blessed to be able to do this.

Baby wearing- Carried babies fuss less and spend more time in the state of quiet alertness, the state that they learn the most in. So yes, I wrapped up Walter and wore him while I was cooking, cleaning, out in the yard etc. We spent countless hours a day holding him and wearing him. There was immense benefit to Mark and I as well, we could finally hold him and not be clockwatching for when he had to be put back down. He was so content to be held, smelled so good, and slept so well that it wasn't hard to do at all. It helped to erase all those guilty and inadequate feelings that snuck in during those long months in the hospital.

Bedding close to baby- OK, I'll say it, we have a "family bed". It has always felt like a dirty little secret that I was a little ashamed to reveal, but the more I talk to people, the more I find out that we are not the only people living in the closet about this. It works for us. I am lazy at night and it is so much easier to just plop him on the boob half asleep. Not to mention he has always had seperation anxiety in his own crib, that's how we started the family bed. We would put him down in his crib and once his first sleep cycle was done, he would wake up and realise he was alone and freak out. That's for my next blog post though, the sleep training. So you needn't message me with your "advise" about the family bed, trust me, we have heard it all before and this is OUR issue and OUR decision.

Belief in the Babies Cry- aka I am not a "let him cry it out" type. It doesn't help that with Walter's BPD he starts to cough, wheeze, gag, turn purple and blue if you let him really cry it out. We tried that a couple times, and the trauma it caused him wasn't worth it. There is no such thing as "spoiling a baby", and it promotes him trusting his environment when we respond to his cries. We don't jump up and grab him at the slightest cry. He has the ability to self soothe. But we have become experts in interpreting his cries and know when it is going to escalate to uncontrollable measures. I believe it is important for him to have some independence and self-reliance, but also to balance that with knowing his world is safe and we are here for him.

Beware of the Baby Trainers- those same "let him cry it out people". Oh I have read the books on sleep training and heard all the old advise. Well, we have our own system and it does not involve listening to Walter cry and scream for an hour.

Balance- We are in a constant state of adjusting our parenting style. We are sponges, we take advise, we appreciate words of wisdom. We adjust how things work as Walter gets older and more independent. He cries more now without us intervening, he naps solo in his playpen, and some nights he starts out sleeping alone in his crib if he is sleeping early. Our goal is to have him in his own crib for the whole night, so we are working toward that goal at a pace we can all handle. But that whole sleep issue will be my next blog.

So there it is, the foundation of our parenting approach in this first year.

Strangers, don't touch the baby!

Life has been a happy journey of learning how to be a mom since we've come home. Walter has thrived, gained weight to the accord of jumping from the 3rd percentile to the 40th or so. Yes, he is strictly breastfed and yes it is normal for breastfed babies to eat every 2-3 hours. He has not got sick yet, probably because he is in lives in a protected environment, I am sure the world wildlife federation would be impressed with how protected this child is. Our pediatrician (and every pediatrician we have had from Vancouver) has warned us of a life of solitude with premies who have BPD. They aren't kidding. Don't bring him around people who have colds, don't bring him around other children, don't bring him to public events or malls or grocery stores, but otherwise lead a happy normal life. Hmmmm....time for this social butterfly to sit back and enjoy the surrounding four walls. Did I mention we had moved to a house downtown (pulpmill and air particulate central) and enjoyed a forest fire smoke filled summer? Needless to say all those visions pre-baby of summer strolls every day, days at the beach, and hanging out with all my other mom-friends have vanished to be replaced with weekend outings to gramma and grampa's (when they aren't sick). I kind of thought the pediatrician may be exagerrating a bit and thought to test the waters. Upon entering superstore with a bundled babe, I quickly became aware of the harsh reality surrounding me. Around every isle was screaming germ-infested kids, snotty nosed and touching everything. There seams to be a sign around my Walter's head that says "look how cute I am, please come and touch me" as a variety of strangers stop to oooh and ahhh at the baby and grab his hand (that he later crams into his drooling mouth). Ok, so no more stores. So no more shopping with mommy.

We did try some family outings which went quite well. Aunt Cynthia's wedding in Quesnel was Walts first introduction en masse. He had a great time, he got cuddles all day from his great gramma, uncle keith and auntie judy, played with his second cousins, enjoyed the festivities. The reality of bringing a premie out to an event who has previously been cloistered became evident on the 1.5 hour car ride home that night. All that over-stimulation made for an irate, screaming baby. Hence our introduction to gripe water. And our first outright all night colic fit. Uncontrollable, hysterical, oh-my-god-what-is-wrong-with-this-kid type crying. Lesson learned.

So then we tried a trip to meet great gramma and grandad O. A quiet weekend spent enjoying the company of my grandparents. A good time was had by all. Walter thoroughly enjoyed the time and the change of scenery. He did great in the car ride. He only started to scream when we got close to PG ( I don't blame him, I used to have similar feelings of dread coming back here :) )

So we live a quiet life, a life I never dreamed of but one in which I am so happy that its scary! Who knew underproductivity and social reclusion could be so gratifying? Just seeing Walter live and learn, grow and develop brings me all the satisfaction that I never had in my busy, selfish old life. It takes having a baby to really appreciate small accomplishments. I never really realised what little miracles they really are, and I think some parents take for granted every milestone their child reaches. The ability to reach for a toy, make eye contact, roll over, babble...these are all valuable treasures that cause such stress and anxiety in parents who have a child with potential developmental delays. You see no new tricks for weeks, listen to my parents concerns, become anxious that you may not have a "normal" child, and then BAM, he turns a corner (or rolls over) and he is where he should be. That is the bottom line. He is where he should be, for him. And he'll grow and develop on his own tangient, at his own speed, of his own accord. He is here, he is growing and developing, he is smiling. That is enough for me.

February 20

Well you are 18 days old! We finally got to hold you on Feb 15. It was the most wonderful moment of my life. I could smell your milk-baby smell and feel you breathe against my chest. Two blissful hours a day we got to cuddle for 3 days in a row! It is a tremendous effort to get set up requiring a nurse and an RT for proper placement so your breathing tube doesn't get dislodged. The way you snuggle in and settle breaks my heart, I can't help the feelings of failure as a mother to you. I can't protect you from all these lights, noise, interfering doctors and nurses who keep wanting to poke you and touch you. You are sooo tiny at 850 grams that you feel virtually weightless. So tiny, but so fiesty!

Your PDA (patent ductus arteriosis) ligation when you were 5 days old went well. There was a small nick to your lung and you needed a chest tube. That was when I had to go to VGH and get readmitted, but daddy took good care of you for me. The worst you suffered was a skin tear from the tape that the cardiologist ripped off to take out the chest tube. The nurse was horrified! So was mommy, ouch!

The night of the 18th, you were needing more oxygen and desatting (dips in the amount of oxygen circulating in your blood, indicates poor oxygenation) more frequently. By the next afternoon you were "fighting" the ventilator and not getting the oxygen you needed. You were dipping to 50-60% oxygen levels (ideal >92%) for long periods. They gave you huge doses of morphine to calm you down and it wasn't touching you. You were restless and trying to tell us something...eventually they paralyzed you so you wouldn't fight the vent and it was very scary- you did not look well. It was hours of torture watching you suffer. I've never been so scared or helpless feeling. PICC lines, ART lines, peripheral IV lines, I can't protect you from any of it...

They put you on a Hi Flow oscillating vent that "gently" shakes you- apparently they use it as a rescue vent when the pressures needed on the other vent aren't enough to keep you breathing. They added a sedation med midazolam to keep you calm and your blood pressure dropped, so then added dopamine to help keep your BP up. No more milk feeds, and numerous pokes for new art lines. You have a crazy christmas tree of IV medications all going into your poor little body, how can one tiny babe take so much?

On Feb 22 they discovered you had a gram negative infection in your blood and you were septic. Such a scary time, the docs aren't sure if you'll pull through. You are on so many antibiotics and suffer from collapsed lungs from tube dislodgements and is consulted to infections diseases and surgery. I have never seen one person get soooo many xrays in one day, let alone one week. They assure me it is safe, and I feel so angry that you have to be jossled so much for each xray and then resettled. Why does your tube cause so many problems?? Every 4 hours a different lobe of a different lung seams collapsed. Apparently the vermin bacteria making you so sick is E. coli. They are doing a lumbar puncture to make sure the infection hasn't gone to your brain to cause meningitis. no one can tell me how you got E. coli sepsis. Also on epinephrine for your BP

Feb 23- Jessica and Bryan got to come and meet you! Starting to look more stable, but we are still so scared. Every day, every moment, my heart is in my throat and pounding, waiting for you to turn the corner...

Feb 25- You are more stable! Off the dopamine for your blood pressure and no more epinephrine. They keep changing the antibiotics, they aren't sure if you have Necrotizing enterocolitis ( a bowel inflammation that can lead to resected bowel surgery and can be fatal). Our fear just keeps growing! I pray every hour (please God, no NEC, please God, no NEC). I have seen the literature on NEC, that is one thing we absolutely fear beyond all others. They are going to treat for it just in case and keep your gut empty, more antibiotics, and close monitoring and many xrays. My poor baby is so full of holes and tubes that it breaks my heart. It's hard to think about it when he is supposed to be safely tucked in my womb, protected from all of this. The lumbar puncture was negative for meningitis- praise God! He has become so puffy that he's like a little marshmallow. After blood transfusions he is pinker and I think he is up to 5 transfusions. He received platelet transfusions as the infection is chewing up his platelets...Still on the oscillator hi-flow ventilator.

February 26- today we walked into rounds and the docs were all beaming at us! You are finally clinically stable! Kicking that E. coli sepsis in the ass. And your lumbar puncture showed NO MENINGITIS so the infectious disease docs were smiling as well. your oxygen requirements are down to 25 % thank god! Mamma is so so happy to get back our cuddle time too!

Feb 28- Another stable day. Watched patches of the Canada/US hockey game, woo hoo for GOLD!

March 3- bad couple of days. Still so sick and so puffy. They have started dropping the phrase BPD ( broncho pulmonary dysplasia) in regards to your lungs, apparently premies grow out of in usually in a few years as they grow healthier stronger lung tissue, but may lead to asthma etc...I am in survival mode, everything is a blur. I just sit near you, sending every positive vibe I can, pleading with God, begging really. Maxing out on the ventilator settings. It seems to be fighting one fire after another with meds and transfusions. When is this nightmare going to end for you? I am so helpless and can do nothing to protect you and can't hold you or comfort you. We just sit by you day and night, daddy reads to you and I sing to you.

March 4- The neonatologist sat down to discuss the need of giving you a steroid today to try to get you off the ventilator. There are many risks with steroid use, including development delays and neuro delays but unfortunately we are up against the wall and have no other options at this point. You responded well to the drug and the ventilator settings are being weened, as well as the morphine and midazolam. Starting to give you caffeine to stimulate your brain breathing receptors.

March 5- finally got to hold you again!!! You are so edematous (puffy) that it breaks my heart. So many chins! You were started back on the milk feeds again, which is good because it makes pumping every 3 hours around the clock worth it if you can actually take it. I can't help but cry for you day and night. Mark says I wake up in the middle of the night panicking, looking for you...searching under the blankets, saying "where is he, where's Walter???" He has to calm me down and make me realize you are safe in the hospital. I never remember these episodes in the morning, but apparently it is a nightly routine.

March 6- Blood gases are looking better. I refused another art line poke as they tried 4 times over the night and couldn't get one and you are black and blue so enough is enough. At 5:10pm they extubated you to biphasic C-Pap- a dual pressure oxygen delivered to you by mask where you breathe and have no ET tube! So far you are doing great! you weigh 1400 grams but so much of that is retained fluid we have no idea what your true weight is...

March 7- You are still doing great being extubated. They say that any day of the vent is great for your lung development as the ventilator damages your lungs, they also say that you may tire out and need to be re-intubated. Slowly you are getting the extra fluid off.

March 9- No more TPN (IV nutrition)! No more PICC line! You are on all oral feeds by nasogastric tube- up to 15 mls every 2 hours. They started you on diuretics to help get the extra fluid off your lungs and body. you weigh 1109 grams.

March 10- still on the biphasic c-pap...Just had a 2 hour cuddle and you were a happy camper the whole time! You are having lots of poopy diapers and are back to you old self again. So much better, no edema! No more triple chins. Adding human milk fortifier to your feeds to give you extra calories for growing. Both your eyes were wide open today, what a beautiful sight to see! I cried as I cuddled you, sang you a couple songs. I feel so blessed. You weigh 1070 grams...


March 13- Hard day. You had lots of oxygen desats and were visibly working hard to breathe. They upped the caffeine. Your heartrate increased and the desats increased. More xrays and BW. I found an inguinal hernia today when I changed your diaper. They say that the dexamethasone steroid can cause that as it loosens the connective tissue. Great, more surgery for the future. I am so scared I don't want to leave the NICU tonight.


March 14- Dear sweet Walter, you had a bad morning with bad desats and you needed to be reintubated. You did so good for 8 days, we are so proud of you! They warned us this could happen, your lungs are just so fragile! Your strength and ability to fight back amaze me. They took blood cultures and started you on antibiotics in case you are getting an infection (again?!?!?). Back on midazolam to keep you calm. They didn't believe me when I told them that something was wrong last night. Now tonight you haven't peed since the reintubation this morning. So you got a catheter to try to get a urine sample. Your oxygen is at 37-40%. The chest xray was no worse. You opened your sweet little eyes tonight and held onto my finger tight until we had to go. You look a little puffy, but much better than this morning. Pray that those blood cultures are negative...


March 15- head ultrasound is normal (yay!).


March 16 - So today my heart nearly stopped. You were desating lots so they did a cxr, well tried to. The ET tube dislodged and your heartrate dropped. All I remember was people running everywhere, grabbing drug carts. A swarm of people at your isolette. The numbers kept dropping on the monitor and then they didn't register at all! So much chaos and we just stood helplessly to the side, wondering if this was it. Is my baby gonna be ok? I remember Maryam (one of our favorite nurses) sitting by me and holding me as I sobbed uncontrollably, the look of fear on Mark's face as the time seemed to stop and everything went in slow motion. The doctor (the only one I don't have confidence in down here) decided to put you back on the biphasic c-pap since you were fighting the vent so much. So far you are doing ok, still desats but self recovering. Blood gas is good. They don't know if you had another infection. Keeping you on the antibiotics in case. You are a little edematous again. Low sodium and metabolic bone disease. More phrases that keep popping up...So they say you won the battle, got off the ventilator. Your stubborness is an asset lil monkey!

Eyes checked again today, still immature. re-check in two weeks. I just want to hold you when I want to, make you comfortable and happy. It breaks my heart every day that I can't fix your world right now. I can't heal your premature scarred lungs, I can't tuck you back into my womb and keep you safe and protected. Will we ever get you off Midolam? They have to intubation cart on standby at your isolette.


March 19- TERROR day. You were working so so hard, and quite pale. I keep insisting that we needed to do a CBC to check if you need a transfusion, no one would listen. We have had a revolving door of nurses that I don't know and trust, and on one seems to hear me when I say something is wrong! Finally got a blood sample but it clotted. I went for lunch, had to get out of there, so frustrated. Came back and saw them in the midst of re-intubation!!!! It was an absolute shit-show. A resident tried first, then my "favorite" doc, then the pediatrician fellow...7 attempts to get a tube in!!! Poor Marie (a fellow 24 weeker mom with a little girl born 3 days before walter who was across from us) kept me calm throughout...Their statement was his vocal chords were inflamed and it was hard to pass the tube...no kidding, you try to jam a tube down me that many times and my chords would be inflamed too!. I just pray that they didn't damage his chords, but at least they got it and he is getting the oxygen he needs. I was so angry that I couldn't even talk to them. This is my BABY. Tonight you are on the scary high frequency (HFO) vent again because your lungs need such high pressures that the other vent wasn't cutting it. BOTH your lungs are severely collapsed. Oh and you need blood transfusions. Your tummy is distended and ropy from all the air bagged into you today.

March 20- they say because of the swelling of your chords, you'll need at least a week to be ventilator dependent. You sure hate this thing and I sure hate seeing you so sedated all the time.
March 21- You are on scary high (90%) oxygen requirements. They started you on your second course of dexamethasone. Increased your sedation. Started back on TPN and stopped feeds. I am sure God is getting sick of my pleading and begging tactics at this point. You are so puffy it breaks my heart. Tiny little elephant feet.

March 23- Today you are calm, quiet. The magic of Dex is kicking in and your oxygen requirements are down to the mid 30% range. Your chest xr and blood gases are looking better. Sure miss holding you.

March 25- Still on HFO, but talking of switching you to the conventional vent tomorrow. Not puffy nowtaking some breastmilk every two hours and TPN stopped last night. Mark flew back to Cranbrook last night to pack up the house and haul it to Prince George to put into storage. Poor guy. Such a big job for one person! Jessica is coming to be with me on Saturday. Today Sophia (walter's comrad) was moved to the back room so he will miss her being close. You have so many bruises from so many IV pokes. Your head ultrasound shows "prominent ventricles" but no one can tell me the significance of that. We finally have 2 primary nurses, Jane and Jane. They are lovely and some constancy of care will be fantastic. You broke the 3 pound mark!!! woop woop!


March 26- started to have a lot of spontaneous bradycardias (dip in heartrate), blood transfusions, bad bad colour to your skin. I have seen you every shade of grey and green in just a 12 hour span. When I came back from supper you went from pale to GREEN. Blood cultures taken and antibiotics restarted. platelets low, CRP high. Another terror filled night, I was at the hospital until 2 am sitting with you, not wanting to leave you.



March 27- Well, the blood culture came back after only six hours positive for E. coli AGAIN! what the eff??? They did another head ultrasound which looked ok, lumbar puncture which the sample was bloody so unable to rule out meningitis. ummmm what???? Meningitis????? Are you seriously telling me that yes indeed things could get much much worse than it already is?!?!?Potassium boluses for low potassium, stopped your feeds, stopped the dexamethasone, stopped diuretics. abdominal xray inconclusive for NEC. Surgery consulted, infectious disease consulted. LOTS of spontaneous brady's....platelets LOW so 3 platelet transfusions. Your edematous again, weighing 1658 grams. I am so full of fear again. When are you gonna catch a break?!?!? Jessica is coming today, come on buddy, rally for Auntie Jess!


March 28- more of the same. Still having lots of brady's. still sitting by you praying, willing a miracle. Was so nice to have Jess sit with me, sang to you with me. Staying at the hospital until 1-2 am and sleeping a few hours and then back to the hospital. Don't tell daddy, he'll think I am not taking care of myself.


March 29- cardiology consult for all the bradys, wearing a 24 hour holter monitor. Echocardiogram and ECG done. Surgery consult shows tummy is getting better. abdominal ultrasound ok, renal ultrasound ok, more changes to your antibiotics. Infectious disease comes every day but still can't tell me where you keep getting this E. coli from. More blood transfusions (lost count, think we are up to 8 or 9), platelets transfusions (up to 4 I think?)and the bradys just keep getting worse and worse. You need bagging occasionaly to get your heartrate back up!

Tonight you opened your eyes and looked at me for quite a while. I knew then that you turned a corner. More active and more fiesty, not just laying there flat anymore...


ok they have this new board with all the patients names and a red-yellow-green dot system showing how stable/sick the babe's are. Red being the worst, yellow more stable, green is good. It shows the medical and nursing team which patients need to be seen in rounds first and which are doing ok. So I am really really tired of seeing that red dot by our name everyday. Everyday my eyes inadvertently skim that board on my way to the pumping room hoping to see a yellow dot, praying that we will NEVER see another red dot by your name...but you are a sea of red dots lately...


March 29- Less brady's, more alert and active. Its all pointing in a good direction, but no one will give me any false sense of security, your still sick. I still feel my over-stressed heart filled with joy. Just seeing your eyes wide and alert, focussing right on me. You looked around for Daddy when I mentioned him to you. I read you Mrs. Puddleduck and I think you were protesting that it was me and not daddy reading to you. I guess I better stick to our daily rendition of "you are my sunshine" for now, lol. Daddy has the whole house packed and drives to Fernie to pick up the uhaul. My parents had to take Justin to Kamloops today, such a hard day. Thinking of him today...

March 31- well well, we finally got you a yellow dot!!!! yay!!! even the other parents are commenting on it to me, they are all happy for us! You are having less brady's and got your PICC line (peripherally inserted central catheter, the 2nd one you've had) after 5 attempts. But at least you don't need IV pokes every day. restarted your milk feeds. You have a big air leak around your ET tune so they think that might be causing all these brady's. Your antibiotics will continue until april 11.

April 12- Well mr. Walter, 12 days of stability. daddy got back april 3. On April 1st the new ET tube was put in by an anaethesiologist since you are now labelled "Difficult Intubation". He said it went slick, no damage seen to the vocal chords. The new tube had no leak and no more brady's after the cuffed tube was put in! You are up to full feeds today, no more TPN and the antibiotics are done. We are weaning your morphine and you are still on hydrocortisone and diuretics. Today is my birthday, and nurse Susan made me a birthday card from you with your little feet prints. I am filling my day with lots of cuddles. There was talk of starting another course of dexamethasone but the neonatologist said that the risks outweighed the benefits, so we let you grow and get bigger and stronger lungs. Yay! seems like all your problems always start when dex comes on board...Erin brought me cupcakes for my birthday YUM! There is an immunology consult that needs like 10 mls of your blood for a variety of tests to determine if your immune system is ok or not (why do you keep getting E. coli). You have 3 primary nurses who love to work with you and I love them all dearly. They keep me sane. They make me laugh. They are so good with you and for me. Oh and I see you smile now time to time (no its not gas, its a real smile)

April 15- Dear Mr. Walter is trying to tell us to get the tube out NOW! You keep pulling on it trying to yank it out. They say wait until monday. They are scared to take it out in case you need it put in again, no one wants to do it. They also don't have enough si-pap (biphasic c-pap) machines. My goodness, it comes down to lack of equipment! You may not let them wait until monday! Today you went for an MRI of your brain, as part of Dr. Miller's premie study. Quite a contraption they put you in. Such a great team though, they said you did great and other than the prominent ventricles saw no issues. They say the slightly enlarged ventricles means nothing, like some people have big ears or big feet. I hope they're right as I have seen some research that says enlarged ventricles related to cerebral palsy. Time will tell though. You get another MRI before discharge and then one at 18 months old.

April 17- Now that you are getting closer to extubation I am feeling excitement and fear together. I remember those days of holding my breath, dreading walking into the hospital wondering if today was the day you needed to be re-intubated. Every desat wondering if this would lead to reintubation. But you are ready. Your vent settings are weaned down, your blood gases are great. Today you had a traumatic lab poke. Your little foot is black and blue and swollen. I thought it was broken. The nurses were upset and wrote an incident report, and recommend I write an official complaint. I just hate the thought of you going through any un-necessary pain on top of all the life-saving measures that cause you pain. Daddy was furious and had to take a walk. Good thing we weren't here when it happened. You are 4 pounds now! Daddy changed his first diaper today, and you loaded it with all kinds of mess for him! haha

April 19th- ok, so the docs are still hesitating about extubating you. It makes no sense to me. They rush and rush to extubate at the begining and then are ultra conservative when even the RT's and RN's say you are definitely over due for extubation. Your blood gases show that you are being overly ventilated, so essentially we are doing more harm than good by keeping the tube in. You are looking a little fluid overloaded again so a dose of diuretics to clear out your lungs will improve your chances after extubation. They better hurry before you do it yourself because tonight you were making sounds (yes noise coming from your mouth!!!) and pulling at the tube...you are rooting like crazy and it hurts so bad to not to be able to breastfeed you.

April 20 - This morning you were extubated!!! It is so wonderful to finally hear you cry, well squack really. You are pretty hoarse from all that ET tube business. They gave you 3 small doses of Dex for the extubation, but I knew you would do fine. I know you are ready. You are telling us you're ready. Tonight you even came off the bipap mask for 10 minutes while daddy held oxygen blow by by your face while we sponge bathed you. Your eyes are so bright and curious. You are my hero!

April 22- well today you get out of the fishbowl honey! You're a big boy now and get into a crib!!! And they finally moved the King of 41 to the "back room". Back with your gf Sophia again. It's such a small dark room and its crowded but I love not being in the rodeo room. Only 6 cribs in here! You look so small in that big old crib! It's so nice to be able to interact with you more without having to stick our arms through two holes and we can just pick you up and cuddle like a normal baby. ( daddy is getting good at unhooking the sipap tubes and rehooking them so we don't need a nurse to help get set up with cuddles).

April 26th- first immunizations! Our days are filled with cuddles, a good 3 hrs for daddy and 4 hours or more for me!

April 30- So a little note to mention what a huge chunk of my life is spent in the pumproom. Yes, every 3 hours, every day I am in there with these mechanical pumps, chatting it up with other moms. There are sometimes tears, sometimes laughter. It is like a social outing for stressed out mammas who can just vent, swap war stories, and recuperate. Picture side by side archaic looking pumps (4-5 in total, two side by side) and the noise of a dairy. oh books could be written from the adventures in the pump room!

May 2- today they switched you to high flow oxygen by nasal prongs because you were getting a mark on the bridge of your nose from the mask. Apparently there are two hernia's now that come and go and will need surgery at some point, but they don't want to have to re-intubate you for surgery for a bit. You are refluxing- don't know if I mentioned that before. During your feeds and after you desat. You are loving your bathtime. We love to bath you because you love it so much. There is lots of laughter now, you crack us up all the time.

May 6- well me and one of your primary nurses took the plunge today. It is so sad to see you rooting every day so today we let you practice latching on a "dry" boob, after I pumped. You are such a champ- you latched right on and knew just what to do!!! We can't start breastfeeding until you are on low flow oxygen, so this is our little secret! Your eyecheck shows retinopathy of prematurity stage II zone II, whatever the hell that means. They will recheck your eyes weekly to make sure it doesn't get worse. Hopefully you won't need laser surgery to correct it, again with needing intubation for the surgery.

May 9- first mothers day. You and daddy got me flowers and a card, and took me out for a nice lunch. thank you! They have added similac lactose free powder on top of the HMF to my milk to try to bulk you up. They are concerned that you aren't big enough, aren't gaining enough. But jeesh, you've been so sick! You weigh 5 pounds 4 ounces!

May 10- we are playing the on oxygen, off oxygen game. Thank God for our primary nurses who advocate for Walter so much! They know him so good and know what he needs, it's a relief to have them in our corner. I know he is well cared for when we can't be there when his primaries are working! They have become good friends, like family really. Mark says I am crying in my sleep at night. I am getting so sick of having to leave you at the hospital everynight! You are wide eyed and waiting for me every morning.

May 25th- wow, today is your original duedate! you are 112 days old! We are waiting for a bed to be available in Prince George and then we will get transferred there. I am so excited. I am so sick of Vancouver and living at the Easter Seal house. It's been great, but now we need change. I can't wait to room in with you and not have to leave you every night. And to get to meet your grandma and grampa! how exciting! Apparently your hernia's have disappeared so they think it was just hydroceles that resolve on their own. phew! And your eyes were re-checked and seem to be staying the same and not getting any worse so the eye doctor is happy for you to be followed up and checked in PG every 2 weeks.

May 27th- Mark left for Prince George last night. We had a bed in the PG NICU, but no plane. Now we have a plane, but no bed in PG NICU. YIKES! I already checked out of Easter Seals and spent last night in the family room here at the NICU. But at the last minute everything works out and we got the bed and the plane! You got your first breath of fresh air on the transfer, and did so good. They had to put you back on low flow oxygen in such a minor amount its almost nil due to the altitude change. It is such a nice unit here. So bloody quiet that it's eery. Miss all our friends and nurses badly, but we get our own room!!! with a huge window and a bed for me! wow! First cuddle with grandma today :)

May 28- first cuddle with grampa today!

May 29- pulled out your NG tube today, so now you are on all oral feeds! You are having brady's that may be related to reflux. The reflux always shows during feeding when you desat a bit. So we are on some Ranitidine now for reflux problems. We are looking for a house to rent. I am getting my first taste of real sleep deprivation and have discovered that you like to stay up all night long to party! Those nurses weren't kidding when they told me you were wide awake at 3 am. You aren't gaining weight well and no one thinks its a big deal but I am paranoid about it. So we are tweaking your feeding regime. a little breastfeed, and a little bottle with HMF.

June 4- We found a house, moved in. I am worried that you are getting a cold, sound hoarse and snuffly. The nurses and doc think its the dry air here. hmmm....hopefully the humidifier we just bought helps you.

June 16- After 134 days in the NICU and many death defying acts of courage, today we finally get to bring you home!!! We have spent the last weeks battling brady's, trying to figure out what is causing them. The last few days it has been trying to pass a car seat challenge where you have to sit in your carseat for a full hour with NO desats. Fail, Fail, Fail, Fail, PASS! The brady's seem to be related to reflux or choking when feeding and the doc is comfortable that we know what to do and how to read your cues and react well, so he is giving us the green light for go!!! You weigh 6 pounds, 11 ounces. We are TAKING YOU HOME!

8 days old

Story time with Daddy

Dear Walter,
It has been quite a journey to meet you! You were so eager to arrive. It all started on January 28, 2010 when I was getting ready to go to work. I knew something was wrong and thought that maybe the doctor should check to make sure. Sure enough my cervix was dilated and my membranes were "bulging" which guaranteed me a quick jet plane ride to Vancouver. I spent 5 days in BC Womens hospital on bedrest in trendelenburg with my head lower than my legs. I mastered the use of bedpans and eating upside down. Daddy was a big help! Your heart beat was strong, and you seemed pretty cozy. I went to the OR and the docs were unable to close my cervix with a stitch, but at least you seemed content for the time being.

Then on February 1st there was more bleeding and we all got to spend the night in the delivery observation unit while we were hooked up to a fetal heart monitor. You were still pretty content, but by the morning the cramping and bleeding were getting worse. I was praying for time, but in the afternoon you decided to kick your foot through my cervix when daddy left to have a shower. This meant a rush trip to the OR for a C-Section. Poor daddy sprinted back just in time to run into the OR to hold my hand and wait for your arrival. You made a squack when they pulled you out and bundled you in plastic before rushing you away. You were only 690 grams!

Today you are 9 days old and it has been a roller coaster journey for your mommy and daddy. You are doing so well, everyone seems really impressed with how well you are doing. I had to leave you for 4 days to work out a nasty allergic reaction, and upon my return you are so much bigger and stronger! Today you weigh 764 grams, are getting breast milk tube feeds every 2 hours, and are still on the ventilator to help you breath. Your breathing tube is a tad small for you, there is an air leak so you are struggling with your oxygen saturation a little bit but the docs don't want to rush anything and put in a bigger tube just yet. Your eyes are moving around a lot and it looks like they can open any day now. Your bilirubin was up a bit today, and so you are lounging under the bili lights. I got to change your poopy diaper for the first time today, daddy gets to do the next one. You love story time with daddy, start fussing when he stops reading to you...Oh and you are famous already, The Minister of Health and the President of the Vancouver Children's Hospital swung by for a visit and took lots of pictures of you- those politicians love to pose with babies and you're making quite a name for youself around here...apparently your picture will be published somewhere, we're not sure where yet. We are just so proud of how strong you are, and can't wait until you are big enough for us to hold. We love you so much, and can't wait to take you home....