Sleep Well...

So, how was your week?

Hi-

Well this week of appointments have Zoe and I completely worn out. Monday's eye appointment went well, her blood vessels have fully matured and the scar tissue is disappearing. This means that her eyeballs are healthy. We will not know for a while whether there is loss of the left peripheral vision since that is more to do with the brain.

The EEG on Wednesday, apart from being an hour long, was good. Zoe tolerated the electrodes being stuck to her head and once she was attached she just curled up in my arms and fell asleep. The only bad part of the visit was the confusion on the blood tests. There seemed to be a misunderstanding on what the doctor ordered versus what Zoe could give up. Four hours later we finally got started and had to listen to her very loud cries as the nurses tried to find good veins. Poor thing was poked 5 times but I was more upset and distraught than she was, Phil will be handling blood work in the future. We won't know the results for a while, once the neurologist gets them I am sure we will get a call. So we keep praying since that is all we can do.

Zoe did go on her first walk today. First time she was out of the house for leisure. The weather was too nice to pass up and bundled in her 'Moby' we took a nice 20 minute jaunt through the neighborhood. She seemed to enjoy it so much she fell asleep immediately. Well had to get it in before the fore casted snow on Saturday.

Kimberly

An Overdue Update

Hello all,

It has been a couple of weeks since I have written but wanted to let you know how life in the Casmer home was.

We had quite a bit of an ordeal trying to get Zoe to eat and keep it down. With changes in formula, added medication, and rice cereal we hope to see Zoe gaining weight again. As of last week, Zoe was 7 lb & 3 oz and 20 inches, great numbers but according to the doctor not good enough. We hope with the recent diet changes we can see a drastic improvement at tomorrow's weigh in.

Zoe has a couple of important appointments coming up in the next few weeks. First, she has an eye appointment, to check if the vessels in her eyes have finally matured and hopefully were not damaged by the oxygen she was on while in the hospital. Second, Zoe will be going in for blood tests, urine tests, and an EEG to see what is going on with her brain. We are praying that things stabilize up there or heal. The tests will hopefully show what is currently going on, possible causes, and potential outcomes. All three are scary to think about so we continue to rely on the Lord.

Zoe's day to day seems great, when she is not spitting up like Old Faithful. We continue to exercise and do our therapy to keep her on track with her developmental milestones. March 11th will be her one month "corrected age" (age if she had been born to term). We hope to see things like, the startle reflex, gazing at faces for brief moments, and grasping on to fingers as a reflex.

We continue to be amazed by our little miracle and thankful for each day.

Kimberly

The Pediatric Neurologist's Report

The pediatric neurologist visit was informative and seemed an overall positive. Based on the MRI we had a couple of weeks ago, the doctor thought there might be some 'fresh' inter-cranial bleeding. Zoe will be undergoing some tests in the next few weeks to see if there is a bleeding disorder. They are also going to check if she did indeed have a stroke, which is suspected to have caused this whole event. So we are praying that whatever the results, it can be fixed with little to no effect to Zoe.

When it comes to her growth and developments, as for now, she is on track. Only time will tell though where we will see the challenges she will face.

The areas for concern though are loss of vision in her left visual field. Basically she only only sees out of the right halves of both eyes. Because she won't know the difference, Zoe will learn how to compensate for this. The other concern is the brain's ability to take in images and understand what they mean. This one I had a hard time understanding, but the doctor explained it like this, "The inability to read the emotions of a face of a person that you see." Again, none of this is for sure, just things we will be watching out for... among many other things.

Positively he (the doctor) thought her frontal lobe (higher brain thinking, like math) seemed in good condition and the concern for the motor development should be there but not as dire as we once thought. Again though this was tempered with the fact that only Zoe can determine her outcome and based on her history and the current data that seems to be where we are at.

So we continue to pray that the Lord cares for Zoe and gives us all the strength and patience to handle whatever comes next.

Kimberly

My Week

... nothing too exciting to update. I have a neurology appointment on Monday, the doctor wants to meet with Mom and Dad and me because of the abnormal MRI. (Well, abnormal in the sense that there is damage.) We expect it to just be informative and more tests, but as always mommy dreads these meetings and the rehashing of the potential outcomes. Well, just keep praying for that little brain of mine (and her peace of mind).

I am doing great on the weight gain front, 6 lb 14 oz on Thursday. They adjusted my feedings so they are not so heavy, but I am still a finicky eater. I bet they hope that these adjustments will help me with my gassiness, pooping and gruntieness. This seems to be my biggest challenge and really limits what Mom and Dad can do for now.

I hope you all are having a good weekend.

Zoe

Midweek Humor

Our Second Week Home

As Friday arrives, Week Two is coming to a close and we are slowly getting into the routine of parenthood.

As of today Zoe is now 6 lb and 8 oz. We seem to have a routine, at least when appointments don't interfere.

Zoe began her Physical and Occupational Therapy this week. Her assessment was great. Some milestones she is achieving or working on;
turning her head left to right and vice versa while on the tummy, grasping objects in her hand, and slowly working on sucking her fingers.

We will have to continue to keep up her exercises and therapy to keep her on track with her corrected age group. (Corrected Age: The age at which she would have been if she had been carried to term.) We have yet to get a good cry from her, but we hear that this is something we should enjoy while it lasts.

Well, have a great weekend.

Kimberly

An Eventful Week

This first week has flown by, especially as we try to get used to Zoe's schedule.

We have been busy eating, exercising, reading, tummy timing and of course sleeping. Getting this into a 24 hour schedule is tough and then throw in the doctor appointments. Whew!

Also this week, we had our first pediatrician visit. The typical check up with the added task of handing over a medical history that is over 100 pages long. We also had an MRI on Thursday. Apart from being extremely loud, Zoe did very well and did not have to be sedated for it. Nothing surprising came from the MRI, damage to her brain is still there and thankfully the left side looks normal. We see a neurologist in March to get their perspective and possibly set up an EEG.

Zoe begins in-home Occupational and Physical Therapy next week. They will asses where she is at and provide the tools to keep on track with her developmental milestones. Zoe also gets two nurse visits a week, for a measurement check and general, "How are you doing?" So far, 6lb and 3 oz., 18 inches and grunty as ever.

We are still on lock-down at home, doing our best to keep the germs and viruses to a minimum. Lots of hand washing and antibacterial goop. The average preemie emergency room visit is 3 but I would like to avoid any since we have lived at the hospital for 100 days already.

Right now we are just getting ready for Grandma Casmer's visit and a quiet weekend.

What a blessing to be home finally.

Love to you all,

Kim, Phil and Zoe

And Phil Writes...

"This is what Moses' basket would have looked like if he had been a girl."

Not so sure about that one, Pastor Casmer...but if it is indeed Moses, then I guess downloading a GPS app on that I-Phone is going to come in handy on that future trip through the desert.

In any event, ZAC sure looks comfortable in her new surroundings. Welcome home little girl. It has been a long, hard trip but you are home at last.

- ZAC's GP

Guess Who Got To Come Home Today

"Mommy, I love my new car seat,

- And I love my new outfit,

- And I love the ride home,

- And I love my new house,

- And I love my new room,

- But most of all I love you and Daddy!"

Homecoming

Just a quick note to all of you to report that ZAC's long hospital stay is coming to a close.

Zoe Ann Casmer is scheduled to be released on Monday, February 1st... wow, that's tomorrow!

All of us would like to thank the staff of WMH NICU, who have gone well above and beyond. They are caring and compassionate angels of mercy and flesh & blood examples of God's grace towards our family. You guys are GREAT! Thanks so very much.

As ZAC goes home and experiences new and interesting things... and faces new challenges, we continue to petition your prayers and praises, but we all also take this opportunity to thank you, the readers. You, who who have followed ZAC's story here and have stormed the Throne of Grace on her behalf have been just as instrumental in her developments as the NICU staff, so thank you too.

And now the 'fun' starts, but we have no illusions about the road ahead and it's potential hurdles... but we also are confident that His grace is sufficient. As for this weekend, we are staying at the hospital for the next few nights in order to ease the transition.

Love, Kimberly

Mommy, When Can I Come Home?

Mommy, when can I come home?

I have been doing better these past few days and I really am trying to master the complex issues with swallowing, breathing and such... but it is hard for me. This is all so new!

I am doing much better now that I am being fed every four hours. The volume of milk per feeding isn't so large so I can take this lighter workload better. This is much more agreeable to me, rather than the heavier feeding. In the future, I promise to be a good eater, but for now 'slow and steady' seems the right way to go.

I am still at a good weight... 5 pound and 1/2 pounds! This is a long way from my starting weight... and it's all good weight too.

And while I may not be the tallest girl on the block, I am happy to say that I am 17 1/2 inches long! That's pretty good too when you consider my birth length. I think I have come a long way in a very short time.

... and that little 'trick' that I do when you try to feed me... you know the one. It's when I stick my tongue on the roof of my mouth and prevent you from giving me the bottle? I promise not to do that so much any more (well, maybe just once in a while, just to remind you who is the boss).


I really would like to come home next week... and if you have to bring all of this noisy monitoring equipment and this cumbersome oxygen setup (just for feedings, mind you) home too, well I guess that's okay. I just want to go home and see my room.

So mommy... when can I come home?

PS - That GP guy is super cool. I like him a lot!

ZAC

Dear Zoe…

Or can I call you ZAC?

Today I got to hold you for the first time. It was an eye-opening experience. It had been quite a long time since I had held a baby as small as you and when you ‘factor in’ that we are family, well I was more than a little dumb struck with the memory of holding your mommy as I was holding you. I will admit that your road has been significantly harder than hers… but it will get easier, for both you and her… I promise you. And until then you are in real good hands.

I am not sure what Providence has in store for you...for that matter I am not sure of what Providence has in store for me either, but I look forward to enjoying the experience of getting to know you better.

I’ll wait while you work out all of the details...

...in your own time and in your own way.

Love Always,

Your GP

In case you were wondering...

... Zoe is still doing quite well.

Yesterday she decided to take to the bottle again, which is of course, a great thing. The only down turn of events is that in order to regain this past milestone, she still needs the assistance of the canula for breathing. We tried doing both unassisted breathing and the bottle and that didn't work out as hoped... but maybe soon we can get her weaned off of the canula. Heck, she has come so far already! For now however, the bottle and the canula are a set.

In light of this 'hiccup', no official take home date has/can be been set, since the feeding has kind of delayed things... but we hope here too for that day to come soon. In the meantime I have been staying at the hospital many more hours per day, for the past few days, just trying to be more involved in her feedings and therapy. I must say that it has been great fun being around her more. A gal could get used to doing this full time!

Well, gotta run. I have 'mothering' to do.

Kimberly

What the Heck is Gavage?

Well Zoe's fantastic Friday, stayed with Friday.

This past weekend she struggled quite a bit with eating and had to be gavaged - (http://en.wikipedia.org/wiki/Feeding_tube) for most of her meals. The nurses are trying various techniques and bottles, hoping that we can repeat Friday's success. Of course prayers are always welcome.

On an upbeat note, the doctor and nurses continue to monitor Zoe's electrolytes and sodium level, they were very happy the diuretic took so quickly, since this is something that usually takes a week.

Zoe had her first hearing screening, one of two before she is discharged, and her left ear seems good but the right one came back inconclusive. Once there is a second screening they can determine if we will need more appointments in the future.

We are thankful for each day that we have with her and the successes she has already had. What a blessed little girl we have.

Kimberly

Quick Update For the Weekend

Zoe was taken off her canula this morning to see how she would do with breathing on her own. As of 1:30 she was still without any breathing assistance and even eating well while she is breathing on her own!

On the 'down side', she has lost a bit of weight over the past few days - the doctors attribute this to the use of the diuretic, but the doctor is increase her food intake so that she can gain some good weight.

Well, that's about it for this week...

Kimberly

Mid-Week Report

All,

Zoe continues to do well. The doctor is working on weaning little Zoe off her nasal canula... and in order to help her, she is on a diuretic. This will remove any extra water from her body especially her lungs. They hope this will do the trick, but will closely monitor her to ensure she gains weight and her electrolytes stay where they need to be.

Zoe is still progressing with her eating. She will still have to take breaks through out the day, but most of her feedings have been by bottle. With the latest level of Zoe's development, the doctor feels that she may be going home now at the end of January! This is great but means mom and dad have a lot of work to get ready.

Kimberly

Baby's Steps

All,

Today, Phil fed Zoe for the first time. She had one little 'purple episode' but she finished strong.

She continues to grow, 15 3/4 inches and 4 lbs, 14 oz. We are aiming at her hitting 5 pounds by Wednesday.

The doctor and nurses are working to wean Zoe off of the canula. They hope within a week she can be off.... We do too, so she doesn't have to come home on any breathing apparatus.

As another indication of her development, Zoe is no longer be under the care of the neonatologist, she has graduated up to her pediatrician. Just a another step to coming home.

We continue to give praise and thanks for the progress Zoe makes each day and the overwhelming response by strangers and friends alike that are praying for her. We pray that the Lord continues to bless Zoe with success.

Kimberly

Hey....

Can't a girl get a little quiet-time? Now how about you turn off that light and let me get some sleep!

Good Night.

signed - ZAC

Counting Down

Well...

Zoe had her ultrasound today and everything is remaining stable, which is great. The doctor's states that they will follow up with an MRI before her discharge date and in the future they will continue to monitor her brain and it's structural integrity.

We continue to pray and petition your prayers concerning the ramification of this injury. God has been very merciful with us already but we still ask for His grace and blessings for Zoe's future.

On the dietary front, Zoe has been eating well, five bottle feedings in a row as of last night! Her current weight is 4 lbs and 11 oz. and we hope in the next couple of days that we will get to start bottle feeding her instead of just being a spectator.

Zoe's breathing has been great too and she has had little to no alarms in the past week so they are going to slowly wean her off her nasal canula. We are praying here too, that this goes well.

In the meantime, we are just counting off the days until Zoe gets to come home!

Love,

Kimberly

Shots?

Hello All,

A little 'Zoe Update' for today.

OT (Occupational Therapy) says bottle feeding and therapy are going well, however Zoe had her immunizations today... and she wasn't too happy about them... but neither would I be if two giant (respectively) needles were jabbed into my thighs.

Overall she had a pretty tiring day. She was pretty gassy too, so a lot of squirming. On a positive note, her weight is now 4lb. 8oz. and they will be stopping the protein additions to her feedings because they don't think she needs that supplement for her growth anymore. Hopefully that will help with the occasional gas issues.

Otherwise, her next head ultrasound is on Thursday - praying for stability there and God's great power to heal.

- Phil

1st Report of 2010

... and Kim reports:

Zoe has now been moved to the 'Big Girl Crib'!

She is maintaining her body temperature very well and they have also moved her off of the High Flow Vent settings and is now just on a nasal canula.

Feedings are going well. She is bottle fed whenever she is awake and is still enjoying her gavage feedings if she takes too long or is asleep.

The doctors and staff are happy about the progress she has made and now are projecting a take home time of beginning of Feb.

Love,

Kimberly

A Trivia Question

Riddle me this…”Who weighs four pounds and is painfully adorable?”

Well… the answer is ZAC – a.k.a Zoe Ann Casmer, who managed to hit the 4 lb milestone last night or as Kim so eloquently put it, “She is getting so big and all her cheeks are chubby!”

So what are the long range plans for Zoe, based on her achievement of this milestone? Well, the plan is that in a week or so she is to be moved to an open crib! She will still be monitored to ensure she can maintain body temperature, heart rate, breathing and such, but the constraints of the plastic box will be gone.

As for her feeding, Zoe is continues to do well with her nipple feedings and she has now graduated to bottle feedings twice a day. She is also being weaned off of her caffeine and air support over the next couple of weeks to see if she can "fly solo".

We are praying that the past few days will be a good indication that it will be successful and we invite all of you to join us in our prayers of thanks and praise for what He has done as well as our entreaties for His continued blessings on this child.

- ZAC’s GP

Kim Provides a Sunday Update

Kim writes,

"Hello all and before you ask, 'How did the ultra-sound go', I'll be proactive and answer...It went alright.

The damaged areas of Zoe's brain continue to dissolve, but it seems that so far there is no clotting. (Which means no additional damage is being created). This is good because it means we can avoid having surgery to put in a reservoir and then later a shunt. So I guess the overall status - stable.

The past couple of days nipple feedings haven't been as good as they have been, but we figured this is due to her still learning.

... And if you live in the 'Great Midwest', I hope you are enjoying the snow.

Kimberly

HO! HO! HO!

Editorial Comments Abound

Hi all,

Hope things are well for everyone.

The nurses and doctors decided not to go with the continuous feed. Rather they just changed her 'High Flow' settings so she is getting more stimulation to help her breathe. (Editorial Comment: Those darn medical-types!)

With this being said Zoe is still on her once a day bottle feedings in order to work on that coordination and built up her strength and stamina. (Editorial Comment: Awesome!) Phil and I got to witness the bottle feeding exercise this morning. 20 minutes later, Zoe had finished the entire bottle! This sight was amazing, especially since the previous day she just got tired out so easily. The therapist and nurses were very excited about her development.

We hope (Editorial Comment: And pray!) that this continues, but know that this was a unique event (Editorial Comment: I disagree!) and working up to regular bottle feeds will still have its ups and downs. (Editorial Comment: I agree, but remain optimistic!) The holiday remains busy and quiet. (Editorial Comment: Just a bit of a contradiction there, Kim.)

Merry Christmas and Blessed New Year,

(Editorial Comment: ZAC's GP & GM say Merry Christmas too!)

Kimberly

An Evening Poem

T’was tonight after dinner, when it rang through the house…
My cell phone was buzzing, so I shouldn't grouse.

Kim had called to say hi and to leave a report…
She was heading back out so she kept it quite short.

ZAC was still doing well, but her feedings ‘had issues’…
No drama, no tears, and for certain NO TISSUES!

The volume of food ZAC was made to intake…
Was stretching her stomach beyond what it could take.


Thus it was decided that for her own good…
Continuous feedings to happen it should.

Beyond this small hiccup, ZAC was still doing great…
Fourteen inches in length, three pounds six in her weight.

Kim was heading back up to see her dear child…
And I thought of another, quite meek and so mild.

So when hassle and haggard vex this holiday…
Find time for reflection, find time to pray.

Sleep well, little girl.

- ZAC’s GP

Dad says, "SHE CAN EAT!"

All,

Just got a call from the hospital. The nurse said that she caught Zoe at a very calm but wakeful moment and so she decided to try the slow-flow nipple feeding.

She said that for about 15 mins Zoe drank about 5cc’s of breast-milk from the bottle. She did not spiral down in oxygen levels, which means she was sucking, swallowing, and still breathing.

Jenn (the nurse in NICU) was very happy about it. She said they will attempt to do that once a day until she’s a little bigger.

Praying for lots of big miracles, God also blesses us with little, wonderful ones too.

SHE CAN EAT!

Phil

Eighth Week Anniversary

... And a cool new outfit.

Say, do animal prints make me look fat? I hope not. I want to look my best for my Eighth Week Anniversary.

Happy Eighth Week Anniversary to me... Happy Eighth Week Anniversary to me...

Have a great weekend everybody, because I will!

- ZAC (Okay, my GP helped me type this up.)

Be Still

"Be still, and know that I am God; I will be exalted among the nations, I will be exalted in the earth." - Psalm 46:10

Zoe achieved the 3 lbs and 1 oz milestone last night.

For us, there will be lots of prayers still...

And lots of hope for the next months and years.

- Kim

The Specific Reason…

Yesterday’s post contained few specifics as to what the concerns of the doctors and the staff of WMH NICU were. This was done on Kim and Phil’s request in order to contact and inform the family rather than have them hear about it here ‘first’. Since this is now done, perhaps a bit more of an explanation, concerning Zoe’s condition is in order. I preface this explanation with a simple statement from Kim, “Just praying for a miracle right now.”

The MRI of Zoe’s head indicated that the right ventricles of the brain were growing. This could have been caused by swelling of the brain or perhaps bleeding, but it was not. Instead, what the ‘second opinion’ revealed was that there were large areas of damaged brain tissue in ZAC’s right brain hemisphere which her body was reabsorbing. The space created by this absorption was being filled with cerebral fluid.

The cause for concern surrounding this development was not so much about the absorption or the fluids, but rather the potential for long term damage already having been done that would cause the brain to go into this ‘mode’. The doctors theorize that while in uterus, Zoe may have experience a stroke which both damaged the brain and spurred her premature arrival.

Following the MRI review, the doctors… cautious as always in the choice of words they used, painted a picture that spanned the distance from stark and bleak in outlook [as it applies to the potential from long term disability and brain damage] to the possibility that Zoe might be able to ‘reprogram’ her brain so that the functions performed by the damaged/missing area could be taken over by the other hemisphere, and thus be ‘normal’. [I question the relative merits of normalcy, but that debate is best kept for another day.]

The next milestone is finding out if Zoe can coordinate the suck, swallow and breathe regimen, a function that should be ‘second nature’ by the baby’s 36th week of development. Since ZAC is only at 30 weeks of development there is still time to go on this, and beyond this new hurdle she continues to grow, breathe, her heart is strong and she is active.

On a personal note, after speaking to Kim at length last night, I can only reiterate what I said then. Understanding the will of God is often clouded from the minds of mortals. I would not begin to hazard a guess as to why this has happened to Kim and Phil and Zoe… to all of us, but suffice it to say that regardless of the end result, it will be to His glory.

If Zoe does indeed have to contend with brain damage, Phil and Kim will be most excellent parents, Zoe will remain a child of God and He will be glorified.

And if Zoe has to contend with a limited disability or a learning complication,
Phil and Kim will be most excellent parents, Zoe will remain a child of God and He will be glorified.

And if He allows Zoe to develop, grow and thrive… unhindered by any disability,Phil and Kim will be most excellent parents, Zoe will remain a child of God and He will be glorified.

If He chooses any option other than the third, will He be less glorified? I think not, and while we would pray and plead with Him for this third option to be His option of choice, it must always be remembered what He said to Paul…

"My grace is sufficient for you, for my power is made perfect in weakness."

- ZAC’s GP

Prayers Re-Doubled

As days go, this one has been less than stellar.

With the memorial service for ZAC’s great-grandmother still fresh in our minds, Kim called to report a significant and serious complication that the MRI discovered with Zoe. According to the doctors, the ventricles on one side of her brain were enlarging and it appeared that they were filling with fluids. The ‘pictures’ were being sent to another hospital for a second opinion, but the general prognosis was not good.

I know that each of you out there have been in constant prayer for Zoe since this all began eight weeks ago, but I would ask now that your prayer efforts be redoubled, not just for Zoe’s life and health but for Kim and Phil’s strength and peace of mind.

May His will be done, but may He also allow us the eyes to see that it is His will as well as the mind to understand it... or at least accept it.

ZAC’s GP

Check Out My New Outfit... Heck, check out that smile!

All,

Zoe continues to do well and she is currently eating 24CCs to support her 2lb and 12 oz body.

She is alert when it comes to her occupational therapy and when the nurses come around to check on her. She is also now sucking on her fingers as well as the pacifier.

By all the nurses' and doctors' opinions, Zoe is doing what she needs to do to get home. It will still be quite a while, but comforting to know that she is on the right track.

We are patiently waiting and praying for that day.

Kimberly

A Time for Everything

There is a time for everything,

and a season for every activity under heaven:

A time to be born and a time to die,

a time to plant and a time to uproot,
a time to kill and a time to heal,

a time to tear down and a time to build,
a time to weep and a time to laugh,

a time to mourn and a time to dance,
a time to scatter stones and a time to gather them,

a time to embrace and a time to refrain,
a time to search and a time to give up,

a time to keep and a time to throw away,
a time to tear and a time to mend,

a time to be silent and a time to speak,
a time to love and a time to hate,

a time for war and a time for peace.

- Ecclesiastes 3:1-8

All,

Well today went very well with Zoe and the "High Flow Canula". She was on room air for most of the day resting peacefully. She continues to gain weight steadily, now at 2 lbs and 8 oz!

The occupational therapist did have to put a splint on her foot to help straighten it out. They said that this is pretty typical for such a small baby that does their growing in a bed.

With lots of prayers and her sheer determination, Zoe is making huge strides to coming home.

Kimberly

Patience Practiced in Earnest

All,

I just wanted to give you an update on Zoe.

The doctor found no change on her head ultrasound since last week, which is good, but after last week I was hoping for more. Patience again is being practiced in earnest.

Zoe continues to do well with her feedings, but the staff is looking to get her growing at a slightly faster rate. They have added more protein to her milk in order to do this. She is now up to 22CCs on her feedings. They also did not switch her off CPAP yet since Zoe had a bad night last night, thus they decided to give her another day and hope that Wednesday will be a better day to make the switch.

Kimberly

Zoe, Meet your Great Grandmother…

Josephine Ann (Greisbeck) Lacher,
Died 12/8/2009

She was born almost a century ago in a far away land. She enjoyed great times as well as horrific ones. She married and moved to this country, where she and her husband gave life your grandfather, who gave life to your mother, who gave life to you. She too suffered many ills, yet she overcame them. She too was tried and tested, yet she stayed the course. Though you will now never be able to meet her, suffice it to say that her greatest wish was to see you. You would have liked her, and she already loved you. I just thought you should know.

- Your GP

Mondays Can Be Good

Evening All,

Things with Zoe are going well.

They (WMH-NICU staff) are slowly weaning my little girl off the CPAP and they hope to have her on the cannula (nose tube) on Tuesday. They have also increased her feedings to 22CCs since she has been gaining weight steadily.

Tuesday will be another ultrasound on her head, again we are praying to see the ventricles shrinking and the clot dissolving.

Other than that, it is a fairly quiet Monday.

Kimberly

Saturday Bath

All,

Today Zoe got her first tub bath! The nurses took out her CPAP, and gave her a nasal cannula (a nose breathing thing) to take her out of her isolette (her little, clear plastic room). She seemed to enjoy bath time once she realized what was going on, she especially enjoyed sitting in the warm tub.

We have also now heard Zoe cry, they are pretty small cries compared to larger babies, but pretty beautiful noises to our ears nonetheless.

The doctor feel Zoe is doing well, especially since they modified her feedings to every two hours and she is still tolerating the CPAP well… room air to 24%. They modified her vent settings to allow her to do more work and this evening they are going to try and go back to 3 hour feedings. We are a bit apprehensive, but the doctor feels that now she has had a few days to get used to the CPAP she may be ready for the next step.

We continue to pray that Zoe and all the other babies in the NICU continue to do well as we celebrate our Savior's birth.

Kimberly

Six Weeks Down

All,


Things with Zoe have been kind of up and down for the last 48 hours...

When Zoe was initially placed on the CPAP the nurses used short prongs to 'attach' it. This worked well for about the first eight hours but the air flow just was not getting to her lungs. To combat this, they decided to use longer prongs, thus preventing Zoe from wiggling out of the device. They also gave her another transfusion to help move the oxygen around. This seemed to do the trick, until until her feedings.


With Zoe on 19CCs every three hours, this combined with all of the breathing she now had to do on her own... well she would quit breathing on her own. (Obviously not a good thing!) To correct this, they now have her being fed every hour 6 cc (small meals, more often) and she has been given a dose of antacid to help.


Since this regimen change [early Thursday morning] Zoe has done spectacularly well!

Her oxygen settings are 21%-24%, she is breathing comfortably on her own and has had no significant drops in her rates.

We are continuing to see her exercise in her occupational therapy. The therapists feel that she is doing well and making progress at the appropriate rate.

Six weeks down :)

Kimberly

Goodbye E.T.

With apologies to Steven Spielberg, it was time for E.T. to go home. As important as the ET (endotracheal tube) was in aiding and assisting with ZAC's breathing it did have certain drawbacks, namely it obscured Zoe's face. In addition, Zoe had developed a severe dislike for the device and spent more than a little time attempting to remove it.

The first attempt at the ET removal and moving Zoe to a CPAP was less than a rousing success but at the time, the doctors attributed this to her age and level of development/maturity and decided to postpone the removal. Well, December 1st was the new scheduled removal date. Here is what Zoe's proud mama has to say about yesterday's events...

All,

After a busy Tuesday this is where things stand for our 2 lb and 2 oz little champ.

The doctor called this morning to state that the radiologist saw a decreased size in the ventricles. The clot is continuing to dissolve and soften. They are going to continue to monitor this on a weekly basis.

Also this afternoon they removed her ET tube and gave Zoe the CPAP. She seems to be handling it well, though she will occasionally try to wiggle out of it or get tired of breathing. The nurses are very quick to get her settled or her heart rate back up. We are praying that this continues to go well so she can move forward on the bath to be breathing accessory free.

The remainder of the week will be all about keeping up her feedings and getting her to grow. We are praying that the Lord continue to bless our little girl.

Kimberly

So How Did It Go Yesterday?

All,

Zoe is did really well with the kangaroo this evening (Monday evening). She is sleeping and and eating really well also. The plan for Tuesday is to remove the Endotracheal tube (ET) and put in the CPAP. We are praying this goes well and she breathes on her own.

They also did her head ultrasound, though we have yet to hear the results from the DR. Other than those two big things it seems like the staff are keeping it low key for the rest of the week...

So lots of prayers on breathing, brains, and continued growth.

Love,

Kimberly