Good Afternoon...

Just chillin at the doctors...

All 9lbs, 9oz of me.

Love,

Zoe

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