5...4...3...2...

On day two, when the air tube was attached under Mathias' nose, it provided 5 liters (5 quarts) of air per minute (?). The air was enhanced with varying amounts of oxygen depending on what was needed. It has ranged from room air (21% oxygen) to 40-50%.

The goal is to remove the tube altogether, have him breathe room air on his own, and not have any breathing spells. That would make him just like you and me! The road to get there is a bit bumpy. When he was stable on close to room air with no spells, they started gradually dropping the air volume being fed to him.

Yesterday, it dropped to 3. Today it is down to 2. The oxygen saturation i the blood is carefully monitored and if needed the oxygen level is dialed up a bit to make sure levels stay where they should. It currently hovers between 30 and 40%. As I mentioned yesterday, there have been a few mild breathing spells along the way as well. When this stabilizes we'll keep going for 1 and later zero. Zero will be nice but it may take a while.

Have you hugged a preemie today?

The most reassuring thing that has happened to us during the past few weeks is that a surprising number of people (including friends we know and formerly complete strangers) have told us that either:
-They were born prematurely (and turned out just fine), or
-Their child was born prematurely (and turned out just fine), or
-Their sibling, friend, in-law, etc. was born prematurely (once again, they turned out just fine).

This doesn't seem to be something that people just mention in everyday conversations (ala "Hello, my name is Bob. I'm was born way early..."). But people are happy to volunteer the information when it is relevant. It is very nice to hear from folks who have been in the same situation and have had a good outcome. That's not to diminish the potential risks Mathias is facing but we prefer to focus on the positives!

For the stats nerd in you...
Turns out, about 7-8% of babies born in have low birth weight (somewhat synonymous with pre-term delivery). Of those, about one in 10 have what they call Extremely Low Birth Weight (< 1000g). They also go by the perhaps overly cutesy term 'micropreemie'. In all, there are just under 30,000 of them born per year. So, if you do your math... look around you and one in 140 or so (depending on who's definition is used) people you see is/was a micropreemie. You probably saw one today!

A few breathing spells today

As you may be aware... Mathias has a hose under his nose delivering air. My understanding is that this serves two purposes: make breathing easier and keep the lungs from collapsing when breathing out. As we march towards a day when the hose is to be removed, the airflow is gradually reduced - that's progress. Learning to do more of the breathing work yourself comes with a few bumps in the road though. Mathias has had a handful of breathing spells in this process. As spells go they are relatively mild (but tell that to his mother!). To combat this they are keeping up the remember-to-breathe meds (which I have learned is caffeine with a more expensive name). He takes after his old man already. Sniff!

Most mornings I would stop breathing if you took away my coffee.

First article of clothing outgrown

It must be progress!

The nurse in the ICU has declared the green hat we all know and love too tight to be worn. It can only be a good sign that his head is growing, right? We borrowed it from the ICU and put it as the first item in a soon to be overflowing souvenir box.

It a case of brilliant timing, Angie P endowed us with a sharp looking new (blue) one today. It even has matching booties! Watch for it in future kangaroo adventures. Thanks Angie!

I'm getting a sneaking suspicion that there will be plenty of really-cute-but-hardly-worn items falling into the outgrown bucket in the near future...

Brain ultrasound - Part II

Mathias had a second brain ultrasound yesterday.
The results were in today. All is looking normal.
Whew!! One more is scheduled for the end of April.

But he is starting to look a little bit anemic. It is evidently caused with all the blod that is being sampled for everything that is being monitored. Therefore, they may need to do a blood transfusion down the road. At this point the docs are holding off on a transfusion as all other measures are in good shape. They never stop watching though!

It seems that every time a potential risk gets checked off the proverbial list there is instantly a new one waiting in the wings...

Give me my green hat and call me Joey!

For you trivia buffs..
a Joey is a baby kangaroo.

On April 14th...

We'll celebrate Mathias' one month birthday.
Until then we'll celebrate weekly - Happy two week birthday!!

Looking back at the last two weeks I make two observations...

1. The past two weeks are just a blur...
2. It is startling looking back at the early photos. He has changed so much in just a matter of days. See for yourself:

On March 15:













On March 27:

Part of why he looks larger is because he added about 6oz (200g).
Part is just that I was closer with the camera (he didn't grow any taller!).
Notice the ears that suddenly appeared. We have cartilage!

Weekend Progress

I love when I get to say it: it was an uneventful weekend in the ICU!

• We're just under 1lb 12oz.
• He was temporarily back under the bilirubin light. But that has been turned off.
• His last breathing spell was three days ago.
• My lovely wife had a very enjoyable kangaroo care session Sunday. I did not attempt it because... I was wearing the wrong shirt for it. Yeah, that's it, I was wearing the wrong shirt...
• There is one thing that the nurses have been impatiently for... as milk intake (which is now just a smidgeon under 1 teaspoon per hour) increases, they would like to see corresponding amounts showing up at the other end of the digestive machinery. And lo and behold, we have had significant production in that department during Saturday and Sunday! Atta boy! (Just what you wanted to read about while sipping on your Monday morning coffee, right?!)

So far so good!

Out of town visitors

Mathias had his first visit from in-laws this weekend.
Grandpa Chuckie and Aunt B stopped by.

Aunt B, who is also one of the most enthusiastic members of the new pro-Mathias movement, took the time to read him the story of Guji Guji, a crocodile who thinks he is a duck. Mathias was back on the bilirubin light and thus wearing shades. He'll get to look at Chih-Yuan Chen's hilarious drawings on a different occasion.

IV free is the only way to be!

We reached a milestone today - the oversized IV was removed. It is now all milk all the time. It is spiked with various beneficial additives from time to time but why have a needle in your foot when you can have a hose in your nose?

Mathias and the doctor (Seuss, not MD)

We try to read to Mathias every day.

For our part it gives you something tangible to do for him while in the incubator. He does tend to relax and focus on you when you speak to him. After a while it gets hard to try to ad lib about your day, the weather, politics, and obsessively repeating to him what a cutie he is. So it helps to have a script.

Perhaps it is wishful thinking because I enjoy reading it more than, say, the very hungry caterpillar (which can be a tad repetitive), but he seems to be partial to Dr. Seuss. He, of course, doesn't understand the words. He probably just likes the sound of daddy trying to pronounce Fizza-ma-wizza-ma-dill. As I think of it, he may not understand the words, but how many of us really grasp the philosophical underpinnings of Horton hears a who? There's something there for everyone!

[Note for overseas readers... Dr. Seuss is a US author of books for children. Although most of his books were written in the 50's and 60's they remain quite popular today]

Captain Kangaroo!

As I mentioned before, Ericka & Mathias were both introduced to kangaroo care Tuesday night. It was a terrific experience for both. Ericka told me so and we're extrapolating from Mathias' persisting snoozing through the whole thing that he approved.

Today, my number was up! I was preparing all day for a truly memorable father-son bonding experience. To quote the fictional Bud Fox "Life all comes down to a few moments. This is one of them"

A word on taking Mathias out of the incubator... As you may have seen in photos, he's hooked up to about a dozen cords, sensors, and tubes. When he comes out of the incubator he's still hooked up to all the marvels of modern medicine. That means that it literally takes 10 minutes to get him out of the incubator trying to keep everything straight. You have to sit right next to the incubator and be very careful not to get tangled up in anything. It is quite the project to get him out and it needs to be carefully planned out. It is not like you can set him down on the floor while separating the milk tube from the surface temp monitor.

So, I'm sitting in the reclining chair and the certifiably cutest child in the world is placed on my chest (hat and all). As soon as he lands it is abundantly clear that he is very, very unhappy being there. You might be too if you were pulled out of a comfy climate controlled home and placed in an unfamiliar situation wearing a loaded diaper. It was 10 minutes to get him out and five minutes to get him back, separated by two less than stellar minutes in kangarooville. When he was back in the incubator with a new diaper he was happy as a clam. I redeemed myself a little by being the one bringing diaper relief.

We may try again tomorrow.

Day 10 Update

Today was a terrific day in the ICU!

• Mathias weighed in at an all-time high 760 grams (just shy of 1lb 11oz)
• He was alert, looking around, and moving his arms and legs (well... at least arm that doesn't have a monster IV in it). There is a possibility that the IV is coming out as soon as tomorrow!
• It has been almost two days since his last breathing spell
• He continues to process the steadily increasing milk supply (and it comes out too!)
• Today he was introduced to two new concepts: sucking and the pacifier. He started out a bit slow but it looks like he'll be a pro in no time

Thx!

Got milk?

Milk intake is continous - still via the nose.

The amount has been cranked up to 1/2 teaspoon per hour. Not exactly a gusher but the name of the game is to ensure that the digestive system starts working properly. If things go according to plan we'll be approaching one teaspoon per hour come Saturday.

As milk increases, the fluids coming via the IV are decreased. With a little bit of luck we may be able to ditch the pesky IV soon. The "one size fits all" IV sits like a boat anchor on his arm.

First adventure in finger paint...

For scale:
Top coin is a Swedish Krona
Bottom is a US quarter.

Kangaroo Care

...isn't just practiced at the Sidney Zoo.
The folks at Children's are big believers in it. In short, mother or father sits holding a prematurely born child towards his/her chest for extended periods of time. The heat absorbed from the parent serves the same purpose as the incubator. The skin contact works to establish a bond between parent and child (I'm sure it can get lonely in the incubator) and baby learns to recognize the parent's smell, voice, etc. Proponents of Kangaroo Care point to all sorts of benefits to the child (see the link to the article below). Intuitively, it makes sense. Not to mention the enjoyment the parent gets out of it!

We were introduced to it for the first time today. Ericka & I found it absolutely delightful. Mathias instantly fell asleep and didn't have much to say.

http://en.wikipedia.org/wiki/Kangaroo_care

Happy Birthday!

Today (Tuesday) is one week since the little prince joined our family. Mom, Dad & Burrito-Boy wish themselves a happy birthday!

We're looking forward to the first month celebration, first "real" birthday, first mother's-day (the US and Sweden celebrate on different days!), first father's day (same thing there), first Christmas, first... you get the idea!

Thanks everyone for your wonderful support!

As promised...the snazzy green hat

-A snazzy green hat - $1.95 in the ICU

-A yellow and blue blanket - $4.99 in the ICU

-The tears on his mother's cheek - PRICELESS!!
(You knew this was coming sooner or later, didn't you)

No news is good news...

...but good news is better!

Sunday was very quiet in the ICU. It has been about 24 hours since the last breathing spell. The doc upped the remember-to-breathe meds which seemed to help. He is receiving 21-28% oxygen in the air he breathes (the air you breathe right now is 21%). The milk is being steadily increased (from a very low starting dose). His bilirubin is creeping up and we may see some more blue light tonight or tomorrow.

Thx!

Unplugged and replugged

Today, the nurses at Children's removed the two hoses going into Mathias' belly button. The belly button was a convenient access point but not a long term solution. They were used to deliver nutrients and draw blood for lab tests. While it is nice to not have the hoses there they will need to be replaced.

Blood samples will now be collected via needle pricks on his heels once per day.

Nutrients and the previously mentioned remember-to-breathe medication will be delivered with an IV. Because of the stress on the blood vessle the IV will be moved daily. Places with significant veins to tap into are the ankles, hands, arms and his head. The day I walk into the ICU and find an IV in my son's head I will pass out. No ifs and/or buts.

Breathing Spells

As a fully functioning human, there are many things you have to remember. Breathing is not one of them. Your body does this for you and it never stops (with rare exceptions such as sleep apnea and public speaking). In premature babies this functionality isn't quite finished yet. While on the ventilator it is not an issue. When breathing on his own, baby can simply "forget" to breathe every once in a while. There is medication (!) to help with this but it isn't fool proof.

So... every once in a while, Mathias will stop breathing. This triggers the following sequence of events: 1) his pulse will drop, 2) an alarm will be triggered on his incubator (see, there's a reason for all those cords attached to him!), and 3) a nurse will immediately reach in and touch him which jump-starts the breathing. From start to finish we're talking something like four seconds.

These spells cause sharply elevated blood pressure, shortness of breath, flop-sweats, dizziness, nausea, and nervous disorders - in the parents sitting next to the incubator. I'm not entirely sure that Mathias notices them at all. This happened twice today. That is not considered a large number of times. If we see elevated spells he may need to go back on the breathing apparatus. Nobody wants the breathing apparatus. Keep your fingers crossed that we're coming out of this. The folks at Children's have turned up the oxygen level in his air which should help.

Commenting

I received a question about the use of a log in ID and a password to make comments. At the bottom of the comment box there is a section for choosing your identity. If you select Anonymous you don't need a log in.

Perhaps too much detail...

Before entering more milk into the blue tube, the nurse 'sucks back' what has already been pumped into Mathias' stomach to ensure that things are being properly digetsted. If the previous delivery isn't digested, they need to hold off adding new milk. After the bump-up in the feeding schedule the 'suck back' came in empty. Milk was already digested and gone. We seem to have a member of the big eaters club! That came from my half of the gene pool!

Feeding has been bumped up another notch. Milk is now being pumped in continuously (at a low rate of course). But it is good news.

It's a good weekend in the ICU.

Friday update...

The ultrasound was done this morning and the results are... no bleeding in his brain, brain structure looks normal, and no signs of oxygen depletion in the brain. In other words: things are looking just as they should!! Whew!!!

More updates:
- blue light has been (at least temporarily) turned off. As the doctor put it, his bilirubin levels are ridiculously low!

-The feeding schedule has been DOUBLED from one teaspoon every 8 hours to one every 4 hours. We're waiting for him to pack on a few ounces!

We love our little overachiever.
Thx

Friday

This morning the docs will perform the ultrasound to check for bleeding in the brain. It is a routine procedure for kids in this situation. Keep your fingers crossed...

Thx!

Resting after a long day of growing

Mathias has added 15% body weight in 48 hours. It's from a small starting point but we'll take it! If you, for example weigh in at 160 lbs it would mean adding 22 lbs over a weekend. You couldn't eat fast enough. You'd need to staple the cheeseburgers to your body...

You have to admit...

...I'm cuter without the breathing tube taped to my face! The new model is much less intrusive.
The blue tube delivers milk directly to the stomach (bypassing the yet-to-be-developed ability to swallow).

Ericka

Will be discharged from the hospital tomorrow (Thursday).
If you have been calling her on the room number you should switch to her cell phone. It will be turned off in the ICU but she'll note the number in the caller ID and call you back.

She is feeling terrific by the way! If you saw her walking down the street you'd never know she delivered a child yesterday.

At 36 hours

Perhaps I'm biased but I see huge amounts of change in skin tone, range of motion, activity, and general "looking around" from just yesterday.

The folks at Children's...

...are very keen on involving parents in taking care of the kids in the ICU. I got to change my first diaper today. 'Nuf said!

If there was any doubt about the spirit of the little guy watch the angry kick in protest when Ericka checks the temperature!
No parents were injured in the taking of this photo.

Under the blue light

If born a bit early your liver isn't quite up to speed in processing something called bilirubin (sounds like someone you knew in college, doesn't it?). While waiting for the liver to catch up, it is processed with light therapy. I asked the nurse and it is NOT the same as being in a tanning booth.

For you trivia nuts, bilirubin is what gives your poop its brown color.

While under the light we're sporting the white shades on the right. They conveniently attach to velcro strips on the side of the head (the ears don't have cartilage yet). Prada has a model just like these.

Thank You!

Ericka and I would like to thank everyone for their completely overwhelming support we have received over the past week. It's been a rough ride but the numerous calls, visits, flowers, and snack packs have helped tremendeously. Thank you, thank you, thank you.

Ps. More pictures to come tonight!

Breathing tube removed!

This morning the breathing tube was removed!
He now only has a small tube delivering oxygene under his nose. I'm sure he doesn't miss it. There is always a chance they'll need to re-insert it if we run into trouble but for now he is breathing on his own!

Healthwise...

Mathias is in good shape (given everything you already know about of course). His breathing is rapidly improving and there is talk about removing the tube in the next couple of days. We have a brain ultrasound scheduled for Friday. Nobody suspects it will yield anything but it is a precaution always undertaken in these cases. We're keeping our fingers crossed. It is anyone's guess how long he'll stay in the hospital. A reasonable guess seems to be until June.

Ericka is in terrific shape. Tuesday she enjoyed several rounds of visitors and countless phone calls. She will likely leave the hospital Thursday!

Thx!

More pictures

As a freshly minted father I didn't hold back on the photos! But they tend to get a bit monotonous so I only published a few. Mathias won't be showcasing his fly rod skills anytime soon. But when he does I'll be there to document and pictures will be promptly uploaded.

Picture 4 - Me mom & daddy

Here we all are... Hanging out in the ICU.
If you put a finger in his hand he'll grab a hold of it (at least he'll reach halfway around your finger).

Sorry, the pictures featuring the snazzy green hat didn't turn out. There may be updates.

Thx!

Picture 3 - Me and mommy

Sorry this picture is a bit fuzzy.

It was one of the first times Mathias laid eyes on his mother. You may be able to make out that his eyes look a bit "slimey". Immediately upon being born they were treated with "something beneficial". At the time they did it I was preoccupied with trying to comprehend what had just happened.

Picture 2 - Introducing Mathias Hilmer Ronnings

Hello!
Mathias is 13 inches long from head to toe when stretching out the legs (which he rarely does). A few words about all the "stuff" hooked up:

The while tape that looks like a huge grin on his face is hoding the breathing tube in place. He is mostly breathing on his own but hey, who couldn't use a little help every once in a while?!

The soft red glow on his left foot is the dohickey (look up that in the Merck Dictionary) that measures oxygene levels in the blod. It is in close contact with the previously mentioned breathing tube. If we come up a little short there's a warehouse full of oxygene to be tapped.

The four white cuffs on arms and legs measure the pulse. If one measurement is good then four must be at least twice as good, right?

Barely visible are also two thin tubes entering his belly button. One delivers grub (incl. milk) the other is used to regularly pick up blood samples for various measurements. Note the conglomeration of feeding tubes on his left. It is a varied diet!

In all, it doesn't look comfortable but at least the air is nice and warm.

Picture 1 - In the ICU

The ICU at Children's is a quite impressive place. I'm guessing there were fewer high-tech gizmos involved when the first man was sent to the moon. Rule #1 - if it beeps, don't touch it! Each premi has his/her own nurse around the clock. The babies are in incubators that resemble greenhouses in an odd way.

Tuesday PM

We're closing in on 12 hours!
Ericka is at good spirits. She's been dividing her day between sleeping and visiting Mathias in the ICU. Kiddo is also doing quite well. He's sporting quite the snazzy green hat. I'll see if we can add some pictures to this tonight when unloading the camera.

Thx!

Tuesday 5:42 AM

Baby Ronnings arrived this morning!
Mom and Baby are both doing fine. We named him Mathias.

He was promptly whisked over to the ICU at Children's Hospital. He is small (1lb 6oz) but doing well. He's moving, reaching, grabbing, blinking, etc. Children's is connected to Abbot via an underground walk way so we can stroll over any time to visit with him. He will likely spend a considerable amount of time in the ICU but he is in very good hands.

Thx!

Monday Evening (Again)

Inadvertently, the settings on the comments were such that you had to be a registered user to comment. That has been fixed. Now anyone can comment.

Monday Evening

We're 12 hours into no-contraction-medicine.
So far everything is quiet! They decided not to do an ultrasound today. Apparently, the heart pace, heart rythm, and frequent kicking (baby) during monitoring was indication enough that everything is good!

Thx!

Monday

The magnesium (contraction meds) drip was removed at 0600 this AM. It is now 10:00 and everything is quiet! According to the doc, the next 72 hours are critical. If we make it to Thursday AM w/o contractions we're in good shape for going for weeks! Still no going home though : (

Ericka is feeling terrific now that the pesky magnesium is gone. An ultrasound to check fluid levels, etc. will likely happen later today.

Thx!

Sunday

We were at good spirits all day as things were quite uneventful - uneventful is good!

In the evening the 'usual' test came back. It was positive this time. Not exactly the news we were looking for. So what happens now? Not being a medical person, here's my understanding...

She is now being treated as if she has a ruptured amniotic membrane (although the test was less positive than it could have been...). That means the meds that were put in place to stop the contractions will be discontinued tomorrow AM at 0600. Those can supposedly only be used in the contractions are happening "on their own". In the context of a ruptured membrane they are inappropriate. The meds will go off and we'll hold our breath waiting for the contractions not to come back.

The forecast right now is that she'll be at A until the delivery. And the docs will try to stall as long as they can. A new ultrasound to check fluid levels is scheduled for tomorrow am as well. Monday marks 26 weeks. We're counting down to 28 weeks. Beyond that, presumably, the medical folks don't really raise any eyebrows.

Thx!

How we got here...

Wednesday afternoon - Ericka rushed to the hospital in Waconia. She was diagnosed with having contractions and was put on close monitoring. A test revealed that she was leaking amniotic fluids. She was promptly whisked over to Abbot with a diagnosis that Baby X would likely be born within the next two days. At that time, she was about 25.5 weeks along. A second test for fluids came back inconclusive. A quick ultrasound test showed that the fluids were low but not alarmingly so. She was put under close watch but in a wait-and-see mode. The staff at A was terrific (still are).

Thursday - A more in-depth ultrasound indicated that Baby X is in terrific shape. Blood is flowing where it is supposed to, at the pace it is supposed to. Heart rate is right where it should, etc. We're weighing in at 1lb 9oz. In other words, Baby X is oblivious to the panic the rest of us are in. Tests for fluids are still inconclusive...

Friday - Lydia put it best "there's a lot of uncertainty but everyone is calm". And that's a good thing! Tests for fluids are still inconclusive...

Saturday - thing have quieted down to the point where she has been moved to a less hectic floor. We're settling into a quieter room with more amenities. It starts to sink in hat we'll be here for a while. Tests for fluids are still inconclusive...

What is this?

Hi!
It's been four very long days since Ericka was hospitalized. The support we have received from family & friends has been phenomenal! I would like to thank you all for being there in an hour of need. I have spent my time, what seems like, equally between being in the hospital and updating concerned friends on what has happened.

As the days and conversations start to blur I find myself more often saying, "what had happened last time I spoke with you?" One of my favorite sisters-in-law suggested, perhaps jokingly, that I should put the updates on the web. Perhaps she was on to something. We'll see if it sticks... I'll post updates here as often as I can. I believe this setup comes with the ability to post comments. Write and I will pass along your well wishes to my lovely wife.
Thx!