Quick Update August 1

I just heard from Ashley (I will be heading over after work today) and they have removed Sam's IV (yay! It was in his scalp and then his hand, but his little veins weren't cooperating so we're glad to have that out so he's not a pincushion any longer). He still has the NG tube in for feedings, BUT he took his first bottle yesterday and took a full feeding. He took another one today but he was pretty sleepy Ashley says so he only took about 1/2 of the full feeding. I get to try when I head over around 5:00 pm.

He's also been moved into a "big boy bed" (i.e. out of the plexiglas box and into an open-air bed that's not temperature controlled).

He's also up to 4 lbs, 5 oz.

This is good news because it means he's a) growing, b) learning how to bottle feed, and c) closer to coming home. It's that last part that we're really focused on!

-- TJR

Ashley's Update - 7/30/08

[This was sent via email; I have simply copy/pasted it into the blog.]

Hello Everyone!

Thank you so much for all of your thoughts, prayers, and encouraging words this past week....what an adventure it has been! We feel very blessed to have such and amazing group of people surrounding us with support, so please know how much that's meant to us!
Sam is doing very well...stronger every day. He's now breathing without any supplemental oxygen, so the nasal cannula has been removed. He's regulating his own temperature, so the heat has been turned off in his incubator. He had a short bout of jaundice, but only had to be under the bilirubin lights for 24 hours and his color now looks great. So now, he's learning how to eat! He's being fed through a tube in his nose and tolerating the feeds very well. They are increasing the amount of milk he gets every 12 hours, so if all goes well, he'll be taking full feeds in about 3 days. Once that happens, they should be able to remove the IV and start trying to feed him with a bottle. He has to do this well before he can come home. His doctor is still saying 2-3 more weeks. We are very anxious to bring him home, but don't want to rush things and want to make sure he's ready. We are now able to hold him each day and it's becoming easier to imagine bringing him home. He seems less fragile to me each time I visit. We have been so impressed with all of his doctors and nurses, which makes it a little easier to say goodbye to him each evening...

Here are some pictures, finally! Again, he still has his IV, which is currently in his scalp, but hopefully that will be gone in a few days and we can send out some pictures of him without so much 'equipment'!!!

Thanks again for all of your support! Keep those prayers coming....we want him to come home soon!

Love,
Ashley

Update as of 12:00pm 7/29/08

So just a quick post to say that he's doing well off heat and oxygen. Nurse told me today (at noonish) that he's maintaining his heat just fine and so he'll probably move to a "big boy bed" (i.e. NOT a Plexiglas box) soon. His stats are staying level and he's gaining weight. His low weight (all kiddos lose weight after being born) was 3 lbs 14 oz and he's already gained back a 1/2 oz which is a lot for a kiddo his size.

They are feeding him through a tube and he's getting increasingly larger feeds. He started at 5cc's went down to 3 (he didn't tolerate the first feeds well), then back up to 6. He eats every 3 hours (8-11-2-5) While I believed that he was going up each feeding, he goes up 3cc's every 12 hours. So he's at 12cc or so now and will go to 15cc in his next 12 hour cycle.

Dr. said that best estimate, based on his progress and her guess, is that he should be coming home in two (2) weeks.

I am going to visit him later today after work and will update if there is any change.

Also, as an example of all the cookie crumbling at once, our microwave went out. It's one of those "hood, over the range" type deals, so I'm searching to find a replacement. It's great fun. At least I get a new microwave out of the deal.

-- TJR

First post, revised.

Some have commented (thanks Kelly) that my first post was a little bit of a bummer. My apologies. So, for the benefit of those who have not yet read my mass email that went out last week, here it is (in italics, with udpate following). It's a little bit more upbeat and gives more details:

"As some of you may already know, we have received our second son, Samuel "Sam" Timothy Ryan, into this world a little earlier than expected. Sam was born at 1:12 pm yesterday, July 22nd. He was 32 weeks and 2 days along. Thankfully, he was 4 lbs 1 oz, 17 1/4 inches long, and scored a 9/9 Apgar score. We're used to early babies (Jack, too, was a premi at 36.5 weeks) but 32 weeks is a shocker and cause for some concern. Sam was born naturally, and I was able to watch and then cut the cord. Even if you think you're going to be queasy, I recommend it to any daddy-to-be. (My experience was more like being in a Monty Python skit, but that's not important right now).

Sam is currently in an incubator being monitored by the St. Joseph's NICU (Neonatal Intensive Care Unit). The incubator is standard operating procedure, and they tell us he's holding his temperature well, so that's not an issue. His breathing is being assisted with the use of a CPAP machine (which some grown ups use to help with sleep apnea - it forces air down into the lungs to help them expand when the individual inhales) and they are feeding him through an IV at this time. The Neonatologist is very reassuring and explains everything to us in detail. Ashley has more questions than I do, simply because of her training, knowledge and experience. All I want to know is "when do we get to hold him and take him home?" At this stage, his lungs were not fully developed so he struggles a bit to breath, but he's not on a machine that forces him to breath, so that's better than the curve. In a few days they will try to start him eating normally (i.e. through a bottle), but "normally" babies don't learn how to suck, swallow and breath in concert until 34 weeks. However, when they are born this early, they generally develop faster since they have to "adapt" to the new environment. The body has to produce a protein that makes the lungs elastic. They are stiff and sticky at this point, making it hard for Sam to talk normal breaths. Best case scenario is him heading home in 15 days, but 30 days would not be surprising to them.

Ashley is doing well. She is recovering much faster than she did with Jack (who was c-section) and is up and about her hospital room and already getting bored. Its a much different experience from what we had with Jack since Sam is about 150 yards, three sets of doors, and a three-minute hand scrub/wash away. The St. Joes NICU is one of the best, if not the best, in the state, so we are relieved to know he's in their care. The nurses have been spectacular and overall the experience has been amazing.

Thank you for all of your thoughts, energies and prayers. Keep them coming. Sam is going to need all the help he can get to develop and be ready to head home to hang out with his big brother, Jack.

How's Jack? He's fine, but you can see him putting the pieces together in his head and realizing he's not the king of the castle any more. When he saw Sam for the first time, he remarked: "Small feet" and "Is that mine?" As we speak, he's enjoying some TV time and plowing through some Kix. He and I are going to be spending a lot of quality time together in the next few weeks, I imagine. If you have a burning urge to hang out with him, let me know. He is a bundle of laughs at this age. Watching kids grow up is amazing, as many of you know."

Since that time, we've been able to hold him, and he's now off all forms of breathing assistance and as of last night they stopped heating his bed to see if he can make his own warmth. They don't want him burning calories to make heat, so they may have to turn it back on. We hope not, since every step forward and off machines is one closer to getting him home.

I worked all weekend on the "office-to-nursery" conversion. Some good friends were benefactors of our old computer and some other stuff that we finally had to part with (we're in therapy for our pack-rat nature) and we still have an entire closet to clean out. But I put up some blackout shades on the windows and curtains on the french doors that lead into the room. I felt pretty manly drilling into our brick walls. It almost inspires me to do some renovations on the house (like new tile floors and such) but my psychoses (fear of getting it wrong) hold me back. I know a couple of good counselors, however (my in-laws).

Otherwise, life seems to move along as normal. I'm back at work today (although taking a few moments to bang this out) and Ashley is running around doing her "nesting" thing while Sam is still at the hospital. Current estimates are still 15-30 days before we get to bring him home, although tomorrow will be one week in the NyICU, so I keep trying to trim days of the 15-30 estimate. It all depends on him maintaining body temp, gaining weight and learning how to eat through a bottle and then breastfeed. We're visiting at least once a day, usually more, and the nursing staff has been amazing. They are very attentive and address any questions we have. They really seem to enjoy taking care of him, which makes life just that much easier for us, knowing he's in caring, capable hands. I would trade our hospital for one of the "spa-spitals" out in North Scottsdale any day of the week. With that said, had it been an uncomplicated, full term delivery, I'd rather have the jacuzzi tub, massages and comfy "partner" bed. [Footnote: Partner is the new politically correct term for the "other half" since "spouse/husband" or "father" aren't always correct any more. Next up: Mother and "Other."]

Again, thank you all for the thoughts, prayers, energies, flowers, gifts, food, hugs, calls, and volunteer time. We're blessed to have friends and family like you all.

I will update again soon. I might even con Ashley into using this as her journal so you can share in our progress. Either way, check back every couple of days to see what's new.

Yours,

TJR