One Tough Cookie

This week Casey has had a couple pretty tough days, but our little girl is definitely one tough cookie. Mid week she started having a lot more bradys and we also noticed her belly seemed very bloated and she had been pretty fussy when we visited. By Friday morning things had not improved, and we got the call that she was put back on a breathing tube. The doctor ran some x-rays and determined she had what is called a Pleural effusion, or fluid collecting around her lungs. This is apparently an extremely rare complication from her PICC line becoming dislodged and leaking her IV fluids out of her vein. They immediately did a procedure to extract the fluid (scariest moments we have had since her birth). Since the procedure, her color and breathing have continued to improve and she has been tolerating her feeds much better since they restarted them. This is a huge relief because if she can hold down her food she may not need another PICC line for supplemental nutrition (as you can imagine PICCs aren't really our friends right now even though the doctors and nurses have assured us it probably wouldn't happen again). Her vent settings are pretty low for now, and if she continues to do well they are hoping to extubate her in the next day or so and put her back on CPAP. Without her CPAP hat and equipment her facial swelling has decreased, we have actually been able to see Casey's features a lot better. We have spent the past couple days trying to figure out just which one of us she looks like.

Here are the latest pictures and you can be the judge:

 Peek-a-boo

 Trying to open her eyes

 Lots of hair

 Close up

 Thinking they may have moved her to the bigger diapers a bit too soon

Not sure who she looks like, but she definitely sleeps like Mommy!

Ups and Downs

Casey has had some ups and downs the last few days. They have decreased her backup rate on her CPAP to 6 (this means she gets 6 breaths per minute to remind her to breathe). Overall she is having way fewer A/B episodes (aka bradys) which is a huge relief, and she is mostly recovering from them on her own without stimulation. Her feeds had been increased to 10 mL every three hours, but last night when we visited she again had some residuals in her belly from a previous feeding, and even more concerning she was spitting up. She had an x-ray to see if the cause was the position of her feeding tube, and the results showed it was in a good position. Because her temperature was also a little low, the doctor decided to draw some labs and start her on antibiotics as a precaution in case the results showed any infection. When I spoke with the doctor today he was fairly confident that it was not an infection, but instead was a side effect of being anemic.  She had another transfusion last night, and she seems to be doing much better today.  The official results should take several days, but prayers are requested that the results come back negative and that she can tolerate her feeds when they restart them so that she starts to gain weight.

I am so appreciative of all the prayers for my vision. I met with an opthamologist on Friday and thankfully he did not see any retina damage. We were concerned that I might have some due to the drastic change I experienced after going on insulin, but I am finally starting to see some improvement. I even drove for the first time in over a month, and I am finally feeling like I may be getting some independence back (which if you know me at all you know I am NOT good at asking for help) so this is a big step forward. It is a very strange feeling to not be at work for the first day of school today, but I am more hopeful that I will be able to go back to work in a few weeks and I can save the majority of my maternity leave for when Casey comes home. I also started Diabetes Education classes this week (try not to be jealous) to learn about carbohydrate counting, which should help me have much more control over my blood sugar. On the plus side the classes are at the same hospital as Casey so I will get to squeeze in an extra visit with our sweet girl every day.

Thank you so much for your continued prayers and words of encouragement. Here are the latest pics of the Doodlebug:

 More Kangaroo Care

 The best part of every day

 Proud Daddy

 She loves to stretch out those legs

I call this her prayer pose

 She also loves to grab her CPAP equipment

 So dramatic!

Grabbing Mommy's finger

Kangaroos are pretty much my favorite animal...

That's because we started kangaroo care today (skin to skin contact), which means we got to hold our little miracle for the first time. Words cannot express how amazing it felt to hold her tiny body in my arms. Today her arterial line was removed from her belly button, which is what allowed us to finally be able to hold her. We are so blessed that she continues to do so well. During the night they did have to increase her backup rate on her CPAP because she was having more A/B episodes (forgetting to breathe or breathing too shallow), but since then she has only had two more today. She also had an ultrasound of her head, and we are very thankful that the results came back normal. She did have to have a blood transfusion several days ago because she was getting slightly anemic, but the doctors had prepared us for this, and told us they were surprised she had not needed one sooner. Overall she continues to make great progress, and prayers are most neeeded for her A/B episodes to continue to decline so that she can be weaned off the CPAP soon.

Many people have asked about my Diabetes diagnosis and whether it is permanent. Because I have been diagnosed with Type 1 Diabetes and not Gestational, I will be insulin dependent for the rest of my life. This means I will be pricking my finger to check my blood sugar throughout the day, and giving myself insulin injections before I eat and go to sleep at night (basically it is like doing math for every bite of food that enters my mouth...now I can tell my students I really do use mental math every day!). My appointment with the Endocrinologist was very informative, and she will be monitoring my blood sugar again in 2 weeks and if all goes well every 3 months after that. She would like to eventually transition me to an insulin pump, which would as a new mommy allow me a lot more flexibility. Thank you to everyone who has been praying for my eyesight. I also have an appointment with an opthamologist later this week to have my eyes evaluated. Currently, I am wearing reading glasses over my contacts for distance, but this compromises my ability to read things up close. From what I have been told it could be several months before my glucose is under control enough to get an accurate new prescription. In other news, I tried on my pre-pregnancy jeans, and they fit (guess I found the one advantage to delivering at 26.5 weeks)!

Here are the latest pics of our sweet girl:

Kangaroo Care

 Cuddled in Daddy's arms

Mommy was in heaven!

 So in love with this girl

In awe that I was actually holding my baby

 All stretched out

 Tiny hand (so thankful that she doesn't seem to have inherited the trademark short jointed Moody hands)

So peaceful

One week old

"Pink it's my new obsession..."

That line from Aerosmith's song "Pink" has been running through my head a lot this week, and looking at the picture of the beautiful pink bouquets and adorable gifts our loved ones filled my hospital room with you can probably see why.

The past few days have been pretty eventful for our little family. A huge prayer was answered when Miss Casey was taken off of her breathing tube on Wednesday and put on CPAP, which means she has tubes in her nose providing her with continuous oxygen flow. Since she is of the ventilator, we have now heard her sweet cry (I know, ask me in a few months how sweet I still think it is) and since she was already showing the desire to suck, she now has her first pacifier. The doctors have been monitoring her bilirubin count and she has been taken off the phototherapy light for now, although they do expect she will be off and on it for a while. Casey also had and echocardiogram of her heart several days ago and it showed she had had a blood vessel that was open (very common). She received a round of medicine to help close it, and miraculously the results of the scan yesterday showed the medicine was successful. She had a little trouble with her trophic feeding yesterday, and they are hoping that today when they feed her with my milk instead her tummy will handle it better (never thought my prayer requests would include a good poop). When I spoke with the doctor yesterday, he said she is doing "extraordinarily well for her gestational age," which is a true answer to prayer.

Also, I was released from the hospital on Wednesday night, which after two weeks of vacation and only a few very sick days at home before I went into the hospital for a week, I was so ready to sleep in my own bed. So far I am adjusting to taking my blood sugar and giving myself insulin injections pretty well, and my blood sugar levels have been much more in the normal range. Many people have asked what they can specifically pray for, and one of the biggest struggles right now is my eyesight. Not uncommon with a new Diabetes diagnosis, I am finding that my glasses and contacts are no longer the right prescription, making it very difficult both to read and to see long distance. I have an appointment with an Endocrinologist (Diabetes specialist) today, and I am hoping to have a lot more information and answers after I meet with her.

While being out of the hospital does mean we can't just walk downstairs and see Casey as often, we have had some great visits the last couple of days. The nurses have been incredible with letting us bond with her by helping with many of their routines. I have been busy trying to capture all of her cuteness on camera, so I will close with a few of my favorites:

Pretty eyes

They like to teach them young in the NICU about expressing yourself through hand gestures (Sorry I couldn't resist posting this one, it makes me laugh out loud every time I look at it)

Hanging out of her swaddle

Daddy got the first poopy diaper

I grabbed a quick face picture while they were changing her CPAP equipment

I got to lift her while they changed her bedding.  Amazing feeling!

My pacifier rocks!

Our little family

"Pink it was love at first sight, Pink when I turn out the light..."

Introducing Casey Elise Sattler!!!

Yesterday I awoke ready to settle in to a routine of life in the hospital, and was once again reminded just how quickly your plans for the day can change...
Throughout the morning I noticed I was having some low back pain, and when the nurse came to put me on the monitor for my daily check, she told me I was having some contractions again. They were pretty inconsistent and no one was too worried, but she gave me some medicine to help me rest. When I woke up, my contractions were significantly stronger and they told me they were moving me to Labor and Delivery (What?!?). By the time I got downstairs, I was dilated to 8 cm and it was at that point that I knew there was no turning back, and she was COMING! Things moved pretty quickly after that, and after a rapid epidural and some amazing coaching from my mom (we hadn't quite made it to childbirth classes yet), it was time to push. Our daughter made her dramatic entrance into the world at 5:08 pm, weighing in at 2 lbs 6.5 ounces and 14 inches long. She may be tiny, but she is perfect! Shortly after delivery she needed a breathing tube, but the doctors tell us she is on the lowest supply of oxygen and she is doing well. They are closely monitoring her blood sugar, to make sure that like mommy, her's stays under control.

Casey is doing well today, and she has been busy meeting all her grandparents and family members. The nurse let me help take her temperature and change her diaper today (making me feel very official!). As for me, I am feeling pretty good (apparently I am going to be in for a rude awakening when I actually deliver a full term baby), and the hospital staff are helping to educate me about the reality of living with my Diabetes when I am released (hopefully Wednesday).

Brian and I want to express our deepest gratitude for all the prayers, support, and sweet messages we have received. All of your kind words and encouragement have truly lifted us up, and we feel at peace that our beautiful little girl is in God's miraculous hands and is growing stronger every minute.

I will leave you with some pictures of our precious girl..

The sweetest face

Our first family photo (please excuse the 5 day bedrest hair)

Mommy's little Doodlebug

Daddy's ring fits around her ankle

A Complicated Road...

Well I originally thought my next blog post would be an update from my recent vacations, but stories of dolphin encounters and baby's first souvenir (which is adorable by the way) are unfortunately on hold. We have had a pretty scary couple of days, and our road to meeting our Little Miss got a bit more complicated this week.

It has been a crazy 48 hours, but here is what has unfolded...

Wednesday afternoon I had a routine doctor's visit scheduled, and I was a little concerned as I had some light spotting. After discussing my symptoms and having the doctor examine me, he too was concerned, and sent me to the hospital to be monitored with an "oh, and and I think you may be diabetic" warning as I headed out of the office. Cue Angela freaking out here! After a couple of hours at the hospital, the nurses checked me again, and informed me I was dilated to 3 cm. At this point I knew I wasn't going to be sent home for "just a little bed rest," and this was really serious. Immediately everyone flew into action to try and stop my labor, and they decided to transfer me to Presbyterian Hospital of Dallas, where they have a NICU better equipped to handle a 26 week preemie. When they eventually ran my blood sugar, they discovered it had spiked to over 600, which apparently means that instead of having a casual lunch at Jason's Deli that morning, I should have been in the ICU. Wednesday night was a terrifying night in Labor and Delivery as they closely monitored my contractions and worked to bring my blood sugar down. More than one nurse referred to me as a "Ticking Time Bomb" since I am apparently one of those lucky women who can dilate to what was now 5 cm and have absolutely NO idea!!! This made it extremely difficult for them to determine if the efforts to stop preterm labor had been successful, so they kept me on magnesium and gave me steroids through Thursday, the safest plan of action for the baby if I was to deliver.

This morning the doctors felt confident enough that my labor had stopped for now, and this afternoon I was sent upstairs to a high risk floor where I will most likely stay until I
deliver. The doctors have determined that the preterm labor was probably caused by undiagnosed Type 1 Diabetes, that I have likely been masking symptoms of for quite some time. For now they will continue to work on controlling my blood sugar through insulin, and I will continue to be educated with a whole new diabetic lingo and diet(for my fellow Big Brother fans, from what I understand it is pretty much like being handed a lifetime slop pass...goodbye ice cream and pop tart cravings!)

The next milestone is to make it to 28 weeks, when the risk for many of our baby girl's complications decrease. Our hope is that she will hold on even longer, and continue to grow stronger every day.

Brian and I sincerely want to say thank you to everyone who has been praying for us over the last couple days and we ask that you continue to keep us in your prayers throughout the tough road ahead. Your love and support continue to lift us up in this difficult time.