"Never Trust a Preemie..."

It is a saying we have been hearing for the last 126 days, and we were reminded of its meaning Wednesday when our little one threw us another unexpected curve ball, this one involving surgery. On Tuesday afternoon, the doctor called to say she found what she thought was a hernia during Casey's daily exam. She ordered an ultrasound, and the results Wednesday morning confirmed a hernia that was adhering to her left ovary (and they suspected she probably had one on both sides). By that same afternoon, she was in surgery. Although it was not an emergency, since she would have to be operated on at some point in the near future, we opted to have the surgery right away to avoid coming back as an outpatient. The surgery was successful, and the surgeon assured us this is an extremely common procedure in preemies (36% for preemie boys, but he didn't know the stats for girls). After surgery, she was sent back to the NICU until she could be weaned off the ventilator. Probably one of my toughest moments throughout this entire experience was walking in that afternoon to see our baby back on a breathing tube. Initially we were told that she would probably come off about an hour post-op, but it seems the surgeon was a bit optimistic. Her numbers looked good in all her labs throughout the night, but she had a few bradys after the surgery and the doctors decided to keep her on the vent through the night until they were sure the anesthesia had completely worn off and she was waking up. It was a tough night waiting to hear that she was back to breathing room air, and just being in the NICU brought back a flood of emotions from the past 4 months (and now next to the tiny little ones, MY child was the "big chunker" that I used to refer to the term babies as).  Luckily, one of our old primary nurses was assigned to Casey both nights she was there, and we had lots of other familiar NICU faces that dropped by to check in on her and exclaim about how much she has grown in the two months since we have been in Special Care. Thursday around noon they were able to extubate her and restart her feeds, and on Friday she was moved back to Special Care. She is back to bottle feeding and so far is doing pretty well with her feeds, so the doctors think it is possible that the hernias were causing enough discomfort that they could have been contributing to her feeding issues. 

Casey also had her 4 month birthday (1 month adjusted) on the day of her surgery, and that same day she joined the 8 lb club (8 lbs 3 oz as of today). Her eye test went well this week, and the ROP is now considered Stage 1 in both eyes, meaning her eyes are showing progress on their own, and he won't need to see her again for 6 weeks. Casey's doctor also decided to try her on a 5 day trial of Prevacid for reflux to see if it would help with the discomfort she has exhibited during feedings, but their hope is to discontinue it quickly if it is not absolutely necessary. She also had her 4 month immunizations, and she is scheduled to get her first Synagis shot in the next couple of days, which for high risk preemies, is so important in preventing RSV during cold and flu season.

The plan is to watch her throughout the weekend, and assuming she continues to recover from surgery well, they will most likely discharge her at the beginning of the week. Right now our biggest prayer needs are that Casey will remain brady free (since it has been determined that we are going home on an apnea monitor she needs to be 3 days free of heart rate drops, and she has had a few post surgery), that she will continue to recover well from her surgery so that we can move forward with discharge, and that Brian and I will feel comfortable in our training over the next few days as we learn all about inserting NG tubes, running feeding pumps, and using apnea monitors, so that we are prepared to care for our sweet baby at home.
 
Here are the latest pics of our big girl:

Adorable and she knows it!

"Wait, what do you mean Mommy is going to insert my feeding tube this time?  Traitor!"

Monkey feet!

If you haven't noticed, I am a sucker for all outfits with things on the booty.

 Chillin' in the bouncy seat

 Stretching out

Her frog pose

Last weekend my grandmother came in town and got to see Casey for the first time since she was only a few days old.

Four generations of first born daughters

This is just too shocking not to post.  Above is the freezer we bought in September.  It is now completely full...of milk.  Apparently since I can't sing, and I can't dance, my talent in life is feeding my kid.  Now to solve the dilemma of what to do with new milk...

Our nurse left us a little note when we came in after Casey's feeding.  It says "I completed!!!" This was only her second attempt at bottle feeding again after her surgery, so we were all pretty excited!