Photoblog 2.0

It took Phileas Fogg eighty days to go around the world in the Jules Verne novel, and it’s been eighty days and change since the birth of Katie Rose. Our darling baby girl is home. What a gift and miracle!

Yesterday we brought Katie Rose home. When we arrived at the NICU, nurse Denise had started the preparations for Katie’s discharge.

Denise promised to come visit Katie Rose at home in our “four ring” circus. Then Dr Nancy came by to go over the discharge instructions with us.

You can see Katie Rose in the photo on Phyllis’s lap waving good bye to Dr Nancy. Then Denise unplugged the monitor leads, and removed the adhesive pads that kept the leads in place on Katie. The red rings on her torso you can see in the photo come from these monitor pads, but Denise was very gentle, the marks went away quickly.

We put Katie in her car seat, put the car seat on a stroller, and Denise helped us out to the car. There was plenty of congratulatory waving, hugging, and some tearful eyes. The lower photo below shows Katie’s car seat insert, which we’ll use until she gets a bit bigger.

Katie Rose has been home a full 24 hours now. The boys love having her, want to hold her, and tiptoe around looking at her. Sleep is in short supply as Katie adjusts to her new environment and we adjust to her. We love her so much!

Katie is shown below in an ad-hoc basinette on our kitchen table.

Katie Rose’s Face, photo by Harold Davis.

When we got to the hospital today we were delighted to find Katie Rose without tape on her face. She’s been off her oxygen cannula for a few days, but they left the tape cannula holder thingees in place in case she needed to go back on oxygen. You can see the setup in this photo.

So the absence of the tape things was a sign of medical confidence that she was fine on room air, good news indeed, and good to see Katie’s face unbound, but better news was coming.

We learned that Katie Rose can now eat as much as she wants. She gets to determine the pace, provided it is at least 100 mililiters a nursing shift. Digesting this positive info, we were startled when Norma, the social worker, came up to us, and told us that Katie Rose is coming home Monday.

Of course, there’s some insurance stuff to deal with, paper work, and a car seat stress test. As Norma put it, after they’ve taken care of Katie Rose this long [it's been eighty days] they’re not about to kick her out before she is ready. If something seems off in Katie’s performance between now and Monday, they’ll delay her release. But at this point it seems like Katie is coming home.

Our girl is coming home. We’re very excited and the boys are singing (to the tune of “The Farmer in the Dell”), “Katie’s coming home, Katie’s coming home, Hi ho the Dairy-o, Katie’s coming home!”

Katie’s Bottle, photo by Harold Davis.

This is a photo of one of the small, plastic bottles used to feed Katie Rose her fortified breast milk. It’s amazing how photography can make mundane objects magical. Making the mundane magical creates fetish objects, and is the stock-in-trade of advertising.

Related objects: Pacifier; Katie Likes Her Binkie (scroll to the bottom of the story).

[Nikon D300, Zeiss Macro 100mm f/2 ZF Makro-Planar T* Manual Focus Lens, three combined exposures from one second to 4 seconds at f/22 and ISO 100, tripod mounted; photographed on a white background and inverted in Photoshop.]

Katie’s Smile, photo by Harold Davis.

When we visit Katie Rose in her new quarters in NICU West she opens her eyes, glad to see us. Temperature checked, diaper changed, she’s ready for lunch. She drinks her fill from bottle and breast, then burps, and smiles with content. Katie’s smile makes us so happy.

What a long way she’s come!

Katie Rose is progressing. The NICU at CPMC is organized into three different rooms: North is where babies are admitted, first treated and evaluated; East is where babies grow long term; and West is where babies who are going home soon stay. It’s a lower stress environment. There are no procedures and no really sick babies in NICU West, and it is even near the well-baby nursery.

Yesterday when we visited Katie we took her temperature, changed her, let her breast feed, gave her a bottle, and just hung out for a while. Then we had to go home to pick up the boys from Fencing Camp.

We were on our way out when the charge nurse, Erin, came running in to ask if we would help move Katie to NICU West. You bet we said “yes” in a heartbeat!

Katie Rose was snoozing in her basinette. We collected her things and Erin unplugged her. Then we wheeled her down the hall in her progress towards a new life.

It’s great to see Katie Rose doing normal baby things. She’s still monitored and in the NICU, still on supplemental oxygen, and still gets most of her calories via a feeding tube. That said, she breast feeds, drinks from a bottle, burps, poops, and goes to sleep on the drop of a dime—just like a normal full-term baby.

Yesterday, I got to feed Katie a bottle. I loved looking at her eyes, with her little fingers touching my hand as I fed her.

After she had drunk her fill, Phyllis held Katie Rose on her shoulder and helped her burp.

Katie Rose looks so plump and happy, just like a normal baby doing normal baby things.

Without Training Wheels, photo by Harold Davis.

Katie is now without tubes, not all the time, but sometimes when she is feeding, and for hours at a stretch. Partly, she’s engineered this herself, by repeatedly pulling the oxygen canula out of her nose.

As Dr Chris put it, she’s riding without training wheels.

Katie and Bottle, photo by Harold Davis.

Katie Rose is sneaking up on five pounds. She is doing so well. A couple of days ago, on her first try, she “got” bottle feeding. She still needs to get most of her calories from her stomach tube, but this will change over time.

When Phyllis comes to visit the NICU these days, first there’s a bit of breast feeding, then Katie gets a bottle. With stops along the way for burping, and micro naps for Katie Rose so she has the strength to keep feeding. With wonderful baby grunting and burbling noises as Katie Rose progresses.

Après Moo, photo by Harold Davis.

When we visited Katie Rose in the NICU today she was about to be fed using the gavage tube directly to her stomach. Phyllis held Katie to her breast and let her suckle as the tube-and-pump did their thing.

This was Katie’s first time at the breast, and she did it like a champ. (My alternate title for this story was “First Nibble.”)

But nibbling at her mom’s nipple took a great deal of energy, and après moo Katie Rose fell asleep.

Katie weighes 2,085 grams, or about 4 1/2 pounds. She’s doing great, or as one of the nurses said today, the “perfect preemie.” Her head compares in size in the photo above with her mom’s hands, which may not seem that big compared to a full-term newborn babe’s head, but is big indeed compared to her 840 gram start.

Go, Katie Rose, grow! There’s plenty more nibbling to come.

Briefly noted: Once again I found myself doing a digital manicure on Phyllis’s hands. I’m now begging her to get a real world (as opposed to virtual) manicure. This proves the point that there are many things photographers can do in Photoshop or in real life, the question is which is the most expedient. If Phyllis’s cuticles didn’t need retouching, then I wouldn’t have to do it over, and over, again.

Katie’s Family, photo by Harold Davis.

Katie Rose is out of her isolette and into a basinette. This is a very big step for Katie, and one that is appropriate for Independence Day weekend.

Katie is still connected to an oxygen supply, and being fed using a gavage tube and pump. There are still monitors attached to her. But she seems happy to be “out in the world” without a barrier, and it is easier to relate to her as a (small) newborn baby.

Oh yes, another milestone: Katie passed four pounds.

All three brothers (and Phyllis and Katie) shown above; Julian and Katie spending some quality time with each other below.

Thumb, photo by Harold Davis.

Katie Rose has found her thumb. Not always, not always easily, but when she does find her thumb it seems to bring her great peace and joy.

Katie is closing in on four pounds, she is getting to be a “big girl.” At 32 weeks gestationally (the age she would have been if Phyllis were still pregnant with her) her sucking reflex is coming in. Sweet!

Hands, photo by Harold Davis.

Phyllis was kangaroo holding Katie Rose, and I thought their hands together made such a great contrast of sizes that I snapped away.

Katie has come such a long way, and grown so much, but comparing mother-and-daughter hands reminds me she is still pretty small. Yesterday she gained two ounces and she is gaining quickly on four pounds. We’re starting to hear talk around the NICU that is promising: maybe Katie will be ready to move out of her isolette and into a basinette soon. Maybe the hospital will schedule a medical meeting in a couple of weeks to start thinking about discharge plans…it all seems like a dream.

Speaking of dreams, here’s a digital photographer’s surreal and dissonant moment: Last night I couldn’t sleep. So I made a cup of chamomille tea and turned on the network and computers. At 4AM I was working on the photo of Katie and Phyllis holding hands. There were no major exposure issues.

But I did find that Phyllis’s hands needed some work, and I knew she would never forgive me if I posted the photo without giving her a digital manicure. So there I was, sipping tea, smoothing cuticles, fixing dry skin, and rounding nails. Katie’s hand doesn’t need this kind of treatment, yet.

Phyllis & Katie, photo by Harold Davis.

When Phyllis holds Katie Rose, first Katie explores. She touches Phyllis with her hands, squeals, and makes little grunts. Her eyes open. She tries to look around. But it’s hard work for her to keep those eyes open, and pretty soon Katie is fast asleep. Phyllis drifts off pretty quickly too, a smile of contentment on her face.

In this photo, the nurse held Katie for me in the process of putting her back in the isolette. As you can see, Katie keeps on growing. She’s over 3 pounds 9 ounces. She’s got some pudge and is a far cry from the tiny little thing of only a few weeks ago.

Some of this growth can be attributed to the merits of Phyllis’s milk, which they feed to Katie using gavage (a feeding tube) and a pump. Probiotic bacteria are added to the milk to aid digestion. Katie also gets shots of Epogen, a biotech blockbuster drug from Amgen primarily used for anemic patients. In Katie, the drug is used to help the growth of red blood cells.

Phyllis pumps alot of milk for Katie. She pumps milk every two hours or so. She is running a surplus. She recently gave literally gallons of milk to the San Jose Mothers Milk Bank, where it will help feed other preemies who are not as lucky as Katie with their mother’s milk supply.

Katie does her job: she eats, sleeps, poops, and grows. Katie is now well over three pounds and almost twice her birth weight. Here’s a photo from a few days ago of Phyllis holding and embracing Katie:

There’s nothing more snoozy than having a warm, happy baby on one’s chest. I was holding Katie yesterday, she looked out with her bright eye, but soon we both fell fast asleep.

We are very pleased that Katie passed a follow-up brain scan the other day with no signs of PVL, something that in theory could have shown up at about this point.

Go, Katie Rose, go. Grow, Katie, grow. You are doing fine!

When we visit Katie Rose in the NICU, if she isn’t fast asleep, she opens her eyes, and smiles at us in greeting. Her eyes follow us until she gets too tired to keep them open (keeping her eyes open is hard work for this little girl). She’s got dimples, and her smile charms us no end.

Yesterday, Phyllis got to Kangaroo hold Katie. Katie looked around, exploring visually and with her hands, before settling in for a deep sleep.