The University Of Maryland

     The head of University of Maryland's neonatology department has recommended that Charlotte be transferred to the NICU at the University of Maryland because Charlotte needs to be seen by several specialists. All of the doctors that Charlotte had seen at Mercy Medical Center also work at the University of Maryland, because these two hospitals are sister facilities. Charlotte will be seeing a nephrologist, an endocrinologist, and a hematologist. The nephrologist will be assessing Charlotte's kidneys because she has had abnormal levels of sodium. The endocrinologist will be assessing her abnormal levels of potassium. The hematologist will be assessing her low platelet levels. Once Charlotte has been seen by all of these specialists, we can transfer back to Mercy Medical Center. Before we were transferred to the University of Maryland,  Laura and Charlotte had a great Kangaroo Care. Charlotte loves to be held, and Laura loves to hold her. It is very scary having to leave our wonderful NICU at Mercy, but we know Charlotte needs the care that the University can provide. The transport team consisted of four people and one tiny portable incubator. Charlotte did so well breathing on the ride to the University that the doctors put her back on CPAP, and she has tolerated it very well. Her breathing is really improving!
     Since arriving at the University of Maryland Medical Center, Charlotte's medical status is improving. They have taken lots of blood so that they can check all of Charlotte's blood levels and also try and find a diagnosis for why her levels are abnormal. Charlotte's potassium levels have returned to normal due to the albuterol treatments. She continues to get IV saline to increase her sodium levels. Her sodium levels are returning to normal. She is still not eating and receiving IV TPN, so that they can get her blood levels to return to normal. The attending doctor met with us and is wonderful. She is going to be sending out lots of tests to different labs to try and find out what has caused Charlotte's potassium levels to be so high. Hopefully this week we will have more answers from all the blood work that has been sent out. Poor Charlotte looks like she has been in a bad car accident. She has splints on three out of four limbs to stabilize all of the lines and tubes that are giving her what she needs. However, Charlotte has settled in nicely to her new home at the University. The NICU is very different than the one at the Mercy Medical Center. The rooms are communal with several babies in each. Only 2 people are allowed to visit Charlotte at once, because it gets very crowded. We can't wait until we get to go back to Mercy!

The roller coaster

They call the NICU a roller coaster ride. It is not as fun as a roller coaster, that's for sure. Charlotte's platelets are low again today, and so she received another transfusion. A side effect of platelet transfusions is increased levels of potassium which is a preservative for the platelets. Today the nurses checked Charlotte's electrolytes and found that she had very high potassium and abnormal sodium levels. High potassium levels can cause heart problems. They sent an EKG of Charlotte's heart to the cardiologist, and it was normal. The neonatologist decided to stop Charlotte's feedings and start her back on TPN through an IV in her leg so that she does not get any more potassium. Charlotte is not happy that she does not get to eat, and so she has been very upset all day. It is the most difficult thing in the world to watch your daughter crying constantly but not be able to hold her. She is also getting saline to stabilize her sodium levels and albulterol treatments to bring down her levels of potassium. Apparently, albuterol, which is normally used as a medication for breathing, also helps the body absorb potassium. On the positive side, Charlotte is still breathing well with the use of the SiPap machine. Hopefully tomorrow will be an better day for her.

This is a present from our NICU nurses at Mercy Medical Center

Mommy daughter bonding

     Today Nana is visiting. Charlotte was so excited to see her nana, so the nurse took her out for a visit. Laura held Charlotte for 2 hours today! She was very comfortable and had no problems with her breathing. Charlotte is on SiPap today because after a day on the CPAP machine, she got tired. Her cries are getting stronger every day. Today the nurse was giving her a bath, and Charlotte hated it. She let out her loudest cry yet! This crying thing may loose it's luster soon.
     Not many people know this story, but when Charlotte was born, David and Laura thought she was going to be a boy. They had wanted a baby boy, because they thought it would be easier to raise a boy first. They had not found out Charlotte's sex prior to her birth. For 28 weeks, they had called Charlotte a boy. During the 5 days of bed rest, the doctors had informed them that premature girls statistically do much better than boys in the NICU. Laura quickly decided that she wanted a baby girl rather than a baby boy. When Charlotte was born, Laura was listening very closely to what the doctors were discussing, and she heard them say that they had delivered a baby girl. Laura told David she heard the doctors say they had a baby girl, and he was stunned. They were so happy to have a baby girl! Woody Allen once said, "If you want to hear God laugh, tell him your about your plans."

The PICC line is out!

What a busy week! We are continuing to make big strides. Charlotte got her PICC line out today! She was getting her TPN through the PICC line, but she is tolerating all of her meals by mouth, and so she will not need the PICC line anymore. This is great because any lines that she has can get easily infected, so the more tubes that can come out, the better. She is eating 15 milliliters or 1/2 ounce of milk every 3 hours. Also, they have added extra calories to her meals to help her grow. Charlotte weighs 1 lb 13 ounces now. Her bilirubin levels are still good, and so she does not need the blue lights. It is so nice to be able to see her eyes and interact with her more. In other big news, Charlotte had the ventilator tube removed today! She is on a CPAP machine to give a little bit of extra pressure to her breathing. This will help her lungs expand to take deeper breaths. Hopefully she can tolerate the CPAP machine a little longer this time. We heard a strong, distinct cry from Charlotte for the first time tonight. Now that the ventilator tube has been removed, we can hear Charlotte's tiny voice. We are enjoying every cry and every sound. Let's see how long that lasts.

Charlotte has a long arms, big hands, and big feet just like her mommy.

Sunshine and snuggles

     It was a sunny day in Baltimore today. The snow is melting, and Charlotte has finally warmed up to letting Laura hold her! Laura was able to hold her daughter for 45 minutes today. Charlotte seemed to love every minute if it. She kept nestling herself right into her chest. The skin to skin contact is amazing for mother daughter bonding. Laura has been on a high ever since she held her!
     Charlotte's is now eating 12 milliliters of milk every 3 hours. If she continues to tolerate the increased food, the nurses are going to take her PICC line out by the end of the week and allow her to eat entirely by mouth.
     Charlotte's room is covered in pictures that her cousins have painted. Her cousins have been spending a lot of time paining her beautiful pictures to let them know how much they love her. It really makes her room look bright and cheerful. Charlotte is blessed to be surrounded by a lot of family, friends, and most importantly, love!

Daddy's girl

The snow is continuing to come down in the city, and Charlotte is warm in her incubator. We want to jump in there with her! Charlotte is continuing to do really well. She is still bathing under the blue lights most of the day. She continues to breathe with the help of a ventilator, but the amount of assistance she receives is low. The nurses are monitoring her closely and changing her settings frequently to try and eventually wean her off it completely. She is continuing to lay on her stomach most of the day because it helps her breathe better. She looks very comfortable. She loves to curl her legs under her and lift her bottom straight up in the air. It is a very funny looking position. Last night, Charlotte received a platelet and blood transfusion because her levels were just a little bit low. Her tiny body is still too small to produce them on its own. The nurses have increased her tube feedings of milk to 10 milliliters every 3 hours, and they have also increased her amount of TPN. She gained 2 ounces and now weighs 1 pound 12.9 ounces! She is tolerating all of the nutrition really well. David was able to change her diaper for the first time last night. It's very exciting, for now. Uncle Adam, David's brother, and his wife, Aunt Kelly, came to visit all the way from North Carolina today. So, Charlotte wanted to come out and meet them. Luckily, today was David's day to hold his little girl. He was able to hold Charlotte for 45 minutes! She was so comfortable and had no problems with kangaroo care.

Diaper changes and spit up blankets

     Today our hearts are full. Laura was able to hold Charlotte for the second time! Her wonderful nurse, Deanna, thought it would be good to try Kangaroo care again. So, we put little Miss Charlotte's pink winter hat on and took her out into the real world. After about 5 minutes, she began to spit up the food she had just eaten all over Laura. I guess we should get used to this. Also, her oxygen levels started to drop. So, we placed her back in her incubator so she could relax. Because she is so tiny, the slightest bit of activity wears Charlotte out. So, we will have to take it slow with the Kangaroo care until she gets stronger. Those 5 minutes were the best 5 minutes of our week!

     Charlotte got tired yesterday after trying to breathe with the SiPap machine for a while, and she was burning too many calories by working so hard on breathing. So, she is using the ventilator again today until she can gain some weight and put on some muscle. Most preemies that are Charlotte's size will go off and on the ventilator several times before their lungs are strong enough to breathe on their own for good. The doctors are really trying to bulk our little girl up. She is eating 5 ml every 3 hours now. They say they will be increasing the amount of food she is eating throughout the week! 

     Laura was also able to change Charlotte's diaper for the first time today! Her diapers are teeny tiny, and she has lots of wires attached to her, so it made things a little tricky, but Laura handled it like a pro.
     In other news, the Duke Carolina game is this evening, and Charlotte is showing her support by wearing her UNC gear. GO HEELS!!!!

It's tummy time!

    Today was a big day for our tiny girl! Lines are coming out and her breathing is improving. The PICC line in Charlotte's leg is still in place and in a good position, so they took out the umbilical lines in her tummy. This is great because those lines can get easily infected. Also, Charlotte didn't need any blood or platelet transfusions today. This is a good sign because that means her body was able to maintain them on her own. The really big news is that Charlotte's breathing has been improving, and so she was able to have the ventilator tube removed! She is now on a SiPap machine. SiPap is used for babies who do not have a lot of energy and get tired quickly while trying to breathe on their own. SiPAP basically gives an extra "burst of air" to her breathing patten at a set rate. This afternoon, Charlotte was able to try laying on her tummy for the first time! The nurse explained that this position will help her breathe better and make her feel more comfortable. She seemed to like it!

Baby steps

     Charlotte is continuing to slowly get stronger every day. Today she has started to eat twice as much food, 2 milliliters every 3 hours. It's definitely not a Big Mac Challenge, but I guess it will have to do for now. (Ask Laura about that story!) 
     The nurses have put a PICC line in Charlotte's leg so that she can receive long term intravenous medications while she is in the NICU. They attempted to put the PICC line in her arm, but it wasn't working. Charlottes tiny little right arm has some unfortunate battle scars. The lines in her tummy that were used to temporarily give her medications will come out in the next few days. This is good because the lines in her tummy are more susceptible to infection than a PICC line. Fewer lines means a better chance that we will get to hold her soon!
     Charlotte is still bathing under the UV lights to help break down her bilirubin. While receiving her normal cares from the nurse the "blue lights" were turned off and her "sun goggles" were removed for about 15 minutes. Charlotte opened her eyes wider than ever before and for longer than we have ever seen.
     She is still breathing with the help of the ventilator, but the nurses are attempting to lower her settings on the ventilator so that Charlotte's lungs can get stronger. It will be a slow process until her lungs are strong enough to breathe on their own. 
     Charlotte also had another ultrasound of her head, and it showed no signs of bleeding. The nurse practitioner said that this is a good sign, and she will not need another ultrasound until she is 1 month old. 
    Every 24 hours, she is getting her daily dose of caffeine to stimulate their breathing. Like the caffeine in coffee or soft drinks, a low dose of caffeine helps keep infants alert and breathing regularly. 
    Charlotte also received another transfusion of platelets today to help her blood clot, and will continue to get the platelets until her body is strong enough to make them on their own. All in all, it has been a pretty good day for our girl! 

This year was our first Valentine's day as a family. David got his girls some beautiful presents. This bracelet is made of amethyst, Charlotte's birthstone, so that Laura can carry a reminder of Charlotte  wherever she goes!

Love Letter from Daddy

I fell in love today. With the emotions and chaos that surrounded the events yesterday, I never got an opportunity to let it all sink in. Charlotte held my hand (well, my finger) for the first time today, and with one touch my life was changed forever. I want so badly to pick her up, hold her, comfort her, and let her know I love her. For now, having her grasp my fingertip will have to do. She is the first thing I think about when I wake up in the morning, and the last thing on my mind when I fall asleep. As a new father, it is my job to protect her and take care of her, but with her being in such critical care, the best thing I can do is get out of the doctors' and nurses' way. I wanted to be that father that is up three to six times a night feeding her, changing dirty diapers, and holding her as much as possible. Those responsibilities will have to wait. I find myself counting the days until I get to do those things. Charlotte is such a fighter. She has already been through more trauma in her two days of life than I have experienced in my entire life. She does not deserve a father feeling sorry for himself and wishing the first few days or weeks of her life would just pass as quickly as possible. Charlotte, I love you and cherish you. Even though my ideas of what a father is suppose to do may be on hold, I promise not to count the days, but to make the days count.

Love,
Daddy

Kangaroo Care

     Today we held our daughter for the first time. Because Charlotte has so many wires and tubes, it is difficult to move her. However, the neonatologist thought it would be a good idea for us to try and hold her. This is called kangaroo care. We were able to hold her for about 5 minutes. Then, her body temperature began to drop. So, we placed her back in her incubator. The most difficult part of having a child in the NICU is to not be able to hold our daughter, but we know that it is only temporary until she gets stronger.

The NICU

      The NICU is not a place that a parent envisions their child being after they are born. It is a difficult road full of ups and downs. Bells are ringing, monitors are constantly buzzing, and Charlotte's medical interventions are changing daily, but Charlotte will thrive better now that she is getting the medical care that she needs. The doctors have reassured us that the interventions that Charlotte is receiving now are all typical for a 28 week old baby. 
     Initially, she was breathing on her own. However, after a few hours, she needed more help because her tiny lungs couldn't breathe on their own. Most likely it is only temporary until Charlotte gets bigger and can gain more muscle to help her lungs function. Doctors are monitoring how Charlotte breathes and are slowly lowering the amount of help she needs from the ventilator. Once the nurses see that she is strong enough to breathe on her own, they will take the tube out. 
     When she was born, Charlotte also had a low platelet count. She is getting platelets and blood daily to help her blood clot and her body get more oxygen. The doctors did an ultrasound of Charlotte's head and found no signs of bleeding, which is a huge relief because that could cause long term damage. 
    Every day Charlotte gets to "sunbathe" under a UV light to help break her bilirubin down because she had too much in her body when she was born. She looks like a diva with her black "sun goggles" on and her "tanning bed." 
     Charlotte has started eating a little bit. She eats 1 milliliter of breast milk every 3 hours through a tube in her mouth that goes directly to her stomach. This is helping her stomach prepare for food. Laura was able to give Charlotte her first tiny bit of food the day after she was born. When she isn't eating, she gets TPN and lipids intravenously which provides the nutrition she needs to gain muscle and fat. She is gaining weight every day, and has gained 5 ounces in her first week! We can't wait for Charlotte to start filling out. 
     The NICU will be Charlotte's temporary home until April or May. Most premies stay in the NICU until they reach their expected due date. It will be a long few months for the Harris family, but it will only make Charlotte's arrival home that much sweeter.

 

Charlotte Mikelle Harris

     Today is the day! Charlotte Mikelle Harris arrived at 12:34 P.M. She was delivered via emergency C-Section at Mercy Hospital in Baltimore, Maryland. Laura was 28 weeks pregnant and we didn't know if we were having a boy or a girl.
     Since December, Laura has been facing many complications with her pregnancy, and the doctors suspected that Charlotte would be delivered early. However, with close weekly monitoring, the date on which Charlotte would arrive became closer and closer due to a diagnosis known as intrauterine growth restriction. Charlotte was not growing at the same rate as a normal baby. The cause of Charlotte's slow growth is that Laura's placenta, the organ that is supposed to give Charlotte nutrients, was less than 10% the size of a normal placenta. There is no known cause for why this happens. On February 8, after about a week of hospital bed rest with a monitor on Laura's belly to monitor the baby's heart rate, Charlotte's heart rate started dropping frequently and the doctors became concerned. So, Charlotte arrived in a very fast, 15 minute emergency procedure, weighing a teeny tiny 1 lb 9 ounces.