Tomorrow! tomorrow!

If that subject line didn't make you think of "Annie" and get that song in your head... I'll have to try again later. (Ask me what song my kids kept singing to Jeremy's Mom, Dottie all week... that's a pretty good one for sticking in your head, too) We are heading home tomorrow. God has been so good in using this last week. I have had the opportunity to bless my roommate (she's going home today and is single Mom, from Montana, with some financial hardship) through the body of Christ. What a gift to see His love poured out in and through His people. Thank you, Ruth, Anastacia, Mom, and Jeremy specifically. She has been MUCH more open and talkative this week, so I thank the Lord that he kept both of us here. I really enjoyed staying overnight with Kara last night. I am getting the feel for her schedule She has her days/nights straight... at least at the hospital, all you Moms and Dads remember how you have a completely different baby once you get home, right? So we'll see! She took 47 mL by bottle last feeding (her new world record). Her record nursing is approx 28 mL. We learned how to operate her feeding tube yesterday. I had to place her NG tube this morning (she pulled it out). I was unsuccessful Tuesday, but today was able to do it first time with a minimum of screaming (poor Kara!) Kara is getting filmed today (I think I posted that on facebook) to show her eating progression. Jeremy & I got filmed for something completely different earlier in our stay. Our little Kara sure does like to attract attention, right? Lord willing we can channel that, and He will change her heart so she will use it for His glory in the future! We may speak at a fundraising event in May as well - crazy, right? Please be praying that we use it for God's glory and not just the "greater good". We have our post discharge Pediatritician, PT, surgery, dietician, and OT/PT outpatient appointments set up. The person in charge of our outpatient OT/PT in North Bend is a former co-worker at Starbucks. Someone I regard highly and enjoy working with. It's been SO GREAT to see God continue to give us the best people to work with. *sigh* We are so blessed. Well, if it's a while 'till we post, you'll know why! Please do feel free to call or e-mail, we LOVE hearing from our friends and family.

Eating Update

We met with our Physical Therapist (PT) again yesterday, and I opted to try nursing (instead of working on holding Kara in a "normal" bottle feeding position instead of on her side). Kara did AWESOME! For all my nursing Mom friends, feel free to ask details if you like, but in short, she nursed without a semi-poor latch and at not the best time but still got almost an ounce in 10 minutes. I am now allowed to nurse her twice per day for up to 10 minutes. Discharge is (Lord willing) this week. We are hoping for Friday as it would be a great transition into the weekend for Jeremy's work and it would work out well insurance-wise. So this week will be soaking up all we can from PT, learning about her feeding tube, staying overnight at the hospital and doing as much of her care as we can, and getting some things ready at home that we've not done since we didn't know when she'd be home (oh yeah, I guess we should get our swing out and get girl clothes - probably 0 to 3 instead of newborn out =) Woo hoo!

Kara - better and better!

We just finished rounds with Kara's doctors and such. Here's the scoop: *Kara's potassium levels are still above normal, but no longer dangerously high (the diuretic and such worked). We are still hoping it was a result of some stomach meds she was on. Those meds were switched so we're hoping her potassium levels will go down over the next few days. *Kara was difficult (o.k... impossible) to wake for her 9 a.m. bottle. We have been feeding her a bottle since Friday, up to 3 x per day for a max of 10 min. Then she gets the rest of her feed via nose tube. Things have changed a bit each day. She slept through eating all 30 mL in 5 minutes and was extremely comfortable at 9 a.m. (wow... just like a "normal" baby. =) So the Drs. said we can now bottle feed her up to 40 mL (max of 10 minutes) every time. That is every 3 hrs. We will do it as often as we're here and probably have nursing staff do it starting Mon/Tue. *Random fact - she has had a pretty yucky rash since the NICU. We are trying different stuff and are hoping something works! So hard to see a little bottom so 'ouchy' (yes, I am a Mom of little ones and use the word 'ouchy') *I asked if we can reasonably hope to be discharged this week, and the surgeon said "yes". Due to some insurance stuff, we are praying for Friday. I think that if Friday comes and we're not ready, we can then just know it's an "April Fool's" ;) We have loved looking back at God's timing for things: *Jeremy's Dad & Sue were here for the surgery and most of the first week where Jeremy & I wanted to be at the hospital (together)every day and to do housework so I could recover from delivery. *My parents have been here constantly and have made time away from us special times with Grandparents. My Mom has graciously helped keep our house clean! *Jeremy's Mom came into town this week when we have needed to be at the hospital quite a bit more to feed Kara 3 times per day. She is also catching up and getting ahead on our laundry (towels, etc.) *Next week is Spring break, so I have NO GUILT in taking a week off of tutoring to adjust to (Lord willing) Kara being home. *If we discharge Friday, Jeremy will have Sat/Sun to be home for the transition. Jeremy's work has been gracious in allowing him all the time off he needs, but his vacation was used up within the first week. We have seen God's provision in so many areas that we are very comfortable with Jeremy working as much as is good for our family. We know who owns the cattle ont eh 1000 hills (or is it the 1000 cattle on the hills?) That brings me to another point, I continue to forget my Bible at home and am THIRSTY for the Word. I'm praying that I find/buy a Bible today. it's taken me far too long to get here, but I know the feeling of the psalmist with panting after the Lord and His Word. Sorry no pics, I think jeremy has our camera with him today, or it's at home. Trust me (and all our nurses) that she is just adorable! Sending love and gratitude from all the Putmans, Meg

Milk... Mmm, good!

Well, Kara continues to create excitement and interest wherever she goes (or even when she's just in on place!)

*Yesterday and today she's had high blood potassium levels. This is pretty rare. She had 3 blood draws to "double check" that this was real. A lot of times, the draw itself creates a false reading of high potassium levels. The 3rd verified that for sure, it was real. In the meanwhile they were able to get those levels down (diuretic with a saline IV to compensate... bummer, thought we were past the I.V.s!) It is just above the high side of normal right now. Hopefully today we can figure out why her potassium levels are high. Apparently high potassium messes with the electrical circuits in the heart (hers is currently doing fine, known thanks to the EKG).
*Kara was not very pacified with sugar-water when she was being poked (at least 3 tried... =( for her I.V. Milk in my finger, however? "YUM! Thanks, Mom!"
*Today PT and I started her on a bottle. She took 25 mL in 5 minutes (not bad with a tiny premie niple and for her first try). We are going to try again, with PT, again today to get some guidance for the weekend. Just this past Tuesday she was having a hard time swallowing even drops. Thank you, God, for her amazing progress!
*She is getting more milk to try to up her calories (her weight was down the past 2 days in a row). Her doctors were originally going to just add more calories (i.e. powdered formula) but agreed to do more volume and see how she does. What a blessing to be part of the decision-making process.
*Jeremy & I have had the pleasure of being interviewed, with Kara to be highlighted in a video to help raise money for NICU expansion. It was a blessing to be able to share our experiences and recommendations (like maybe a nearby potty for postpartum women!!) for the NICU.

Looking forward to the weekend!

Kara - looking forward

It's been a while since an update. We've had internet down and it's been busier at the hospital (a good busy). Let's see, my thoughts are a bit random, so here's an update in bullet format.

*Kara is OFF morphine =)
*Kara had her PICC (long term IV) line removed so she now has a "bare" right hand =)
*OT/PT thinks it may take Kara weeks (as opposed to days or a week) to get to a bottle, so we discussed our discharge/transfer options yesterday. Looks like we may stay another week and then discharge with "home hospital" support and feeding support from an Issaquah entity.
*Our nurse yesterday said we had the BEST surgeons (she thinks 3 are the best and 2 are taking care of Kara). She wants her Mom to be operated on by these surgeons instead of adult surgeons. Thanks, God! Again, we have gotten the BEST healthcare this whole process.
*I have finally figured the traffic out. Leave at 6:45 or 8:30 (but not in between!)
*Yesterday at noon, Kara did an excellent job on her "binkie trainer". So to get her sucking/swallowing, we are doing 2 things
1) finger/pacifier in mouth, dropping drops on top and letting them roll into her mouth so she has to swallow tiny amounts at a time and gets used to sucking with swallowing
2) binkie trainer which is a pacifier with a tiny tube going through the hole, connected with a syringe filled with milk. If she sucks well, she will get small amounts of milk each suck. I can "hold back" the syringe if it's too much for her to swallow, or advance a little milk from the syringe to get her started. Yesterday she powered through 2, 5mL syringes without choking or coughing and wanted more (but we are starting slowly). Hooray! Good job, Kara.

We are thankful for the support of our family and friends. Connor & Katie continue to do well (said 'goodbye' to both of us this morning with smiles). God has been giving them lots of grace, no wonder when we know how many of you are praying for us. Thank you.

Sorry no pictures, apparently I can't use the USB ports at the Chidlren's computer and our internet has been down at home.

Kara Update - Monday

Hello all,

Mom & I went in to see Kara today (Monday). She is now off of morphine. Well, she's off the drip. She did need a bolus at 1 p.m., but no more as of 5 p.m. and hopefully will not need any tomorrow.

I got to talk to the chief surgeon and a few things were clarified. It sounds like he is in NO rush to send us home (not even discussed) and certainly does not want to send us to another hospital. The increased the amount of calories they are adding (they call it fortification, I chuckle and call it "additives") to my milk to compensate for Kara's high respiratory rate. This will most likely be needed for a long while. (It's adding powdered formula to the milk, but we're still at a 5:1 milk to formula ratio, so that's good).

I also got to watch Kara get an "echo" (ECG) and her pulmonary hypertension looks like it's resolved.

The Occupational Therapist (OT) came to work with us on watching Kara suck and start to give her little drops of milk to help her learn to swallow. We are seeing that we need to be at the hospital more to work with Kara during her awake times. With this, we would appreciate prayer for wisdom in how to balance time with C&K, work, and time at the hospital. We know we can't do it all and that's where we need wisdom in choosing what is "best" vs. what is "good" (for all of us).

We're thrilled Jeremy's Mom is coming into town on Wednesday for a week. Yay for Grandma Dot!