Quick update

Mary was discharged on Monday. We 'roomed-in' with Nora in the NICU II on Monday night. Tuesday morning, Nora was discharged. We all went home and rested. Nora met her pediatrician on Wednesday morning and Dr. Shults said she was wonderfully healthy. So, we have spent a wonderful Christmas with Dolly and Pop in Cleveland.
Thanks for all your prayers and wishes. We can't wait for Nora to meet each of our wonderful, supportive friends in person.

Here's The Story Of A Girl Named Nora

Nora Katherine Miller was born to Mary and Paul Miller at 5:51 a.m. on Friday, December 18, 2009. It was somewhat of a surprise. Paul and I went to see Dr. Roussis on Thursday, December 17, for a repeat ultrasound to check the baby's growth. We thought we were going to schedule a cesarean section for the next morning if the baby was estimated to be 9 pounds or greater. At that visit, Nora was estimated to weigh 8 pounds, 10 ounces. Dr. Roussis then gave us the option to induce labor so that we could try to have Nora vaginally. This was preferable to us since it is the natural way to give birth, and I would be able to avoid surgery. Dr. Roussis felt that if we waited until Nora's due date, we would be obligated to have a cesarean section because of her size. So we opted to go ahead and try the induction. We were admitted to the hospital that afternoon to start a medication, called Cytotec, which helps to encourage the cervix to dilate in preparation for labor but does not actually augment labor or cause contractions. The plan was for us to get a good night's sleep while the Cytotec was working, and Dr. Roussis would come in on Friday morning and start Pitocin, a drug which does augment labor. Things worked a little differently for us, however. We started the Cytotec around 6:00 p.m. A little after 8:00 p.m., Dr. Stephens, who was on-call, came in to see me. He asked if I was feeling the contractions that were apparently being picked up by the external fetal monitor. I had very little discomfort but was already in labor! He examined me at that point, and my cervix was already dilated about 3 centimeters (10 centimeters is complete). He then told me he thought we needed to "break my water." I was shocked. Here I was about to have a baby, and Paul and I were watching "G-Force" on his computer! I continued to have contractions with very little discomfort until about 11:00 p.m. The contractions were more intense and more frequent at that point, and I requested an epidural. The CRNA came in to do the epidural at 11:45 p.m. My discomfort was relieved, and we continued to watch and time the contractions. I started to have more pain between 1:00 and 2:00 a.m. The CRNA came back and gave me more anesthesia. My nurse then examined me around 2:00 a.m. and was very surprised to find that I was completely dilated. She called Dr. Stephens then and informed me that we needed to begin pushing. Nora and I worked very hard together, but after 2 1/2 hours of active pushing, Dr. Stephens informed us that we had made very little progress and that a cesarean section was necessary. I was initially very upset. Everything had gone so smoothly, and we had worked so hard. Now I was going to have to have surgery anyway? I knew that it would not be good for Nora if I kept pushing, so Paul and I agreed to go ahead with the surgery. The CRNA came back and added more anesthesia, and they took me to to the Operating Room around 5:15 a.m. Nora Katherine was brought into this world at 5:51 a.m. Paul and I were ecstatic. We would have been thrilled either way, but we both really wanted a girl. She was beautiful and perfect in every way. They brought her to Paul while I was being stitched up, and he held her right next to me so we could both look at and talk to her. Very soon after, we returned to our room with Nora and were overwhelmed with happiness.

Unfortunately, Nora had some difficulty with her blood sugar levels after birth. The doctors explained that Nora had begun making higher levels of insulin while she was in the womb because I have diabetes. Not all babies born to diabetics have problems with blood sugar control, and it is less common in women who are well controlled like I was during the pregnancy. Sadly, Nora was one of the few. They initially tried feeding her to see if she would bring her blood sugar up. But she was unable to keep them up in response to being fed. At that point a neonatologist (doctor who specializes in the care of infants less than 28 days of age) from Children's Hospital came to see her and felt that Nora needed to get dextrose through an IV and be watched very closely in the Neonatal Intensive Care Unit (NICU) at Children's Hospital. We were devastated, but we knew that we had to do what was best for Nora. So they took her to the NICU at around 11:00 a.m. on Friday. Although we know she is getting excellent care, it has been stressful and disappointing to me and to Paul. We were expecting to have our daughter with us - to hold her and feed her whenever we wanted. Instead, we are in separate hospitals, which feel miles apart even though they are directly across the street from each other. Every morning we have woken up and headed immediately to the NICU where we spend several hours with Nora, feeding her, changing her diapers, reading and talking to her, taking pictures and video of her. We then come back to Fort Sanders for my assessments and then head back to the NICU. We generally go 3 times each day for several hours each trip. It is not ideal, but we feel very fortunate to have the ability to spend as much time with her as we have been allowed.

Nora has improved dramatically in the las 24 hours. Her IV came out late Saturday evening, and the doctor decided to leave it out as long as her blood sugar levels remained stable. Her blood sugars have been excellent since she stopped receiving the fluids, and her appetite has increased significantly. She is more alert and active. The swelling she had at birth related to trauma during the labor process has improved, as well. The doctor, who saw Nora today, told us that he is very pleased with her improvement and that he is hopeful that she will be discahrged soon. We told him that I was going to be discharged on Monday, December 21, and he told us that there was a possibility that Nora could go home with us if she continues to eat well and maintains her blood sugar levels.

Please pray for all of us. We are all doing well, but we have been through a lot. We are looking forward to taking our daughter home and spending Christmas with family. We hope that all of you are well and that your holiday season is as bright as ours.

Dad's short story

Had a minute. So, I uploaded the pics. Later tonight or tomorrow, I will get Mary to help me post the details from delivery to current. The short story is:
We had a baby. Baby and Mom are recovering fine. We will all be home in time for Christmas!

Nora Katherine Miller

Nora Katherine Miller
Born December 18, 2009 at 5:51 AM
9 pounds
21 inches
& a full head of hair!

Poor Correspondence

So sorry for the lack of updates. Things have been really hectic. In addition to preparing to give birth, I am also trying to wrap things up at work and prepare for Christmas. Whoever thought Christmas was a good time to have a baby was mistaken.

Both the baby and I are doing well. The baby continues to grow at record speed. We are having another ultrasound on Thursday (December 17th) to estimate the size. If the baby weighs over 4000 grams (8 pounds, 13 ounces), we are having a cesarean section on Friday (December 18th). Dr. Roussis tells us that with a baby this large, there is a risk that his or her shoulders could get caught in the birth canal (a disorder called shoulder dystocia). If this occurred, it could cause permanent damage or disability to the baby. Shoulder dystocia is more common in infants weighing more than 4000 grams and in babies born to diabetic mothers. The risk to me, with a cesarean section, is minimal. So if the baby is at risk, we have opted to do whatever we need to do to lessen the risk to the baby. We will know more after the ultrasound on Thursday. Of course, we could go into labor between now and then, but I doubt it. This baby seems very content, and I do not think he or she has any plans to leave anytime soon.

The swelling in my feet and ankles has gotten a little worse. My blood pressure has been up a little from my norm this last week, but Dr. Roussis is not overly concerned. I am monitoring my blood pressure 3 times per day at work. So far so good. Speaking of work, tomorrow is my last day! Yay! I have 3 months off for maternity leave and will go back part-time in April. Paul has recently had some promising leads at Oak Ridge National Lab, where he has been doing his internship, and we are hopeful to stay in Knoxville.

I will make a point to update the blog on Thursday after we have the ultrasound. That way everyone will know if the baby will be born on Friday or in his or her own time. We appreciate everyone's prayers and support.

The Ankles Begin to Swell

So today was not my favorite day at the doctor. My ankles had swollen pretty badly yesterday and were not back to normal when I went in for my appointment. My weight was up 5 pounds since last Monday! They feel like it's all fluid, and they are a little bit concerned about blood pressure and fluid retention. Apparently being an old lady and having diabetes put me at increased risk for something called pregnancy-induced hypertension (or toxemia). I think they are just being cautious, but they ordered a bunch of bloodwork and urine tests today. They want me to take my blood pressure and record it each day at work. I follow up with them again next Monday (11/09), and we will see how things stand. If the swelling is better, my weight is back down and my blood pressures are all normal, we have nothing to worry about. If the labs or my blood pressures are abnormal, I may have to go on bed rest. It sounds like a nice treat, I know, but I'm pretty sure it would get really boring really quickly. My gut reaction is that this is no big deal. Everybody has swelling with pregnancy, and I have had none until now. So no worries until they tell me I have something to worry about. On a good note, my blood sugars continue to get better and better. The baby is doing great. He or she continues to be very active. All things baby look good!

Foot and Hair

Monday, October 26, 2009

31 Weeks

Once again, our little bean likes to hide from the camera. Today we were only able to get pictures of his or her foot, which measures about 2.5 inches (see top photo), and they tell us the baby has hair on his or her head. They promise us that there is evidence of this in the bottom photo. I'm not sure I'm buying it. See for yourself.