Olivia has been out of the womb for 11 weeks and 2 days, but she was 8 weeks early so her corrected age today is 3 weeks and 2 days or 43 weeks and 2 days. đ She looks like an entirely different being, but her soul – her spirit – that has been a constant. My dear @melissalflower came for a visit this past weekend and reminded me of one my absolute favorite Shel Silverstein poems:
Listen to the MUSTN’TS, child,
Listen to the DON’TS
Listen to the SHOULDN’TS The IMPOSSIBLES, the WONT’S Listen to the NEVER HAVES Then listen close to me â
Anything can happen, child, ANYTHING can be
(Iâm not crying. I just have watery eyes from the dry air in the hospital. Why? Are you crying?)
I think we all need to hear this piece of wisdom for the times that we doubt ourselves, our intuition, our calling, our vocation ordained by God. This time, I needed to hear it for Olivia. Because whatâs weird about moms and babies is that even though she is no longer in my womb, we are still so intimately connected. That will continue past this postpartum stage. But right now it is as if I can translate and transfer this wisdom and encouragement to her simply by my knowing it in the same way I was able to pump blood and nutrients to her.
Iâm coming off of a few heavy weeks of negativity and frustration. Yesterday, after a family meeting with Oliviaâs primary teams I left the hospital feeling defeated again. Right when I thought I was out of my funk. On my walk back (to our temporary) home I remembered the Shel Silverstein poem. For Olivia we have heard our fair share of shouldnâts, impossibles, wonâts, and nevers. We have heard them. And Olivia has shown us anything can happen, anything can be.
My apologies for the radio silence – we have had a rough go of it. It took me coming out of this fog that I was in to realize how rough the last two weeks have been. I shared previously that Caseyâs bike was stolen a month ago. Luckily, we have renters insurance and a lot of receipts are digital nowadays so we were able to get some money back to replace his bike with a pretty quick turnaround. For those of you that know Casey, this experience has been pulling at every one of his triggers. Having a bike eased a little of the monotony and helped make him feel less trapped. Shortly after, Caseyâs brand new bike was damaged and his wallet and glasses were stolen. This added even more to the daily stressors of the NICU life and the beginning of the medical bills rolling in.
Although Olivia is now officially weaned off of pain medication, which is a huge relief, other things in the hospital arenât progressing as quickly as before. She is still breathing on her own and she hasnât shown any signs of infection. She is even able to go âoff monitorâ and go on walks around the unit. In the big picture she is doing great. Sheâs even wearing clothes now! But. And there is always a âbut.â But, in order to be discharged without a feeding tube Olivia needs to take all of her feeds by breast or bottle. She is making slow progress, which is putting a lot of pressure on me to breastfeed and pump and a lot of pressure on Olivia to perform and prove that she can take milk from me and from a bottle. We have literally tried almost 10 different bottles in the last few days. The shape of her mouth and a high palette, which is a result of her skin condition, has made eating by the bottle difficult. Each feed is being monitored, measured, weighed. The success of taking a bottle is key to discharge because she will not be able to reach her caloric needs by breast milk alone. Her jaw is still very tight so she has to work hard to be efficient, which burns calories. And, on top of it all, she is getting A LOT of volume to keep up with her caloric needs so she is often gassy and uncomfortable. Needless to say, this has felt like an infinite loop of going nowhere. We continue to adjust and plan and trial and adjust again. Itâs absolutely exhausting. Itâs especially exhausting when youâre sweet 2-year-old champ isnât sleeping well and is fighting bedtime with every ounce of his being.
It was a rough, rough few weeks.
Here we are on the other side of this fog and I can barely believe I held it together. That may be the iced coffee I had around 5 PM talking, but things are looking a little clearer now. Casey has his repaired bike back. I have settled into the patience of taking Oliviaâs feeds day-by-day and suggesting small changes as we go. Oscar is getting much better sleep. Each day, I (admittedly often begrudgingly) remind myself that tomorrow we can start again. Truly, this has been the most sacrificial Lent I have ever, ever experienced.
On my walk back from the hospital tonight I was reflecting on why things feel so hard right now and thinking about what helped me get through the last two weeks without a major meltdown. In this hospital stay, the times that things have felt the hardest for me are the times that we are so close to achieving a big milestone: when Olivia was on the cusp of being extubated, when we were waiting for the last plaque to come off, when the humidity in her isolette was being weaned, when she was being moved into an open air crib, and now to get the darn feeding tube out. We can see the milestones coming long before they are accomplished. Each time I wanted more than anything for the waiting to end. I desperately wanted to be at the finish line so we could start working towards the next goal. The conservative moves only exacerbated my impatience. Each accomplishment means that we are that much closer to going home. I just want to hurry it all up here so we can go home and slow it all down to bask in some of that postpartum-maternity-leave bliss that I may never get. Thatâs why these few weeks have been hard. The last achievement before discharge is the one that is taking the absolute longest and requires my proactive involvement.
I just want to go home. And yet I find myself feeling sad about the day that we leave. Some may call it Stockholm syndrome, but really it is just that I have found some really special people. What I am going to say next should be no surprise to a) anyone that has spent a significant amount of time in the hospital and/or b) anyone that knows my mom: What has helped me avoid a total and complete meltdown are the nurses. P.S. my mom is a nurse so I may have a tiny bias because my mom is the best. The kindness and compassion from the staff at the hospital and the staff at the family housing, especially the nurses, is the antidote. Being able to slump into Oliviaâs room or drag my feet through the door at the family housing and be greeted by people that simply understand the struggle that every day brings is refreshing. It is freeing to be able to converse honestly about our situation with no judgment and no offering of solutions or pity. Just open ears. I am still learning how to be of support to families in circumstances like mine, but I have to say I have some astounding role models. Reading through this article Being Supportive: What to Say and Not to Say to Families of Ill Children helped a lot, too.
Oliviaâs most recent feeding trends are increasingly positive and we really are close to going home. The progress that has been made in the last two (!!!) months is staggering. Olivia could not have done it without the love and support from the community of people that are so anxiously waiting to meet her. Thank you for the continued love and support as we patiently prepare for our return home as a family of four.
Warmly,
Natalie
+JMJ+
P.S. The featured picture on this post is of Olivia’s first walk around the NICU with some of her primary nurses. The one in the maroon would be especially proud of my accidental punny title.
Special Prayer Intentions: Oliviaâs feeding, my patience, all families of babies in the NICU, and the continued wisdom of the nurses! Our Lady of Mercy, pray for us!
Yesterday, February 19th was Olivia’s due date. We have been here for 8 weeks and we have experienced a fullness to life that I could never have imagined, but seems to only come in these few times that life and death are so closely intertwined. How appropriate – perfect even – that we are here during Lent, the liturgical season where we are reminded that we are all dust and to dust we shall return. This has truly been one of the most humbling and grounding experiences I have ever encountered. A constant reminder to embrace life, find joy in the simplicity, and strip away the excess. Living out of a tiny room with just a backpack I packed in a hurry two months ago helps with that, too.
Olivia is doing really well. Honestly, she is doing better than we could have ever imagined. Because of this, people at the hospital are starting to share with me their experiences from when Olivia was first admitted. Yesterday, one of the dermatologists said, âI do not in any way want to down play everything you guys have gone through because it has been a rollercoaster, but Olivia has done so much better than we could have hoped for.â A few days ago the respiratory therapist that took care of Olivia the first day she was in the hospital said when he first saw Olivia he broke down in tears. He knew he had to pull it together because we were coming in from Monterey and hadnât really gotten to see her yet. He was so sad for us. He told me this as we stood over her open isolette looking down at her big eyes, cooing and bringing her fist to her mouth. She has done so much better than any of us even knew was possible during those first days. December 26th and the days that followed were filled with so much uncertainty. There is still uncertainty that looms, but it is an uncertainty about what life for Olivia will look like instead of an uncertainty about life without Olivia.
It was uncomfortable to hear from doctors that we had a diagnosis, but the condition is so rare that the basic science behind the disease isnât understood. Each baby with this condition has a different set of variations in the DNA since itâs a double recessive genetic disorder. The recessive variant I gave her and the recessive variant Casey gave her are different (because we arenât related â whew!) so the resulting combination is one of the reasons for all of the unknowns. We donât know why plaques build up in utero. We donât know what her skin will look like or to what extent it will improve as she gets better, if it will get better at all. We donât know if developmental milestones like crawling and walking will be delayed because of damage done by the plaques. And because babies with this condition used to die within the first days to first month of life, there simply are not enough known cases to even make educated guesses. The doctors did a great job at focusing on what is known about her condition and being honest enough to admit that there was a lot no one knows.
Late in the night of December 26th, after Olivia had already made it to UCSF, Oscar was finally asleep at home, and we were still too shocked by the dayâs events to go to sleep we sat in our living room and talked. There was a peace we had because we knew that Olivia had a spirit that was going to teach someone something. Our conversation kept coming back to the fact that even if Olivia didnât make it, her short life would not have been a waste. Two months later, we know that Olivia has touched more lives than we could ever have imagined and she still has a lot of life ahead of her! Our hope is that from her fantastic and innovative care at UCSF, plans of best practices can be shared with other hospitals to treat similar cases so that other children can blow nurses and respiratory therapists and doctors away the same way Olivia has. Oliviaâs spirit, her soul, has always been palpable from the moment she was born. That spirit has attracted fierce advocates and loyal champions. She is one popular lady in the NICU! Olivia is so deeply loved and for that we are grateful.
This week we are focusing on breastfeeding. The goal is for her to get all meds and food through her mouth before we go home. We still do not have a discharge date and we will likely not have one for a couple of weeks. But we are talking about weeks now, not months. That is a relief for me because as Olivia has stabilized and developed more and more into just being a newborn, I am getting increasingly annoyed at having to live by the schedule of a hospital. My days are dictated by feeds that are given every three hours, and rounds that happen in a two-hour window in the morning, and hurrying up to wait around to just be getting ready to leave and running into doctors and nurses in the halls that I need to talk to. This schedule is hard enough on its own, but adding in the complexity of splitting time between Oscar and Olivia is starting to really weigh on me. Oscar still hasnât met Olivia due to the visiting restrictions during flu season. This is just not how I envisioned our first months as a family of four. I know we will eventually get that time of soaking in the sweetness and slowing down, but I know that on the other side of the NICU is getting back to work and adjusting to life with a newborn that has complex care regimens.
This Lent I am learning how to let go and focus on the tangible things around me. I am trying to remind myself that I will eventually have some control back about how we spend our days or what is applied to Oliviaâs skin and her food wonât be automated through a tube. Eventually I will be able to have both of my kids in one room. My hope is that in the moments when I am feeling overwhelmed by the noise or frustrated that I havenât been able to go on a run in weeks, I will be able to slow down and be reminded that in these long days in the NICU all I wanted was to have my family in one room. A reminder that we are all dust and to dust we shall return.
Blessings,
Natalie
+JMJ+
Â
P.S. Please join us in praying the Our Lady of Mercy Novena. We started yesterday, on Oliviaâs due date, but itâs not too late to join us! Itâs easy â just pray this prayer once a day for nine days:
Our Lady of Mercy, Immaculate Mother of God, hear our prayer. You responded in love to the captives who cried out to you from their  oppression, breaking the chains of their bondage. Be with us as we seek to be heralds of God’s love and freedom. The Word of God became flesh through your fervent and pure love. We ask you, dear Mother, break the chains of our slavery (mention in silence any need or difficulty) for free of them, we are able to imitate your Son, Jesus Christ.
Amen.
Special Prayer Intentions: Oliviaâs continued growth and success, all families of babies in the NICU, our patience as a family as we are displaced a few more weeks, and for Oscarâs sleep!
Since our last update, some very exciting things have happened! The reason that this is a little late is because I wanted to wait to post until after the meeting we had today.
First the stupid stuff: Caseyâs bike got stolen and I got sick AGAIN. Womp womp. Super lame. We are recovering, but I am probably most bummed about Caseyâs bike. That was his affordable healthy outlet and quick transportation around the city. We are in the process of filing a police report and a claim with our renterâs insurance.
But onward and upward!
Oliviaâs room is off of contact isolation. This means no more sterile gloves, no more gowns, and no more sterile water and wipes. Although Olivia still has a feeding tube, her feeds are increasing in volume and decreasing in duration. We have had some really promising moments breastfeeding and she is taking a bottle well. Due to her high caloric needs, Olivia will likely need to have a few bottles a day to supplement what I am able to provide breastfeeding. Olivia is also able to get tub baths now, which is great because tub baths are so much more effective for exfoliating and cleaning her skin. Most of the plaques have now come off and we can really see her eyes, ears, and nose. She needs less and less outside support for her breathing. The humidity in her isolette is gradually being weaned so that she can be in a regular crib. This is new territory for the NICU team because they do not usually keep a 38-week (gestational age) baby in an isolette for this long. But Olivia loses fluids through her skin at a rate that typical babies donât. I feel so thankful for a group of doctors and nurses that donât want to rush through anything and really does let the baby, the person, guide the decisions. And Olivia really does show us when it is time to move to the next step.
The meeting today was about the milestones Olivia needs to hit before being discharged (no more apneas, no longer dependent on a feeding tube and tolerating all her feeds, and acclimating to life outside of the isolette) and preparing us for what life will be like when we go home. We still donât know exactly when that will be, and it is both exciting and scary to think about being home without the hands-on support of the incredible nurses at USCF. Life will eventually go on and we will find our new normal, but I know it will take a lot of time and patience. And lots of doctorâs appointments. Realistically, we will be here through part of March.
The last weeks havenât brought good news for just Olivia though. When we were first touring the housing facility where we have been staying, Anna, our tour guide, was saying that when they built the building they had purposefully set it up so that little âneighborhoodsâ were created. I kind of (internally) rolled my eyes when she said this. Would we really get to know anyone that well? I should know to never underestimate the power of community.
A few weeks back we excitedly welcomed one of two twins to the floor. His brother is still in the same unit as Olivia, but this twin gets to be snuggled with his mama and go and see the world! On Saturday night we celebrated with a family on the floor as their 16-year-old daughter was in recovery from a double lung transplant. They have been here since this fall waiting for the phone call and finally it came. Within hours of the phone call, she was being prepped for surgery. Her father was bursting with joy as he shared the news with us â a joy that I donât think I have ever seen before. A burden had been lifted from him that you could physically see. We hugged and laughed, wiped away tears, and congratulated him.
Just days before he had seen me with a luggage cart and excitedly asked if we were leaving. See, around here, as much as you cherish these friendships you have forged in the midst of hardship, in the end you want so desperately to say goodbye to each other because that means that our babies are okay. I told him, no, we werenât leaving yet. We were just bringing in some stuff from the car. Last night, as we were leaving the kitchen we wished 5-year-old Isaac good luck and shared our prayers with him because this morning he had open-heart surgery. Today I ran into his dad, grandma, and little sister in the hospital elevator. Isaac had his surgery and is stable this evening.
This road can be so lonely, but these little âneighborhoodsâ within a temporary living facility have come to be a shining light for each of us. As Dorothy Day wrote, âWe have all known the long loneliness and we have learned that the only solution is love and that love comes with community.â
Blessings,
Natalie
+JMJ+
P.S. If you arenât an organ donor, please reconsider and go sign up. Right now. Your lungs could be the second chance at life for a 16-year-old. If you havenât donated blood in awhile, go and do it because that blood may be the transfusion a little 34-week corrected gestational baby may need to fight through the night.
Olivia is a month old! And we have been here for a month.
Every milestone brings conflicting feelings.
That is much longer than I ever expected to be here. But I have learned to throw expectations out of the window. Thanks coyote wisdom (for more on that, click on over here). We still donât really know how much longer we will be here and, really, I am not sure anyone would be really able to tell us that anyway so I donât even ask.
Each day I hear from at least one person exclaiming, âwow she looks so good today!â or âI canât believe how much better she looks than the last time that I saw her.â I find myself saying similar things and a few days ago I admitted to one of the nurses that I am not really sure why I keep saying that. Olivia amazes us with her progress in one way or another every day â sometimes more than once. I really shouldnât be surprised anymore. We joke that all Olivia knows how to do is make big strides. Thatâs all she has done her whole life. We imagine her saying to herself, âGuys, I got this.â Casey and I nervously laugh in fear and excited anticipation when we think about our future with Oscar and Olivia because so far they both have bigger personalities than we could ever take credit for. Itâs okay, guys, we got this.
And at the end of that sentence I exhale a sigh as the smile fades off my face. We are tired and some mornings it musters everything in us to make the (short) trek to the hospital to do âitâ all over again. I know that some of the therapeutic-trained folks around the hospital are concerned about whether or not I am really coping in a healthy way. People continue to give me permission to cry or have bad days. They keep telling me that itâs okay to show that to the hospital staff. I always kind of smile and nod at them. I know that I am not showing the emotion outwardly, but I am feeling the up and down and every curve of this rollercoaster. And I am processing it inwardly until I am ready to share. I am learning that I am a very private person and what I share with a complete stranger is far less emotion-filled than what I share with those closest to me.
This realization has made me deeply thankful for our community near and close, far and wide. Casey and I have spent the last year thinking about the true purpose of community and the gift that comes from radical hospitality. For those that have visited our blog you may have seen a quote at the top of the page by Thomas Merton: âWe do not find the meaning of life by ourselves alone â we find it with another.” I have it written on the whiteboard in our room, too. Earlier this summer, around the time I found out I was pregnant with Olivia, I shared with friends a similar quote by Dorothy Day: âWe have all known the long loneliness and we have learned that the only solution is love and that love comes with community.â We believe that it is within our communities that we find our identity. It is coming side-by-side with those that we are in relationship with and staying there. At this season of our life, these quotes have layers of meaning. I know the professionals are there to help me through my bad day, but I am one of the lucky ones that have a multitude of people around me that are truly committed to community and the beauty of being in relationship. What is jaw dropping is the way in which complete strangers have also stepped up to offer support. If anything, this experience just casted a wider net for what Casey and I get to call our community. I know the hospital staff is there when we need them, but so far our whole family have been taken care of in ways that we didnât even know were possible. To that, we humbly and gratefully say thank you to each and every one of you. Thank you for your generosity, your prayers, your hope, and your willingness to be in community with us.
For those of you that follow Casey or me on our social media accounts, you may have seen a post I shared recently about music therapy. Olivia is still on pain medication and some days are better than others. We have been talking to the Music Therapy team for a few weeks and they finally came in to see how she would respond to some tunes. They were pleased with the results. When they found out Casey is a musician they suggested he play for her, too. We all agreed itâd be good. But none of us knew how good. In the first moments of Casey strumming the guitar and singing, Olivia turned her head to look at him, settled in, and her heart rate dropped and stabilized. Olivia has now been prescribed what I call âmusic medsâ a few times a day. Itâs a special time for us to share as a family as I am holding her and heâs playing for her. Itâs healing for us all.
Thank YOU for your role in helping our family cope, heal, and transform.
Yesterday marked three weeks outside of the womb (and inside the NICU) for Olivia. This makes her corrected gestational age today 35 weeks and 1 day. I really cannot believe three weeks have passed since she was born. The NICU is a time warp. I never seem to know what day it is or how many days have come and gone because nights turn into mornings so quickly and afternoons seem to drag on forever. We have made some progress in creating a routine for Oscar thanks to all of the great resources from the nonprofit providing lodging and the Child Life Specialists at UCSF. But for Olivia the last week and a half was really hard. Or at least it was for me and Casey.
A few days after my last update, one of Oliviaâs nurses noticed that Olivia wasnât acting like her usual feisty self. She wasnât moving her little arms and legs around as much and her heart rate was elevated. As suspected, it was confirmed through blood cultures that Olivia had an infection. More consultant teams were called in, like pain management and infectious disease.
It was tough for us to go from seeing so much positive progress day-after-day from her first days in the NICU to almost a week of Olivia just âdoing okayâ. Her infection put a stop to a lot of the big strides that she was making and there were setbacks to her breathing and feeding. The possibility of getting her breathing tube removed (a key step in getting to hold her) was put aside until things improved. Her feeds were decreased, which affected if and how she was getting other medications. Each evening I left the hospital feeling empty.
Slowly things did start to improve and on Sunday afternoon Oliviaâs breathing tube was finally removed. This was a huge milestone for Olivia. And I finally felt relief after she was successfully off the breathing tube for 24 hours. We are now able to hear Olivia cry and make those sweet newborn noises. And yesterday, three weeks after she was born, I finally got to hold my daughter for the very first time. I am grateful for each opportunity I have to hold her, but it came with its own complex range of emotions. A sense of relief and purpose came over me once she was placed in my arms. But that feeling has been shadowed by the fact that when I hold her she is still connected to machines and there are layers of blankets and mattress between us. I have to wear sterile gloves and a gown to be able to touch her.
The progress of her skin has been remarkable. As we shared previously, Olivia has a rare genetic skin disorder that resulted in her being born with thick plaques all over her body. This is because her body creates too much skin too quickly and she canât naturally shed it like the rest of us. A major focus has been gentle exfoliation and daily baths to remove the plaquesâa routine that will continue after we leave the hospital to avoid skin build up again. Olivia is slowly emerging from under the plaques and every day she shows us a little more of herself. We are back on track to finding little wins every day and I will cherish each as this trend lasts. Good news is followed by bad news that is followed by good news. And sometimes news is just news. The thing with the NICU is that you truly have to take life moment-by-moment. So thatâs what we will continue to do.
I have been struggling to provide an update about our Olivia Mercedes because I am trying to strike a balance between two things: sharing enough information so that people feel âupdatedâ and not over-sharing in protection for the dignity of our daughter. Mix into all of that the fact that everyday we receive mountains of information from various teams of doctors and specialists. Granted, a majority of this information lately has been positive and hopeful, but there are still pieces that are unknown and no one has the ârightâ answer.
There are teams of specialists that come in on a daily basis, including orthopedic surgeons, respiratory therapists, dermatologists, plastic surgeons, neonatologists, geneticists, pain management units, physical therapists. And those are just ones that I remember off of the top of my head.
We have yet to hold Olivia and this might be the most emotional piece of this journey for me. Upon delivery I made the split second decision to have the neonatologist at CHOMP take Olivia away from me and attempt to âmake her stable.â At the time, I honestly didnât really know what that meant.
I barely even got to really look at her before she was whisked away into another room. Not until January 2nd, when she was seven days old, did any of the doctors or specialists or nurses really address giving me the opportunity to hold my daughter. Just hearing someone else talk about it was enough for me to cry in front of strangers, which is probably one of my least favorite things to do in the whole world. I actually donât really like crying in front of anyone, but especially not respectable and intelligent strangers.
Today Olivia is 9 days old, with a corrected gestational age of 33 weeks and 2 days. In all honesty, when Casey and I were packing to come to UCSF I thought we would be home within 4-5 days maximum. We had prepared ourselves for saying goodbye to Olivia and then coming home. We had gotten her baptized before she left CHOMP and I was finding peace in that. In the back of my head I was thinking about the logistics of funeral arrangements for an infant.
So, the update you are probably looking for is this: for a preemie, Olivia is doing well. Her breathing is strong and she may be able to have her breathing tube taken out soon. She is currently getting an MRI done to help figure out when this might beâwhich also means we are one step closer to holding her! Her feedings are also through a tube and they are increasing every other day or so. She is getting my breast milk, which is being fortified with extra nutrients. The complications that require the attention of these specialists are around her skin. Olivia was born with thick panels of plaque all over her body that constrict her movement and have caused some problems around circulation, especially as she has been growing. She is highly susceptible to infection and she has a hard time retaining fluids and regulating temperature. For this she is kept in a humidity-controlled isolette. The plaque has also made putting in lines to put in and take out fluids, meds, and blood incredibly difficult. Underneath the plaque, however, she has ânormalâ skinâthe severity of the condition will reveal itself as the plaque comes off (which is a whole ordeal in and of itself, but it requires more Aquaphor than I knew existed in the world).
We are currently in housing a few blocks away from Olivia provided by a partnership between UCSF and a local non-profit. Casey and I are trying our best to make a routine for Oscar and find a rhythm in the hustle and bustle of the cityâa bit of shock after being in Carmel Valley for so long.
Realistically, we will be temporarily re-located to San Francisco for 3-4 months. This will likely be followed by frequent visits to the city for doctor’s appointments and specialist care.
We are so grateful for the generosity and support we are receiving from our communities. The music community, the people of the Monterey Peninsula, our families and extended families, and friends-that-are-basically-family from near and far, and even complete strangers that have contributed to the GoFundMe.
It has been suggested to us to increase the goal on the GoFundMe now that we know that we will be in San Francisco for much longer than expected. We appreciate prayers for our little girl as she continues to make progress every day.
Specific prayer requests for our family at this time: Oliviaâs fingers and toes and Oscarâs transition to being a city mouse after only knowing the life of a country mouse.
coyotesandsaints.com 