Friday, September 30, 2011

2 mo. old!!

Today we celebrate 2 mo. with Buddy! He is continuing to surprise us with his growth and development. He has more alert moments, and feeding more through nursing and bottle. I think he is somewhere around 40% of his feeds he is taking without a feeding tube. He needs to be at 100% before he can go home.

Last night as we were about to leave a doctor pulled us aside and wanted to have a conversation with us about something they had recently learned in this week's blood work.

Harrison's new born blood screening showed a barely normal thyroid hormone level. It warranted another screening at 8 weeks. So they learned that his thyroid hormone level is in the normal state. This is very, very good news. Up to this point he has not missed a beat. Everything that the thyroid does and tells other systems to do has been happening. He is growing and everything in his endocrine system is clicking.

The one number that was off was his Thyroid Signaling Hormone (TSH). TSH basically stimulates the thyroid to function and keep functioning. Harrison's TSH level was high. High enough to address immediately. He will be taking a synthetic thyroid hormone that will lower this number to help re-calibrate his body. This is one pill per day. And he will need to take this pill for the first year of his life until he is mature enough to come off of it, and see if his body has re-calibrated and okay on its own.

We have been affirmed that he has not been effected developmentally because his thyroid hormone is normal and functioning and will not be effected developmentally because they are treating him. Had they not caught this they would be concerned.

They are attributing this TSH # being off solely due to his prematurity and nothing else at this point. In a year we will re-evaluate with a pediatrician and endocrinologist.

This is definitely something to pray about but we are comforted by the nurses who know Harrison and think that based on all his great progress and development they don't think its anything significant.

Worst case scenario he takes a pill a day for a long time. Best case scenario he takes a pill for around a year.

Another great thing is today he was put on the low-flow cannula. The least amount of respiratory assistance. He has been doing great the last 2 weeks on the cannula and they have been lowering periodically his pressure the past 2 weeks. Today he is basically receiving O2 with no pressure. He will continue to be on the low-flow through his stay and we have been informed he will probably be on O2 until he reaches sea level at home.

Happy 2 mo. Buddy! We love you.

Tuesday, September 27, 2011

For They Shall Be Comforted

A few weeks ago Miles, our director at UNC, asked us to film a short video of ourselves he could use in a talk at our weekly meeting. Cornerstone at UNC is going through a series on the Sermon on the Mount in Matthew 5. It was a great way for us to make a contribution, process what we are learning, and introduce ourselves to new students.

Here is the end result...

Monday, September 26, 2011

Pictures from the past few weeks

From Three to Four Pounds

Well, he did it. We are pretty amazed. 58 days later he has gained 2.5 pounds to round out to an even 4 pounds.

Erin had a good long hold with him tonight and daydreamed with him about going home.

It took him 15 days to go from 3 to 4 lbs. This went really fast. A few more weeks and maybe another pound or so and we might be out of here. It is pretty ridiculous to see so many steps of progress he has taken.

Saturday 9-10: Turned 6 wks old, 33 wks gestation.
9-11: 3# and came off the CPAP mask onto the nasal cannula.
9-12: Nursed for the very first time with Erin.
9-18: 3# 9oz.
9-20: 3#10 oz.
9-23: 3# 12oz. Took his first attempt at a bottle. And in 15 min he tagged a full feed 33ml or 1.1oz.
9-24: 3# 14oz Turned 8 wks old 35 wks gestation.
9-25: 3# 15oz
Today 9-26: 4#!! Moved from his isolate to an open air crib.

He has been eating in 3 ways since last Friday. Nursing with Erin, taking a bottle, or through his feeding tube. It is based on his cues and how alert he is when his care time shows up. All premies go home bottle feeding, because we won't be able to know how much they obtain while nursing.

We are pretty excited about his progress and hopeful for the next month to go quickly.

Wednesday, September 14, 2011

Harrison Cole Smith

Many have inquired about the origin of Harrison's name. It took us about a month or longer to settle down on a few finalist in the process. Naming your child was harder than I thought it would be. Especially with the last name Smith. Had to be original and different. Couldn't be Joseph or William. Both liked by Josh and both taken.

We both really liked it from the beginning. Neither of us had any direct affiliation with a Harrison we just liked it. So no, Harrison Barnes isn't a direct influence and we will probably have to fight that off until after the Tar Heels win the championship next April.

Basically, we just liked it a little more than a few others. What sold us on the name was when we were having a conversation over dinner in KS last June. The topic came up and my dad informed us that Harrison was a family name on his mother's side. I have 2 older brothers and they have 3 boys between them so all the immediate male family names had been taken. My dad went on to tell me that his grandfather was named Henry Harrison Starkey. Sold.

So we landed the plane on that name real quick after we learned that fact. Shortly after we found some documentation in my dad's files.

Here is a small section of a 5ft document of my family tree on my maternal grandmother's side. My father is Quentin Smith. Not sure why JOSH is in pencil and Abe and Ben got left out there. Sorry bros, ask dad about that one.

And here is a pic of Henry Harrison Starkey with his bride Anna on their 50 year anniversary April 24, 1960.

Cole is a derivative of Erin's maiden name Coltrane. We loved that name too and thought it was very fitting middle name. And it sounds great.

Harrison Cole Smith we are grateful for you.


Continued Steps of Growth

The days are really long, but the weeks are going fast. Last Saturday Harrison turned 6 weeks, 33 gestation. A lot has gone on the past few weeks and all of it good. We've had visits from Erin's mom and Josh's folks. And tomorrow Erin's dad is coming.

Last Friday September 9, Harrison went from the CPAP mask to the High-Flow nasal cannula. It's a regular clear tube that you would see an adult would wear. He has been very stable and comfortable on this. The cannula falls second on the tier of respiratory assistance.

1-Low-flow Cannula - no additional pressure, only mixed O2
2-High-flow Cannula - small amount of pressure with mixed O2
3-CPAP- substantial amount of constant pressure
4-Si-PAP- substantial amount of constant pressure, with pulsating bursts, with mixed O2
5-Ventilator Intubation - tube installed in trachea breathing, completely breathing for patient.

This is the ladder Harrison has climbed. Over the last 3 weeks Harrison has gone to the High flow cannula from the ventilator and has been showing great signs of strength and growth. Prayerfully, he will continue to progress and only need a little mixed O2 as he continues. Today they lowered the pressure by 1/4 the strength to ween him some and continue to encourage him to do more on his own. He will probably be on low flow until he leaves the hospital. It is likely he will need assistance until we descend from altitude.

Another exciting sign of progress is that Harrison has been eating like a champ. One of the nurses told us, generally speaking, a pre-mie usually has digestive issues or respiratory issues and rarely both. If the doctors and nurses could pick they would want a baby to have respiratory because over time the lungs do develop. But if a baby doesn't eat, or can't digest it obviously makes it very difficult to grow, develop and gain weight. So Harrison has needed help breathing but he is getting stronger in this area. We are glad he has a Smith appetite.

Monday Harrison actually nursed with Erin for the first time. It was a trial run and we did it simultaneously while he was being fed through his feeding tube. He goes as long as he can, usually until he falls asleep which is about 10 min. But it was a huge success!! Nurses were so impressed since he is only 33 wks. And they say this is huge milestone, because he may be able to go to a bottle or nurse sooner and consequently gain weight at a quicker rate.

Harrison needs to start producing his own red blood cells. Last week, his hematocrit was 27. Just on the edge of being normal. So they didn't transfuse him or give him any epogen shots. They want to see if he can do it on his own. This week he has not shown any signs of being anemic. Good color, good O2 saturation, and not laboring too hard while breathing.

We haven't had a bad night since the night he went on the ventilator several weeks ago. It's been a steady rate of progress. We just want him to keep gaining weight. Last night, he was 1405 grams or 3lbs 2 oz.

He is doing great and we don't want to get too far ahead of ourselves. We've kind of had 34 weeks in our mind as a goal to reach because doctors feel comfortable delivering a baby early if there are any complications in-utero. So we are almost at that point now. All his vitals, head ultrasounds and blood work has been really good.

Please continue praying:
-Weight gain
-Progress on nursing and bottle feeding.
-Good respiratory development and strength and that there would be no set backs in this area.
-That his hematocrit (red blood cells) would develop on his own.
-Our attitudes and homesickness as we continue on for potentially 6 more weeks.

Josh and Erin

Sunday, September 11, 2011

Day 43 and 3lbs!!

Lets get some weight on that length!

Momma time - 1

Momma time - 2


Granny Smith time - 1

Granny Smith time - 2

Granny Smith time - 3

Extreme Close-up. Probably Josh's favorite picture yet.

Momma Time - 3

At certain points in the day we catch him so alert!

I guess it's official.

Friday, September 9, 2011