another niece on the way!

It's time, it's time!  Baby Cate is finally going to make her arrival tomorrow!! I'm so excited to meet her!!!!  My dear sister-in-law's due date was February 21.  A whopping 8 days ago.  Since she had a c-section with her first child, her doctors have been trying to avoid inducing her.  But after no progress this week, she finally got admitted this evening and is having a balloon procedure done overnight and then the plan is to induce her in the morning.

I had to work all last weekend, and although I'm anxious to meet my newest niece, I was afraid she would come over the weekend when I'd be stuck at work.  Well, I'm scheduled to work tomorrow also but thanks to a dear fellow nurse, I will get to leave at 4pm.  Thank you so much Sara!!  So I'm hoping to hop over to Brookwood when I get off work and hang out in the waiting room with the rest of the Boggs crew.

I can't believe she's finally going to be here!  We've all been so curious what she's going to look like.  Evey (our first niece) is a miniature version of her mama, and Bennett (our nephew) is a spitting image of his daddy. So, who will baby #3 look like!? :)

So, in honor of welcoming Cate to the world, let's take a walk down memory lane with Evey and Bennett :)

Now I didn't meet Greg until January 2010, so Evey was already 2 years old when I met her. But here's some baby Evelyn Grace (Jordan, I snagged all these from your facebook, hope that's ok!)

 

then along came Bennett Callaway...

 

We are all ready for you Cate! See you tomorrow :)

an afternoon with Evey

This morning I woke up and literally had not one thing I absolutely had to do today.  Sure, there are always bills that could be paid or errands I could run, but nothing was necessary for today's agenda.  While I was lying in bed doing my typical morning blog reading, I read my sister-in-law's post about "waiting around" for baby Cate, who's due date was yesterday.  Yep, we have another niece on the way and she's taking her sweet time.  For someone who works with premature babies, it boggles my mind that babies actually come after their due dates!  I mean come on!  We are WAAAITING for you :)

So, while waiting for our newest niece to make her arrival, I decided today would be a perfect day to spend with our 1st niece, Evey.  Plus, I knew Jordan would probably welcome any break from the kids these days!  So after getting the ok from Jordan, I picked Evey up from their house when she got home from school and brought her back to "Amy and Bubba's house."  And yes, Evey refers to Greg as "Bubba."  She decided that was his name one day (when she was still a baby, basically!), and he's been uncle Bubba ever since!

She was SO excited when I drove up to their house. Her and Jordan were waiting outside and she was jumping up and down with excitement literally until I strapped her into her carseat.  And we had so much fun all afternoon :)  We took Sophie (our hound) with us on our walk to the park, played on the playground, came back to the house and watched some Bambi, took all 3 dogs out to the field by our house so Bubba could throw the ball with them, and then watched half of Little Mermaid before all 3 of us (humans, not dogs!) went back to her house for dinner!  What a day!

We loved having her over to play! And I'm pretty sure she had a great time too.  She fell asleep on the car ride home, so I'd say it was a success ;)

She walked Sophie the whole way home from the playground.

 Trying to take a picture with Sophie...

I think Evey found herself a new friend!

sweet little miracles

**Warning! I want to show you some pictures of premature infants...if you are not comfortable with this, this is your warning! I will stick with the PG version, but this is what I work with every day, so what I'M comfortable with may not be your comfort level!*
While I'm on the topic of work, I want to take a few moments to share about my job.  Working in a neonatal unit is kind of top secret.  Like most NICUs, I work on a locked-down unit, meaning only certain people have access to it.  Parents of our little patients, the guests they bring with them, and Women and Infant's staff are pretty much the only people allowed on our unit.  They do this for security reasons.  In the old days, hospitals had large nurseries and you could peek into the windows and see the babies.  Unfortunately, horrible people in this world attempted and sometimes successfully stole babies from hospitals.  So now our precious babies (both full term and premies) are in locked units.

That being said, not a lot of people besides those who have been involved or had experience in the world of the NICU know what I do or get to see the little patients I work with each day.  Obviously, I cannot show you actual UAB patients, or discuss actual cases for the sake of confidentiality.  However, thanks to the internet world, I can show you other premies and tell you about some general neonatal knowledge and share with you all the wonderful work that I love to do!  And I love to talk about it, so if you're willing to listen (or read!) then let's go! :)

A baby is considered "term" if they deliver anytime after 37 weeks gestation. Full term (meaning a mother's due date) is at 40 weeks.  Pre-term is obviously anything prior to 37 weeks.  Thanks to the medical science of neonatal medicine, it is possible to deliver a baby as early as 23 weeks and they still have a chance for survival.  23 weeks means delivering at only a 5 1/2 months pregnancy!  Obviously these babies have many milestones they have to overcome in order to survive.  They typically need ventilator support to breathe, they often have difficulties digesting the nutrition they are given, they are at very high risk of infection, and everything about their tiny little bodies is simply that...TINY!  A 23-weeker typically weighs about 1 pound, around 500-600 grams.  They fit in the palm of your hand.

Everyone remembers baby Josie (19th child of the Duggar family).  She was born at 25 weeks weighing 1 lb. 6 oz...

Here's another 25-weeker (who was only 15 oz. at birth). He is 1 week old in this pic...

There is a vast degree of developmental changes that occur between 25 and 32 weeks gestation.  The most significant challenge for these infants is breathing.  Their lungs lack the intricate branches that are used for ventilation.  Another challenge is eating.  Until infants reach at least 32 weeks, they don't have the neuro-development to coordinate breathing and swallowing at the same time. This means until our babies reach 32 weeks adjusted gestational age, we provide all their feedings through a feeding tube either through their nose or mouth.

Once they reach 32 weeks, we can begin introducing the bottle.  This can be a smooth and quick process, only taking a few weeks for the infant to fully transition from tube feedings to bottle feeding. Or it can take many many weeks.  Typically, the more neurological challenges the infant has faced the more challenges they face with learning to eat.  Brain bleeds are common in premature infants (Intraventricular Hemorrhaging, or IVH).  Infants with larger, more severe IVHs have more significant neurodevelopmental issues.  A large portion of my job consists of working with teaching infants how to bottle feed.

 Also, premature infants have difficulty maintaining their heart-rates at times. They frequently have bradycardias, where their heart rates drop below 100 beats per minute.  They often receive medication that helps them maintain their heart-rates, but in order to go home they must be weaned from this medication.  It's all a matter of time with most these infants.  They also have to grow and be able to maintain their own body temperature.  Typically when infants reach around 1600 grams (about 3 1/2 lbs), they are able to maintain an acceptable temperature, at least 97.6 degrees F.  At this time we begin to wean them from their isolette to an open crib. But until that time, the isolette heats and cools to maintain their temperature.

There are SO many other things I could tell you about my day to day duties at work, but I don't want to completely overwhelm everyone.  So in a nutshell, here's a typical day...

• get report at 0730 on the 3 or 4 infants in my daily assignment
• first "round" begins at 0800 with whoever eats first.  Our babies eat around the clock, every 3 hours.  So, there is always an 0800, 0830, 0900, and 0930 infant I round on, and then the cycle continues every 3 hours from that at 1100,1130, 1200, 1230....and so on.
• Infants on oxygen get vital signs written every 2 hours.
• Oral medications are typically given at feeding times closest to the meds' dose time, with the exception of IV medications which are given within 30 mins of whatever the dose time.
• Full assessments are done during the 1st round.  Continued assessments are done throughout the day and changes are charted accordingly.
• Labs are run typically on PM shift, but on day shift as needed.
• Some infants eat entirely by feeding tube.  Some eat by bottle once a day, twice a day, or as often as tolerated depending on how far they are in their development.
• Babies are weighed every night, either the last round of day shift or the first round of night shift.
• Speech and physical therapy work with RNs to help infants grow developmentally.
• The day runs fairly smoothly unless an infant show signs of illness or worsening conditions.  A "work-up" is then done which can be as simple as a few labs, or as complex as chest and abdominal x-rays (typically with breathing or digestion problems), lumbar punctures, and changes in medications, sometimes starting IVs for initiating antibiotics.
• And most importantly, working with parents and teaching them all the things they need to know about taking care of their baby.

Whew. How about that!? So I'll leave you with some of my favorite pictures I came across today, all of which are very typical of what I see and work with every day!

night shift vs. day shift

I feel like I've complained about work a lot lately to Greg.  Adjusting to day shift has been rough.  I worked as a night shift nurse for 3 years, and then shortly after we got married in October, I was offered a day shift position.  Although I never really hated night shift, I took the position (cause I knew if I turned it down, it could easily be 5+ more years before I got asked again!).  And night shift definitely had it's downsides.  Some days I could come home and stay awake and have a normal day (sometimes being awake for 24+ straight hours).  I'm pretty sure I pushed it to 30 hours a few times, which I'm sure is SOOO not good for your body, or mind, or overall health.  But I would hate those days that I was so tired I just couldn't stay awake and would have to sleep through my off days.  When you work night shift, you essentially need 2 off days to feel like you've had a break. And I spent so many hours awake at night and you can't do much at night. No stores are open, and you can't run errands.  Housework and laundry is about all you can knock out late at night/early AM.  So, I was ready to give day shift a shot!

The annoying thing now though, is I STILL cannot wake up at a decent time.  On my off days, I'm lucky if I make it out of bed by 10am.  It's almost always 1100-1230 before I'm up and awake.  That's ridiculous.  And waking up at 630AM is sooo much harder than waking up at 530PM.  I really thought by now I would be doing great in my day shift schedule and I'd be up bright and early every day...maybe not at 630am every day, but by 9am at least on my off days. Nope.  And it's a different kind of tired.  Night shift tired is almost a painful, dizzy, sick-like tired. My current state of tired is a simpler tired, but I end up wasting just as much of my day as I did before, if not more!  Oh, and did I mention night shift PAYS so much better!  Yeah, that hit our bank account hard.  One of these days...ok, years...we're gonna want babies of our own.  And we need to be saving for that now.  But that's not happening :/

I know working night shift over long periods of time will wear and tear on your overall health far more than keeping a normal day shift schedule.  Research shows night shift workers age quicker and are more prone to illness  and other health issues.  So I am a battle point these days.  Night shift or day shift?  Which is really better?  Clearly they both have their pros and cons.  But which carries more weight?  I'm not sure I really know.

One thing I do know, regardless if it's at night or during the day, I love looking at these sweet little faces every week!! (and no, these are not UAB babies!  I'm HIPAA compliant!! These images were just pulled from the internet)

 

I love the actual work part of my job! :) And it helps with my baby crave! haha. If I didn't work with these little ones all the time, I would really be itching to have one of our own!!!!  But they help make it ok to wait :)

Room updates!

A few weeks ago we had some pros come in a do a little re-wiring of our master bedroom TV.  Here's where our TV lived before....sticking out from the wall right where you walk into the room. Ok, so this is not the best picture, this is from December. See it in the top corner there? To the right? Basically, it stuck out about a foot from the wall...and all the wires were exposed. Meaning the cable wire ran down the wall, into my closet, over the door frame and back behind our dresser on the other wall.  Also please note the blanket that used to serve as our window treatment....

 Here's the wall...(with the crazy cords, and then minus the tv)

We made the decision to move it permanently to the corner opposite the bed.  That meant calling in the pros so they could run the wires behind the wall where they belong.  So now, here's our set-up...

It's a minor change but we love it so much better!!  And note the new window treatments :)  No more blankets covering the windows.  And while we are on the subject of upgrades....let's talk about the master bathroom...

Remember this picture from last spring when Greg decided to demo the bath?

Although I would have loved to make it look something like this...

Our bathroom is just WAY too small.  Every square pedestal sink we looked at was a good 6 inches too wide for the space.  So, we had to go with a tiny round one.  But who knows, maybe one day we will put some beadboard in there!  But, after a new coat of paint, new toilet (from ReStore), sink, light, and medicine cabinet (from Lowes), and some hardware (from Target and Hobby Lobby), 6 months later Greg's bath is coming along nicely!

And the guest bedroom is finally useable!  It went from this cluttered mess (and this is after moving stuff into our outdoor shed)

 

 To this!

 Buuuuut, don't look at this corner!  haha.  It's a slow process ;)

 Baby steps, people.  By the time I'm "done" with the house, we will probably be ready do move. Isn't that how it always goes?  And I have all kinds of outdoor plans in mind, but this weather has got to warm up before we tackle any of that.

my sweet Valentine

Our first Valentine's Day as Mr. and Mrs. went very well.  We decided to do our Valentine's date last night.  My mom had given us a gift card to Village Tavern at Christmas, and we saved it for this date :)  But wait, let's go back to yesterday morning. I slept in, as usual.  When I woke up I found this in the kitchen...

 

Beautiful roses and chocolates!  Gooood Ghirardelli chocolates :)  And a not-so-sneaky husband. haha, I kinda caught him in the act while he was laying the card out.  The rest of our day went about as usual.

Before we headed out to dinner we wanted to exchange our gifts we had gotten each other.  For Greg, I printed this picture of him and all his groomsmen and framed it in a nice leather frame to put in his office...

And he bought me some Valentine's scrubs!  He knows how much I love my holiday scrubs :)

Dinner was delicious!  We ate some steaks and potatoes, salad, and we wanted to get some dessert at the Cheesecake Factory, but we were way too full after our awesome dinner.  So we just headed over to Hoover to see The Vow.  But before that we stopped by Cajun Steamer to visit our friends who were out celebrating a birthday. It was nice to have time to stop by and visit between dinner and the movie.  Ok, so about The Vow.  I won't say too much about it so I don't give anything away, but I enjoyed it!! Greg got a little frustrated with it, but still liked it.  It was a sweet story, and it's a true story!

So today, on Valentine's day, we asked our friend Michael over for dinner.  I made meatloaf and roasted red potatoes. And we actually sat at our dining room table for the first time :)

 And dinner wouldn't be complete without these yummies!

So I would say we had a wonderful Valentine's Day this year!  I love my sweetie and am so thankful to have him in my life :)  Happy Valentine's Day everyone!!