Thursday, October 30, 2014

Thursday 10/30/2014

As they say in the NICU -- One day at a time...  

Mixed emotions today.  Ava has been doing great with weening the oxygen and nitric. Oxygen levels are at 35% and nitric levels are at 10%. 

They have also made additional changes to the vent. 
From 26 to 24 on the pressure support
From 32 to 30 on pressure control

Which are all good thing, but she is just not taking well to the feedings this far. She had a hard day with a lot of throwing up - which they can't really explain at this point.  They did another X-ray at 6/00 this evening to ensure there was nothing out of the ordinary.  They have stopped feeding her the breastmilk and continued with the Gatorade cocktail for now so they can figure out what is going on.  Another X-ray first thing tomorrow morning will help to determine any issues. 

I did get to hold her for a few minutes today but she started getting sick again and they had to quickly put her back in the bed.

Hard to take a setback after such a great couple of days.  So goes the nature of the NICU.  

She has really dark blue eyes like Ryan's but looks like a mix of the two when looking back at baby photos of the boys. All of the nurses say she looks like Daddy.  

Matthew and I did have a little break tonight and got to see what Olivia Pope was up too in the White House.  

Xoxo









Wednesday, October 29, 2014

Wednesday 10/29/14

Another great day for Ava Jane!!  She has been able to ween down the oxygen assistance from the ventilator to 40%!!  They have will continue to decrease by 5% until she gets to 20%. They have also begun weening down the nitric oxide and she is at 15% on that. They removed the central line that was in her belly button which they derermined was no longer needed and did not want any additional possibility for infection.  

So since they removed a major lead, she had been doing so well on weening the oxygen levels -- look what Mommy got to do for the first time today!!!



It is safe to say that today was a very good day!!  

Matthew had to go home and teach his class tonight, so I had some excellent alone time with my baby girl. I got to FaceTime with the boys later in the night and got to send some good night kisses from the iPad -- not the same...  

Looking forward to another good day tomorrow and an even better weekend!  









Tuesday, October 28, 2014

Tuesday 10/28/14

Ava has made it down to 60% oxygen assitance!  Her numbers were dynamite this morning, a bit low this afternoon and back to rock star status this evening.  The docs have warned us that this can be the hard part because it just takes time- for her lungs to heal.  

Her x-Ray and echo from today came back with "mild" improvement which is good- again, slow and steady wins the race.  She has done really well with eating the breast milk kepping down all 10mls they have given her (through the feeding tube).  

The docs also gave permission to take out her back up PIC line.  According to Jill (one of our nurses) this is just a positive sign they are happy where she is at!  From my understanding they were able to put two PIC lines in her when she was first admitted (they continue to use the other).  These are essentially IVs that go deep into your body to larger blood vessels or organ areas.  They are extremely important to get in place on newborns because their veins don't hold up as well- with typical IVs.  Once you get these in they usually always last/don't clog until you take them out.  Anyway, it's important to have access to them but nurses also want to minimize the amount of tubes going in because they are all a risk for infection.  So they took it out!  Removing some of these lines gets us one step closer to holding her as well! 

We are so happy that she continues to have long periods of time with her eyes open and moving her arms and legs.  Docs said this is an great indication that all of her brain functions are in tact.  They will eventually do an EEG to confirm all is ok, this will test the electronic activity of her brain.  Liezel said they won't even attempt this until she is more stable.  

We have been learning the ins and outs of the NICU and how babies get assigned nurses and how the rankings of doctors happens.  I swear I would have been lost if it weren't for Grey's Anatomy!  So I have mentioned a couple nurses several times and wanted to explain.  Liezel is our Primary Nurse so she will have Ava everytime she works for the duration of her stay.  And then Jill and Keri are Ava's Associate nurses.  The two of them hopefully work when Lizel is not working.  All three of them are fabulous!
 
 

I will get into the whole world of Nurse practitioners, Residents, Fellows, and Attendings at a later date -- i have been out of the Greys loop for the past 2 weeks so I need to brush up on who is Meredith, Christina, Mc Steamy, and Mc Dreamy in my new NICU life... 

Mason and Ryan came up again today with Nana and Mimi.  We played for a long while in the Comer's Children's Center- it's basically a children's wonderland full of every kind of toy and activity known to man.  The boys painted rocks, played Halloween bingo and their favorite- rearranged the train table.  We hung at the RMDH and had dinner together...  They are doing great all things considered.  Ryan has started asking, "when is baby Hava done?"  I could eat him up!  

Thank you for all of the care packages, cards, emails, texts, FB messages... Ava is one lucky girl to have so much love and support around her.  So are we! 💗

The happy baby sleep pose... 

Monday, October 27, 2014

Monday 10/27/2014


It was a great day!  Ava not only reached her goal of 80% oxygen - she beat it and was lowered to 78% at her 8:00 gas.  Never in my life have I been so excited to hear about gas!  Her next goal is to get to 60% oxygen.  They will then start weening the nitric oxide as well- which is currently helping to dilate the blood vessels in her lungs.  
They started feeding her breast milk -through a feeding tube.  Up until today she had been on a Gatorade like cocktail.  She has handled it very well!  
Liezel, her primary nurse, also gave her a sponge bath.  She was awake and alert the whole time.  Moving her arms and legs and checking out what was going on!  It's amazing to us how alert she is now even with all that is going on with her.  
Luke came up to meet Ava and we all ate at the house again.  They also had a painting lesson this evening- guess who was first in line!  My kind of therapy!  
So happy going to bed tonight- thank you for all of your thoughts and prayers! 💗

Sunday, October 26, 2014

Sunday 10/26/14



Look who is bright eyed and bushy tailed!!! Ava hasn't made it to 80% oxygen quite yet but she the paralytic drug was not really doing it's job anymore so they turned it off completely. They said this is common as their little bodies grow used to the dosage and they didn't want to give her more.  She is still on pain meds, calming drugs and some sedation.... But she is able to move on her own and open her eyes!  We can tell she knows when we are here with the reactions to our voices.  She was squeezing my fingers and reacting to istouching her toes!  Warms my heart!

The oxygen/ gases game has been tough for Ava- they have warned us that this would be the case.  They thought that she would reach the goal of 80% by tomorrow.  Praying for that!  Excited to see what they will say at rounds in the morning.  

Matthew and I had a good day- both my Mom and Dad came down to see Ava.  Mom helped me do all of the laundry and clean the RMDH room.... Thanks Mom! The boys spent today with Kendra and crew- went to church to pray for Ava (pic in the car) and had a campfire and carved pumpkins tonight.  For some reason I think they are going to think we are borning when we get home! Lol!  

Thank you all for your continued thoughts and prayers!  Xoxo 💗

Saturday, October 25, 2014

Saturday 10/25/14

Ava has made great -small- strides in the last 24 hours.  The next big milestone we are working toward is getting her at 80% oxygen (assistance).  She was at 100% and we have successfully made it down to 88% this afternoon- with keeping her output gas levels at perfect ratios.  Once they get her to 80% they will take the paralytic drug off to allow her to move.  They are hopeful this will be by Monday.  She has started to move a little bit only because they have not increased the paralytic drug with the amount of weight she has gained (due to all of the fluids).  It is so nice to see her moving and reacting to our voices.  Once she is able to move more her lungs will start to clear liquids at a faster rate- and heal a bit quicker.  

Last night Matthew and I ate at RMDH.  Mettea's Joy, a charity started by a couple from Bourbonnais, served dinner to the house.  We actually ate with the couple who started the charity.  It was nice to relate to people from home- they actually live blocks from us!  


Erin came down this morning while Matthew had to work.  Mimi and Papa brought the boys up for the afternoon/evening.  We took a long walk and ended up at the bowling alley.  Once again eating dinner at RMDH - served by yet another great charity group.  




Thanks everyone for your continued thoughts and prayers.  We are so lucky to have all of you in our lives. 

Regarding the site.  We are trying to figure out how people can comment and receive email updates.  Anyone know how to make this happen on Blogger???

Friday, October 24, 2014

Friday 10/24/14

This morning at 6:56 Ava Jane is 1 week old!!  The doctors have been giving us continued hope on her status. Everything went really well last night and the goal for the day is trying ween the ventilator oxygen level down to 80%  Once she continues to be stabile with her blood gas levels with the lowered oxygen level they will stop the paralytic medicine. 

After the paralytic is stopped she will be able to move on her own.  The doctors say that allowing her to move on her own will help move more blood through her body which will help the blood gas levels.  

They have also informed us this morning during rounds that babies do not start creating red blood cells until they are about 3 months old.  Becuase they have been pulling so much blood so frequently they had to provide her with additional blood this morning.

They have taken her off the antibiotic but are doing a DIF panel which allows them to determine how her white blood cells are reacting without any antibiotics. The white blood cells are at 23 which a little elevated but nothing overly concerning. 

Sarah got to spend the night last night with the boys. They had a great time this morning going through Ava's room and finding all her bows.  They are asking plenty of questions and they know that Ava is sick and the doctors are trying to make her better.  They have drawn some pictures that we hung in the wall next to Ava's bed.









Thursday, October 23, 2014

Thursday 10/23/2014

Our girl had a great night.  Gas levels all trending in a positive direction... We don't know if we have ever been so excited to hear about gas in our lives!  Lol
As of today they are no longer treating Ava as an acute patient but as chronic patient.  Small step!  She is still listed as a 5 - on the critical list, but over the initial hump.
Because of this we are now trying to ween her of assistance and drugs.  Today they have taken her off the dopamine- this is the drug that helped to keep her blood pressure up.  Docs wanted it higher than a typical baby while she was so sick.  They have also decreased the rate and pressure of oxygen being pumped into her lungs.  She has had no signs of infection so they have stopped giving her the antibiotics.  She is also getting a dose of Nexeum to help keep her stomach settled.  
Matthew is staying with her tonight and I am heading home to spend some time with the boys! 💗

Wednesday 10/22/2014

Yesterday was such a roller coaster and we were a bit confused about her status.  We were able to catch rounds this morning which gave us a little bit more light into what is going on.  Doc said that she has entered into a new phase of her syndrome.  The echo showed that the little blood vessels that had so much damage are now showing some signs of improvement.  What that means is she is maintaining better pressure between the lungs and the rest of her body.  Ideally our lungs are supposed to be at a lower pressure so everything moves outward from the lungs.  In Ava'case this was not happening because of the amount of fluid she had aspirated.  This is great news but she said the next part is hard because it is a big waiting game.... She said we can expect her gases to be in lower ranges which are more typical of a baby - oxygen levels from 60-80 vs 100 before.  

Matthew got to head home and see the boys today.  Kendra made killer meat balls and got to see B, Andy and some of the neighbors.  Alison stopped by at the hospital- she (along with Amy and Mandy) have been my oooober cheer leaders in this whole breast feeding/pumping learning curve.  Who would have thought I would learn how to do this on my third child!  Also got to see Kyle and Lisa who brought dags pizza- so good!  Been a calmer day!  💗

One of the nurses spent about an hour explaining these machines to us tonight.  We are getting an education!  

Tuesday 10/21/2014

She is all warm and cozy again.  They put clothes on her and she can even sport her hats!  She continues to get really puffy from all of the drugs they are pumping in her.  Doesn't look like herself anymore.  
Today was such a roller coaster- with Ava's gases all over the place.  They were a bit frantic in figuring out what was going on- they said it was normal for changes because her body was reacting to being warmed- and needing more oxygen because she was working harder to get blood flowing to her extremities.... But her numbers were still surprising low in their eyes.  They did an echo and X-rays and figured out her vent was being pushed out of her throat because of how swollen she is- essentially not giving her all the help she needs.  This was actually a good thing because it was a quick fix.  Once they got the tube back in place her numbers were back at good ranges.  Went to bed last night feeling that she was once again coasting and buying time for her lungs to heal.  Very emotional day. 
On a happy note my Mom brought Mason and Ryan up to see us.  Ryan was all smiles, Mason had a few more questions but seemed ok with being able to see us as much as possible.  Was great to see them although made reality set in a bit more.  

Monday 10/20/2014

No strides forward but didn't really loose ground today.... Another plateau day.  We actually welcome this very borning day- it is nice to see it calm by her bed side.  She is getting a bit puffy today.  Nurses said this is very normal and to expect her get much more fluffy.  

Big night tonight.  She will get off of cooling therapy.  Praying that all goes well- it takes over 12 hours to warm her back up- they will start this process around 7pm.  

The boys are coming up tomorrow.  They can't see the baby but they have a play area at the hospital and also one at the Ronald House (RMDH).  We are so excited to see them! 

Sunday 10/19/2014

After an awesome day of gas numbers yesterday Ava just kind coasted/plateaued today- docs said that is pretty normal.  The 72 hour cooling therapy ends tomorrow night  The next milestone will be getting her off this cooling treatment which takes about 12 hours or so.  The doctors have explained that there is a risk of seizures when warming a baby back up but they will watch her closely and adjust accordingly.

Saturday 10/18/2014


They threw everything but the kitchen sink at our girl yesterday.  She is currently stable but in critical condition.  They have her completely sedated, paralyzed and are controlling all of her breathing with a ventilator.  Last night about 7:00 they started her on cooling therapy.  Cooling therapy is a rather new treatment which essentially sends your body into hibernation mode.  This will reduce Ava's core temp by several degrees. Allowing her brain to function using less oxygen.  Studies have also shown it protects the brain when oxygen levels dip very low.  She feels really cold which does not seem right.  Overall today was a really good day. Her gas numbers (oxygen and carbon dioxide) numbers are soaring and the docs are really happy.  

Matthew and I are doing ok... Realizing we will be living up here for a while.  Doctors have been very clear that once she is out of the woods this treatment plan takes weeks- not days.  
We have a room at the Ronald McDonald House which is more than amazing.  People here are so kind and caring. If you are not familiar with the organization, they provide free housing, meals, support, etc for families with sick children.  Everything in this house is 100% donated.  

Wednesday, October 22, 2014

Welcome Ava Jane!!!


Welcome to the daily blog/update site for the well-being of the newest addition to the Hemenover family – Ava Jane.  Before we get into any details we would like to thank all of our friends and family who may be reading this.  We have had an over whelming out pouring of support, thoughts, and prayers.  For this we cannot be grateful enough to have each and every one of you here to support us and help us along what we hope is a very short-lived journey.

We have decided to use this mode of communication to provide regular updates and to post pictures.  We did not want all of this information to be posted to Facebook for the world to see and comment on, so we felt this is a bit more private and personal.  Feel free to share this information with anyone whom may be interested in updates on Ava and our family.  Please respect our privacy by not posting any of this information to any other form of social media. 

Some may know the details already, but we thought it would help to give everyone an insight to how we ended up here at Comer Children’s Hospital in Chicago.

We had an appointment at 8:00 am on the morning of the 17th – on Ava’a actual due date - to begin the induction process.  Mason and Ryan stayed with Mimi and Papa the night of the 16th and I do believe Ava wanted us to know she was calling the shots on this one as I actually went into active labor Thursday night.  Contractions began about 11:30 pm Thursday and progressed quickly over the next hour and half.  At 1:15 am we decided it was time to take a ride to Riverside.  Oh yea I forgot to mention we were test driving minivans until about 9:00 on the 16th as well.  Matthew until the day he dies will stand by the fact that Ava simply was telling us that she WILL NEVER drive or ride in a minivan.  Or at least this is his last ploy to get us NOT to buy one. 

We arrived at Riverside about 1:30 AM.  With the contractions I was experiencing, the intervals between them, and with a little motivation from Matthew (because I am pretty sure he was not at all interested in taking me home in my current state) they quickly admitted me.  Progress came fast, by 2:45 AM my water broke and I quickly dialed to 5cm and had the epidural in place – so for the time being -- life was good….

The nurses mentioned when my water broke that they had noticed some meconium present, but did not make any major concern about it.  Meconium is essentially when the baby poops inside of you before it is born.  Really gross and puts the baby under additional stress – but for the most part common. 

Resting now and not feeling my legs from the waist down I began to feel nauseous.  Tried to fight it off for about an hour or two, but they finally gave me some meds to cut the nausea which knocked me out like a light.  At about 6 AM, I was just past 8cm.  With only having to push for a short time with my previous pregnancies they called the doc in stat! 

When Dr. Taylor arrived he was his normal jovial self and said “Let’s have a baby!”  As I awoke from my sleep I agreed.  The anti-nausea meds still kicking my tail I began pushing and with 5 hard pushes and a ton of great encouragement from Matthew, including him having to wake me up every time to push, Ava Jane was born at 6:56 AM.         

Knowing there was meconium present the pediatrician Dr. Garcia and her nurse were in the room waiting for Ava to arrive.  They immediately began suctioning her mouth and nose which is very typical.  Then they began to suction her stomach, and at this point approx. 5-6 minutes after delivery Ava had only made a couple very short and small cries.  They took her to the nursery where they began to work on her more extensively.  I not knowing the extent of her well-being and under the trance of the anti-nausea meds could not keep my eyes open so I fell back asleep.

Matthew went to visit her in the nursery soon after they left and quickly noticed the amount of commotion happening around her.  Dr. Garcia came out and spoke to him and said they would need to get a chest X-ray to see how extensive the damage was in her lungs, in the mean time they had put her on a ventilator to help her breath. 

About 20 mins later Dr. Garcia came to the room and told us that Ava had extensive blockage in her lungs and that she had aspirated some of the meconium while she was still inside the womb. Due to the aspiration she was now extremely worried about her blood “gas” numbers.  She also told us that Riverside’s nursery is not a Level 3 (Neo-Natal Intensive Care Unit – NICU) and are simply not equipped to handle as case like Ava’s and that she had already called University of Chicago and the helicopter is already in route to Riverside to pick her up.

The helicopter picked her up at 9:30 AM and flew her directly to the UofC NICU.  They allowed me to be in the nursery with her until the helicopter crew took her – which could have possibly been some of the hardest 2 hours of my life thus far…  Matthew and his mom left immediately to go be with Ava and my mom stayed with me in Kankakee.  He released me from the hospital exactly three and a half hours after my delivery, so my mom and I left for Chicago.  We met Matthew and Claudie at Comer Children’s Hospital about 11:30 on Friday the 17th.

Shortly after our arrival we met with the Attending doctor who gave us a full download on Ava’s status.  She talked about all the different options and steps which they would try first before they tried others.  She mentioned that the next 24 hours were the more critical for her and that our worst case scenario would be that Ava would have to be hooked to an external lung and heart bypass machine while her lungs heal. 

Now there are scary things that happen with kids, they fall down and cut their leg, they tip over their bike and scrape their knee, but when a doctor tells you that we may have to hook your 6-hour old daughter to a machine that will drain all the blood out of her body, run it through a machine to add oxygen to it, and then pump it back into her 6-hour old body – it got very real.

For the next several hours there were at least 6-10 nurses, doctors, cardiologists, lung specialists, pediatricians, etc… at her bedside monitoring every last detail and every blimp on the radar screen.  We began to learn some of the lingo that they are using like, blood gasses, PO2’s, CO2’s – all of which was foreign language to us but not one of the nurses, doctors or specialists ever overlooked our questions, or inquiries.  We learned that blood gasses are the key to her entire puzzle.  These numbers which were tested every hour on the hour are the key indicator of how much oxygen is being allowed into her lungs and how much carbon dioxide is being let out. 

After the first 10 hours of her being at Comer’s we met with the doctor doing her fellowship in the NCIU who was on for the night shift.  Up to this point they had run through and tried options 1-4 that the Attending doctor had informed us about as soon as we arrived.  Option five being the heart and lung bypass machine.  As we sat with the doctor in the family waiting room at 10:30 pm on the 17th Matthew questioned the amount treatment options we were throwing at her.  Wondering if we needed to give her some time to adapt to each.  By this time we had an opportunity to really get our heads wrapped around what the bypass machine worked and how invasive it is.  The doctor agreed and said “Yes have been moving fast, but it is because your daughter is very sick and because she is so sick we need to make sure that if something is not working the way it should immediately, we need to make a change immediately to offer her the best chance to come out of this.”

There was a moment when the gurney rolled out of the nursery at Riverside to the helicopter that we were very scared of what the outcome may be.  As we sat in the waiting room 12 hours later and had the doctor tell us basically some things are working and others are not – it was time to start praying.