Grateful for Thirty Days

Ava has been in the world for a month and there's a list that's been growing in my head since the day she was born...we have so many things to be grateful for:

~ A spectacular OB, who got the most out of my crazy placenta and kept me pregnant despite the odds.
~ an incredibly peaceful birth...amazing under the circumstances
~ Ava is a girl. Ask a NICU nurse about it and she'll tell you that on average, preterm girls are heartier than boys. We'll take any advantage that's out there!
~ Ava got the full benefit of steroids to help mature her lungs and magnesium for her brain.
~ My mom, able to change her flight home twice, allowing her to be here and helpful for Ava's birth
~ Matt's mom, willing to fly out with 24 hours notice to help during my bed rest.
~ a private room on the newly remodeled side of the NICU
~ a world class children's hospital 15 minutes from our home
~ family and friends, willing to make meals, grocery shop, run errands, watch our girls, clean our home, mow our lawn, bring caffeine, snacks & treats, send emails, texts, gift cards and love.
~ newborn exam, passed
~ eye exam, passed
~ head ultrasound, normal
~ jaundice, resolved
~ growing...like a champ! In fact, it's common for babies in utero to grow better than their premie counterparts...babies simply grow better on the inside! BUT, according to the weekly "pregnancy email updates" telling me how much my baby should weigh right now during my 32nd week of pregnancy...Ava's weight is still right on track! Pretty amazing.
~ 6 years ago, a generous friend purchased for me a breast-pump that at the time felt like a total luxury for this stay at home mom. Well, I pumped for 6 months with Elizabeth, intermittently with Ruby, a month with Hannah Mae, and now around the clock for Ava. Once again am thanking God for this friend and her gift. My milk supply is robust and Ava is getting all the food she needs!
~ prayers from all around the world
~ an easy and quick recovery from 3 1/2 months of bed rest and Ava's birth.
~ so far, mama has stayed healthy and been able to visit Ava every day.
~ peace & grace...God has supplied it every day just like he said he would.

Beautiful Blue Eyes

Ava has had many tests since her arrival, and will have many more before she finally gets to come home. So far, she's passing each one with flying colors, and we couldn't be happier.

~ her head ultrasound done at 1 week was normal. She has no brain bleeds! One reason my OB was working so hard to keep me pregnant until at least 28 weeks is that micro premies--babies born prior to 28 weeks--are at a substantial risk for brain bleeds since the blood vessels in their brains are so small and under developed. Those brain bleeds can have severe outcomes like cerebral palsy and hydrocephalus among other things. In light of that, we knew at the time I was hospitalized that the magnesium that I was given to help stop my pre-term labor has an added "neuro-protective benefit" for Ava (babies whose moms were given mag. have statistically fewer brain bleeds), so we're thankful it seems to have done it's job!

~ her first newborn screening, which premies often fail since it's the same screening full term babies get, showed a few abnormalities, but when they repeated it a week later everything came back normal!

~ her eye exam was perfect! In fact, her neonatalogist said she'd never seen a baby born at Ava's gestational age who had such a flawless course. The retinal vessels are perfectly formed and her opthamologist doesn't need to see her back until she's 9 months old! Praise God for his mercies!

Who thinks their daddy is the best???

Twelve years ago I married the most wonderful man. The catch is, I didn't even realize just how amazing he was and would become. Our journey together has been anything but dull, and the challenges and triumphs, the sweet times and hard times have only served to reveal the true character of the Prince I will, Lord willing, get to spend the rest of my life with.

He is the hardest working man I know. He faithfully goes to work at all hours of the day and night, frequently giving up hours of sleep in order to be available to the girls and I when we need him. He frequently walks in the door from work, and jumps right into the bedtime routine, often without takiing time to ditch his tie or eat dinner. He'll mow the lawn at 9pm (sorry neighbors!) because he's spent every waking hour seeing patients or caring for Elizabeth when she's in the hospital, Ava in the NICU or the girls at home. He is excellent at what he does, and doesn't do anything halfway. And while the rest of the world admires him as a stellar physician and scientist, (which he is!) he pours his best energy into loving our family.

He is faithful with what God has given him. Through "lean years", and times of abundance, during hospitalizations, bed rest, in sickness and in health, he never wavers in his commitment to our family, willingness to lay down his own plans, and is core desire to honor God in everything he does. He doesn't ever stand at the pulpit, but his life preaches faithfulness, long-suffering, endurance and overcoming love.

He reflects God's love to his wife and daughters. Our girls know such security and affection, they have such confidence in his love and delight. I can trust his heart intentions and rest securely I his love. I know I can stumble and fail, and he is a constnt source of truth and grace. Our daughters can approach God and believe in his love for them because of what they've experienced with their daddy. At the end of the day, He Is Present. There have been countless overnight stays in the hospital, he's worked for hours to build the girls a backyard swing, to share his love for the outdoors and teach them about gardening, bugs and plants, and over and over he's sacrificed his time, his hobbies and his own pursuits, so I could have a full-partner in parenting our daughters.

Matthew, you have been God's best gift to me, from the day I met you. Thank you for your faithfulness to the vows we made, thank you for embracing each challenge we've faced and allowing it to soften your heart, strengthen your faith, purify your life. I love you with all my heart. Happy Father's Day and Happy 12th Anniversary.

Love,
Sara

People Say I Look Like My Daddy

Three weeks, three pounds!

On Tuesday Ava turned three weeks old and on Wednesday she passed the 3lb mark! She's taking just under one ounce of fortified breast milk every three hours, is now up to 1430 grams (try holding 4 navel oranges) and is doing incredibly well. On Saturday, Elizabeth finally got to meet her and yesterday she met her grandma and grandpa for the first time. It's been a big week!

Everyone says the pictures make it so hard to really capture how small she is...maybe this view on daddy's chest will help. She's like a little kitten...so light, so perfect and miniature. She's amazing.

This weekend Matt's parents and siblings arrive in St. Louis to celebrate his parents 40th wedding anniversary (the real date is in August, but they're graciously accommodating our crazy family circumstances). We're thrilled that the adults will get to meet Ava and our girls will get some fun cousin time. And of course, it is a complete blessing to be able to witness and honor the amazing marriage my in-laws have.

Matt and I will be balancing extended family time with "Ava time" and I especially would appreciate prayers for peace in my heart about when to be where...the bottom line is, we can't possibly have "enough" of either, so we'll just need grace to let things be as they are.

First Smile??

Ruby's on the mend

Thanks for your prayers last night. Ruby went to bed with holding down some apple juice, snd made it through the night without incidedent. As for the rest of us, so far so good! I've already got everything Ruby touched yesterday in the wash, so as long as no one starts throwing up today, we might be in the clear.

Flu Bug

Yesterday at noon, Ruby was ooh-ing and aah-ing over her Ava in her isolette. Today at noon, she was throwing up all over the couch.

Please pray the rest of us stay healthy! If I get sick, I can't visit Ava. Also, last night, Matt's sister, husband and son arrived from Germany in advance of a Harms Family reunion later this week. They're staying with us, and the last thing we need is a flu bug passed around.

Mommy & Daddy are Tired

Ava's doing great. Remarkably well.

By God's grace and thanks to the presence of Grandmas and Auntie over the past month, Elizabeth, Ruby & Hannah Mae are holding steady at home and their signs of stress from all the transition and my absence are diminishing.

We're in a pretty good routine...Matt's able to work as much as he needs to; after breakfast with the girls and putting Hannah Mae down for her nap I head to the NICU to see Ava, and spend the day snuggling with her skin-to-skin and pumping. Unless he has to work late, Matt and I head home in time for dinner, graciously provided by friends or (recently) miraculously whipped up by my sweet sister-in-law, and then spend the rest of the evening playing with and putting the girls to bed before tending to the necessary bills or admin stuff that's piling up. It's incredibly smooth, thanks to all the generous friends and family who are pitching in. We most certainly wouldn't have this much peace were it not for you.

But in the middle of it I am exhausted. While pumping around the clock and tring to be present for ALL our girls, I'm not resting like I would normally after having a baby. And my heart is torn in half every day. I miss the girls when I'm not home, and feel guilty and sad when I'm not with Ava. I know this is par for the course and it's not truly going to feel "right" and "good" until Ava is home, but until that can happen, I need extra grace for myself, stamina and discernment about when to be where.

The day before I had Ava, as I lay alone in a dark hospital room, praying for endurance while magnesium was pumped into my veins, God graciously gave me two gifts. One was a gentle reminder:

Be STILL and KNOW that I Am God.

The other was a picture:

my little hands releasing their grasp on all the things I was clinging to...trying to hang on for dear life to...and opening the contents into his great big, strong enough hands.

As contractions grew stronger, I clung to those truths: I can let go. He is enough. I can cease striving. He is God.

When I cried into my pillow as I spent my first night apart from my newborn daughter...now for the second time in my life...I grasped for the peace that would come...He is trustworthy. He cannot fail me. He is God. I can rest.

Every day, and every night now, I search for that place of rest. We know God is sustaining us. We know he is faithfully carrying our family. We don't know when this will end...but we can be still. He is God.

Two Weeks, Birthweight and Bathtime!

Ava is two weeks old! She's doing brilliantly at being a baby...handling her feedings, growing like a champ! She surpassed her birth weight this morning! Finally, yesterday I gave her a bath for the first time. She's just yummy. Overall, we're amazed at how smoothly things are going for Ava-bean. Thank you for your continued prayers!

Elizabeth is doing well after almost a full week of antibiotics, and now Ruby's on them, so hopefully we'll have a healthy household soon.

Ruby update

Ruby doesn't have strep, but does have a ear infection...thus the horrible night of sleep! Thank God for antibiotics. Bless her heart, she was so excited to go to the dr. she excitedly told our friend, "I might have to get shots!" Elizabeth is recovering well from the endiscopy, and they didn't need to sclarose any verins! Ava's started gaining wight now that they're fortifying her milk a bit...she's almost back to her birth weight. Hannah is loving having her same-age cousin around and has finally decided she might like to become a pedestrian. The days are full and the nights are long, but we have much to be thankful for.
Now off to hold our newest blessing.

In and OUT!

Elizabeth's endoscopy want flawlessly! She was off to surgery at 8:00 and we're leaving now! Unfortunately, her rapid strep test from the ER last week came back positive (meaning she had strep throat) and since Ruby's been complaining of a sore throat for the last two nights, I'll drop Elizabeth off at home and take Ruby to the pediatrician at 10:30 before going back to be with Ava. Please pray for protection for the rest of us...

Elizabeth's Endoscopy

Tomorrow morning at 5:45, we'll take Elizabeth in for her endoscopy to check out the condition of the varicose veins in her esophagus. She's never has a major bleed from one of them, and we're hopeful that things will go smoothly tomorrow. She will be under general anesthesia and intubated, so hopefully I'll be able to bring her home mid afternoon. That means I'll have to spend less time with Ava tomorrow. We'd appreciate your prayers for our day, for energy for Matt and I (the sleep deprivation is catching up to me!), stamina for Auntie Tawni, and grace and wellness for all our sweet girls, both in the hospital and at home. I'll keep you posted.
Love,
Sara

Full Feeds!

Ava's been a busy girl today. Right now she's getting a full feed (23 mls or just shy of 5 tsp) for the second time today! You can see the syringe with a little milk still in it on the right side of her incubator. That will slowly drip in through her NG tube over 10 or 15 minutes. The first feed went in pretty fast and she threw up all over me! But of course I didn't mind. She's still under the bili lights for one more day...just to make. Sure she's good and done with them. Go Ava Go!

Ava goes wireless!

She got rid of her PIC line (IV) this morning and now she just has monitors and an NG tube for feeding! Yahoo!

Elizabeth Home for Now

Matt was able to bring Elizabeth home around 12:30 this morning pending the results of her blood and urine cultures. Her initial white blood cell count was high but not horrible, which diminishes the likelihood that this is a blood infection. However, in the even that it IS a blood infection, she came home with a dose of the oral antibiotic that covers for blood-borne bacteria, and we have to go back to Children's this morning to pick up the rest of the prescription, since no one could fill it at midnight last night. We are so thankful to have her home and pray the blood and urine cultures they took last night will remain negative.

Prayers for Elizabeth

I know I sent last night's email out with a plan to fly below the radar for a while, but we are again in need of your prayers...this time for Elizabeth. Today I spent the day at home with the girls helping to manage the transition from Granna (flying home) to Auntie Tawni (arriving to help).

We had a fun trip to the salon where the girls got a trim and then enjoyed playing with our cousins here at home.

After dinner she crawled up on the couch complaining she was really cold and within minutes she was deep asleep, breathing fast and developing a fever. She now has a 104 fever without an obvious source, so she and Matt are at Children's Hospital for labs and cultures to determine if it's another case of bacteremia. Because of her history, Elizabeth isn't allowed to just have a run-of-the-mill fever. We don't know yet if they'll want to keep her until the cultures are negative, or if they'll give her a dose of IV antibiotics and send her home pending the results. Matt has full clinics tomorrow, so another hospitalization it the family would be a big challenge. Sweet Elizabeth is handling this with her usual courage, but obviously, we'd like to bring her home as soon as possible.

Please Pray for:
~Healing and protection for Elizabeth
~A clear source for the fevers and course of treatment. Last time she had bacteremia, the bug was resistant to the antibiotics they gave her for the first 3 days...that prolonged her illness and recovery.
~Encouragement and grace for Matt. He spent all day at the hospital with Ava and came home expressing how sapped he was. He needs a boost to get him through what could be a very long night.

Amazingly, things are going tremendously well with Ava. When Matt left the room to grab some lunch, Ava grabbed hold of her nasal cannula (the tubes in her nose giving her a little extra air) and her NG tube (for feeding) and yanked them out! Fortunately, she'd been assigned a veteran nurse in the hopes that she could be weaned from her O2 today, so the nurse decided to only replace her NG tube and leave the O2 off for a while...and she did great! She's up to 16ccs (3+ tsp) and will keep advancing as long as she keeps moving things through! Now that his cold is gone, Matt got to snuggle with her for the first time today...of course, he's completely in love.

Tonight, we again feel the tension of being so thankful for so many blessings, while also carrying the burden of Elizabeth's health. The same God loves all of our daughters and we know, true to His character, He has already provided for what is ahead...even what we can't see. Please pray for our faith to remain strong, and our trust in His goodness to grow.