I wanted to take a moment to talk about the genesis of Brennan’s name, and how we feel that his name was chosen for him by his older brother.

Let me preface this post by stating that I am not a spiritual or religious person.  Neither is B’s Mom.  I have a really practical/analytical personality.  New age, spiritual, mystical, power of prayer, etc. are things that I basically roll my eyes at, so it is difficult for me to talk about Brennan’s name in the way I’m about to.  I don’t believe in guardian angels, divine intervention, and so on and so forth.  I am, and will always be, a skeptic.

Yet I know with absolute certainty that Finn had a hand in choosing Brennan’s name.

After the second ultrasound with Brennan, Chief Medical Officer Mom was still concerned that everything was going to fall apart and needed reassurance.  As we were leaving the clinic, we drove past a red truck in the parking garage with a license plate that said, simply, “Finn” – no numbers even, just the four letters.  All winter, the CMO had said that every cardinal was a sign of Finn, and I’ve come to associate the color red with him as well.  It’s difficult for me to describe my feelings about this occurrence – wanting to believe in a sign, but looking for rational explanations.

As the pregnancy progressed, we began discussing names.  As I once talked about Finn’s naming on his blog, so I will link to our spreadsheet of possibilities here:

https://docs.google.com/spreadsheets/d/1QMCWHxAMJIePJujFgdcn7dQMoS1JGArZBaYEoVONXGE/edit?usp=sharing

After the anatomy scan, we began earnestly “testing” out various male names we had compiled.  We gravitated towards Irish surnames as we had with our firstborn.  We really liked Alistair quite a bit, especially Alec as a nickname, but kept getting hung up on the exact spelling of it (and that it was not Irish in origin).  Brennan was one of the names we liked initially because Cheryl referred to the fetus as “Baby B”.

In mid January we had the following conversation:

After Alistair, we tested out Brennan towards the end of January.  On February 8, I received the following “like” of my work homepage:

I had never heard of this company before, which is a construction business that has nothing to do with libraries and isn’t even located near where I live and work.  There was no reason for them to “like” my work page.  After this email, I was convinced that we had our name, although the CMO needing more convincing.  She would get it.

After this incident, I had an issue with a catalog record at work that I had to send to the CMO to fix.  It was for the “Cedar Cove” television show, and one of the actors was Brennan Elliott.  I feel that Brennan is an uncommon enough name that it was fairly significant that I had to send her a record with this name attached to it within a week or so of the Facebook occurrence.  Later, I would run into another issue with this very same DVD when another library contacted me about having one of their patrons request it even though we weren’t putting it on interlibrary loan yet, as if to dispel any doubt about Brennan.

I suddenly kept seeing the name everywhere.  However, there were two more significant events that finally convinced the CMO that Brennan was it.  My sisters like to reference the movie “Step Brothers” to each other, and  because of this, one week the CMO decided to borrow the DVD from the library.  One of the brothers is named Brennan.  Shortly after that, the CMO drove home from work one day and noticed a chiropractor office she hadn’t seen before: The Brennan Family Chiropractic and Nutrition Center, which is located 1 mile from her job (http://www.brennanhealth.com/).

I don’t know why I believe Finn reached out to tell us Brennan’s name, and to let us know everything would be fine.  The rational part of my brain explains that these are just coincidences, however improbable.  And perhaps my own healing from this last year comes simply from a need to believe in something like this in order to survive and continue on, so I seek out the random coincidences.  For the first time in my life, I am comfortable with this “spiritual” thing, and I know that Brennan’s name was chosen for him, not by his parents, but by his brother, the Mighty Jedi Finn.

Admiral Dad

If you don’t want to read stuff, skip to the bottom for the TLDR and pictures.

I haven’t been posting much lately.  Raising an infant is really exhausting, and I haven’t been able to muster much energy to post.  I guess you always hear how tiring it is, but it’s one of things that only once you experience it can you finally understand it.  As I’ve heard many times lately, the days are long, but the years are short.  I can’t believe it’s been 7 weeks now since the Captain was born.

Tomorrow is Brennan’s “due date”, and he is now just over 8 pounds.  He will be 7 weeks, 1 day chronological, but 0 days adjusted tomorrow.  What do I mean, he will be 0 days adjusted?

For premature infants, they have two ages until about age two or three.  The first age is his chronological age – calculated from the day he was physically born, and when he will legally be allowed to gamble, vote, and drink alcohol (always responsibly, of course!).  The second age is his adjusted age (also called corrected age) – calculated from his original due date.

Typical developmental milestones for a preemie are viewed from their adjusted ages.  For Captain B, milestones such as rolling over, reaching for objects, sitting up, babbling, etc. will happen much later in his chronological development.  While a term child will begin sitting up between 4-7 months, for example, Captain B will begin this in 6-9 months based on his actual birth date (May 25).

Some characteristics will still develop partly from experience, such as the ability to eat (food in digestive tract speeds up its maturation), and familiarity with language due to earlier exposure.  But a general rule of thumb is that his development timeline will occur based on his adjusted age of July 14.

It’s really difficult to get others understand the difference sometimes, as they think a baby is just a baby.  I’m not saying B is “special”, but I think it’s basically hard for people to get the fact that we have had 7 weeks of abnormal bonus time to our parental experience.  It truly has only been the last few days as if CMO and I have felt like we had a regular baby, and we have been able to tell he’s acting more “normal” at last.  I use the term “normal” loosely, because every baby is different anyways, regardless of chronological maturation.  Some babies walk or talk sooner than others, just because of various biological and environmental factors.

The best analogy I have is thinking about how vastly different a 14 year old is from an 18 year old.  But as people mature, that same gap effectively closes as you get older.  There is little difference between a 60 and 64 year old, but obviously the difference between a 1 year old and 5 year old is much greater.  If you continue to think along those lines, two months difference at birth is a much larger magnitude than you have probably thought about.

There is no magic or scientific rule for when B will “catch up” exactly, but his noticeable chronological developmental delays should begin to smooth out around age two or three. B is most likely going to see slowest development in physical or motor skills, as preemies are weaker due to abnormalities of muscle tone that may make it longer for him to develop sitting up or rolling over skills.  At this point, only time will tell.

TLDR; You adjust a premature baby’s age based on his due date, and refer to that as his adjusted age for assessing development milestones, such as walking or talking, which makes B “born” tomorrow.

‘I’ve been thinking for a while now about doing a series on the “differences” between having a premature baby and a term baby.  Mom and I find that most people don’t really understand what a premature baby means, and some of the things it entails having to deal with.

One of the bigger pieces in our current routine is having to track weight gains and caloric needs.  I know that there is a bit of a “debate” on the whole breast milk vs. formula thing. For premature babies, breast milk is emphasized due to the nutrient content as well as antibacterial properties that help out preemies from lack of development time in the womb.  However, in order to help preemies gain weight, a formula mix is recommended to boost calories, as well as provide vitamins.  It’s a bit of a conundrum.  In particular, iron is needed for parts of brain development that occur in utero in the last couple months of gestation.

Before leaving the hospital, a nutritionist put us on a plan that requires a mix of formula that provides extra calories.  Breast milk is about 20 calories per ounce, and we are upping Captain B’s intake with a special 30 caloric formula that gets mixed in with his milk.

For a goal in calories and volume, his weight in kilograms multiplied by 160 is a general rule of thumb for his total daily intake (in Milliliters).  So, for example, if he weighs 2.9kg he needs about 464 mL per day (2.9 x 160).

This also gives us a rough approximation of when he takes a bottle of how “long” he can go before needing fed again.  As you can see from the picture in this example, if he takes 58mL in a feeding, it is a decent approximation of how “full” our baby is, and when he will want (or need) to eat again.  In this case, 58 is about 3 hours.  It is all a bit tedious, but Admiral Dad loves numbers so he rather enjoys doing this sort of thing.  It’s part art, and part science.  I like to think of it like eating a meal myself.  Am I full after two cheeseburgers and some fries?  Yes.  What about if I only had 1 and 3/4 cheeseburgers?  Also yes. I’d still be “full” and I probably couldn’t tell you which had made me “fuller”.  B is probably “full” whether he takes 58 or 62mL every 3 hours.

Once B hits his “term” date (July 14), he can move off the special mix and just do breast milk (or regular formula) only at that point, but in the meantime he needs the extra caloric intake.  The major goal for his weight is to get to 7.5 to 8 pounds by July 14.

I’m sharing via Google Drive some stats I’m keeping for his weight (current growth projections show his weight gain is on target for 7 pounds, 12 oz by July 14).  Special note to Fleet Admiral Grandfather: you can go here to get updates when I’m not answering your texts on his weight gains.

Weight Tracker
https://docs.google.com/spreadsheets/d/1IIWjN5u2j24jsVyIHy2ravnT5azk_0sr6MFKWY31gJQ/edit?usp=sharing

I thought it would also be interesting to share out how we keep track of his feedings.  Chief Medical Officer Mom and I keep a log book that we record his feedings in.  This helps us know how much and when, as well as keep track of some things like how many “wet” diapers a day he has to make sure he’s doing all right.  I apologize if this is TMI, but reading this blog is of your own free will.  Mom has also devised a “system” for tracking B’s poop.  It’s sort of one-upmanship competition to say that you got to change a diaper that was rated a 9 instead of a mere 1.

Feeding Tracker
https://docs.google.com/spreadsheets/d/1Ksuu05_DsYfkipLVGxIC9A6vLWg0_cJwzXJiqVHY5AM/edit?usp=sharing

I hope that was both enjoyable and informative to read.

Admiral Dad

PS – WHY can’t we use the metric system for everything?

Brennan is home!  More on that later! In the meantime…

SPECIAL NOTE REGARDING VISITORS

We are happy so many people want to see/visit/hold B, and sometimes we forget Admiral Dad has a public job in a small town and knows lots of great people.  Numerous people have helped out and supported us, and we are glad they are anxious to meet the Captain!

However, the doctors strongly urged us not to have any visitors until after Brennan has passed his term date, gained a certain weight, and had his immunizations.

Now that B is home, we ask you to continue to support him from a distance. Please remember that he is still small (being born two months early) and continues to have special needs at home.  We want the best for his health, and we know you do too.

His immune system isn’t completely developed yet.  He was also born with respiratory distress syndrome, and his respiratory system is still particularly vulnerable. Babies born before 36 weeks are at highest risk for complications like bronchitis, pneumonia, respiratory syncytial virus (RSV), and other serious breathing problems that could put us back in the hospital. Sometimes the side effects are so bad that, while uncommon, they can be fatal for premature babies. So please understand why we prefer not to have visitors just yet.  It is not simply being over-protective — we have personally lived through uncommon complications that were fatal to our preemie child.

Additionally, as B is still underdeveloped, his sensory system is also learning how to cope with the new world and he gets overstimulated easily. In the hospital, he was in a warm, dark, and mostly quiet place where he could sleep a lot. He still needs all his energy to eat, grow, and thrive at home. He is still very small, and needs to keep a lot in reserve.

Please know that this note is not meant to hurt or offend anyone, it is simply meant to show that even though B is home, he still needs some extra time before he can personally greet you. Thank you for understanding and respecting our wishes to keep B happy and healthy in order to complete many missions in the future.

Mom & Dad

We are getting the sense from some (not all) of the nursing staff that it’s bothersome that the CMO or I am at the hospital 24/7.  Yesterday, his nurse said we could go home together because they could watch him, saying “it’s what we do”.  During medical rounds, the neonatal nurse practitioner seemed somewhat offended by my insistence on a particular piece of B’s care saying that the nurses know what to do and they would guide us to what’s appropriate.  They are probably annoyed that I insist on keeping track on my own of B’s vitals and progression.

The NNP then went on to discuss B, giving us some info based on his gestational age which she had completely wrong.  When corrected, she said she must have “written it down wrong”.

B’s brother would have had a significantly increased chance of survival if a different nurse had written a negative sign instead of a plus sign on her OB chart and let us come in instead of insisting everything was fine and we didn’t need to.  Through some internet searching, we discovered that nurse was later fired on the day we told the clinic what had happened.

For the rest of our lives, we will always wonder what an extra day would have meant for B’s brother if someone hadn’t “written it down wrong”.  We will wrestle with the guilt of it all our lives. Now I understand better how some people get to be “those parents”.  We are “those parents”.

This is an unofficial report, so I’ll drop the act.

C and I are somewhat frustrated by assessing B’s progress at the moment.  He has to take so many feedings without a tube within a day, then they will give him 2-3 days after that to come home.  We keep thinking we are at that point, then nurses will tell us we are pretty much there, but then a different nurse will contradict what was stated.  The problem with being in such a large institution with nursing teams is that we are having difficulty assessing B’s overall progress and when he will be coming home.  Today, we though he might be home as early as Monday (6/13), and we had been rushed to do some infant CPR, watch some educational videos, read some literature, and push to do a bottle feed or two.  Then right at shift change, our departing nurse said he would need to do a tube feeding, which would reset the 2-3 day clock.  THEN the evening nurse asked us if we wanted to breastfeed or bottle for his next feed (not tube), when the previous nurse made it sound certain we needed to tube him.

So when is B coming home?  We don’t know.  We guess next week… sometime.  In the midst of all this, I’m trying to juggle a work schedule and putting in as much time as I can, but also needing to be at the hospital as much as possible.  Since C can’t leave the hospital now at all, this makes logistics like feeding cats, etc. even more touch and go.

Admiral Dad reporting the events of Captain Brennan’s birth.

I wanted to spend some time thinking back on the events of Stardate 0525.16, so Brennan can read about his birth someday and I can remember it more clearly.  Mom has already covered events pretty well in her report, so I will not duplicate things, but wanted to write a little more about the emotional side of things.

After the Captain was born, the neonatal nurse practitioner told us that he was borderline for being sent to the Neonatal Intensive Care Unit (NICU) instead of the level II special nursery.  I did not want to go back to the NICU again with another child. However, initial x-rays of his lungs after receiving the curosurf showed they were still not clear for him to stay in Level II. So he was intubated (a breathing tube placed into his lung) and sent to the NICU.

I had remained mostly calm throughout Brennan’s birth, beginning at Mom’s initial signs of labor.  I knew that the Captain was much further along than his brother Finn was, and even if there were complications, it was extremely unlikely that he would have the same devastating complications that Finn did.  I left Chief Medical Officer Mom back at the hospital so I could be with the Captain over in the NICU.  I remember standing in front of those NICU doors again, and I started shaking.  I really did not want to go into that place again and it brought back all the feelings of being with Finn while he was dying.

The NICU is set up so that there are several large open rooms, each containing multiple stations that can be monitored from a centralized desk.  You can see a portion of the large room in the pictures below, with the centralized desk behind the sink, and a baby isolette in the back a bit at one of the stations.

We were in a large room adjacent to the large room where Finn had passed away, and it brought back a lot of memories, and worry about losing the Captain too.

I knew, however, from looking at the Captain, that he was already healthier than Finn at birth.  His color was good, and he was (in Doctor’s words) “vigorous”.  We requested a head ultrasound, which they have to wait for 3 days to do.  Those days were very tough.  Finn’s ultrasound had shown bilateral grade IV hemorrhages, which is the most severe bleeding that can occur in the brain. B’s scans, however, were fine.  Finn’s progress was mostly downhill, while Brennan’s was mostly uphill.

On the same day the Captain’s ultrasound came back clear, he had also been breathing on his own for 24 hours.  He had rapidly transitioned from intubation for 8 hours to CPAP for a day or so, to no breathing mechanisms by day 3.  The neonatologists said he was clear to be moved to the Level II Intermediate Care facility that same evening.  Everything was going to be fine with baby B.

While waiting for transport, Chief Medical Officer Mom and I went over to the adjoining room where Finn had passed away.  His corner of the room was unoccupied, and the isolette was empty, so Mom and I stood for several moments, and pulled up pictures on my phone, remembering Finn and crying our hearts out.  Weeping for our son who was gone, and weeping for our son who was going to make it.

Enduring those fateful 72 hours in the NICU was difficult.  I hated being there.  Looking back, however, I am grateful for the chance to say goodbye to our son, Finnegan, once more.  I felt him alive again.  I remember holding him, touching him.  I remember how hard it was to say goodbye the first time.  I remember his scrawny body, his long face. I remember his little eyes.  I remember placing my fingertips inside his palms, which could barely contain them, and resting my own palm on his chest.  I remember wondering what he would grow up to be like.  And I remember most of all, looking at him as he passed peacefully in his mother’s arms, and feeling so broken that I didn’t know how I could go on living.  But I did.

I know that Finn watched over his little brother in the NICU, and while my arms still ache for my first son, I received closure I didn’t know I needed. It feels good to hold the Captain close to my heart and listen to him breathe.  As I exited the NICU for the last time, it was late at night and quiet.  Still.  No babies cried out, and nothing stirred.

I will always remember these empty halls.

These are the halls where one son died.

These are the halls where one son lived.