A's and B's

Unfortunately I am not talking about grades.  As Oliver's need for respiratory support lessened he began to have episodes of apnea and bradycardia, basically he would stop breathing and or his heart rate would drop drastically.  The apnea was caused by three things, his brain, his trachea, and reflux.  Since Ollie was so early his brain was not quite ready to keep all his systems going at the same time.  He simply would stop breathing, without intervention he would die.  His nurses explained to us that the cartilage his trachea was super flimsy so it was like a bendy straw and would sometimes get kinked.  They showed us how floppy his ears were and said that his ears and trachea would firm up at the same rate.  So the fact that you could bend his ear in half and it would stay that way was not a good thing.
His brady episodes were directly related to his apnea episodes.  We would get him breathing again and seconds later he would alarm for low heart rate and we would once again have to stimulate him to get him going again.  Somedays he would have several cycles of these, I hated those days.
To counteract the A's and B's he was started on caffeine.  We made jokes about him being a Starbucks junkie and how I would have to get him his morning coffee along with mine.  In the early days when he would set off his alarms nurses would quickly pop open the portals in his fish tank and shake him to try and trigger his brain to breathe.  As he got older they would wait a few seconds to see if he could "self correct".  They would watch the numbers on his monitor and if they continued to go down then they would stimulate him.  I hated sitting there and resisting the urge to reach in there and flick his foot to get him to take a breath.
Once Ollie was stable enough to start kangaroo care with us he had apnea each time we held him.  Kangaroo care was where Justin or I would hold him skin to skin for as long as he would tolerate it.  We could only hold him one time a day so we would take turns and on the days Justin was visiting he got to do it.  I loved it and was scared @%$&less at the same time.  I knew that it was just a matter of time before he had an episode.  Usually it was because his head was too far back or too far forward, we would try and gently reposition his head to realign his trachea.  That act in itself was scary too since he was so premature his skull bones were so thin and fragile and you could feel them shift slightly under your fingers, ugh.  I found it very difficult to relax and enjoy kangarooing with him.  I was afraid that if I shifted the wrong way or moved too much that he would stop breathing.  

 Justin and Oliver's first time kangarooing. 

 My first time kangarooing the day after Justin.  Yep doing it during a mealtime.

Once Oliver started having larger meals he started to have reflux.  His reflux was due to the feeding tube that was put into his stomach that did not allow the valve that connects his esophagus and stomach to fully close.  The reflux was also caused by him being a preemie with lower muscle tone.  Each time he had a reflux episode he would spit up and stop breathing.  The first solution was to place him on his tummy when he was being fed.  That worked for a few days.  When that stopped working they took him off gravity feeds and his milk was pumped in over an hour.  This was how he was fed until he could nipple all his meals.  After he was eating by bottle if he refluxed his eyes would roll in the back of his head and he would turn blue and pass out.  Then it would happen again a few seconds later when he would have a brady.  He did eventually outgrow the bradys while he was in the NICU.  He had to be brady free for 48 hours before being allowed to go home. 
Each morning when I arrived at his fish tank I would ask how his night had been and how many episodes he had had overnight.  I basically spent my days holding my breath waiting for when he would stop breathing and how long it would take to get him back on track.  There was so much anxiety around holding him and feeding him, that I approached each with a sense of dread, but forced myself to do them.
As we got close to discharge we were told that since Oliver was still about a month away from his due date that he would be sent home with a monitor and caffeine.  Studies had been done that showed that most babies stopped having apnea by the time they were 44 weeks gestation, so we were looking at a minimum of 2 months with a monitor.  Oliver had his for 3.5 months and it was so very scary to turn it in.  The monitor gave me a sense of security so that I could sleep, knowing that it would alarm if he stopped breathing.