Toby Robert Conger

It’s all official… I ain’t a little feller no more!  I’ve got more creases and rolls than a cotton shirt that needs ironin’!

It’s hard to believe that 4 weeks ago tomorrow we were bringing Toby home. Now he’s almost 7 pounds. Per doctor’s strong recommendation, we’ve kept him at home and isolated except for a trip to the pediatrician. Tomorrow we take him for the 2nd pediatric visit and to get his monthly RSV shot.
He’s doing very well. We’ve struggled a bit to get a handle on how and when is best to feed him to keep his tummy happy. Safe to say he’s teaching us!.
Other than that there’s nothing new to report. Thanks for all the e-mails of support!

Well, it’s official – Toby was discharged from the hospital Monday, December 31!

We “roomed in” Sunday night at the hospital. A hospital room was used like a hotel room and we spent the night with no monitors, nurses, or interruptions. Of course, we could hardly sleep for excitement. Monday came, the neonatologist did one last examination and visited with us, then we hit the road.

We’re getting settled in to a schedule this week, and we’re somewhat sleep deprived, but it will get better when we figure out what we’re doing! (Nothing prepares one like reality.)

Regarding visitors to see Toby, the neonatologist has warned us sternly to keep him away from just about everything – including visitors, for now. RSV season is upon us and doesn’t end until March. (RSV is a highly contagious, very serious respiratory virus.) Since Toby’s lungs are just now getting the capacity to support him unassisted, RSV would put him right back in the hospital and require a ventilator. Even we have to wash up every time we hold or handle him, and when one of us goes out to a public place (Walmart, for example) we toss our clothes into the hamper and take a shower. RSV can hang around on surfaces for several hours. Toby is getting a very expensive shot per month to reduce the severity of RSV if he gets it, but nothing can prevent it but keeping him isolated.

So, for now, we’re asking for no visitors until further notice (probably March.)

The journey to remove Toby’s nasal canula (supplemental oxygen) has been unfolding over the past few weeks. The nursing staff had tried to remove Toby’s canula several times over this past week or so, only to see his oxygen saturation drop substantially. It was unknown whether the drop was due to his nasal congestion, swollen nasal passages or just immature preemie lungs. After our visit this past last Sunday, the nurse tried removing him from his canula again and this time, Toby was able to maintain his oxygen saturation! There has only been a few times that Toby has needed to go back on his canula, but not for very long.

Today Toby weighed 6 lbs., 4 oz and is 19 inches long. His feedings (every 4 hours) are now at 70 mL (a little over 2 oz., each.)

Since the supplemental oxygen was the last hurdle to conquer before discharge, you know what that means – time to come home! The doctors have set a tentative “room-in” date of December 30th or 31st with discharge on January 1st, 2008. Toby still needs to get his immunizations and his circumcision at the end of this week. The doctor wants to see how all of that goes before the discharge date is “officially set.”

Having said all of that, we are thrilled and excited that we might be able to start the New Year off right – with our little boy at home with us!

Merry Christmas to everyone! Toby is “officially” 37 weeks gestational age or 10 weeks corrected age. He’s now 5 lbs., 13.5 oz. and 18 1/2 inches long! No word yet about discharge dates since he’s still on a tiny bit of oxygen and the doctors really want him to go home without it.

Hope this Christmas finds you and yours healthy & happy. All of our thanks for the well wishes, thoughts and prayers for our little boy. Have a very, Merry Christmas!

It’s been incredible to watch Toby grow and put on weight over the last 10 days. Today he weighed in at 5 pounds, 2.2 ounces and is now 17.25 inches long. Compare all of that to when he was born 2 months ago at 2 pounds, 1.8 ounces and 14.5 inches long. God sure is incredible (and so is everyone’s prayers!)

The doctor has also changed his feedings from every 3 hours to every 4. In addition, to make sure Toby gets enough calories, he now received 60 mL (2 ounces) of Mommy’s milk at every bottle feeding.

Toby also seems to have “grown” out of his apnea – at least he hasn’t had an episode since November 27th. The doctors have also discontinued his caffeine as of December 4th. The caffeine was used since he was born to prevent the apnea all preemies suffer from.

I’m sure a lot of you are wondering when Toby will come home. Discharge requirements have changed a lot and the 5 pound rule is no longer used. Here is what the doctor’s look for before Toby can come home:

• Be able to keep his body temperature normal in an open crib.
• Be on complete breast and/or bottle feeds, taking in an adequate number of calories.
• Be gaining weight on all breast or bottle feeds.
• Not have any apneas (pauses in breathing) causing slow heart rate (bradycardia) or change in color for 7 days.
• No oxygen supplement for at least 5 days (but some infants who will need oxygen for a long time are sent home with it).

It would be great to have him home for Christmas, but we’re not rushing things. We want Toby to be healthy when the big day comes so we’ll just be ready when he is!

This past Sunday Toby was moved from his Incubator/Isolette into an open crib. The doctor wanted to do a “trial run” and see if Toby would tolerate being able to maintain his own body temperature. Toby’s done great and there are actually times when his temperature runs a little hot (which is normal with all the clothes & blankets the nurses keep on him.) When he’s in his crib, the nurses bundle him up even more to keep him toasty warm.

As a bonus being in an open crib, we were able to dress Toby in his first outfit. We thought it was only fitting that it be the outfit Lucy purchased the day before she passed away. It’s still a little big, but we think Toby looks fabulous. He is now 4 lbs., 6.1 oz. and getting 38 mL of milk in each bottle feeding.

Toby continues to improve in big steps. He’s now 3 lbs 14 oz. and filling out quite nicely. When Toby was born, my wedding band would fit over his upper arm; now it fits over a couple of fingers.  He’s also maintaining his oxygen levels with minimal assistance and is quite taken with bottle feeding – so much so that they took away the feeding tube and just feed him like a regular baby (the photo is from the 26th before they removed it.) We’re gonna have to get a pair of scissors soon for his hair it’s getting so long!

It’s been a landmark couple of days for Toby. We hold him every chance we get (when the nurses says it’s okay) and last Saturday Toby turned 4 weeks old. As of today, he now weighs over 3 pounds and is now 16 inches long!

Also last Saturday, we noticed that Toby had something in his mouth – turns out it was his thumb.

Lastly, to put the icing on the cake, Toby’s great-grandparents (Colleen’s mother’s parents) from North Carolina came for a visit. They are both in their late 80’s and Toby is their 9th great-grandchild!

What a day! Mark got to hold Toby for the first time outside of his incubator today  Mark has been a great husband, father and all around Superman this last month letting me spend the majority of the time with Toby. But today, Mark got to spend our visit holding his son!

Toby now weighs 2 lbs., 11.4 oz. His feedings are holding steady at 24 mL. Today he got some extra red blood cells to help him grow big and strong. The doctor might have to repeat this procedure because Toby was born before his body had a chance to get a head start growing his own red blood cells. As the weeks progress however, Toby’s body will be able to make all the red blood cells he needs.