Saturday, January 26, 2008
Out of the Isolet, No More IV
It was another good day for Sadie. She is no longer in the isolet. She's in the same spot in the NICU but she's now in a basinette. She has also lost her IV. So the only thing that she's hooked up to is the three leads to the heart and respiration monitors, a lead to the oxygen saturation monitor, and the tube down her nose into her stomach. The doctor said that it was "quite an accomplishment" to lose her IV. The next step is for Sadie to eat enough on her own to gain weight. At her 2:00pm feeding today, she was able to eat half of the 42cc's from the bottle and the rest was gavaged.
Friday, January 25, 2008
Breathing on her own
Sadie continues to do great...
- She is now breathing on her own without any assistance.
- Her gavage tube has been moved to her nose since the nasal cannula is gone. This will make feeding her easier since there is nothing in her mouth now.
- The IV in her scalp actually didn't take so she has an IV in her hand again.
- They are going to discontinue the TPN order when it expires either tonight or tomorrow morning. I'm not sure what it stands for, but that in the order with what nutrients and vitamins are given to her through the IV. I think they are discontinuing it because she's drinking a lot of milk now.
- I'm not sure of the number, but her bilirubin is okay as she isn't on the lights.
We also talked with the doctor. She agreed that Sadie is doing great, but didn't want us to get our hopes up that she will be leaving soon. She just wanted us to continue to be realistic. She said that most babies fully develop the instinct to suck at 36 weeks (from conception). Although she might be able to bottle or breastfeed some of the time, it most likely will not be until Sadie is at 36 weeks that she'll start to feed like this all the time. She used an analogy of expecting a 6 month old to do things that a 12 month old can do. This same way, we shouldn't expect preemie at 34 weeks to do things a preemie at 36 weeks should be able to do. We both wish that a doctor would have explained it to us this way with Aedan. That would have made things a lot easier.
Have a great weekend everybody and thanks again for all your prayers for our little girl!
Thursday, January 24, 2008
A Day of Firsts
Today has been a day of firsts for Sadie. She wore her first outfit today. You can see pictures on her Picasaweb album. Each day has multiple pictures so you can click on the "album cover" picture in order to see the rest of the pictures.
Feedings:
She also started getting fed from a bottle and breastfed. In terms of the amount she's eating, it is being increased by 2cc's every feeding. She was up to 16cc's (about a tablespoon) at her 10:30am feeding. They will gavage her through the tube to her stomach most of the time and bottle or breastfeed starting twice a day. They will then increase that number as she does better and better at her feedings.
Breathing:
The doctor has also ordered that she get weaned off the nasal cannula as long as she is able to breathe well without it. The nurse decreased the flow to 0.5 liters of pressure for an hour today and she did well. They continue to decrease the pressure for longer periods of time until she's breathing on her own with no extra oxygen or pressure
Her IV:
If you've seen today's pictures, you might have noticed that she now has her IV in her scalp. She's had to have her IV replaced a couple times in the NICU. Because Sadie is a bit more chubby than the normal NICU baby, it a little harder to find good veins for her IV. They spent 10 or so minutes trying to find a good vein in her hands or feet and were unsuccessful. The next step in to put an IV in her scalp. They say that it's actually less painful than a hand or foot IV and it will actually last longer. So hopefully she won't need her IV relocated for a while. My mom asked me what they were giving her though the IV and I'm sure she's not the only one. As far as I know it's just nutritional and doesn't include any medicine. If I remember right, it's some form of sugar (dextrose?), some lipids (fat), a neonatal vitamin mix, and some other things.
Other stuff:
Her bilirubin level bumped up a bit and was up to 7.2 from 6.7 yesterday. This is normal and as long as it's below 10, she shouldn't need to be on the lights anymore. She is also regulating her temperature quite well. One of the nurses said that if she's able to sustain her body temperature on her own, she'll be able to move from the isolet to a bassinet. That's another of the little steps she needs to take in order to come home. Every little step helps.
Mom and Dad:
We're doing well. Jen continues to heal from her c-section and is able to do more and more each day. The pain with her pelvis, or Sympysis Pubis Separation, is still rearing it's ugly head when she's lying down, but she's able to sit, stand, and walk with little or no pain. We are adjusting very well to getting up three times a night due to Jen's pumping schedule.
Technical Update:
If you haven't noticed, I finally got the video of Sadie being born up onto YouTube.
Feedings:
She also started getting fed from a bottle and breastfed. In terms of the amount she's eating, it is being increased by 2cc's every feeding. She was up to 16cc's (about a tablespoon) at her 10:30am feeding. They will gavage her through the tube to her stomach most of the time and bottle or breastfeed starting twice a day. They will then increase that number as she does better and better at her feedings.
Breathing:
The doctor has also ordered that she get weaned off the nasal cannula as long as she is able to breathe well without it. The nurse decreased the flow to 0.5 liters of pressure for an hour today and she did well. They continue to decrease the pressure for longer periods of time until she's breathing on her own with no extra oxygen or pressure
Her IV:
If you've seen today's pictures, you might have noticed that she now has her IV in her scalp. She's had to have her IV replaced a couple times in the NICU. Because Sadie is a bit more chubby than the normal NICU baby, it a little harder to find good veins for her IV. They spent 10 or so minutes trying to find a good vein in her hands or feet and were unsuccessful. The next step in to put an IV in her scalp. They say that it's actually less painful than a hand or foot IV and it will actually last longer. So hopefully she won't need her IV relocated for a while. My mom asked me what they were giving her though the IV and I'm sure she's not the only one. As far as I know it's just nutritional and doesn't include any medicine. If I remember right, it's some form of sugar (dextrose?), some lipids (fat), a neonatal vitamin mix, and some other things.
Other stuff:
Her bilirubin level bumped up a bit and was up to 7.2 from 6.7 yesterday. This is normal and as long as it's below 10, she shouldn't need to be on the lights anymore. She is also regulating her temperature quite well. One of the nurses said that if she's able to sustain her body temperature on her own, she'll be able to move from the isolet to a bassinet. That's another of the little steps she needs to take in order to come home. Every little step helps.
Mom and Dad:
We're doing well. Jen continues to heal from her c-section and is able to do more and more each day. The pain with her pelvis, or Sympysis Pubis Separation, is still rearing it's ugly head when she's lying down, but she's able to sit, stand, and walk with little or no pain. We are adjusting very well to getting up three times a night due to Jen's pumping schedule.
Technical Update:
If you haven't noticed, I finally got the video of Sadie being born up onto YouTube.
Wednesday, January 23, 2008
Making Progress
Sadie continues to make very good progress. Her bilirubin number dropped another four points today to six so they took her off the lights. They will continue to monitor her bilirubin level for the next couple days but as longs as she stays under 10 or so, she'll stay off the lights. She definitely looked a lot pinker today. She is also doing better breathing so the nasal cannula is down to 1 liter of pressure. And last but not least, they will be increasing her feedings 1cc every 3 hours. She started today with 5cc's of milk and add 1cc every feeding as long as she does well with more food.
Sadie still has a lot of things she needs to do in order to go home, but we are very thankful that she's progressing so quickly. Thanks again for all your thoughts and prayers!
Sadie still has a lot of things she needs to do in order to go home, but we are very thankful that she's progressing so quickly. Thanks again for all your thoughts and prayers!
Tuesday, January 22, 2008
Long road with many steps
Life in the NICU is a long road with many steps. There is still a lot of growing and developing Sadie needs to do before she gets to come home. We still expect her to be in there for a month or more. The good thing is that she is consistently making progress.
Respiratory System:
She has gone from a CPAP with oxygen levels in to 30% range down to 21% (same as normal air). Then she graduated to a nasal cannula. She's currently between 21-30% oxygen at 2 liters of pressure. The next step is to lower the pressure to 1 liter. This may happen tomorrow or the next day. Then when she is breathing fine for a day or two on the cannula with 21% oxygen and 1 liter of pressure, they'll try removing the cannula. The trick is to give her just enough support for her respiratory system to grow and develop without creating stress on Sadie.
Feeding:
She's currently eating 5cc's of milk every three hours. She has been doing well with this so they will most likely start increasing the amount they feed her tomorrow. They will continue increasing the amount and eventually she will graduate to being bottle fed. The danger with going to the bottle to quickly and it can have an effect on the respiratory system as Sadie may be concentrating on eating too much and forget to breathe. "Suck-Swallow-Breathe" is one of the main things Aedan has to master before he was able to come home.
Heart:
Looks like we are out of the woods for the most part on this front. Her hole (PDA) closed successfully with the first set of indocin. The only residual "problem" is a slight heart murmur. The name for this has escaped me, but it was caused when the hole closed. The closing of the hole created a small part of the heart that is a bit thicker than it should be. This causes a little turbulence in the heart, thus the murmur. This will work itself out as the heart grows and will not prevent Sadie from coming home. The cardiologist said the Sadie's pediatrician will be notified and will follow up as Sadie gets older.
Final Thoughts:
We're adjusting to life at home with Aedan again. I can tell he likes being home, although he did enjoy his sleepovers with Grandpa/Grandpa and Nanny/Papa. He is an extremely well balanced kid and we are very thankful that he did so well being away from us as much as he was. Jen's walking quite well but sleeping is still a core. The pelvis pain still is occurring when she lays on her side or turns over in bed. Please pray that she's able to sleep well and that the pain continues to subside whether she's walking, sitting, or laying down. Well, it's time for bed. Thanks again for all your prayers and well wishes - they mean the world to us.
Respiratory System:
She has gone from a CPAP with oxygen levels in to 30% range down to 21% (same as normal air). Then she graduated to a nasal cannula. She's currently between 21-30% oxygen at 2 liters of pressure. The next step is to lower the pressure to 1 liter. This may happen tomorrow or the next day. Then when she is breathing fine for a day or two on the cannula with 21% oxygen and 1 liter of pressure, they'll try removing the cannula. The trick is to give her just enough support for her respiratory system to grow and develop without creating stress on Sadie.
Feeding:
She's currently eating 5cc's of milk every three hours. She has been doing well with this so they will most likely start increasing the amount they feed her tomorrow. They will continue increasing the amount and eventually she will graduate to being bottle fed. The danger with going to the bottle to quickly and it can have an effect on the respiratory system as Sadie may be concentrating on eating too much and forget to breathe. "Suck-Swallow-Breathe" is one of the main things Aedan has to master before he was able to come home.
Heart:
Looks like we are out of the woods for the most part on this front. Her hole (PDA) closed successfully with the first set of indocin. The only residual "problem" is a slight heart murmur. The name for this has escaped me, but it was caused when the hole closed. The closing of the hole created a small part of the heart that is a bit thicker than it should be. This causes a little turbulence in the heart, thus the murmur. This will work itself out as the heart grows and will not prevent Sadie from coming home. The cardiologist said the Sadie's pediatrician will be notified and will follow up as Sadie gets older.
Final Thoughts:
We're adjusting to life at home with Aedan again. I can tell he likes being home, although he did enjoy his sleepovers with Grandpa/Grandpa and Nanny/Papa. He is an extremely well balanced kid and we are very thankful that he did so well being away from us as much as he was. Jen's walking quite well but sleeping is still a core. The pelvis pain still is occurring when she lays on her side or turns over in bed. Please pray that she's able to sleep well and that the pain continues to subside whether she's walking, sitting, or laying down. Well, it's time for bed. Thanks again for all your prayers and well wishes - they mean the world to us.
The hole is gone!
The hole (patent ductus arteriosus) that Sadie had in her heart has closed up. Praise God! We got a call from the cardiologist this morning and she said that the hole was completly closed.
We visted Sadie this morning. She still is as cute as ever. She was put back on the CPAP for a while last night. They ended up suctioning a lot of stuff out of her nose and after that she was put back on the nasal canula and has been doing well ever since. She's also "eating" through the tube to her stomach and has been tolerating that well.
If all goes well with the lights, she'll be off of them tomorrow. If she does okay will the 5cc feedings, they'll most likely start increasing the amount she eats.
We visted Sadie this morning. She still is as cute as ever. She was put back on the CPAP for a while last night. They ended up suctioning a lot of stuff out of her nose and after that she was put back on the nasal canula and has been doing well ever since. She's also "eating" through the tube to her stomach and has been tolerating that well.
If all goes well with the lights, she'll be off of them tomorrow. If she does okay will the 5cc feedings, they'll most likely start increasing the amount she eats.
Monday, January 21, 2008
Home at last
It's nice to be home but it was hard to leave Sadie. We know that she is where she needs to be now, but it's still hard. After we got home, we cried a bit, slept a bit, and then Jen's parents brought Aedan and Brutus back to us. It's great having most of the family back together and are looking forward to having Aedan full time again; we've really missed him.
Sadie is still on the nasal canula which is a great sign the indocin is working. Hopefully, we will hear the good news that the hole has closed when we visit Sadie tomorrow.
It's a little after 10pm - Aedan's fast asleep, Jen's snoring peacfully, and I'm ready to join her...
P.S. There are more pictures and a new video of Sadie kicking.
Sadie is still on the nasal canula which is a great sign the indocin is working. Hopefully, we will hear the good news that the hole has closed when we visit Sadie tomorrow.
It's a little after 10pm - Aedan's fast asleep, Jen's snoring peacfully, and I'm ready to join her...
P.S. There are more pictures and a new video of Sadie kicking.
Under the lights without the CPAP
Sadie has started her light therapy for jaundice. She has two bright lights shining down on her making her look like she's in a tanning booth. They measured her bilirubin level and it was at 13.9 and the lights will get this level down. It's nothing serious, just something preemie's have to deal with since their livers usually aren't working at 100% yet.
A little before noon Liz was able to take off the CPAP and graduate Sadie to a nasal cannula. So far Sadie has been doing great keeping her oxygen saturation levels where they should be.
Sadie also had her last dose of indocin. Now it's time to wait for the indocin to work and close the hole in her heart.
Jen had her staples removed and replaced with steri-strips. She's also doing very well. We are in the process of figuring out when exactly we'll leave for home today.
A little before noon Liz was able to take off the CPAP and graduate Sadie to a nasal cannula. So far Sadie has been doing great keeping her oxygen saturation levels where they should be.
Sadie also had her last dose of indocin. Now it's time to wait for the indocin to work and close the hole in her heart.
Jen had her staples removed and replaced with steri-strips. She's also doing very well. We are in the process of figuring out when exactly we'll leave for home today.
Sunday, January 20, 2008
Holding Sadie
Jen was able to hold Sadie again tonight. But why haven't you held her yet, you ask? Well, I love seeing mommy and daughter bond. Plus, Jen's been through enough and has earned the first few times that we can hold Sadie. And last, but not least, I get to see her way more because I am the one that accompanies vistors to see her.
Sadie's status really hasn't changed all that much. She took the first dose of indocin at noon and will take the last two tomorrow - one at midnight and the last at noon. Please keep praying that the indocin will work and the hole will close without surgery.
Mom and Dad are mentally preparing for departure tomorrow. It will hit home a little more once we are way from the hospital and aren't within walking distance of our girl. I'm so thankful that she's only 20 minutes away. This time around will be so much easier than the one hour trip from Livermore to Oakland when Aedan was in the hospital.
Sadie's status really hasn't changed all that much. She took the first dose of indocin at noon and will take the last two tomorrow - one at midnight and the last at noon. Please keep praying that the indocin will work and the hole will close without surgery.
Mom and Dad are mentally preparing for departure tomorrow. It will hit home a little more once we are way from the hospital and aren't within walking distance of our girl. I'm so thankful that she's only 20 minutes away. This time around will be so much easier than the one hour trip from Livermore to Oakland when Aedan was in the hospital.
Technical Difficulties
I know I promised getting the video of Sadie's birth posted. Well, that video was taken with an actual video camera and saved the video directly to a DVD. I having a bit of trouble converting the videos to a format that I can edit on the computer. Granted, I'm trying to do this with software I can download for free. I guess you get what you pay for...
High Tech Hospital Stay
The hospital has WiFi and I have some time on my hands between visitors, checking on Sadie, and helping Jen out. As you can see, I'm turned my e-mails into blogs. I'll still be sending out e-mails, but I may blog little things that don't make it into the e-mails. We will see how long this goes. Along with my blog, here a list of where to find everything:
Blog: http://bullfrogskin.blogspot.com
Pictures: http://picasaweb.google.com/bullfrogskin
Videos: http://www.youtube.com/bullfrogskin
Blog: http://bullfrogskin.blogspot.com
Pictures: http://picasaweb.google.com/bullfrogskin
Videos: http://www.youtube.com/bullfrogskin
Not your normal PDA
The neonatal cardiologist visted us. I'll preface this with this: Sadie's okay and this is a normal premie thing to deal with - it just sounds worse than it is. Because she's been on the CPAP for a couple days and is not tolerating being off of it, they decided to check out her heart. Turns out she has the following: "Patent ductus arteriosus (PDA): a small hole in the heart that normally closes by itself, but may be more likely to stay open in preemies" Babies have this hole to bypass the lungs before they are born (since they aren't breathing). Normally (hole closed) the blood goes from the body into the right atrium, then into the lungs, then to the left atrium, and back into the body. With the hole, a portion of the blood goes from the left atrium back into the lungs instead of going into the body. This causes the lungs to work a little harder than they should. For more information and pictures, click here. To correct this, they are going to give her three doses of Indocin (Indomethacin) starting today at noon and happening every 12 hours. Because she's an older preemie, she has a great chance that this will work the first time. They plan on evaluating her again on Tuesday. If the hole is still present, they will try the medication again. The nurse we talked to said that she's only seen two babies Sadie's age not respond to the indocin in her ten years of nursing. But if for some reason it doesn't work, they would preform a simple surgery while she's still in the NICU to close the hole.
Prayer requests:
Please pray the the indocin works the first or second time and she won't need the surgery. Please also pray that this is the reason that she's needed to be on the CPAP and after the hole is closed, her lungs will start working to the point where she doesn't need it anymore.
Mom and Dad:
We are doing well. Liz prepared us by saying what PDA was and that it may be a possibility with Sadie. Because we already knew what it was, we weren't as shocked this morning as we could have been. I had a bit of a hard time yesterday as I realized emotionally that Sadie was going to be in the NICU for a while. My head knew it was going to be a month or more, but I guess it took a while for my heart to catch up. Jen's progressing well and it able to walk more and more with less and less pain.
Prayer requests:
Please pray the the indocin works the first or second time and she won't need the surgery. Please also pray that this is the reason that she's needed to be on the CPAP and after the hole is closed, her lungs will start working to the point where she doesn't need it anymore.
Mom and Dad:
We are doing well. Liz prepared us by saying what PDA was and that it may be a possibility with Sadie. Because we already knew what it was, we weren't as shocked this morning as we could have been. I had a bit of a hard time yesterday as I realized emotionally that Sadie was going to be in the NICU for a while. My head knew it was going to be a month or more, but I guess it took a while for my heart to catch up. Jen's progressing well and it able to walk more and more with less and less pain.
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