Chunky Monkey

My little guy is a roly poly 4lbs 9oz as of last night! He was extremely sleepy when I got there for the 8:30 pm bottle. He was having desats around 85% (limit is blood O2 levels <88%) because he was taking shallow breaths or forgetting to breathe at all so I popped the bottle out to let him catch up and he wouldn't wake up after that so he got the last 10ml by tube. The nurse this morning said he took all bottles throughout the night and did well. So for his 8:30am feeding again today he was sleepy but finally finished it - I don't think he's a morning person he must take after Daddy! :) He was having really bad desats - like around 80% - so the nurse gave him a shot of oxygen. No idea why he started doing this now - I squeegee'd his nose but it wasn't stuffy. She thought maybe he was moving his feet and the monitor wasn't picking up very well because he hasn't been having desats like that and hasn't had oxygen in several weeks. Hopefully he will pull out of this desat trend today and get the NG tube out of his nose which would help!

This is a picture of Nick's condo. Doesn't he have a great view of the beach? It was actually painted by Sean's 2nd grade art teacher Olivia Scott. And I used to work with her husband back in the environmental lab days- small world huh?

4lbs 7.5 oz

Nick was 4lbs 7.5oz when I called last night. Sean had a swim meet 4:30 - 9:30 (and I thought soccer games were long holy smokes!) so I couldn't make the evening feeds. The nurse had given him a bottle at 8:30 which I think is the 1st one he's gotten from anyone else besides me. She said they were going to try a bottle at every other feed which is 8:30 and 2:30. I called this morning and he had gotten one at 5:30am (he was probably too tired at the 2:30am feed so they waited). Well we weren't sure he would be interested in a bottle at 8:30 for me...but sure enough he was! He drank 37ml in 5min flat (pass the Alkaseltzer). He keeps it down fine even though everyone is pretty surprised he's got such gusto when the bottle is about as big as his leg! That is 24 calories/ounce.

I came home for an hour and Nurse Kristin called and said Nick was wide awake if I wanted to give him the 11:30 bottle - heck yeah! So 20 min later I was parked in the special care nursery feeding him again...I could probably sit there all day rocking away. He took yet another bottle - 3 in a row. Very good job, baby!

What do babies dream about?

I've got a long to-do list sitting in front of me and look where I am *sigh*. I'm busier now than when I was working - and I'm so good at procrastinating. Some days it just seems like the hospital will never end. Then some days I can't believe he's 7 weeks old (or minus 5 weeks from his due date!)! Since he's closer to home now I've been going over twice a day but not staying as long. I give him his 2:30 and 8:30 bottles and when he falls asleep I put him back. He's so funny he drinks the 1 ounce in like 5 minutes then he moans and looks like "Oh my God why did I do that!" Like that Alkaseltzer commercial I can't believe I ate the whole thing! I'm thinking it'll be 1.5-2 weeks til he's home. They aren't pushing him too hard so he's still only getting 3 bottles a day (NG tube for 5 feedings to let him rest) . So he's got a ways to go. He did get his big boy bed today how exciting! That means he meets 1 of the criteria for him coming home (1. keep temperature steady 2. take all feedings by bottle 3. have no desats (apnea) and no bradys (bradycardia)

The swim meet was cancelled last night due to lightning so I did go for Nick's 8:30 bottle. He was getting a bath when I got there...he loves that! He was 4lbs 5.5 oz. His eyes were swollen from the eye exam poor baby. I gave him his bottle (35 mls) then he fell asleep from exhaustion - it's hard work for such a little guy to master the suck -swallow-breathe skills (which usually happens at ~34 weeks gestation). He was smiling and dreaming - what do babies dream about?

Out of the box!

Nick is getting 3 bottles a day now (35ml). I go the hospital for 2 of them (2:30 and 8:30) and the nurse tries to do 1 during the night - but so far he's been too tired to drink that one. Last night they opened up Nick's incubator like a DeLorean to room air and he has kept his temperature up just fine. So tomorrow he may get his very own crib like a big boy. He's 4lbs 4oz. now and actually has chipmunk cheeks - he's fair and looks like his mama and he's just now getting blond eyelashes. I went to feed him his bottle at 11:30 and the Dr. was there to give him his eye exam...good news - no sign of ROP (Retinopathy of Prematurity). He has premature blood vessels which is normal at his age (almost 36 weeks) and we'll get another exam in 2 weeks to make sure he's progressing. The blood vessels are in level 2 if you look at the diagram in the ROP link half way down the page. After that he was too tired to take his bottle so he got it by tube. Sean has a swim meet tonight so I won't be back to the hospital til tomorrow.

Good days

Friday June 22, 2007
Nick is 35 weeks old (adjusted) and weighs 4lbs 2oz. I went to see him at the 2:30 feeding (tube) and just held him. He was alert and hungry and looking for a bottle but they are only allowing 1 bottle a day to start. He had a few beeps from the pulse ox* but not too bad. He can't have any of those desats if he wants to come home. Sometimes he has those when he's tired or if his neck is tilted too far back or forward. The Duke nurses would say he was looking for chest hairs. :)

We're hoping to increase it to 2 bottles in a couple days if he does well and drinks the whole thing. Went back for the 8:30pm feeding - Bri wanted to feed him. He drank the whole ounce yay! He was in a very good mood after that and Sean got to hold him too. He's MRSA + on the 2nd swab too. He's not infected with it - he just has it on him. Who knows why. Especially after 4 weeks being negative?!

*(Pulse Oximeter - The "pulse ox" continuously measures the baby's blood oxygen. There is a tiny light which is attached to the baby's palm, foot, finger, toe, or wrist by a piece of adhesive elastic. A cord travels from the light to a machine that displays the amount of oxygen being carried by red blood cells in the baby's body. Each hospital is different but 85-88% blood oxygen is the cutoff from our experience. Ideally we like 90%+.

Thursday June 21, 2007
Decided Nick was more awake and alert when we went at 8:30 so I went at that time tonight. He was wide awake and raring to go. He drank almost the whole ounce in about 3 min! Then he got the hiccups and tried to drink a little more but choked so that was it. But he only had 6ml left. Unfortunately he turned up MRSA positive again :( I don't know how that happened as he was negative for 4 weeks in a row. So he's on contact isolation which is basically for the nurses (extra gown and gloves) it doesn't really affect us. He just had the bacteria in his nose he doesn't have an infection and we definitely hope it stays that way. Nasty bug!

We'll get the results of the 2nd swab tomorrow night. He's off the reflux medicine (zantac and reglan) and seems to be doing fine.

First bottle

Nick was transferred to Cary and did great on the ride. He's all moved in to his new pad and is settling into the new routine. He's getting 2 more MRSA swabs to be sure he's negative since this is a new hospital but other than that all is staus quo. We all went to see him last night and I got to give him his 1st bottle. He was very alert and when he started sucking his eyes got wide and I could almost hear him thinking "Wow nothing ever came out of my pacifier before this stuff is GOOD!" :)
He drank almost the whole 1oz which really surprised me. I thought he would choke or gag on the first bottle but he was a pro. He fell asleep toward the end so we put him back in his condo and nurse gave him the rest of his feed in his tube. He'll get 1 bottle a day to start - then we'll work up to all bottle feeds. He's 3lbs 10oz. tonight and should be going home in 2-3 weeks!

Road trip!

Since Nick is now MRSA negative and doing so well, he no longer needs a level III NICU so he's going to a level II. He's getting transferred to Wake Med Cary this afternoon - which is only 8 mi away from home as oppsed to Duke which is 25. So that is good news! He's almost what the nurses call "a feeder and a grower" - it means he has no health issues or problems, he's there just to grow big and strong enough to come home. Once he gets the hang of the bottle he'll definitely be ready to graduate. I held him for an hour then changed his diaper and put him in his preemie Elmo outfit for the trip to Cary.

Sean came home (after 6 weeks) at 4lbs 6oz. so we're getting close!! I remember taking Sean to his 1st Dr. visit and one lady looked at him in the elevator and said "He's so small!!!!!!!!!!" I'm like "What do you mean he's huge!" Well when you're born at 2lbs and a few spare ounces, 5lbs seems like a porker!

Thank you to all the doctors and nurses at Duke who were so awesome! Forgive me I don't want to miss anyone (I didn't start learning names until a couple weeks into the game): Kim K., Annette, Alicia, Lori, Michelle, Ashby, Kathleen, Randi, Rachel, Karen, Kaleigh, Julie, Lisa, Mary, Tana, Shanda, Nicole - you're great you made all the difference!

Kick some MRSA butt!

Nick got a perfect score - 4 negative MRSA swabs in a row so he has moved out of the contact isolation room! He's doing well eating too. They started a few weeks ago with 2hrs on and 2 hrs off and he's now 1hr on then 2 hrs off. If he does well they'll do 30 min on and 2 off. They're getting ready to try a bottle so he has to be able to take the food faster than 1-2hrs! Things will be speeding up now...not sure if he'll go to Rex or not - it's up to them. I like Duke, the nurses and doctors are wonderful and they know him there.

He was 3lbs 9.5oz but he hasn't pooped in a day or 2 so that could be a bit off! I told you everyone spends a huge amount of time contemplating baby poop! :D

97 degrees and no A/C :(

Our A/C units (yes both of them!) decided to konk out a couple days ago. I'm already dying and it's supposed to get up to 97 degrees today. Someone is coming out "sometime today" - who knows when - so I probably won't be able to get to the hospital. I'm bummed. Hopefully it'll be an uneventful day in the ICN.

Transfusion #2

Nick weighs 3lbs 7oz today! His hematocrit was a bit low so he had his 2nd transfusion today - so the blood might be adding to his weight a bit. They had to put an IV in and try a few times because his little hands were still bruised from the one on Monday (NEC scare). He did well with it but was a little puffy from the fluid so they upped his lasix (a diuretic). I held him for about an hour and a half today. The nurse had to give him a bath because she used the old glycerine chip trick and he filled 3 diapers. He was chilly after his swim so when I got there he was bundled up like an eskimo baby.

Father's Day

We all went up today. Bri held him for about 30 or 40 min (Sean and I went and had a snack) but they're restricting his "outside time" because of his feeding issues. He hasn't been gaining as much weight lately because of the formula change and all - so Sean and I didn't hold hm. Getting him in and out and handing him to different people uses calories...he is still around 3lbs 2oz - don't know what he is tonight yet. They'll weigh him before feeding at 9. The nurses made a sweet fathers day card with his footprints.

He's keeping his temp up well. They started off with his bed detecting his temperature and it would go up or down as he needed. Then they set the bed at around body temp and he had to adjust his own body. Now they have the bed set to room temperature and he's still keeping his temp up well so next week he should be going to a big boy bed with lots of blankets. He's is now wearing a tshirt or onesie - so cute. Rosanne said she was going to mail me some preemie clothes so hopefully she will. I hate to buy a lot of that small size but he could use a few.

He's been there over 30 days so we could get a parking pass at least! So we get free parking whooppee. One more negative MRSA and he'll get moved out of that room and maybe even to Rex as early as next week. As long as he's MRSA negative they'll take him.

Whatta doll!

Friday June 15, 2007

I wanted to get a picture of Nick with this doll to gauge his size in the future - they're actually about the same size right now. So I said "Nick pose like the dolly and we'll get you out of the hospital really soon!" and this is what he did!! Just kiddin...my kids don't listen to me that well...

Thursday June 14, 2007
As soon as I got to the hospital this morning the nurse was trying another glycerine chip routine and very soon the plumbing was fixed! Everyone was very happy. I'm sure Nick was happy also because when I held him he slept for an hour. He lost a few grams today which is no surprise - so hopefully he'll be on the road to gaining again tomorrow.

He got the nasal canula and the IV port out yesterday so that's 2 less wires to mess with.

What's for lunch?

My breastmilk is dwindling...one of the hazzards of being hooked up to a plastic contraption vs. feeding the "normal" way. Nick is having digestion issues on the formula so the drs are trying to find one that will work for him. So far we had the NEC scare on Monday and he hasn't been pooping. One thing you wouldn't know if you don't have kids is that baby poop is a huge deal. We have a lot of doctors and nurses getting paid a wheel barrow full of money to find out why he's not pooping. Let's hope the plumbing starts working soon!

NEC...or not?

Tuesday June 12, 2007

Good day at the NICU! Held Nick for an hour and 45 min. and he slept the whole time. He was one worn out baby today. After the IV/antibiotics and bowel xrays yesterday, today he had his eye exam for ROP (retinopathy of prematurity) and a head ultrasound. The eye exam left his poor eyes red but the results were very good...no sign of ROP. The ultrasound was also good...no sign of cerebral hemorhage. They dressed him in a way-too-big onesie. The size is "under 10lbs" so you could fit 3 of Nick in it...but it's so cute.

Monday June 11, 2007
I went up to the hospital this morning and found out that they had taken xrays of Nicks bowels because they didn't sound quite right and he had some residual in his stomach which indicates that he wasn't digesting as well as he had been. They were concerned about NEC - necrotizing enterocolitis which a large percentage of preemies can get. It's an infection of the intestines that can eat away the walls and cause perforations. The doctor said his first xray was borderline so they weren't really sure...in his words "it could be nothing or it could be devastating" Here is a link that explains it more http://www.hoinews.com/news/news_story.aspx?id=21913

I just turned around and came home because they had to put an IV in and a bunch of other needle sticks to do blood cultures and I couldn't stand to watch that. It would've been over an hour and I thought he could use the rest after all that. We waited all afternoon for the results of the 2nd xray and at 6:00pm -Bri called the nurse and everything is ok. He doesn't have NEC!

Even though formula is very good these days, breastmilk is easier digested in most cases so it could've been just the transition from breastmilk to formula or just a random thing - So another bullet dodged! He's 3lbs 2oz as of last night and eating 19.3ml/hr (about 7oz./day). He looks downright plump at this weight (compared to a few weeks ago!).