NICU Day #36 - Updates

Wednesday, May 26, 2010

It's been a crazy day.

I got up with the kids around 7 and sat down with a twin on each leg. Usually takes me about 10 minutes of just sitting there to fully wake up and get motivated to get going on the day. About that time, I looked to my left and it was pretty obvious it was going to take Callie longer than that - she was out. Definitely not a good sign. When our kids fall asleep on the couch right after getting out of bed it means they don't feel well.

She woke up for her juice and then settled back in while Trevy and Landon helped me make breakfast. (Yes, more Chef Landon on video, but James has the camera right now so I'll have to add later.)

By 11:00, we have only accomplished making breakfast and watching 4 episodes of Super Why. I had also filled my last breast milk storage bag overnight and had two of my expression bottles in the refrigerator. I was racking my brain trying to figure out how to get to the store to get more bags when there was a knock at the door. Don't know how Amber knew, but there she was, standing in my doorway with a plate of cookies and bless her, she went and bought more storage bags for me. Thank you so much, Amber! We love you!

We never made it out of pajamas yesterday. I took a nap with the twins again. (Hate that Trevy watches so many movies, but love that she will and I can lock the doors and not worry about her going out or letting someone in.)

I called the NICU when I woke up for updates on Timmy, although I was fully planning on going in later. His flow rate was down to 14 on the ventilator. I was thrilled! When he gets to 12, he'll be close to another attempt at extubating! They are going to go a little slower this time, however, as it was just this past Saturday that they tried to take him off and he didn't do very well.

The one thing Ashley told me that disturbed me was that they started the feedings again. Not bothered so much by that but that we had asked to be called. We would just really like to be kept abreast of everything going on with feedings, as that has been Timmy's biggest obstacle since the day of his birth. The one positive is that they started him over on 1ml every 6 hours. Still Pregestimil, but I think more of us are coming on board with this being better for him than jumping straight to breast milk at this point. His intestines are having such a rough time that any assistance - in our case, this being pre-digested nutrition - is beneficial.

He received the first feed at 11am. As far as Ashley knew, they would just keep him on 1ml for a little while with the next step being to increase frequency from 1ml q 6hrs ("q" being medical speak for "every") to 1ml q 3hrs. I'm fine with that.

We lucked out yesterday that James's workday ended early. He walked through the door around 5:40. Oh, happy day! Having him home early gave me the chance to load the dishwasher. So fortunate that he isn't a neurotic clean freak. I hadn't had a chance to do any cleaning during the day and it's nice to know that a living room that looks like we're having an indoor yard sale doesn't bother him.

Finally got waffles thrown together for dinner around 6:30 and kids tucked in bed around 8. (Just running late and running ragged all around.) I was then able to take a shower and started getting ready to head back over to see Timmy. Mostly packed, one more pumping session and I was out the door...until it hit. Not sure what is going on inside me, but it actually hurts sometimes. Almost the entire 15 minutes were just not comfortable to just be sitting there.

James said his stomach was starting to feel not so good either so we decided it would be best not to track anything over to the NICU. So sad! I was so looking forward to another good holding session, but not with my stomach in knots!

I called again and talked to Christina. She told me that he was currently satting at 98 - phenomenal! This really goes up and down, but 90s are great. No change in plans on the feeding, he had received another milliliter at 5:00 and she would give him his third feeding at 11pm. He had also stooled with the last feeding and had no residuals. Great news to hear that he is pooping normally again. Still no blood. And he is getting very good at digestion single milliliters of food. Attempt #5...not a big surprise. It's when we get up to about 5ml that I start worrying.

I asked if there were plans to x-ray Timmy's abdomen more frequently now, just to keep tabs on the state of his intestines. She didn't know.

She also wasn't sure what the plan was for extubation attempt #2, but the flow rate would be dropped to 12 at 2am. Wonderful! He did really well last week when they would challenge him this way. (They drop his flow rate - number of assisted breaths/min - by 2 points every 12 hours and monitor how he does as opposed to watching him and dropping them when his O2 requirements drop and he doesn't need as much assistance, which doesn't happen as often.) At that time, his FiO2 (the percentage of oxygen being delivered by the ventilator) was at 43% and she dropped it to 40%. Room air is 21%, so that's a substantial assistance, but not a terribly high number.

His blood gases continue to come back good. CO2 was 48 (normal is 35-45), down from 49 at 4am. He gets his heal pricked at 4am and 4pm.

He was again on his belly and looking very comfortable. Looking forward to the day when people get to call me for his updates instead of me calling them!