Monday, February 28, 2005

George is two months old today! Happy birthday! He's cuter than ever. Aunt Amanda came out to visit: she hadn't seen him since his first week.

Today was his first post-steroid day this cycle, and sure enough, his oxygen needs crept up a little. Tonight he was at 72%. He's still on CPAP though, which is quite an accomplishment, no matter how you slice it. The next couple of days will determine if he stays on CPAP or needs to be reintubated and put back on the ventilator.

Sunday, February 27, 2005

George now weighs 2.098 kilos (4 pounds 10 ounces). :-)

I got to bottle feed him today for my first time, and he did fantastic. He's still limited to test bottle feedings of 10 cc, since more than that might wear him out, and we want his energy to go to his healing lungs. Apparently the breathing/sucking/swallowing combo takes a lot of concentration for newborns.

I also got to give him a bath today. He didn't like it at first, then decided to enjoy it.

Saturday, February 26, 2005

George had a lot of visitors today. Scott B., Pat B., and David M. came up at lunch, and Aunts Barb, Kathy, and Melinda came up in the evening. It was great to get to share him with so many loved ones.

He did a great job on another 10 cc bottle feeding.

Today is the last day of his second nine-day steroid regimen. If all goes well, he'll be able to stay on CPAP. We're keeping our fingers crossed.

Friday, February 25, 2005

Our big news today is: George surprised everyone and had his first bottle feeding! Nurse Kim thought he might be ready for it, and got permission from NNP Elaine. He drank 9 cc from a 10 cc bottle (1/3 ounce): the rest of his 36 cc feeding went through his tube. He did fantastic. We didn't expect him to get to even try to bottle feed for another week or two.

Allie and I each got to hold him for two hours. He got lots of sleep.

Thursday, February 24, 2005

George's second CPAP day went very well. I got to hold him for an hour and a half today, and he was comfortably napping the whole time. Later in the day Carly got to hold him, too.

His oxygen needs are in the 60's, which is fine. For a CPAP transition period like this, it's normal for a baby's oxygen needs to be double what they were when intubated.

Overall George is resting well, and very social. Good timing, since he'll have some out-of-town visitors this weekend. :-)

Wednesday, February 23, 2005

Today was one of George's best days ever. He was extubated and put on nasal CPAP, which is a big step forward in his respiratory progress. For the first time in his life, he does not have an air tube in his trachea. CPAP is much less invasive, and will be easier on his growing lungs. And with CPAP, his vocal cords are unobstructed, so now we can hear what he sounds like. So far we have heard him squeak and cry a little, but nothing big, yet. He's doing a great job getting used to the CPAP gear plugged into his nose.

He gets chest x-rays every day or two. Today, for the first time, his x-ray looked marvelous, very clear, with a high degree of expansion.

Here's a picture of what he looks like in CPAP gear:

I got to hold him this afternoon and look at that pretty face. What a handsome boy!

Tuesday, February 22, 2005

George is eight weeks old tonight! Yay George!

Aunt Alisa came to visit today (I think she might like him a little bit).

All sorts of hints about CPAP were dropped today, and it sounds like tomorrow will be his big day.

George was generally restful and happy today. He was very alert and social, charming innocent bystanders with his handsome eyebrow wriggling.

Monday, February 21, 2005

Gram got to hold George for the first time, for 45 minutes tonight.

George got an eye exam today, and he has stage 2 ROP. There's a very good chance he'll heal by himself, as he gets older.

He continued to make respiratory progress today, as he continued to tolerate further weaning from the ventilator.

Sunday, February 20, 2005

George is making good progress with his steroid treatments. Today his oxygen needs got down to the low 40's, practically unheard of for him. Since "room air" is 21% oxygen, we are very excited about this.

He is now cleared to be held twice a day, once for kangaroo care (parents only), and once bundled up (parents or grandparents only) just like a baby! So Carly got to hold him for the first time ever tonight.

Allison and George got to kangaroo for two hours today. Since we're kangarooing daily, we may stop mentioning it here. But don't get me wrong, it's still the coolest thing ever.

Saturday, February 19, 2005

George had a great day today. His steroids seem to be working well.

Aunt Dorothy, Cousin Ruth, and her girls Annamarie and Gabrielle came to visit today. It was great to see everyone. Ruth got to meet George and chat with me.

I got to kangaroo him for a full 2 hours and 15 minutes today, and he (okay, we) tolerated it very well:

Today is the first day he wore clothes:

Tonight, if all goes well, the doctors and nurses will attempt to take advantage of this second 9-day steroid treatment to begin to wean him off of the ventilator. The goal is to try to switch him to CPAP by Wednesday. So far his progress is good, 48 hours into the treatment.

Friday, February 18, 2005

Things improved for George today:

He now weighs 1992 grams (4 pounds 6 ounces).

He started his second 9-day round of steroid treatments.

He got to kangaroo with Allison for an hour.

His feedings are now 34 cc every 3 hours.

I hope to get kangaroo with him tomorrow, and take more pictures.

Thursday, February 17, 2005

Well there was no kangaroo care for us today (but Uncle Scott came to visit).

George's oxygen saturation levels were bouncing from high to low in a disconcerting way today, so Dr. Kelly has put him on a fancier respirator in an attempt to make George better. This fancy ventilator has more variables that can be adjusted, in effect supporting George's breaths more gently, instead of blasting air down his trachea.

It's sounding like we'll be starting a second round of steroids in the near future.

Wednesday, February 16, 2005

George and Allison kangarooed for an hour today, assisted by Nurse Elaine O'Brien. Allie and Elaine had a nice chat while George slept away on Allie's chest.

He's reached the age/weight where he can now be swaddled, and he's enjoying it.

Looks like his cracked rib has healed.

His tracheal aspirates have been cultured over the last ten days, and what had been potentially harmful traces of fungus have turned out to be benign. As far as his ventilator settings go, his assisted breath rate is now at 32, down from 40, meaning George is doing more of his own breathing. Lately his oxygen needs are in the high 60-low 70%s.

For now the doctors' strategy is to let him grow and strengthen a while, before we consider any changes (more steroids, CPAP, etc.).

Tuesday, February 15, 2005

George and I kangarooed for a whole hour today. What a great experience. He is tolerating the move to/from his bed very nicely. And there's nothing like the buddha-on-buddha of kangaroo time with Daddy for quality male bonding.

Nurse Lesa helped Allison give George his first tub bath. He really enjoyed it. Then he got warm blankets when he got back into bed. :-)

And if that was not enough for one day, George got weighed today and is up to 1867 grams (4 pounds 1 ounce). That's awesome.

Monday, February 14, 2005

Today Allison and George got to kangaroo for 90 minutes. George was perfect, content, and stable the whole time.

George gave out Valentine's Day cookies to the NICU staff, and Carolyn (his "Carly") brought candy for his team.

Recently a large purple monkey has taken up residence at George's bedside. Lee Ann, one of his Respiratory Therapists (RTs) gave it to him. George is making some really good friends!

Sunday, February 13, 2005

George now weighs 1707 grams (3 pounds 12 ounces). :-)

His feeding tube was moved from his mouth to his nose, since he kept playing with it, and could pull it out. His feedings are now at 30 cc (one ounce) every three hours, and include extra protein mixed in.

Allison and George got to kangaroo for an hour and a half today. They did great:

Saturday, February 12, 2005

We got to give George Elliott a bath today. Well okay, a sponge bath. It sure was fun for all involved. Overall he had a quiet day.

Friday, February 11, 2005

Today started off well for George, then fell apart, then got better.

Lately he's established a pattern of good oxygen stats ("high satting") after his respiratory treatments (suctioning), followed by poor stats ("low satting") during and after his feedings.

Low satting (low oxygen saturation) after feeding can sometimes indicate acid reflux problems in preemies.

We tried kangaroo care tonight, but were cut short when he low satted quite severely. When this happens (like it did tonight) his blood oxygen saturation gets so low that he starts to literally turn blue, and multiple respiratory therapists and nurses take quick action to get him breathing properly.

While scary as all get-out, this actually happens every night somewhere in the NICU. Sometimes the baby's breathing tube gets mispositioned, and other times the baby is actually clamping down on his tube, as if he's learning to hold his breath. Yikes.

Later in the evening George decided he had caused enough concern for one evening, and spent the rest of the night relaxing.

Thursday, February 10, 2005

It was my turn tonight to hold George Elliott!

I GOT TO HOLD HIM FOR 45 MINUTES.

Wow, what a peaceful feeling to hold our son for what was, for all practical purposes, my first time. He settled in for our kangaroo care period, and we did quite well together. Here's a picture (overexposed so you can see him in the shade):

His weight is up to 3 pounds 7 ounces. That's gaining an ounce a day for the last three days, a good sign.

Wednesday, February 9, 2005

George's left arm is free of the big metal (35 gram) splint he's worn for 23 of his 43 days. It was so nice to see his nice, normal arm free and comfortable. I know the splint was needed to stabilize his arterial catheter and how important that was, but now that it's not needed, it sure looks good to see his little baby arm unencumbered.

The down side to removal of the arterial line is: each time they need blood for gases or other tests, the nurses must stick George in a heel. Ouch! At least he won't be banging himself in the face with that splint.

Other than losing that heavy splint, he's had a quiet day. His oxygen needs are at about 55%, showing steady improvement.

I got to thank Lesa tonight for arranging for George to have this private, quiet room. All of his nurses are doing a very good job looking out for him.

Tuesday, February 8, 2005

George is six weeks old!

Last night George was relocated from the open bay (where he's been since day 1) to an isolated (glassed off) private room, in order to decrease the amount of noise he's subjected to. He's always been very sensitive to noise, and we're hoping the quiet will help him fight his chronic lung disease.

Big thanks to Nurse Lesa and Nurse Michelle for making this happen.

Today and tonight he has been resting peacefully. His blood gases look good, and his oxygen needs are between 80 and 75%. Tomorrow they may work on weaning his ventilator settings. Tonight Nurse Michelle is just letting him rest and enjoy his pacifier.

One bit a good news: he has officially doubled his weight. He was born at just 735 grams, and is now pushing 1479! That's 3 pounds 4 ounces. Excellent.

For those of you who haven't been able to visit George yet, here is what his world looks like:

That's his ventilator on the left (all of that). The display above his bed shows his blood pressure and blood oxygen saturation level. The red numbers above that are his temperature and bed heater readings.

Here's a bird's-eye view of his bed. Tonight he's snuggled in and all covered up:

Monday, February 7, 2005

Yesterday was two steps forward. Today was one step back. George had a rough day: everything seemed out of kilter. They had to turn up his ventilator settings: breath rate up to 60 from 36, pressure up to 27 from 24, all of this to keep his blood oxygen at reasonable levels. He also required additional sedation, again.

He's resting tonight and starting to bounce back.

No kangaroo care for me tonight! Allison is very sad for her boys.

Sunday, February 6, 2005

This morning we got a surprise phone call from Nurse Kim. She wanted to know if we wanted to "kangaroo care" George. We rushed to the hospital and Allison got to HOLD GEORGE FOR AN ENTIRE HOUR. Here are the photos to prove it!

It was wonderful to see the two of them together again. George seemed to really enjoy being with Mom. It's my turn to do kangaroo care with George tomorrow.

Saturday, February 5, 2005

George got a new breathing tube: he had outgrown the first one, and over the last several days had been making a chirping/snoring sound as a small amount of air escaped from around the tube. That was not a cause for alarm, but it finally became time to replace the tube.

He got great results from a head ultrasound that checks for small areas of the brain that aren't developing correctly: no problems found.

He got an eye exam, which stings since the doctor has to dilate and clamp open his eyes. After all that, George's results were pretty much as expected, "too immature to score" (coincidentally, a phrase often used to describe his father's essay exams in college). He should get more eye exams every two weeks or so. The exams are important due to the high amount of oxygen these preemies are treated with. This oxygen can interfere with eye development in a condition called "retinopathy of prematurity" (ROP).

And as mentioned before, he's down to a minimum of IVs (zero or one, depending on his pain medication needs that day).

Overall he's resting up and getting strong so that he can likely try CPAP in a few days (we'll see).

Friday, February 4, 2005

Today George finished his antibiotic treatment, which started three weeks ago. Thank goodness it worked: things were pretty dicey there for a while.

His steroid treatments ended yesterday: he may or may not need a second round, depending on how things progress. We wouldn't be surprised if he does need a second round.

He's off the Fentanyl drip, but may occasionally need a dose to calm him down. Sometimes he simply gets too fidgety for his own good.

One good aspect of getting off of all these medications is that he needs fewer IV needles poking him, a big source of discomfort. His veins have been traumatized by repeated sticking, and need a rest.

His oxygen needs have been all over the place today. He's resting tonight, and we hope this will be a restful weekend for him.

Oh and by the way he's gorgeous.

Thursday, February 3, 2005

George had a really good day today. What a relief. He rested all day, and his oxygen needs were in the 50-55% range. That's awesome. Plus, his feedings are back up to 23 cc every 3 hours.

It sounds more and more like he's getting ready to graduate from the intubated ventilator apparatus to what's called CPAP, which uses the same ventilator machine, but different headgear. It's a big step (there are many) toward respiratory independence, since it makes him breathe in on his own, as opposed to the respirator forcing him to breathe. (You can read more about CPAP using the glossary link to the left.)

George has been intubated his whole life: the thought of being extubated and trying CPAP has me excited and a little anxious. I really think he can do it.

Wednesday, February 2, 2005

Today was a relatively slow day. George got a lot of rest. His oxygen needs were all over the place, from the mid-50s to 100%. His ventilator-assisted breath rate is down to 25/min., which is good. He's back on full feeds through his feeding tube (non-IV).

I forgot to mention that his spinal fluid analysis came back showing no bacteria (excellent), and "scant" numbers of white blood cells (a minor concern). As a result they'll keep him on antibiotics for a few more days.

George is learning to control his eyebrows, and is starting to use them to flirt with the nurses.

Tuesday, February 1, 2005

George is five weeks old today! Here's a picture of our little prince, surrounded by his stuffed animals (the color is a bit off due to the low-light conditions):

He was holding my hand, that blob on the bottom left, for about 20 minutes.

After apparently wearing himself out this afternoon, George is resting better this evening. Nurse Michelle Price is keeping him comfy, and hopefully he'll sleep soundly.

Earlier today, George got all worked up and tried to crawl out of his bed (at 10 weeks preterm!). Thank goodness his mom was there to calm him. Today's stool samples were blood-free, so NNP Patty Downey let him resume his milk feedings.

He is making headway with his breathing: the ventilator is only doing about half the breathing for him, and he's doing the rest. His oxygen needs are still a little high (65%) but he is making overall progress.