Thursday, January 29, 2009

01-29-2009 Zachary Update

I've got great news this morning! First off last night he had another eye exam and the doctor said that all his vessels have grown out into Zone 3 without stopping early, the ridge is gone that started forming on his retina and he no longer has any signs of ROP. So whereas he was stage 2 ROP for a while it has all reversed and gone away. I've been very OCD about his oxygen with the nurses etc over the past couple months since we learned he was starting to get ROP. So I'm so glad that the efforts paid off!

Next, his main doctor took him down to 1/2 a litre for his cannula. He's been on room air 21% since I got here. He was higher when I first came in then he pooped (finally rofl) and is back down to room air! So it's a miracle he's not had to be bumped up while on the 1/2 litre that means his lungs are ready to go w/out the oxygen or very very close.

I talked to the doctor about the possibility of him going home with supplemental oxygen. Meaning I'll have it on hand if he needs a few puffs here and there but he wouldn't have tubes up his nose. She said that if we can get him down more on the litres probably to a 1/4th etc and he's still on room air and only needs it for eating/pushing etc then we can do it. So hopefully he'll continue on his recent trend of staying on room air 90% of the day so we can work towards that.

Personally, I'd like to have some oxygen on hand if he needs it but not be giving it to him all the time. He clearly doesn't need it all the time anymore.

He's also up to 6lbs 6ounces (course he's now pooped 2x quite a bit after 2 days of not pooping) so he may be down a bit tonight when they weigh him. For the week though he's up a lot so he's gaining well!

So all in all a great week he's had so far. I really think he's wanting to go home he's definately acting like it. He's doing what the nurses describe often that when the babies are ready to go home they'll just one day start needing less and less oxygen they'll start eating better etc. He's definately starting doing all that.

We still haven't been told when he may be going home the doctors are just watching him and seeing how he's doing. I'm glad they're taking it slow with him I'd hate to take him home before he's ready. I think we've worked out the feeding issues with calories etc. We seem to have a good balance of weight gain ratio to work done etc. So really the last step is getting him off that tube in his throat then we'll be home free. It gives us some time to work on getting the oxygen down low so I don't mind working on the feeding part so much if it buys us some time :)

S

Monday, January 26, 2009

1-26-2009 Zachary Update

He's doing pretty well today and that's good considering yesterday he didn't wake up for a 12+ hour period. We noticed that the third day being off supplemented milk(extra calories) that he just wouldn't wake up for feedings at all. He'd fight you if you did his vitals so we knew he wasn't sick but he was just too exhausted to even wake up. Usually they ween them down from 27 calories they ween to 24 then to just regular breastmilk which is 20-22 calories not just cold turkey. On top of all that he didn't gain weight for 2 days and 3rd night he lost a bit. Needless to say I was getting concerned since we had to tube feed him most of the day yesterday. So I talked to his Doctor and she put him back on supplemented milk up to 24 calories. Within 1-2 hours after he got the extra calories milk he was awake and back to his more normal self. He was even breathing better.

So the rest of last night went well and he gained weight (course he hadn't pooped yet by the time he was weighed). Since he pooped a HUGE amount this morning he's probably at 6 lbs 1 ounces. He's also 18 inches long.

Today they took him from 1 liter down to 3/4ths a liter for his oxygen pressure. This is a good sign slowly weening him down. Awesome thing is he hasn't needed any higher amount of oxygen he's still been getting down to 21% occassionally (that's what we breathe) he keeps that up they'll turn it down again until hopefully (I pray) that before he goes home he'll be off of it.

They keep talking about sending him home on oxygen I'm just going to be more aggressive with the nurses to keep it down. It's more a function of them being lazy and not wanting to micromanage his oxygen. IMO tough crap. If he goes home on oxygen there's no mixing so it's 100% all the time which is VERY bad for his eyes which his are still growing. He's still not on full feeds and they toned him back to 4 feeds a day from 6. They still think he's having issues because he won't take a full amount they're trying to give him. He thinks he's full so he stops. Other than yesterday he often will play etc after being "done" in his opinion, which tells me he doesn't stop becuase he's tired he stops because he thinks he's full and wants to play/explore.

That's a hard concept to sell the Doctor on. She's just a fill-in while his doctor is on vacation anyway. I'm not too worried that we can't get him back on full feeds once she gets back. At any rate the longer he has that tube that longer we have to work on weening him off the oxygen :P So although it's annoying to not be able to feed him w/out that tube most of the day at least it buys us some time. He can always use the extra rest anyway.

So all in all he's doing well, no date yet or even talks about when he'll be going home. They usually do circumsicions 1-2 days before they go home and that's not been scheduled yet either so still a few weeks off probably.

S

Saturday, January 24, 2009

1-23-09 Zachary Update

I'm still a bit under the weather so I stayed only up part of the day. I stayed for the weighing tonight he didn't gain and is still at 6 lbs .5 ounces. He's gaining overall for the week and that's what matters most. He seemed kind of sleepier than normal today, you can tell he's just not the same when I'm not there. We're coming up to two weeks before his original due date, he'd be considered full-term if he was born right now. Even not being there in two days he looks/feels a lot bigger than he did. He's definately growing fast. Not much else to update sometime no news is good news.

Wednesday, January 21, 2009

1-21-2009 Zachary Update

I'm still sick and worse today. I spent the day and evening with Zachary yesterday. He nursed fairly well not having nursed for 2.5 days. He's up to 5 lbs 12 ounces now. The doctor came in and said she can't barely hear the PDA anymore so they're pretty sure it's closed or nearly closed. They've now upped his fluid intake to normal levels for his size so he's up to 54 cc/ml per feed 8 x a day.

He's still pretty stuffy never really cleared up from the cold we all had a few weeks back. Some of that could be the cannula and feeding tube in his nose too. I won't make it up there today I'm still too sick and shouldn't push it.

So good news overall and hopefully he'll be able to take the new feed amounts without problem since that is so much greater than what he's used to.

Tuesday, January 20, 2009

01-19-2009 Zachy Update

I've been sick past couple days so unable to see Zach but Andy told me he's doing well and looking good. He's been dropping the milk off for me while I've been under the weather.

He's up to 5lbs 11 ounces and all that much closer to 6lbs! Found some more clothes for him at a thrift store today some still had the original tags on lol for 18$ I paid $1.50 lol.

I should have more to update tomorrow when I go to see him and stay with him while I work :).

S

Thursday, January 15, 2009

12-15-2009 Zachary update

It's been a crazy past few days his brady's after eating relating to gas/bowel movements and sometimes GURD (reflux) have been getting worse. Some pretty bad where they need to pull out the supplemental oxygen.

He had a pretty bad day with them yesterday and last night today they've been off an on but none too serious that he didn't recover quickly. Trick is to get him to burp very very frequently. Problem is once you stop him BF sometimes he doesn't want to feed after and you know he didn't get enough.

He is definately hard to get to burp a lot of times and that causes him to dstat and then brady so every few sucks he has to be stopped.

He's also sometimes very piggy he acts like he wants more food and then over eats till he spits up. He did that tonight fed himself silly then spit up a lot. Was a like a fountain of milk rofl. So sometimes you can't get him to eat enough and other times he eats too much. I do hope some of these eating issues he grows out of soon.

He's up to 5 lbs 7 ounces he was the same yesterday. Overall for the week he's up though so that's what counts. Still no word on when he'll be coming home and at the rate he's going it'll be mid Februrary I'm guessing unless something turns around significantly.

On a positive note his ROP is now regressing ie. His vessels in his eyes are growing out into Zone 3 finally and not stopping growth in Zone 2. Also, the ridge that started to form on his retina seems to be smoothing out and going away. So it appears that his stage 2 ROP is reversing. Some lucky babies this happens about his gestational age. We won't really know how well they're finished until he's 40 weeks gestational -42ish. His vessels are almost done growing though and they didn't stop early in Zone 2 and that's what the worry is. Very thankful they've continued to grow woot.

Thanks to all who have been following Zach's progress and sending your loving thoughts and prayers! Doubt we'd of gotten this far without them.

Much Love,

S

Monday, January 12, 2009

1-12-2009 Zachary Update

He had a mostly ok day. He did brady a few times some pretty bad but for what I'd consider a kind of good reason eating too much while nursing rofl. He sometimes wouldn't burp easily so the air would impede him breathing that's when it'd happen. We'd eventually get him to burp then he was fine.

He did lose 10 g today so he's 5lbs 3ounces that's after gaining 45g yesterday. He was at his highest at 5lbs 6oz this week so he's working on getting back to that. The transition to nursing 3x today he was bound to lose a bit. I was hoping he wouldn't have but they will probably put him back to only 2 feedings tomorrow I figure. It's a lot of work for him to nurse that's what they're worried about with him by doing too much work to feed he expends more energy than gains from the food. He ate a lot more than he normally gets fed and overate a few times to the point he spit up rofl. He's a little piggy hehe, but in a good way. So it's slow and steady we may have to cut back on the nursings so he can get back to non-brady stable then slowly add them back in. Takes a lot out of him when he brady's so hopefully that will lessen tomorrow.

He overall though seemed well today despite his issues during feeding.

S

Sunday, January 11, 2009

1-11-09 Zachary Update

Today the little munchkin is doing well despite the rough week he's had. He went down in weight overnight from 5lbs 6 oz to 5 lbs 2 oz the day before he gained 70 grams so it's not unusual for them to drop the next day usually do to poling times etc. Today was the first time I nursed him without giving him any of the supplemental fortified breastmilk. Only problem I notice is that he feeds for 15 mine needs to be burped.. Gets sleepy or just looks around then in10 mine he wants to eat again and he does this cycle for about an hour and a half I'm having to hide it from the nurses they'd have a cow if the knew I was letting him feed that long instead of giving him supplemental via the tube in his nose. Personally he's had no bradys or destat since I feed him like he wanted today. Whenever we give supplemental after nursing he always destats and sometimes Brady's and is constantly pushing and looks in pain haven't seen any of that today. Just normal gas and nothing that seems to be causing him pain or dicomfort.

So I think tomorrow I'm going to press the issue of more frequent feeding with less amount that way his body can deal with the food better. My daughter was the same way she ate every 2 hours and we never had any issues with her.

Friday, January 9, 2009

1-09-2009 Zachary Update

Well I'm happy to report he's back to his normal feeling well self etc. He does need to get another shot today Hep-B but it doesn't have thirmersol in it so I'm guessing this 1 will not be as bad as the 4 he got the other day.

He didn't want to wake up for nursing but he'd take the pacifier and suckle vigorously so I asked the nurse again if they had nipple shields. I'd heard they do well for babies that have trouble latching on. His problem is more 1. He doesn't want to wake up :P and 2. He's not opening his mouth wide enough.

When he's fully awake he nurses perfectly doesn't need any aids or anything. But the shield worked really well much better than I had expected! He got more milk in a shorter amount of time so I was impressed. Needless to say if he's sleepy again I'll keep trying it. It's always better if they can nurse unaided but I have no problem getting him to learn faster with some help.

He's gaining weight well and they went up on his feeds again to 40 ccs x 8 per day. He's probably right at 5lbs or barely under. He lost a bit one day but gained it back the next day. He usually gains 30g -50g a day depending on how active he was throughout the day.

So overall much better than the scare we had the other evening/night. He hasn't had any brady's at all and only a minor dstat here or there and only associated with feeding which is normal for him.

His eye exam also came back with good sign. It's not progressing any worse still stage 2 ROP and his vessels have grown out even farther and almost into Zone 3 which is where he's home free. Most of the ridge that's started to form on his retina will go away in a few weeks to a month and it just requires follow-up eye exams at this time. So hopefully that will continue to be the case and his eyes will recover well.

S

Wednesday, January 7, 2009

01-07-09 Zach update #2

Mr. Zachary definately does not like shots or eye exams. I'm still at the hospital with him been here since around 7:45am. He did well at his 12pm feeding but I'm guessing the shots hadn't started affecting him yet. He had them right before 12 pm. So I'd hoped they weren't going to be bad. I showed up for his 6 pm feeding and he didn't look well at all so I figured I would just hold him and not try to breastfeed. I didn't know he's had his eye exam or his eyes dialated so when I picked him up he started bradying badly it got so bad several nurses had to give blow by supplemental oxygen. We finally got him stable and his nurse found out he'd just had his eye exam and was very apologetic. Babies always destat a lot after exams that plus his shots were to much for him. So basically he can' t even stand to be moved right now normally holding him helps but he's just not able to tolerate being moved. So I'm hanging out with mr mansy till he's more stable. He's brady'd many times since that inital one and he's going to be exhausted tomorrow but hopefully he'll feel better and the shots will have worn off.

1-07-2009 Zachary update

He's been doing well so far last night and today. He's down at around 30% oxygen which is very good and hopefully he'll get abck down in the mid 20s soon. They're going to lower the liters of the cannula down to 1 litre in the next couple of days.

He's getting his 2 months shots today (poor guy) so hopefully he won't be too fussy since they're letting me try to breastfeed 2 x a day now. Oddly enough immunizations go normally (no adjusted age stuff) so he'll get them at 2, 4 months and so on.

He was enjoying looking around the room today he can only see things up to maybe 2 ft away and not well. Only stuff right up next to his face can he see fairly well. So I got out one of his rattles for him to look at, it's the first time he seemed truly interested in looking at it. So I put it by his head before I left to give him something to stare at while he falls back asleep.

So all in all a good day so far :)

S

Tuesday, January 6, 2009

12-06-2008 Zachary Update

He's doing pretty well today and had a good night. He's been in the 30s for oxygen and was down to 31% before I left a bit ago. So hopefully he'll be back down in the 20s soon again. His nose is starting to clear up and although he's still occasionally having to be suctioned it's not nearly as bad as it was.

His breastfeeding today was fairly successful he got half an ounce about the same as he got the first successful time. He's up to 4lbs 15 ounces and gaining more and more each day.

I asked the doctor this morning about his ROP Stage II progression and she said that since he's almost to Zone 3 Growth (ie the vessels almost done growing to the retina) that his ROP just requires monitoring and the slight ridge that's formed should fade in a few weeks - months. So hopefully this next eye exam this week will show that the ROP isn't worsening and hopefully if anything it's getting better. Apparently, where his ROP is it deals with your peripheral vision which is important :P so they're monitoring it closely.

They're saying his lung disease is improving a lot but we may need to start considering him coming home on oxygen. I do hope not as I figure he's still got 3ish weeks to go before homecoming and a lot can happen in 3 weeks.

S

Sunday, January 4, 2009

Zachary Update 01-04-2009

Well he was doing pretty well today not too many brady's or dstats (nothing out of the normal for him). His oxygen requirements have been going steadily down and he was at about 26-28% most of the day. The lasic (medicine to remove fluid from his lungs) really seemed to work well. Hopefully this continues and they'll start lowering the water agitation currently added to his cannula. He's still at 1.5 litres. As he gets bigger a lot of these issues will go away.

He's up to 38 ccs x 8 feedings per day. The amount of milk I'm brining to him is starting to be significant :P Not too much of a big deal but it's taking more pumpings to get him the milk he needs for one day. That's a good thing in my eyes. I've not gotten to try and breastfeed him again since those first 2 times but I'll probably ask tomorrow as it's been several days and he's as stable if not more stable than he was when we did it the first time.

He was negative for RSV thank god that's a really nasty virus that can cause pneumonia and many other bad things. He definately has a nasty head cold but nothing serious that warrants anything other than suctioning. He's not had any fever or too low temp etc issues from the head cold. He's just a bit stuffy.

2 days ago he was up to 4lbs 10 ounces with the expectations he'll be up to 5 lbs this coming week. No word from anyone on a "go home date" other than expect it to be around his due date which was in the Feb 1- 6 range. So we've got some time to go before really worrying about him coming home.

He had an eye exam the other day and he's in Zone 2 growth (zone 3 is where the blood vessels are finished growing). With really little babies like him they see a lot of abdnormal growth and the blood vessels may stop growing early in stage 1 - 2 or 3. They've seen a few extra branches on his but nothing to be really concerned about. At this time he'll just continue to have some eye exams every few weeks to track the progress and see if there is any what's called ROP or not. When ROP gets really bad it causes blindness and the surgery for it really may not help though in some kids it does in some it doesn't. Hopefully, we won't hear any bad news on the next one either. So far, nothing majorly concerning the doctors has come up regarding his eyes just things for them to watch etc.

I should be more frequent with my postings over the next week as I go back to full-time office again after the long break tomorrow.

Friday, January 2, 2009

01-01-2009 Zachary Update

Well today he was more tired than yesterday it seemed. I was able to attempt breast feeding for the first time yesterday and he did really well. Today, he was too tired and really didn't do much. He had a few brady's overnight and those tend to tire him out a lot. I'm going to try waiting until 3pm again like I did the first day to breastfeed him as he seems to be more awake then and have more energy. Midday just isn't a good time for him.

He had another eye exam today the doctor didn't say anything but she didn't seem like she had any pressing issues. We'll get an overview from his main doctor regarding her findings tomorrow. He was doing so/so after the exam and they say it's normal for them to dstat for a while afterwards.

Andy held him for the first time today after his eye exam while he was eating. That seemed to calm Zachary some so he wasn't dstating so much after the exam. Andy was very happy to finally be able to hold him.

They weighed him yesterday but I didn't call to get the weight and I forgot to ask today but I'm sure he's up to 4lbs 12+ ounces. He's nearly 5 lbs!. I know he's up to 45 cm almost 18 inches. He's growing fast.

They still swear he doesn't have an active infection of the MRSA just that they found it in his nose. He's progressively having more boogers and snot and sneezing/coughing. The coughing not so much as the sneezing. I personally, think they should do a culture to see if anything is growing in there becuase his oxygen requirements have been slowly getting higher in the low 40s now which he's never needed before. I think tomorrow I'm going to insist they do a culture and blood check to see if he has some kind of active infection something left unchecked can grow into pneumonia.

The nurses just keep on saying he's not exhibiting any of the normal signs of illness. Well that may be true but that doesn't mean he doesn't have something. Green snot usually = some kind of cold/infection etc.

Anyhew.. I'm going to bug them about it tomorrow again. They've always been very good at listening to our concerns and usually act on them before we have a chance to finish asking or they've already done something about what we're asking on. This is the first time they seem to not be concerned. I wish I felt that way I'm just worried he might go from just green snot to something much worse.

S