Tuesday, June 28, 2016

Week 8 with Ellie

NICU

Week 8

*June 22, 2016   Weight 2.283 Kg

You are 7 weeks old!!! Your gestational age is 36 weeks! It is Day 49 in the NICU!

You dropped a little bit in your weight, but you are still a little over 5 lbs.  Little chunky monkey!  When I arrived you were still on high flow oxygen, 1 liter at 21 %.  But a few minutes in, the Respiratory nurse switched you over to low flow oxygen.  It is measured a little differently. You are getting about 25 cc from it.  Which really isn't very much.  Seems like they are trying to wean you more slowly this time, thank goodness.  The oxygen kind of makes your face puffy. When you open your little eyes you can see just how swollen they are.  You are on full bottles still and eating like a champ!  You weren't quite as gassy as you were yesterday, thankfully!  You took your bottle really well, not quite the 60 mL you took from me yesterday, but a good portion.  Your temperature was a little bit high when I took it during your care.  The nurses said it is because you are too big for an isolette! Maybe they can put the order in for you to be in a crib! How nice would that be?? Then you would be able to wear all your cute little preemie clothes!! I can't wait for that!



a little smile!

The low flow oxygen tube is a little smaller than the high flow.
If you look at the first picture you might see the difference.

Look at that sweet chubby chin! I love it!



*June 23, 2016    Weight 2.382 Kg (5 lbs 3.8 oz)

So, when I came to see you today, your isolette looked a little weird....

All your little doors were open and you were wrapped up in a little bundle




At first I thought that maybe it was because of the rotten stench that often leaks from your little body. But, they were doing a temperature trial to see if you could maintain your body temp. And if you did for 3 hours, checking your temperature every hour,  you would get into a crib!!!!  And then you will get to wear clothes and have your own blankets, and it is just a huge step towards coming home (at least in my heart!)

  Also, I brought some more milk for you, a whole 70 mL.  You drank 50mL and they saved the rest for the next feeding. I know it isn't much, considering it is produced over several days, but I'm grateful there is some milk in there!  I had to feed you in your isolette, as to not mess with your temperature.  Sadly, I had to leave before they put you in your crib, but I called to make sure you made it.

  Today you were doing your stinky toots, but I bet it was nice for you to have them air out with the doors open.  However, you seemed to have a lingering one, turns out it was a big old dirty diaper.  I changed it, and after I wiped you clean and took the dirty diaper away, you began pooping again on the new diaper.  I closed it up, to wait for you to finish.  After a few moments, I cleaned you up again, you weren't quite finished again, but I was able to keep it in the dirty diaper.  Nurses from all around the unit would walk by and catch a whiff, and cringe.  It was bad and hilarious. I know your uncles would be proud!  You changed to a new formula, so hopefully that will help!

   The nurses are worried that you won't fit into your preemie clothes, because you are just so big!  I think you will be fine!!  At least for a little while.  All I ask is that you wear each outfit at least once!  And I will try to get a picture of you in each one!  It will be so fun to see you in clothes, with a bow in your hair!  I feel like a kid on Christmas, can't wait to see you tomorrow, all wrapped up like a present!

You are on a new formula!
Hopefully this will help your stinky
gas and stinky poops!

sweet little dreamer

sometimes you look so serious!
One day you will be clear of all wires!


Look at that smile!


Going through all Addie's baby clothes,
trying to find some that are still in
good shape. One thing is for sure, you
won't be lacking for clothes!



*June 24, 2016    Weight 2.410 Kg (5lbs 5 oz)

  Well, I walked in and you were in a crib!


Look at what a big girl you are! It was so strange to be able to reach right out and just touch you!  You looked so restful. However, I spotted that they put you back on high flow oxygen, darn it.  I talked to the nurse and she said you had a series of spells after midnight. They figured you needed a little boost, and once you were on it, the spells slowed down.  But sweet girl, you can't have high flow oxygen forever! You need to grow big and use your lungs all by yourself.  And I need to be patient.  While I was there you did have a pretty big spell.  I kind of nudged you a bit, but it wasn't enough, the nurse came over and rubbed your chest pretty vigorously, I didn't like it, it looked rough.  You woke up with a very irritated look on your face. But your SATs and heart rate came back up.  As much as I do want you to come home, I don't want to have those spells at home.  It would be so scary.  You should outgrow it.  The NP came by and said they are putting you back on Zantac, to see if that would help.  I didn't realize they took you off.  They also wondering if the caffeine was finally leaving your system and that may be causing the spells again, and maybe they would have to put you back on the caffeine??  They would like to eliminate the reflux as the cause, so they are trying different things.  They wanted to add rice cereal to your formula, to make it heavier to help if it is reflux.  However, one of the Doctors didn't want to do that because it could cause other problems like constipation and such. So, they have you on a special bottle type, Dr Brown's (or something like that), which is supposed to help reduce reflux.  They also have your crib tilted, so that your head is up.  Maybe we all just need to relax and just let you grow and mature.  I just really really don't like the spells.  I worried it was the milk that I would bring from me.  Like your body was reacting to it. The nurses assured me that wasn't it, because you did have donor milk all the time.  I just want to find a reason to, so it can stop and you will feel better and be ready.
I have been
producing more lately!

  The fun thing is now you can wear different things!  Changing you out of one outfit to the next proved to be difficult with all the wires and oxygen tubes.  But I got you changed!  I was definitely a little rusty when it comes to snapping snaps and dressing little babies.  You are getting big! Maybe you will be out of your preemie clothes soon, with your growth?!  I will do my best to make sure you at least wear everything once!!!

I love you my angel!  You are in my prayers always! Grow grow grow my flower!


My little sweetheart!








How cute is that hat!??


I got you snug as a rug!


*June 25, 2016   Weight 2.435 Kg ( 5 lbs 5.7 oz)

No spells last night. You are still on 1 liter at 21%.

Today we had another swim meet in the morning, so I didn't come to visit you until tonight, with Daddy on date night.






 You had done really good!  I changed your clothes and got you all snug for bed.












They had a new plan for you for feeding, to see if it will help with reflux.  We need to watch for cues to see if you are having a moment of reflux, and to pull back on the bottle.  Gently burping, and not moving you very much after eating.  We will see if that helps.

Daddy fed you most of your bottle.  You eat so well. I helped you finish your bottle and it was getting time to go.  Daddy had said "We need to go" and suddenly you made a sad little face.  It was so pitifully precious.  Your little lip puckered a little, as if to say "Please don't go!!"  You are so darn cute!!  I did a little comparison of you to Daddy's  hand, and from a comparison we did 5 weeks ago.  You have grown a lot in the past 5 weeks!














*June 26, 2016    Weight 2.405 Kg ( 5 lbs  4.6 oz, you lost 30 grams)

   You lost a little weight, but that could just be from a real big diaper and nothing to worry about.  It was Sunday, so I called before church to check on you.  You had had a few spells during the night, one around 6:00 am.  I knew I couldn't come until after Church and Sunday lunch.  We did a few comparisons of you with Addie, it is kind of neat that you two can look somewhat similar! Addie was of course much heavier than you, here she is about 2 lbs 8.4 oz heavier, and she is a little hairier. But there are some similarities, which is pretty neat considering!

I changed you out of your little heart pajamas into you "Little Sister" outfit.  You are very patient when you are getting changed. It is very tricky with all the wires and such to work around, but I got you looking super cute ( you make that very easy!)
Then I brought some milk that I had pumped and was feeding you.  While you were feeding I heard a little burp inside your tummy and then you coughed a little. So I pulled the bottle out to let you recover.  Well, it was too late and your heart rate and your SATs dropped and the nurses had to come over and stimulate you.  They bumped up your oxygen and were getting ready to bag you with the oxygen mask.  You slowly came back up.  I know it is normal behavior A & B spells, but they scare me, they worry me.  It worries me that you just slowly slip away like that.  Without a real cue that you are doing it.  A little burp inside your tummy isn't enough to warn me of a big spell coming.  It seems like I when I get to thinking "Wow, Ellie is doing so good, maybe she will be home soon. How exciting and great that would be!"  And then, blamo, reality.  That maybe it won't be as soon as I think, and I feel discouraged and defeated.  My Mom told me, the hardest part of the marathon is the end, that is true, even for the spectator.  I want you home my love, but I definitely want you to keep breathing and keep your heart beating when you do!  I know you are just little and premature, and maybe this is just something you will grow out of.  Patience is a constant learning principle with me. I wish I could just learn it already! :)  Be strong my sweet.  Just keep swimming swimming swimming, and breathing, and keeping your heart beat too! Love you!
Sweet Little Sister!
That little finger there is telling something
to those darn A & B spells. My sentiments to
those spells are the same!




You look a little exhausted by your spell






*June 27, 2016   Weight 2.385 Kg ( dropped 20 grams! No more dropping! 5 lbs 3.9oz)

15 years ago, I came home from serving an 18 month mission.  My mission was one of he greatest things I have ever done!  Serving the Lord and preaching His gospel. Can't believe it was that long ago.  Feels like yesterday.


So, I think I have been letting all this stress of you dropping weight and having spells get to me.  It is stressing me out. Even if I fill my day with busyness, I still can feel the worry creep in.  I went to see you and you looked so cute and dressed up. You are still on high flow oxygen, 1 liter at 21%, they turn it up to around 30% sometimes more when you have a spell, to give you a bump.  You had a good night, a few spells. They had made some changes in your food.  They are adding rice cereal to your milk, to thicken it up, to help with your reflux.  But I really don't think you have reflux.  A few of the nurses agreed. A baby with reflux has a lot more cues that they actually have it.  You have never spit up, reflux babies almost always have lots of spit up.  You enjoy eating, reflux babies don't because it can hurt.  There are several things, to me, that indicate you do not have reflux. But I think they feel they need to do that in order to rule it out? They want a cause for the A & B spells, but here is a clue..... you are premature!  And it might just take time and growth for you to overcome these spells.  I am not inherently patient, but I am trying to be patient through all of this.  It has almost been 8 weeks since you were born!  That's a lot of patience, and both of our part!

  I noticed your eyes looked dilated today, so I asked if you had gotten an eye test, and you had.  They also mentioned you got and echocardiogram.  I asked the results, the NP would have to give me those.

 Eye Exam:  You have  Retinopathy of prematurity (ROP), which is a disease that occurs in premature babies. It causes abnormal blood vessels to grow in the retina, the layer of nerve tissue in the eye that enables us to see. This growth can cause the retina to detach from the back of the eye, leading to blindness.
  There are 5 stages of ROP:

Stage I — Mildly abnormal blood vessel growth. Many children who develop stage I improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.
Stage II — Moderately abnormal blood vessel growth. Many children who develop stage II improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.
Stage III — Severely abnormal blood vessel growth. The abnormal blood vessels grow toward the center of the eye instead of following their normal growth pattern along the surface of the retina. Some infants who develop stage III improve with no treatment and eventually develop normal vision. However, when infants have a certain degree of Stage III and “plus disease” develops, treatment is considered. “Plus disease” means that the blood vessels of the retina have become enlarged and twisted, indicating a worsening of the disease. Treatment at this point has a good chance of preventing retinal detachment.
Stage IV — Partially detached retina. Traction from the scar produced by bleeding, abnormal vessels pulls the retina away from the wall of the eye.
Stage V — Completely detached retina and the end stage of the disease. If the eye is left alone at this stage, the baby can have severe visual impairment and even blindness.
Most babies who develop ROP have stages I or II. However, in a small number of babies, ROP worsens, sometimes very rapidly. Untreated ROP threatens to destroy vision.

Your first exam you had Stage I: Mild 
Today your eye exam you had Stage II in Zone II of both eyes.  Apparently there are 3 zones of your eyes.  You will have another exam in 2 weeks, to see if it gets worse or stays the same.  Often they will have to do a laser surgery to correct the scar tissue there.
It is very common for premature babies to develop ROP:

"About 14,000–16,000 of these infants are affected by some degree of ROP. The disease improves and leaves no permanent damage in milder cases of ROP. About 90 percent of all infants with ROP are in the milder category and do not need treatment. However, infants with more severe disease can develop impaired vision or even blindness. About 1,100–1,500 infants annually develop ROP that is severe enough to require medical treatment. About 400–600 infants each year in the US become legally blind from ROP."


This is what the NP drew to try to explain ROP Stage II
Zone II.  Addie thought it was hilarious!

So we will just hope and pray it doesn't get worse and that you won't require treatment.
Then, the results of the Echo.  I'll try to explain best I can the information given.  You have 2 small openings in your heart that usually close on a full term baby when they are born. First term she gave me:
Small Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart. This hole exists in everyone before birth, but usually closes shortly after being born. PFO is what the hole is called when it fails to close naturally after a baby is born.
Second:
Small Patent Ductus Arteriosus:In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart. Before birth, the two major arteries—the aorta and the pulmonary (PULL-mun-ary) artery—are connected by a blood vessel called the ductus arteriosus. This vessel is an essential part of fetal blood circulation.
So, hopefully they will close on their own, so you don't require surgery.

Lots of things to prayer about for now!  I have asked my family to fast for you this coming Fast Sunday.  I also asked Daddy to give you a blessing.  We need to draw on the powers of heaven a little.  All this stuff with your heart, hurts mine.  All these things about your eyes, make mine water.  I try to be still, I try to trust the Lord, and leave it in His hands.  I know the only thing I can do, is pray, fast and love you.  That is all I can do.  I have to leave the rest to the Lord, and His inspiration to the Doctors and nurses who care for you.  I love you so much Ellie.  I have been having more dreams about you. Being home. Being very smiley and happy. And I am grateful for those dreams. Soon, one day, you will be home, and I long for that day!


Girl, how is the oxygen gonna help if
you can't keep the cannulas in your nose!??
We had trouble keeping the cannulas in
your nose!


Sweet girl full of rice cereal and milk,
ready to drift off!
You in your cute outfit.
It says "Pretty Like Mommy"
Of course I bought it! Ha!









































(I don't know why the background is white right here?! I blame google and copying and pasting stuff from there!)


*June 28, 2016   Weight 2.425 Kg (5 lbs 5.36 oz)

   Whew! You gained some weight back!  Maybe you were just trying to get used to this new formula with rice cereal in it.  You are still on high flow oxygen at 1 liter, 21 %.  You are still having some A & B spells. You still have the stinkiest gas and poop in the unit! You might just get the nickname smelly Ellie! :) And you are the cutest baby there too!




A little smile


I love your eyes open wide!



  The nurse this morning washed you hair, so it was all downey and soft!  I fed you your bottle and you ate a whooping 65cc! You must have been hungry.  You had 2 spells while I was there, but  they were short, and the nurses didn't seem bothered.  They both happened before I fed you.

I asked the doctor why they are treating you for reflux, like what symptoms you have to make them think that is what is causing it.  He really didn't have a clear answer, except that a lot of the time that is the problem with babies who continue to have A & B spells.  And it is a precautionary measure.  It could be reflux, it could just be prematurity.  Either way, it does mean you will be in the hospital longer.  You have been in the hospital 55 days now.  That is quite a lot.  The hospital bill should be awesome! Ha!  But I see the babies around you, having surgery, having other problems or who are just beginning their journey in the NICU. So for now, I am okay with where you are at, it definitely be worse!

We will fast Sunday for your health, for your A & B spells to stop, for your heart to close how it should and for your eyes to not have any serious problems.  That is a lot to ask for, but I pray Heavenly Father will continue to pour out His blessings upon you.  Love you!
Wardrobe change









Sweet love