Saturday, September 3, 2011

68 days and in the home stretch!

Well, in the 23 days since last doing an official update so much has happened!!! I could spend 5 hours giving all the crazy updates, if I had that kind of time... but I don't! Therefore, I am going to give a very simple and quick update about each boy,

For both of them ---

Feedings- both boys were introduced to bottle feedings just before 34 weeks gestational age (around 9/17) They started off doing 1 bottle feed a day and they would suck about 3-6 mL of their 30-35mL feeds and we then put the rest in the tube. Then, the series of events proceeded really quickly in the following order... finished their first full bottle>moved to 2 bottles per day>finished both>1 bottle, 2 tube pattern> finished all feedings well>2 bottle, 1 tube pattern> finishing all feeds well.... Now, we are hoping for the report tomorrow that they will be on a 3 bottle, 1 tube pattern and the next step after that is all bottle!!! I love that both boys have kept up with eachother in the development of their bottle abilities!

Location- The NICU has 1 large room and 1 small room. The big room is for the sicker babies and the smaller is known as the "grower/feeder room". A few weeks back, the boys moved from the middle of the big sick baby room, to the corner and into a crib! Then on 8/31 they were moved to the grower/feeder room! Best part of the move?? Their is a window and Athan got to see his brothers!

Their nurses - When the boys were first born, they each had a personal nurse 24/7 who pretty much sat in front of their bed and kept a constant eye on all their vitals. Now, there are 6 babies in the grower/feeder room and only 2 nurses total!


Oxygen- Dax came off the nasal cannula for 2 days the first time and then needed to go back on it. Then, about a week later(around 8/25ish) came off the cannula for good and has been doing very well with his O2 saturations since!

He has very steadily gained weight and tonight he was at a whopping 4lb, 15oz! We're hoping to hit the 5lb mark tomorrow!! Dax seems to have a very calm and curious demeanor to him. He rarely fusses and loves to just look around during his bottle feeds.

Eyes - A common preemie problem is known as Retinopathy of Prematurity (ROP). If you look at any diagram of a haelthy eye, you see the blood vessels all grow outward toward the pupils. ROP is when they grown in an abnormal way and become somewhat mangled. There are multiple stages of ROP, the lower the better, as well as 3 zones. The higher the zone, the farther it is from the retina which is better. Currently, Dax has stage 2 ROP in zone 3. stage 1 ROP is common in all preemies and typically goes away as can stage 2. HE will continue follow up eye exams. If ROP does fully develop, it can lead to blindness, but if caught early enough it can be treated with laser surgery.


Oxygen - Trev has been off of O2 completely for almost 3 weeks now. He is doing great!

ROP - Last checked, Trev has stage 1 ROP in zone 3, which is better from his first exam of stage 1 ROP in zone 2.

A few weeks ago, Trev was very fussy all the time, had some trouble gaining weight and even lost almost 3oz in 2 days. He had very high blood pressure during this time too. A normal blood pressure for a baby his size would be something like 80/40 while a normal blood pressure for an adult is 120/80. Well, Trev's was as high as 137/105. VERY HIGH! The nurses didn't tell let on at the time, but they were getting worried as it was so high at times that the cuff couldn't even get a reading. First, the Dr, took him off of his caffeine (used as apnea prevention). Then they performed a series of tests one of which was an xray and doppler scan of his kidneys. Well, the radiologists reports seemed all over the place and it seemed that the conclusion was that his right kidney was functioning normally, but his left kidney had blood flow through the middle but not the top or bottom. The Dr. decided to send the scans to a pediatric nephrologist at UC Davis to be reviewed by someone who had more experience with preemie scan reading. The nephrologist believes that there is nothing to worry about and any abnormality of his kidney function is something he will grow out of.

We have since put Trev on blood pressure meds. He began on captopril which he was given every 8 hours and was on this for about 2 days with no improvement and then the Dr. switched him to, I think it's called enalapril. The enalapril worked amazingly and quickly too! Within a short time (a day maybe??) Trev's BP was down to a normal level. You could tell when visiting him that he felt soooo much better to. He was instantly in a better mood and less fussy with a better, pinker flesh tone. He was on the enalapril for a short time and the Dr. has since taken him off of it as of about 4-5 days ago and still no high BP! We will be taking Trev for a follow up with the pediatric nephrologist after they have been discharged.

Since Trev had a hard time gaining weight for a short time, he is playing catch up to Dax. At one point Dax was a whole 3/4lb heavier than Trev. But Trev is catching up and is now only 4.6 oz behind at 4lb, 10.4oz!

It is amazing how much the last 68 days have flown by and yet so much has happened. Dr. Jain told us yesterday that we can expect to take them home in about a week and we are now in a bit of a panic with so much still to do to get ready for their arrival! I can't wait to sit in my back yard with a sleeping baby in my arms and my feet in the pool while Athan splashed around!

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