Wednesday, April 8, 2009

Tuesday Update

The kids have been pretty good lately.

Both of them continue to do great with their breathing. They continue to progress and the doctors continue to challenge them. Sunday they moved from 2liter to 1liter on their flow (canula measures the air pressure in liters). Along with the obvious mechanics of breathing (breath rate, ventilator, CPAP, canula, etc) how they process that breath is also very important. You may recall us mentioning their O2 Saturation. That is how much oxygen is in the bloodstream and that is also an indicator to how well the lungs are processing the air they take in. As lil micro preemies, they wanted their o2 saturation to be between 80-90%, which closely mimics the situation they would have experienced within the womb. As they got bigger, the Doctors upped the parameters and their expectations to 84-94%.
Well.... Monday one of the Dr's decided to change the parameters to 94-98%. The reasoning behind this was to continue to challenge them, and to prepare them for what will be expected in order to leave the NICU. This is a pretty narrow window, so the monitors were constantly going off, indicating that they were either below, or above their set parameters. Another consequence to this change is that they needed higher amounts of o2 in order to keep them within those parameters. By this time, we have become pretty used to hearing monitors going off and making all kinds of racket. However, this whole time we've been working toward getting them on lower & amounts of o2 through their breathing assistance, so this had me a bit concerned. As part of that, I was also very concerned because high amounts of 02 is the cause of ROP & Rush disease (eye problem that Blake experienced). He had just pulled through that difficult time, & I didn't want to take any chances of putting him right back into it. The nurses and Dr's assured us that the amounts of 02 he was on, was no danger at all. That helped reassure us, but it kept nagging at me anyways. While I trust the Dr's immensely, ultimately our babies lives and health are our responsibilities, so this was still stressful. Adding to the stress was that Dr. Su has been off for the past few days and we haven't been able to talk through this change with him. All the Dr's are great, but we have developed great communication and rapore with some Dr's more than others.
To our relief, a separate Dr. was on shift today and decided to change the 02 saturation parameters to 90-98%. A rather small change, but it's easier for them to maintain those levels.

Now to the fun part.
Bottle feeding!!!! It's been nothing short of amazing to hold our little ones and feed them from the bottle. Bathing them and bottle feeding has really made me feel like a Dad, doing normal parent duties.
Jenna has been improving nicely with her bottle feeds. She's doing more breathing and gulping less of her milk. This was a pretty freaky situation when I first saw it. It's amazing that their brains are not developed enough to have the automatic breath response, so she could just swallow and swallow, without taking a breath to the point that she would turn blue, her monitors would start going crazy and her 02 saturation would get Very low. Its safe to say that I could go the rest of my life without seeing one of my children blue like that again. But....that is something that is not uncommon in premies, and is something that we can help her with. We just need to pay attention and follow the speech therapists instructions.
Blake has been doing wonderful. Due to his cautious nature, he hasn't had much of a problem. He takes a few swallows, pauses to take a few breaths and look around. The only down side is that when we hold him, he gets way comfortable, forgets that he's feeding & falls asleep. So we have to stimulate him a bit and he'll start feeding again. Tonight I made an effort to get him fully awake before I sat down to feed him. So, I unwrapped him (he was swaddled), checked his diaper, played with his lil hands and feed, and generally messed around with him. It may have worked as he finished his bottle in 30min, which is 15-30min faster than he's done in the past.
To round out a great day, Dr. Cho gave orders to increase their bottle feeds to twice daily, and to increase their canula flow rate to 2liters while they are feeding in order to make the work a little easier. It sounds funny, but the act of feeding really makes these little ones burn a bunch of valuable calories, & not having to work hard breathing will help quite a bit.

On the way out of the NICU we ran into our friends the O'Briens. We were able to do a little catching up on how our little angels have been doing. We really miss being neighbors, and seeing the girls. Please keep them in your thoughts and prayers as they are in ours.

It's way late and I fear I've been rambling, so I'll wrap things up.
Take care.

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