Four weeks 4 days old - Update

Written October 4, 2013 10:57 pm

Howdy and sorry for the delay!

We were woken up on Thursday morning due to a call from the hospital. Not really the way I want to start the day... Overnight, Evan's acidosis had gotten worse. They stopped his feeds and administered sodium bicarbonate (essentially Tums). He was also taken off the high flow cannula and put back on the NIV (still not intubated though). The NIV would give him more respiratory support so he could concentrate on brining the acidity in his blood levels down. Thankfully, we were already aware of the acidosis situation so it was more of a "heads up" phone call.

Evan experienced lots of bradys on Thursday. (During rounds on Friday I learned he had 15 brady episodes.) Andrew and I were at the hospital Thursday evening and witnessed 7 alone. Bradys are very scary because Evan's heartbeat drops. He will pick it back up with mild stimulation (a pat on the bum or a rub on the head).

An X-ray early Thursday morning showed that there was some air in Evan's stomach and intestines. Up until this point, he has never had a problem with his stomach or intestines. Sometimes air gets into the stomach and will cause a baby to have problems with feeds. Evan always digests his food and his belly is always nice and soft. To help vent the air, Evan had a new tube inserted into his stomach. (I tried to look up the word so I could be technical, but couldn't find it...) The tube was set to suction to help rid his stomach of the extra air. The air that was stuck in the intestines would have to come out the old fashioned way. Evan needed to fart!

During rounds, I was able to see the X-ray. Instead of focusing on the stomach and intestines, I right away noticed that his lungs were much clearer. The doctors did say that his lungs looked great. Woot! :)

Evan's labs were repeated to check for infection. The doctors started him on preventative antibiotics incase any of the labs did grow out an infection. This was particularly frustrating as he was set to come off his antibiotic.

Evan also received a transfusion in the morning. This will also help with the acidity.

When we got to the hospital Thursday night, our smiley little boy greeted us. The stomach vent was no longer suctioning air. The latest X-ray showed that the air was looking much better.

Around 9:30 pm, Evan experienced a really bad brady. The doctors couldn't figure out what Evan was struggling with. They ordered the labs from the night before redone to see if he picked up an infection. They also increased his respiratory support. The doctors were also talking about re-intubating Evan and putting him back on the conventional ventilator. The whole experience was very scary to witness. By the time we left, Evan was peaceful and stable.

"I don't trust this thermometer!
I'd rather have my blood drawn!" 

Four weeks 3 days old

Written October 3, 2013 at 7:53 am

Sorry for the lack of update last night... after milking I zonked right out!

I rushed to the hospital to beat the doctor to rounds and I made it! Evan's new doctor rounds early and fast.

The head ultrasound from the day before continues to look normal. They'll check again in another month.

Evan will start receiving eye exams next week. Preemies have routine eye exams as their eyes (along with everything else) are underdeveloped.

The hydrocortisone steroid ends on Thursday. Once the steroid is fully out of his body, we may see him take a step back.

I believe I had mentioned yesterday about acidosis. I think I had referred to acidosis as essentially heartburn - I was incorrect. Acidosis relates to the kidneys. As Evan's kidneys are still developing, they don't work fast enough to get rid of some of the toxins in his body. This can lead to an imbalance in the acids and bases in the body. The doctors monitor acidosis through blood draws (part of the twice daily blood gas draw). Medications are mixed with various ingredients. It is believed that the first antibiotic Evan was on (to treat the infection in his trach) may have been mixed with something too acidic. Since switching to a different antibiotic, the acidic levels seem to be leveling out.

Feeds are increasing to 21 mL. Evan will also start receiving an extra bump of vitamin D in his milk. He would normally receive this in the third trimester.

We had a nice snuggle, but it was cut short after he had a brady episode. Evan hasn't been prone to them too much since coming off the invasive respiratory vents (jet and oscillator). I felt really bad but the nurse said that he probably would have had one anyway. He looked completely fine and recovered fully on his own.

We just need to concentrate on fattening up Evan so he can get stronger. I am going to do my part and make sure I'm eating lots of ham and bacon. :)