Tag Archives: cpap

the eric update – day 49: eric’s 7 week birthday!

day 49: 7 week birthday kangaroo care

let’s all give odin a little birthday cheer, as it’s his 7 week birthday today! he gained a few grams and is now solidly in the 3 pound category at 3 pounds and 3.5 ounces. he also added a half a centimeter and is 38.7 centimeters or 15.25 inches, which means he’s added 3.25 inches to his length in the past seven weeks! woohoo! he’s rapidly being weened from the cpap and is on 6 hours of nasal cannula and 4 hours of cpap. since he’s doing so well breathing on his own, i suspect that within the next few days they’ll see if eric can go 25 hours on the nasal cannula. despite having to do more breathing on his own than ever, he’s throwing very few alarms; he only seems to alarm when the nurses are doing their “meanies” or when he’s put his head in a position that’s not conducive to breathing. his breastmilk feeds stayed the same as yesterday, as they’re pulling up more undigested food than they’d like to see, so they’re going to back off a bit on increasing the amount of milk that he’s receiving. you might remember that anytime digestion slows and milk starts hanging around, there’s an increased risk for a gut infection, so they’re just going to take things slow.

day 49: ouch!

the nasal cannula needs to be taped on his face to reduce the chance that he’ll pull it out and the process of repeatedly removing the tape when he goes back on cpap has made his skin a little raw. tonight, he even has a tiny bit of flesh pull away, which he obviously didn’t care for at all; nurse peggy put little pieces of what’s known as comfeel on his face to prevent it from happening again because open, irritated sores are not a good thing when you’re enduring a prolonged stay in the nicu.

day 49: pacified. I.

eric’s getting much better at coordinating his sucking and breathing; a mere week ago, he’d alarm when a pacifier was in his mouth for more than 15 or 20 seconds, but now he can keep the pacifier in as long as he’d like. since he’s doing so well, nurse peggy said that it’s a good time to introduce a pacifier during his breastmilk feedings so he can begin to associate sucking with feeling of food in his stomach. this is but the first step in a long process of getting his used to having to coordinate the sucking, swallowing and breathing that must occur for real breastfeeding, so it’s a big step.

day 49: pacified. II.

sometimes he has trouble keeping the pacifier in his mouth with the tubes in the way, so peggy has “illegally modified” the paci by notching it so that the tubes can stay where they need to stay and he can more easily keep it in his mouth. nurse peggy is thoughtful like that.

day 49: longhair

eric’s hair is getting so long that it’s growing over his ears!

the eric update – day 47: 3 pounds! no ROP ( yet )! the return of the nasal cannula!

day 47: 3 pounds! I.

wow! a mere 16 days after hitting 2 pounds, eric weighed in at 1370 grams tonight! or 3 pounds 0.3 ounces! it’s absolutely stupendously amazing that he’s gained a whole pound in such a short time, especially when he’s been so sick.

day 47: 3 pounds! II.

i guess he really does have the snowdeal genes, since putting on weight has never really been a problem for generations of snowdeal men. it’s amazing to see how quickly his appearance is changing on a day-to-day basis with the weight gains.

day 47: plumpy.  I.

eric is also getting 4 cc’s of breastmilk every 2 hours. he has a long way to go to be considered on “full feeds”, as he’d need to be getting about 19 cc’s of milk every two hours before they’ll discontinue his IV completely. still, he’s making great progress and seems to be tolerating the milk quite well.

day 47: plumpy.  II.

and he has a mere 2 days left on his antibiotic regime to treat the pneumonia and suspected sepsis. interestingly, after all the hullaballoo surrounding the sepsis it appears that the gram negative stuff they found in the yeast culture was likely a contaminant. i guess that’s the way it works sometimes.

day 47: back on the nasal cannula. I.

also, the eye doctor came by for his regular ROP checkup and didn’t detect any sign of abnormal blood vessel growth in his retinas. while this is great news, the doctor felt the need to warn us that not only was eric not out of the woods – he wasn’t even in the woods yet! now that’s some smooth bedside manner. he then stated matter of factly that eric’s most vulnerable stage will be between 33 and 39 weeks and that most 24 and 25 weekers will develop stage I or stage II of the condition. so, once again, while we’re extremely happy that his eyes are fairing well, his next few checkups will be the ones that will really give a better idea of if he’ll develop ROP.

day 47: back on the nasal cannula. II.

and just as we suspected, they’ve started testing eric out on the nasal cannula again, with 2 hours of nasal cannula, followed by 6 hours of cpap. and despite my many attempts to miminize the appearance of one of the side effects of the cpap mask, sometimes it’s impossible to hide the conehead that he can get from the tight cpap straps pushing against his very soft head.

he seems to be tolerating the nasal cannula very well and is continuing his streak of remaining alarm free! that’s right – he hasn’t had a single incidence of apnea or bradycardia. it really is hard to believe that he’s showing such great improvements in such a short period of time. i guess it’s hard to remember that things can get better just as quickly as they can turn for the nurse. such is the way of the nicu.

the eric update – day 45: off the vent! kangaroo care! first shirt! doubled weight!

day 45: the transfer

wowza. so many good things happened today that it’s going to be hard to summarize them into an easy to digest nugget. after eleven long days on the ventilator we were quite surprised ( as were many of the nurses ) that the neonatologists decided that eric was ready to be free of the vent. apparently his right lung looked much better than anticipated after this morning’s x-ray and the doctor’s decided that he was recovered enough from pneumonia to give the cpap a try. woohoo! and you know what that means – we can hold him again! here, nurse peggy is handing him off to kris for a little kangaroo care.

day 45: at long last!  a little 'roo time with mama.

despite getting the great news that he was back on cpap and therefore able to be held, everyone thought that he would only be able to stand small amounts of kangaroo care. nurse peggy watched his stats carefully after the transfer for 5 minutes. then 10. then 15. and 20. until she finally decided that eric was doing better off the vent than on. he did spectacularly for an hour, with not a single alarm, and he was only put back in the radiant warming bed when kris decided that she had to go pump breastmilk. it was quite and accomplishment as he’s still has pneumonia. his breathing was as stable as you could ever want it, which is impressive because babies can sometimes get lazy after being on vent, as the machine does much of the work for them.

day 45: being held by pops.

after an hour of kangaroo care from mama i was able to hold him “regular style” ( i had no idea that he’d go off the vent today so i didn’t wear clothing appropriate for kangaroo care ) for a half an hour. fun! (

day 45: his first shirt. I.

as if all the great news about him getting off the vent and getting kangaroo care wasn’t enough to absorb for one day, nurse peggy announced that he’d be getting his first shirt!

day 45: his first shirt. II.

it’s a sign that his caregivers think that he’s getting more stable than ever, since it means that they aren’t so preoccupied with having to see how mottled or flushed his skin is at any particular moment. i picked a very stylish blue pinstriped top.

day 45:  doubled his birthweight!

and last, but certainly not least, eric hit a big milestone today by officially doubling his birthweight. he weighed in at 1335 grams or 2 pounds 15.1 ounces!

it’s hard to believe that he only needs to gain about an ounce to hit 3 pounds. it seems like just yesterday that we were celebrating the 2 pound milestone. gaining so much weight while fighting pneumonia is an impressive feat.

they grow up so fast!

wow! wow! wow! after eleven days of hardship, it’s really exciting to have to much good news to report.

day 45: measuring his head.

random aside – i realized tonight that i hadn’t got a shot of a ritual that occurs every 3 days – the measuring of eric’s head. since the last measurement, his head grew a half a centimeter and is now 27 centimeters in circumference.

the eric update – day 33: the sounds of cpap

there’s not much to report today, as eric is slept soundly through much of his 33rd day and the nurses more or less sensitively told us and his other visitors that we shouldn’t disturb him too much – which, of course, means no lights and hence, no pictures. he had very few alarms, although his ‘oooohs’ from his cpap machine are still cranked up to 30-40%, as he still doesn’t seem to be able to cruise along on room air.

speaking of cpap ( continuous positive airway pressure, a type of respiratory aid – for the many of you who haven’t been following along from the beginning ), i thought i might try to capture what the experience is like from eric’s perspective. you might think that he’s bothered by bells and alarms and clanging all day long, but at least as long as he’s on cpap, i suspect that all he can hear is the very loud white noise produced by the air rushing through his mask. so i stuck the ibook mic near his head and recorded a minute of the sounds of cpap and overlayed it on one of the few shots that i was able to get today. if he looks like he’s wincing a little and trying to cover his hears, now you know why.

if you listen closely you can hear the muffled sounds of nurses talking while standing at the bed next to his, which is about 6 feet away. turn the volume up and put on some headphones to get the full effect, while trying to imagine enduring the sounds 24 hours a day.

the eric update – day 27: the ho-hums

day 27: ponderous

we spent a lot of time at the nicu today, just keeping an eye on eric. he’s had a few more “a’s” and “b’s” than normal over that past few days and his oxygen levels have been turned up ( room air is about 20% oxygen and after a long stint of not having any supplemental oxygen, he’s getting anywhere between 25 and 30%. the bloody goo problems are continuing and it’s raising the background level of anxiety as we’re spending more time tapping his butt or rubbing his back to try and get him to breath. we discussed things with his nurse practitioner and from her perspective he’s still doing really, really fantastic. and concurred with kris’ observation that the bloody goo problems and the cpap mask are part of a vicious circle. the air in the cpap mask dries out his throat and the suction catheter makes the irritated parts bleed. it just comes with the territory. here’s to hoping it doesn’t continue for too much longer, because at this rate he’s not going to want anyone to touch every touch his nose after he gets out for a very, very long time.

day 27: four 0'clock prep time

we also didn’t get much ‘roo time in today as the only chair that fully reclines was in use and if we try to do the ‘roo while sitting upright, we find that his neck muscles can’t keep his head in the rights positions to get him a steady supply of air. so instead, we just hung around his bed and kept him company.

kris talks with eric a nurse beth does her regularly scheduled nasty things to him. he’s moving his head around looking at all of us as kris talks to him and holds his hand.

he’s just had his cpap mask taken off and you can how the cpap regime makes his eyes red and swollen. this time it’s not too bad, but sometimes it looks quite uncomfortable. he’s on the cpap mask for 4 hours and the nasal cannula for 4 hours. hopefully soon, he’ll be off the mask entirely.

[ update: much later in the day ( o.k. maybe it was technically early, early the following day, i did get to hold him for awhile; the nicu was abuzz with reports of a possible ’22 weeker’ being admitted, but as our nurse said, everyone is hoping that they can delay the birth, since – as she put it – “22 weeks is not really, well, compatible with life.” it’s odd to look at eric and know that there’s just two short weeks between their birth gestational ages. a lot of biology must happen in those two weeks. ]

day 27: ears and gray hair

while i normally hate pictures of myself, and would typically despise pictures that featured by ear prominantly, i think i’ll make an exception with this one. there’s something i like about the composition of the ears and my hairy head with his not-so-hairy one.

and i i can blame all my gray hair on eric. see, it’s not that i’m old – people with black hair go gray prematurely. and having a 24 weeker doesn’t help the situation.

glad i cleaned my ears that morning. and no, that’s not a mullet. honest.

day 27: the cpap machine

with all the commentary about it, i realized that i hadn’t taken a photo of the cpap machinery. it looks innocuous, no?

i don’t think you understand just how difficult it is to take an interesting shot of a cpap respirator.

day 27: eyes on you

he’s on his belly, but that doesn’t mean he doesnt want to look at you.

the eric update – day 26: beating the wrap. more bloody goo. and personalized snugglies.

day 26: doing "the swim"

today, eric took one of those teeny, little micropreemie steps that gets him one step closer to being released. he finally beat the wrap! literally. in other words they don’t have to cover his bed in plastic wrap to help keep his body temperature stable. it’s a big deal for a micropreem to be able to maintain his or her own temperature ( in fact it’s one of the release criteria ) and while he can’t do it all on his own, he’s making great progress.

he’s threw more “a’s” ( apneas or stopping breathing ) and “b’s” ( bradycardia or stopping breathing ) today than usual, almost all of them due to mucus and goo collecting in his nasal passages and throat. the nurses joke that eric is “slimy”. it’s not super unusual, but the downside is that they can only get the gunk out by thrusting a tube into his nose and suctioning it out. as i’ve noted before, he doesn’t like it at all and the downside is that you can imagine that the suction tube irritates his passages and he’s getting a bit more blood in the stuff they are suctioning out. it’s one of those things that’s “normal”, but that gets harder and harder to watch day in and day out. and bloody nasal passages seem like nice little areas for infections to grow, so kris and i spend a lot of time just wishing he’d be a little less slimy.

day 26: personalized snugglies

in addition to postcards, eric is receiving surprise gifts! a friend of a friend of a friend who had twins that graduated from the other nicu in town sent us custom bedding! they were hand made by a nicu doctor and they kept her twins bundled; if you look down in the lower left corner you can see that she even stiched “snowdeal” on the bedding so it doesn’t get lost in the laundry.

dang. that’s some serious kindness from a stranger.

the bedding is reversed so i could get the stitched name in the shot with him. you might notice the cloth straps which are used to really give him a bundled feeling. micropreems get distressed at the sudden lack of boundaries and really like feeling things pressing around them which they lost when they were suddenly taken out of the womb.

jeanne, thank you.

earth angel

a family member bought eric a little angel with his name on it a day or two into his stay at the nicu. for some reason, it kept falling off the stand on his radiant warming bed which would lead to endless “fallen angel” and “the angel fell down on the job” jokes from the staff. somebody came up with the idea of putting it in a plastic bag and hanging it over the edge of a stand on the bed.

for some reason it makes me chuckle whenever i see it.

the eric update – day 25: a tantrum and a little perspective.

day 25: the tantrum I.

with eric IV looking quite content much of the time ( except, of course, when his care routine requires that not-so-fun things are done to him ), i found myself wondering when he was having those tantrums that preemies are famous for. sure, he can get worked up sometimes, clenching his fists and thrusting his feet and making little squeaks. but i we’ve never seen a full-blown, let-out-all-the-stops tantrum. not that you want to see a tantrum, but still. and so, with perfect timing, soon after i arrived this evening, eric decided that something was not right ( of course, it couldn’t have been my voice. no, certainly it wasn’t that ) and started trying to launch himself right out of the bed. and the screaming. if there was any doubt, him pipes are developing well. this went on for about a minute and no amount of consolation from me or kris was helping one iota.

day 25: the tantrum II.

that’s when nurse jan decided it was time to bring in the passifier, because if he has a tantrum for too long then he’ll stop breathing and that’s no good.

day 25:  big hand.  little hand.

the only problem is that he doesn’t really know how to suck on the passifier and breath at the same time, so it’s a delicate balance. eventually, he figures it out and i rest my hand on him, which helps a little too, i guess.

day 25:  postcards

the postcards have started coming in! i’m not sure the nurses believed me when i told them that he was going to start getting cards from all over the world. we’ve just received a few so far, but is suspect they’ll be trickling in for awhile. we were very touched by the kind story from a nice person we don’t know who hails from santa clarita, california. it’s going to be hard to maintain my cynical side if people keep up with such random acts of kindness.

day 25: more 'roo

kris is continuing with her record setting ‘roo sessions. she might do two sessions a day at about 2 or 3 hours apiece ( i bet she’d go longer, but that’s the longest she can go before she has to “pump” ). as i said yesterday, there are many factors involved in how well eric is doing, but i really think all the kangaroo care is big factor. we’re fantastically fortunate that kris can spend so much time in the nicu. she teaches at the local college and has the summer off, so she can spend as much time as she likes with eric. and of course, she likes to spend a lot of time with him ( not that i don’t, silly. you know what i mean. ).

day 25: bearer of the ring

ahhhhhh. it’s the ol’, “put your wedding ring on his diaper to give a sense of perspective” trick. with all the close-ups, it’s easy to forget just how small he still remains ( although he has grown 3.5 inches centimeters ( arrgggh. there’s a big difference between inches in centimeters. i think 3.5 cm is a little over an inch. ) since birth. yeah!).