Tag Archives: ericiv

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

August 20, 2004 snowdeal Leave a comment

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.

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.

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.

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.

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.

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.

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the eric update – day 46: many more postcards. no alarms (almost). and a little ‘roo time with pops.

August 19, 2004 snowdeal 1 Comment

well, it looks like we’re back to having days where the biggest news came when we received 16 postcards all at once! i had joked with the staff yesterday that perhaps the mailroom got sick of running his cards up to the nicu and maybe there was a kernel of truth in the joke, since some of the postmarks were from 8 days ago. regardless, we finally did get them all and we’ll enjoy reading them to eric over the next few days. thanks again to everyone two has taken the time to send a card ( or two, or three! ). as always, it makes our day that much more special to be able to read eric postcards from all over the world.

in the above photo, as always, eric isn’t too subtle about letting you know that the lights might be too bright.

clinically, eric had a – thankfully – boring day. i forgot to mention that he didn’t have a single alarm yesterday and he would have kept the streak going today had it not been for a tantrum after his “eight o’ clock meanies”. at eight p.m. his nurses do the various things that nurses have to do and tonight he let us all know that he was none too happy with the situation. he got really mad and when he gets really mad he’ll decide that breathing isn’t too high on his priority list. the nurses have come to expect eric to be “naughty” ( a common nurse euphemism for when babies are being uncooperative ) at such times and don’t really count it against him on his permanent record.

eric is getting three cc’s of breastmilk every two hours and if he keeps tolerating the milk, i think it’s reasonable to expect that he’ll be back on “full feeds” ( meaning no intravenous fluids ) by the end of the weekend or early next week. obviously, with his gut shutting down last week, they are monitoring him very closely for signs of necrotizing enterocolitis. so far, all signs indicate that he’s tolerating the feeds quite well.

eric’s hands and feet were looking a little puffy, which partly can be explained by water retention as a consequence of the intravenous drip. however, his hands looked very puffy and likely related to relatively minor issues with his IV line. due to a variety of reasons he’s been having troubles with the line being put in his hands so after trying a few different locations on his hand they decided to move the entry point to his foot. in the end, they found a spot that seemed to agree with him, but not after leaving a few battle scars on his hands.

in addition to 2 hours of kangaroo care with kris, i remembered to wear an appropriate shirt, so i was able to spend about an hour of quality time with eric, doing the ‘roo.

and finally, kris gave eric a brief bath today without his cpap mask ( meaning he didn’t have any respiratory aid ). he didn’t throw a single alarm and his blood oxygen looked great, which prompted his nurse to make a clinical note that they might want to think about putting him back on the nasal cannula ( the nasal cannula requires more work on eric’s part than cpap and is considered to be the last phase of “assisted” respiration ) sooner than they originally planned. woohoo!

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

August 18, 2004 snowdeal Leave a comment

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.

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.

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! (

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!

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.

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.

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.

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the eric update – day 44: almost closed pda. bugs? and more bugs?

August 17, 2004 snowdeal Leave a comment

i think eric is enjoying dragging out the drama of doubling his birthweight. he was up 10 grams today, topping the scales at 1270 grams or 2 pounds 12.8 ounces.

we finally received word on his patent ductus arteriosis and it’s almost amusing – it’s not closed, but it’s not open wide enough to warrant additional measures to try to close it. although everyone seemed quite confident that it would close on its own, it’s still slightly disconcerting to not be able to give a definitive answer to the innumerable questions regarding the status of the hole in his heart. i didn’t follow up as rigorously as i might normally as to why they weren’t going to pursue another round off indomethacin simply because everyone seemed so confident that the hole wasn’t big enough to have any physiological consequences and that it would close on its own accord.

unfortunately, i don’t have any good an answers as to what may or may not be the source of his sepsis ( if, in fact, he does have a blood infection ). remember, they caught a gram negative bug in a blood sample that was being used to determine if he had a yeast infection. they’ve been having trouble determining the exact type of bug in the sample because, as a person from “infectious diseases” said today – “fungus is funky”. in other words, they are trying to grow enough of the bacteria to allow identification in a media that was meant to grow fungus and it’s not working well. all you armchair microbiologists in the crowd could perhaps speculate as to why they can’t transfer the small amount of the bacteria they did find into a more suitable media. then again, i might have some of the details confused so it might not be worth your effort. luckily they haven’t found any bugs growing in any other samples they’ve drawn, so all this might be much ado about nothing.

we also received the results from another round of “trach aspirate” tests, which indicate if he has anything growing in his trachea ( being intubated on the vent greatly increases the chances that strange bugs will grow in his trachea ). six days ago, they discovered small amounts of enterobacter and klebsiella growing in his trachea and today they said the bugs were still there, despite being on antibiotics for nine days. the staff seem to not be overly concerned about the bugs sticking around for now. things might be different if they are still there after they finish the antibiotic regime, which will last for about 6 six more days.

oh. and his arm was quite red around the entry point of his IV line, which would strongly indicate that a superficial bacterial infection was starting. they moved the line and applied a topical antibiotic which will hopefully prevent any further complications.

i was joking with the nurses that i didn’t have any of these problems with bugs when i was a 26 weeker, 32 years ago, and that one couldn’t help wonder whether or not eric IV had the misfortune of finding himself in a “dirty” unit ( really, it was all in good humor ). aside from being continually astounded that i survived the ordeals of being a micropreemie in 1972 ( indeed, one nurse commented that when she started in the nicu at about that time, they would have never tried to save a 28 weeker, little less a 26 weeker ), the nurses all remind me that we can thank indiscriminate usage of antibiotics for causing all the “bug” problems that are seen in the modern nicu.

so think about the micropreemies the next time you jump for the medicine cabinet to grab an antibiotic for a minor ear infection.

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the eric update – day 43: readin’, feedin’ and nicu noise.

August 16, 2004 snowdeal Leave a comment

another day of quiet recovery, which is a good thing these days. slightly frustratingly, we still haven’t heard the results from the echocardiogram which will tell us if his patent ductus artierosis has closed, but his blood gasses are so good that i think everyone is assuming that it’s closed. also, they are apparently having trouble determining what the bug was that showed up in one of his blood samples and haven’t been able to find any more of it, so it’s likely that we’ll never know for now if it was contamination or is simply lurking in the background at undetectable levels while he’s on the antiobiotic regime. or maybe it’s gone for good.

they started eric’s breastmilk feedings again, which means that they are getting more confident that he’s recovering from his recent “troubles”.

technically, they aren’t really feedings as they are giving him such a small amount – only 1 cc every 3 hours, but it’s a start. rather than sending the food directly to his intestines via an “o.j.” ( oral to jejunum ) tube, they’ve decided to see if he’s can tolerate sending the milk directly to his stomach via his “o.g.” ( oral to gut ) tube. this is another small sign that they believe he’s getting stronger, despite his pneumonia.

the nicu is packed these days and when it gets packed it gets noisy. it’s a small nicu with only 15 beds, but it’s a small space and can get quite crowded when all the beds are filled, if all the babies have visitors. there’s and ebb and flow to visitors and during peak hours it the constant din of conversation and bells ringing can make it sound like a surreal cocktail party.

if you’re paying attention when it’s noisy, you’ll notice eric sending little signs that things are getting too loud, such as grasping his ear tightly in an attempt to block out the sound. subtle signal, no?

kris finished reading eric jonathan livingston seagull. he liked it a lot.

“poor fletch. don’t believe what your eyes are telling you. all they show is limitation. look with your understanding, find out what you already know, and you’ll see the way to fly.”

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the eric update – day 42: two birthdays!

August 15, 2004 snowdeal Leave a comment

it’s eric’s and and kris’ birthday today! we all know eric turned 6 weeks old today, but i’ll leave it up to kris to decide whether or not to reveal her age. grandma and grandpa snowdeal came into town just to take us out to lunch; and we celebrated a quiet birthday in the evening with some of her family. it’s hard to put much mental energy into really celebrating outside the nicu, but that didn’t stop me from eating more than my fair shair of cake.

the nurses all knew it was kris’ birthday and decided to give her an extra special present by letting her wash him. as you can imagine, it’s a little difficult to give him a good scrubbing while trying to not extubate him, but kris did a great job.

eric is continuing to really pack on the weight. he weighed in at 1240 grams or just under 2 pounds 12 ounces. he looks a little puffy from water retension related to the intravenous drip, but i think a lot of his recent gains are real thing. amazingly, he just needs to gain 2 more ounces to have doubled his birth weight! over the past few days, nurses that haven’t seen him for a few days have been commenting how much different he’s been looking as he fills out and today was the first day that i really could see what they were talking about. ( as i’m writing this, a nurse walks by and exclaims, “ohmygosh! he’s big! oh my!” i swear that she doesn’t know what i’m writing at the same moment ).

during his bath, kris cleaned his hair and we both noticed that it was long enough to get “mussed” up and it stayed that way, as if it might be wavy. so august 15, 2004 was the first day and probably not the last day, if he’s anything like his pops, that eric’s hair was messy.

kris was also able to sneak in another brief bit of holding by picking him up while the nurse changed his bedding around. after a week of no holding or kangaroo care, these brief interactions which were made possible by an incredibly thoughtful nurse, made kris’ birthday quite special. all the nurses are great, but some of them are much more attentive and thoughtful and have not forgotten that any contact, however brief, is magical.

random observation, his fingers are getting bigger.

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the eric update – day 41: closed pda? a bigger diaper and growth curves.

August 14, 2004 snowdeal Leave a comment

eric received his round of indomethacin to treat the recurrence of patent ductus arteriosis, but we won’t have any decisive answers as to whether or not the hole in his heart has closed until monday; there’s only a small number of people who are skilled in doing the diagnostic echocardiogram on micropreemies and, apparently, they don’t work on weekends. it’s actually a good sign that the nicu staff don’t feel the need to call the technicians in for an emergency procedure, since it means that they think that the hole has closed. eric’s blood gasses have improved and his need for supplemental oxygen has decreased to 22-24%, which is almost the same as room air. also, none of the nurses can hear the characteristic “murmur” that they’d expect to hear with pda, so everyone is fairly confident that the hole has closed quickly in response to the medicine. good news!

as for the sepsis, we won’t know anything definitive for quite some time. we’ll probably know tomorrow exactly which bug is causing the problems, but that knowledge won’t change his treatment protocol. as i stated yesterday, eric will be on antibiotics for a full 15 days in an attempt to beat the bug into submission. however, we learned today that it’s likely that they won’t get rid of it completely and they will probably change tactics after 15 days and move towards a protocol that involves giving him short, sharp bursts of antibiotics. it’s a delicate balance, as giving eric a continuous feed of antibiotics obliterates the good bugs along with the bad; and dampening his natural immune capability increases the chance of eric getting a systemic yeast infection, which is really, really difficult to get rid of and can cause all matter of ugly and unspeakable problems. so for now, all we can go is hope that he continues to respond as well as he has to the current protocol. the good news is that his overall immune system profile is excellent, so we can only hope that it stays that way.

we haven’t been able to hold eric as he’s been back on the vent while he’s fighting pneumonia, but the nurses cleverly found a way to let kris sneak in a little touch time by letting her put him on the scales for his weigh-in. eric’s nicu nurses are so incredibly thoughtful and considerate that it really is impossible to imagine how to properly convey the gratitude we felt at the kind gesture.

also, we talked with his caregivers for quite some time about how long he’d be on the vent and the possibility that he’d suffer from the negative side effects that are known to accompany the vent, including respiratory distress syndrome. luckily, eric’s vent settings are at the lowest that they can be and, while nobody can predict the future, they don’t think he’ll suffer any adverse consequences from being on the vent.

eric tipped the scales at 1170 grams which is just over 2 pounds 9 ounces. that’s right he gained just over 3 ounces, despite battling pneumonia and sepsis.

they say that every baby excels in one area of development and eric seems to be doing great with gaining weight. some of the gain can be attributed to water retension, but i think much of it is real. speaking of weight gain, eric also graduated into a new, bigger diaper! his previous diaper was only appropriate for babies at or under 1200 grams, so he’s crossed quite a milestone.

the new diaper looks amusingly large on him, but with any luck he’ll quickly grow into it.

while we’re on the subject of gaining weight, it’s interesting to note that eric is following the “normal” gestational growth curve as if he were in the 10th percentile. in other words, if he were born today, his weight would be in the 10th percentile of all babies born. not bad for a guy who’s been out of womb for nearly 6 weeks.

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Tag Archives: ericiv

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

the eric update – day 46: many more postcards. no alarms (almost). and a little ‘roo time with pops.

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

the eric update – day 44: almost closed pda. bugs? and more bugs?

the eric update – day 43: readin’, feedin’ and nicu noise.

the eric update – day 42: two birthdays!

the eric update – day 41: closed pda? a bigger diaper and growth curves.

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