Smile For The Camera!

Kayley's getting the hang of this picture taking business. As soon as she hears the camera turn on, out come the smiles. All right. Maybe I just got lucky. I probably caught her in the middle of a sweet dream or possibly with some gas. Either way, I was lucky enough to snap some great pictures.

Again today, there were not any significant changes. As I sit down to write this post every night, I always like to have big news to write from the day. But, the more I think about it, we'll take the boring ol' feed and grow days. At this point, that's what we should expect.

Kayley's oxygen is better today. They were able to lower it some and she's done quite well. She's been down around 28% which is a good sign. Her oxidation has been stable all night. I can tell the difference from last night when her oxidation was more of the up and down type. Tonight, she's keeping it pretty much at a consistent level.

Kayley's stuffed up nose is sounding much better. The nurse today cleaned her out a bit and so did the night nurse. The day nurse even asked the doctor if she could use special drops to help Kayley's nose. The doctor said to stick with the saline drops for the time being. It looks like they worked so we're not complaining.

Our little grower weighed in at 2040 grams (4 lbs 8 oz) tonight. That's up 50 grams from last night. She's doing a great job. Megan must be supplying that weight gaining formula. At this pace, we could be taking home a 10 lb baby...ok, that's not likely. But, she'll be a good size for a 27 weeker.

Megan said the physical therapist was in today and she's actually been in a couple times before. She is very happy with Kayley's development. She likes how Kayley put her hands to her face. She also mentioned how she likes that Kayley twirls her ankles. I'm sure there were some other updates but I didn't catch them all while Megan was telling her mom. I'll see if I can find out more for tomorrow's post. In any case, Kayley seems to be doing good in that area.

The last update is that Megan and I are going to be assuming some new duties for Kayley in the NICU. As you can see in the last picture above, we'll be taking a class to learn infant massage. As with the skin to skin holding, Kayley will benefit greatly from this. Some of the benefits for Kayley include emotional nourishment, loving communication with us, primary system (respiratory, circulatory, nervous, etc.) strengthening, reduction in gas and colic, better sleep, and just overall relaxation. And of course Megan and I will benefit also. We will learn Kayley's cues and responsiveness, enhance our communication with Kayley, increase our confidence and handling skills, increase our bond with Kayley, and relax and listen to Kayley. So, it sounds like a winning situation for all of us. Let the massages begin...

More Feeding And Growing

Kayley doesn't have many updates again today. Her feedings are still 35 cc's. They may stay there for a little while until they make sure she's not getting reflux when she has a full belly. In any case, she's still gaining good weight. Tonight she weighed 1990 grams (4 lbs 5 oz - very close to 4 lbs 6 oz). She's still a very little girl but she has come a long way since she was born.

Kayley's prongs are still in. Since this past weekend when they tried to take her off of them, they've had to keep her oxygen setting around 40%. Prior to the weekend, the oxygen was quite a bit lower. She seems to keep her oxidation high with the 40% setting but there are times when she dips a little. The nurse told me tonight that they've been trying to ween her off a bit but she doesn't handle it as well as they need her to. Let's hope she's not starting to rely on the oxygen too much.

I also noticed while I was holding her tonight that she sounds really stuffed up. She sneezed and coughed more than normal which tells me that she needs to be suctioned. I relayed my thoughts to the nurse and she said she would probably try to suction her when she changes her diaper the next time. Hopefully that clears Kayley up a bit and allows her to breathe more comfortably so they can ween her off the oxygen. It seems like this is becoming more of a hurdle that we thought it would be. Or maybe she's just really resting up to give it a good "go" the next time.

5 Weeks Old

There is really not much to update from today. Kayley has just been resting, feeding, and growing. Everything stayed the same for her. She is still on the prongs and they haven't tried to feed her with a bottle or the breast yet.

Megan gave her another bath today. From the sound of it, it was quite the little episode. Kayley pooped on some stuff while she was being transferred to the tub. I guess it was better to do it then rather than when she was in the tub.

Kayley now weighs 1960 grams (4 lbs 4 oz). She's definitely doing a great job gaining weight.

Oxygen? I Don't Need No Stinking Oxy...Wait, I Guess I'll Take Some

Kayley had a semi-rough day today (it's not often that I write that). She was taken off the prongs at 9 am this morning. She was doing great with the low settings she was on so it was almost an obvious decision. She did very well most of the day. Normally, her oxidation hangs out in the high 80's to low 90's (83 to 93 is acceptable at her age) with the occasional trip down to the low 80's. Today, she took a lot of trips to the 70's. That wasn't really a problem early on because she would always recover on her own very quickly. It was expected that she would maybe have some slight issues. However, when I got to the hospital for Kayley's 3 pm feeding (Megan and Marla were there all morning), things got a little worse. Normally, Kayley's feedings tend to make her oxidation level go down a bit because her stomach becomes so full. At the 3 pm feeding, it was much of the same except Kayley didn't really recover as quickly as she normally does. She stayed in the upper 70's...not an acceptable state. Our nurse had a feeling, and I agreed with her, that Kayley just had some reflux that was causing her discomfort which caused her low oxidation. So, we tried a little experiment. We put the prongs in her nose for a little bit to see if it would help. The nurse had no intention on leaving them there so she didn't even tape them to Kayley's face. I had been holding Kayley the whole time so I decided to put her back in her bed to see if that helped also. With the little extra oxygen, Kayley slowly climbed into the upper 80's. That backed our theory a little bit that Kayley may have some reflux with the new feeding amount and need a little extra help when she has a full belly. Then, Kayley desat'd (oxidation went below 75). The nurse wasn't in the room so I immediately got up to check on her. Kayley had spit up. Again, this backed up our theory that Kayley's low oxidation was caused by reflux. I found the nurse and told her and she helped me change Kayley. While we were doing so, Kayley let out a lot of gas. More reason to believe she was uncomfortable. So, we got her all cleaned up and swaddled and life was good. Her stats looked great so the nurse gave her to me to hold.

Kayley was going strong. Our new plan to help Kayley with her reflux was to increase the time she was being fed. She was receiving 35 cc's over 45 minutes. Our new plan was to give her the same amount over 1 hour to give it time to settle and digest. It was a good plan except that Kayley didn't allow us to make it that far. She began desat-ing rather regularly. And during these times, she wasn't recovering very fast if at all. Her oxidation lowered to the upper 60's a couple of times. The nurse whisked her away from me and gave her oxygen from the bag. Even then Kayley was very slow to recover. However, she did recover so we were going to give her one last chance.

It wasn't long until Kayley was desat-ing again. And this time, she even threw in a brady (slowing of the heart). So, the nurse had to report it to the Neonatal Nurse Practitioner. The decision was made that Kayley just wasn't ready and she needed to be back on the prongs. The respiratory therapist was called and Kayley and I prepared. It was very scary at the time because her oxidation was dipping into the low 60's. The lowest I've ever seen it. At that point, Kayley becomes very limp and doesn't move a whole lot. Thank God the respiratory therapist was in within a couple minutes to put the prongs on Kayley. By the time it was done, Kayley was pooped. It took her a while to recover fully even with her oxygen at 40%. Normally, her oxidation is shooting through the roof at 30%. So, Kayley was back on the prongs and resting comfortably. Her 6 pm feeding was given to her over the planned hour instead of 45 minutes. She did great. It looks like we just didn't have the correct combination this time but we learned from it.

So, we'll try another day. This was just a small bump on the roller coaster ride...which we really can't complain about. It's been a very calm ride thus far. But, no one wants even the slightest bump when it's your little girl at stake.

Other than the real big news today, Kayley did gain a little bit of weight. She's now up to 1905 grams which is still 4 lbs 3 oz. A gain's a gain...

Tomorrow Kayley will be 32 weeks gestation according to the doctor's calculations. She was born at 27 weeks 2 days gestation. If Megan would have still been pregnant with Kayley now, they would have started doing tests on her lungs to see if they were fully developed. As soon as they were comfortable with their development, she would have been delivered. No need though. Kayley decided for them and her lungs have done a great job.

Kayley keeps going down on the air flow that she's receiving. This afternoon she was moved down to .2. She has handled the change without any issues. The whole time I was there tonight she was on 21% oxygen (room air) which means she's really not receiving any extra oxygen. She's just benefitting from the air flow. We can't help but wonder how soon she'll be off the prongs all together. I'm betting it will be soon.

Kayley's feedings are now at 35 cc's. She's doing very well in this arena. With her gestational age now at 32 weeks, they will probably start introducing her to a bottle or breast sometime soon to see how she can handle feeding on her own. We've heard a couple theories on this. We thought maybe they'd try when Megan is in tomorrow but the nurse tonight said she thinks they'll wait a little bit. She also said they may want to start Kayley with a bottle first so that they can control how much she gets. I guess we'll just have to find out the plan tomorrow. Megan will be in when the doctor does rounds so we should get everything straightened out and have a good idea after that.

Kayley is back on track with her weight gaining. Her weight is now 1895 grams (4 lbs 3 oz). That more than makes up for not gaining anything last night.

Lastly, Kayley is experiencing something most babies do. She has a sore butt. It started turning a little red today. I guess it was bound to happen since she has a full diaper almost every time she is changed. The treatment is normal. They apply cream every time they change her diaper. Hopefully it isn't too painful and heals up quickly.

Another Kayley Video

.5, .4, .3....

There aren't many updates for Kayley today. Everything pretty much stayed the same except for her air flow. By the time Megan called in this morning, they had turned Kayley's flow down from .5 lpm to .4 lpm. The nurse mentioned that she was doing so well that she recommended to the doctors that she be turned down to .3 lpm by the end of the day. And so it was done. Kayley was down to .3 lpm by the time Megan got there. She's been at the same setting all night and is doing great. The nurse from today said it's possible that they turn Kayley's flow down even more tomorrow. We'll keep you posted.

Kayley's weight stayed the same today. She is still 1830 grams (4 lbs 1 oz). Again, that's not a big deal. She's been doing so well that one day without a weight gain is no problem.

The nurse told me tonight that they have scheduled Kayley's next head ultrasound for July 21. It's just a follow up to make sure everything is continuing to go fine up there.

Since there are not many updates, I took some video. Kayley is becoming more active every day. She stays awake for longer periods of time and makes more and more noises.