5 lbs!!!

Kayley hit the 5 lb mark today. Last night she weighed in at 2205 grams which was up 20 grams from Sunday. And tonight, she weighed 2275 grams which is up 70 grams from last night. According to my calculation, that's just over 5 lbs (1 ounce = 28.34952 grams)!

Nothing else really exciting happened today except that Kayley was supposed to have a bath. Yep, I said supposed to because we decided to postpone it. There was a very small amount of Legionella germ found in a culture from an adult patient at the hospital today. This germ is found naturally around us, usually in water. It poses little risk to healthy adults and children but sick/premature babies and cancer patients can get sick from it. It cannot be passed human to human. It is spread by direct contact usually by breathing in water mist or vapor that contains the germ. The hospital has a water treatment system that is designed to help prevent the germ from growing in the water. However, just as a precaution, the hospital water is off limits for the babies in the NICU until it is tested and comes back normal. Until then, the only water that can be used for babies bathes or rinsing their supplies is bottled water. They now have cases and cases of it here.

Sonographic Imaging Of The Brain

We received great news on Kayley's head ultrasound today. Rather than beat around the bush, I'll just write what the report says and then try to put it in terms we can understand. The report has a lot of medical jargon.

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REPORT:

Reason for Procedure

Intraventricular Hemorrhage (bleeding in the brain)

Indication

Real time sonographic imaging of the brain was performed through the anterior fontanelle in the sagittal and coronal planes.

(They performed an ultrasound on Kayley's brain through the soft spot on the top of her head...in real time.)

The ventricles are normal in size with no shift of the midline. No hemorrhage or space-occupying lesion is identified. No abnormal intra- or extra-axial fluid collection is identified. Periventricular echogenicity is unremarkable. Linear striations in the thalami are consistent with mineralizing vasculpathy, a nonspecific indicator of perinatal stress. Previously suggested hemorrhage is no longer appreciated.

(The spaces in Kayley's brain called the ventricles are not bigger than normal due to her brain bleed. There is no collection of fluid which means that the bleed is pretty much all resolved. There are no signs of scarring or cysts...therefore being unremarkable. The ridges in the thalami (part of the brain) are consistent with the resolving of inflamed blood vessels, which could be an indicator of perinatal stress...meaning that Kayley really might have had a bleed that resolved. And finally, the brain bleed that they suggest Kayley had gets no appreciation....I mean it's no longer there.)

Impression

Normal examination

(the exam was normal)

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So, that all seems like good news to us. Anyone else wonder why they insist on using all the medical terms?

Another big event from the day is that they tried to bottle feed Kayley for the first time at her 6 pm feeding. Megan was there with Kayley. She said it didn't go so well but it could have been worse. Instead of being in rhythm with her suck, swallow, breathe, she was doing more of the suck....then swallow....then breathe...then take a break. Kayley did swallow some milk but Megan said she was basically telling them, "Hey, I'm not ready for this." Even though she didn't pass with flying colors, it was better that Kayley was able to understand that she didn't want to do this new thing rather than just suck away and then choke on the milk. She understood what to do with the milk in her mouth once she got it. She knew that the bottle was not the pacifier and something different was happening that she wasn't ready for. So, I guess we'll try another day...

I am unable to report on Kayley's weight tonight because all the scales were in use elsewhere when the nurse normally weighs Kayley before her 9 pm feeding. They will weigh her sometime after I leave. I'll have to report it tomorrow after Megan calls in the morning to check in.

Does This Onesie Make Me Look Fat?

Kayley must have heard the news about her gaining all that weight because today she worked a little bit of it off. Megan said Kayley had a little attitude while she was there today. She didn't want anyone touching her. If they tried, Kayley would greet them with flailing arms and kicking legs. When I got in tonight, the night nurse said she heard Kayley was a little ornery today. The day nurse told her Kayley was crying so loud at one point that she could hear Kayley all the way down the hall. Kayley has really never cried that loud. I suspect she was just working off a bit of that weight. She weighed 15 grams less tonight than last night. She is now 2180 grams (4 lbs 12 oz).

I sat down and had a talk with Kayley about how we weren't making fun of her weight. Last night when I said, "Geez. She's getting huge," I meant that in a good way. She understood and promised that she'd keep putting the weight on. We'll see if she really meant it at tomorrow's weigh in.

Kayley's next head ultrasound is scheduled for tomorrow. It's just a routine ultrasound to follow up. They don't suspect anything is wrong. They just want to make sure everything is continuing to go well. Also, sometimes when babies have bleeds in the brain, it can cause cysts. Since Kayley's resolved so quickly and one doctor even told us they weren't real certain she even had one, they don't expect to find any surprises. But, we'll still keep our fingers crossed.

Getting Bigger...

Kayley didn't have many changes again today. She's still on the same settings with the oxygen prongs and she hasn't tried to eat from a bottle yet. However, they did bump her feedings up from 38 cc's to 40 cc's. It's starting to seem like quite a bit for that little stomach of hers...but that's why I'm not the doctor.

The new feeding amount seems to be giving Kayley a little more reflux than what she's had recently. When she starts to reach the end of her feeding, you can hear her cough and gasp a little bit. Her oxidation also drops at the same time. The new feeding amount will just take some getting use to. I asked the nurse and she said that reflux is quite common and they normally out grow it. So, it's really nothing to worry about.

Kayley gained her normal amount of weight today. She went up 40 grams to 2195 grams (4 lbs 13 oz). 5 lbs is in her sights. The way she's going she'll hit that in the coming week.

33 Weeks Gestation

Kayley may decide on her own when she wants the prongs out.

Kayley broke out of my swaddling job to say, "No pictures please."

Kayley did some more resting and eating today. She's getting very good at it. Her oxygen was at 21% the whole day. That's a good sign. It led me to ask the nurse tonight if there was anything in her chart about when they'll try to take her off the oxygen again. The only thing the chart says is to "start weening Kayley off the .2 lpm." So, it looks like they've been talking about it. I'm sure they'll be more cautious this time so Kayley has a better shot at succeeding. Plus as I said last night, she only has one more week until she has to keep her oxidation at 90% or above. That's a big jump from the 83% now.

I also asked the nurse if there were any notes on nipple feeding in Kayley's chart. The chart is a little vague again as it only says to "try after she is 33 weeks gestation." Well, she's 33 weeks gestation tomorrow so it could be as soon as that. Otherwise, I'm sure it'll be within the next couple days.

And last, the weight update. Kayley jumped up another 40 grams today. She is now 2155 grams (4 lbs 11 oz). She's doing her job.

Night Owl?

Feeding and growing. Feeding and growing. That has been the motto as of late. That means not much else has happened in the NICU. The oxygen she is getting is staying pretty low. The whole time tonight, she's been at 21%. It'll be interesting to know when they are shooting to take her off the prongs again. One thing worth noting is that in a week and a half (when Kayley is 34 weeks gestation), Kayley will need to keep her oxidation level between 90%-98%. Right now she only needs to be between 83%-93%. So, that could factor into the decision. I'm sure we'll find out their plans in the next couple of days.

Kayley is still doing great. She may be somewhat of a night owl though. Today the nurse said Kayley slept most of the day and didn't wake up much for her feedings. The nurse was a little concerned until Grandma Marla arrived to hold Kayley for her 6 pm feeding. Evidently she was wide awake then. And when I arrived tonight, she was wide awake again. She stayed awake almost her whole feeding. Could it be that she's becoming a night owl? For Megan's and my sake, let's hope not. We'll make sure to have her trained by the time we leave the NICU. Night time is for sleeping.

Kayley gained more weight today. She went up 55 grams to 2115 grams (4 lbs 10 oz). 5 lbs isn't far off.

Uneventful Day

Today was a pretty uneventful day in the NICU. Kayley gained some weight and that's about it. She is now up to 2060 grams which is still 4 lbs 8 oz. And, I also found out tonight that Kayley's feedings were increased to 38 cc's yesterday. It slipped under my radar but Megan knew about it.

Kayley is doing a lot better with her oxygen. Today she was between 23-25% the whole day. Tonight, she has been on 21% the whole time I've been here. I guess she just needed those couple days to get her feet back under her. I think the plan is to let her grow a little bit more and then try to get her off the oxygen again. Hopefully, she'll do better the next time.

The nurse told me tonight that they have written in Kayley's chart that they will start trying to bottle feed her after they see cues that she's ready. In the nurse's opinion, she's ready. Cues could be anything from tongue thrusts to sucking on her fingers to sucking well on the pacifier. She does all of those things. Again, they will try a bottle first so they can control how much Kayley gets.

So even though today was uneventful, it looks like the coming days may bring some changes...