With the warning of the roller coaster of the NICU, I thought only of ups and downs. But anyone who has played Roller Coaster Tycoon as much as I have knows that plateaus are a necessary part of roller coasters. Today was a straightaway.
Aubrey was moved back to a Giraffe incubator, which is the type of incubator his siblings have been in since they were born. This is a minor change, but good news because it means that the doctors feel the surgical incubator is probably no longer necessary (i.e., Aubrey probably won’t need another surgery anytime soon). He has a bit of discoloration on his tummy still, but it’s a small bit. He is no longer on the morphine drip and is receiving pain medication only as necessary, which was only once today. His vitals are all excellent and he is breathing really well. And, that red/pink discharge in his lungs? That’s gone! So maybe we don’t have to worry about that PDA from before. But we don’t know that yet.
Lydia is up to 50% of her maximum feeds and weighs 1lb 6 oz today. She is very close to her birth weight and I expect she’ll be there by Monday. She really loves sleeping in her swaddle and, really, that’s all she does every day. Which is a great thing. That’s what she’d be doing if she were still in my tummy.
Finn got moved to an incubator that offers less support. (Aubrey had been moved to one but then he had the perforated bowel.) That’s also good news. He’s doing really well. They did do an EKG on his heart because he has a heart murmur and because he hasn’t advanced as fast as they’d like on his breathing support. What this means is that he requires a pretty decent amount of pressure to keep his lungs moving, but also a higher than preferred amount of oxygen is necessary to keep him from desatting (keeping his blood oxygen level from going too low). He is also the least tolerant of being touched or moved. When he has his care times (they change his diaper, check all of his tubes and monitors and move him), he desats and his heart rate and blood pressure climb. Despite these things, I did hold him last night for the first time! The doctors have said holding him frequently will really help him realize that not all touching is stressful.
He has a pretty large PDA (which, remember, is very normal in premature babies). The doctors have recommended that we treat him with the indomethacin. You may recall that I had had a bit of a panic and called a friend about this treatment when they were planning to treat Aubrey with it. Still relying on the advice of my friend, Dr. Patrick Jackson, the Virologist, I asked the doctor the following questions:
What are we hoping to get out of this treatment? Answer: the PDA to close which will hopefully allow his lungs to work a bit less so he can be on less support. Removing him from lung support sooner will help his lungs become stronger which will reduce the risk of lung complications in the future.
What will they do to reduce the risk of the bowel perforation? Answer: The doctors believe his risk is already rather low because of his age and size. However, they are reducing his feeds to a minimal amount to minimize the stress on his intestines. If his bowels become perforated, they would know within 3 days, so after the 3 days, they will resume full feeds. (In the meantime, he’ll be on that fancy Powerade again.) They will also monitor him very closely for a bowel perforation so, if one should happen, they can act quickly.
Emotionally, I’m in a much better place for this treatment on Finn than I was for the same treatment on Aubrey. (And for those of you who know Brise, my being more calm about it means that Brise is in a better place, too).
Today’s prayer requests: 1. That Aubrey continues to heal, 2. That Finn handles the indomethacin well. 3. For Peyton, who is not my baby, but is someone else’s, and is going on her 7th day of a struggle with a collapsed lung. Please pray for her healing and her parents.