Today I think it is sinking in more that Josh's journey in the NICU is not a sprint, but a marathon. However, he continues to be a very strong fighter and even though Josh is back on the ventilator, he is not using it too much. According to the "what to expect" manual that Becky and Evan received from the hospital, it can be common for preemies to go on and off ventilators for up to seven weeks while their lungs continue to develop.
Becky said that it is a relief for her and Evan to see Josh stabilize with the machine even though they know that it is not good for him over the long-term. They are working through reconciliation of these feelings and balancing the immediate desire to have him safe versus the long-term health goals. Their caregivers told them that it is common for things to get stressful for the parents as the reality of the NICU and the long-term stay sink in, and the "honeymoon period" of the birth wears off.
Backtracking a bit, the reasons behind the breathing difficulties that Joshua is encountering are two-fold. First, his lungs are still quite underdeveloped, as would be expected for a 25 week old baby. To treat this, he is still receiving medication. Second, Joshua is experiencing Patent Ductus Arteriosus (PDA), a heart problem that affects some babies soon after birth. In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart. Before birth, these arteries are connected by a blood vessel that is a vital part of the fetal blood circulation. This usually closes within a few minutes or up to a few days after birth. However, in some babies the vessel remains open, which allows oxygen rich blood from the aorta to mix with oxygen poor blood from the pulmonary artery. This can strain the heart and increase blood pressure in the lung arteries. (Source of information: http://www.nhlbi.nih.gov/health/health-topics/topics/pda/)
The doctors will try and treat this second condition by giving Joshua medicine to try and close up the blood vessel. Within 24 hours, they will know if this is working or not. There are some risks associated with the medication as it can also close up other arteries such as those to the kidney, meaning that this process is monitored carefully. In the worst case scenario, surgery is sometimes required to close the artery, but typically the baby is able to self correct the condition over time. PDA is fairly common, occurring in about 8 cases out of every 1,000 premature births, and it is generally treatable with no long-term side effects.
In other news, all of the tests for infections came back negative today and Josh was also able to do kangaroo care (although not too long, because he gets cold). Becky is also going to start sleeping with a small blanket that they will put in the incubator with Josh so that he is able to be comforted by her smell. They also received a donor breast milk pump, which they can use until Josh is out of the hospital - a great program. Grandpa and Grandma Yeager have continued to come down to the hospital to offer support and lunches. Grandpa and Grandma Jorgensen are offering assistance from afar on many items that they can do remotely until they can get an extended period of time to come out to Colorado - likely to be at the end of the month.
Becky said that it is a relief for her and Evan to see Josh stabilize with the machine even though they know that it is not good for him over the long-term. They are working through reconciliation of these feelings and balancing the immediate desire to have him safe versus the long-term health goals. Their caregivers told them that it is common for things to get stressful for the parents as the reality of the NICU and the long-term stay sink in, and the "honeymoon period" of the birth wears off.
Backtracking a bit, the reasons behind the breathing difficulties that Joshua is encountering are two-fold. First, his lungs are still quite underdeveloped, as would be expected for a 25 week old baby. To treat this, he is still receiving medication. Second, Joshua is experiencing Patent Ductus Arteriosus (PDA), a heart problem that affects some babies soon after birth. In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart. Before birth, these arteries are connected by a blood vessel that is a vital part of the fetal blood circulation. This usually closes within a few minutes or up to a few days after birth. However, in some babies the vessel remains open, which allows oxygen rich blood from the aorta to mix with oxygen poor blood from the pulmonary artery. This can strain the heart and increase blood pressure in the lung arteries. (Source of information: http://www.nhlbi.nih.gov/health/health-topics/topics/pda/)
The doctors will try and treat this second condition by giving Joshua medicine to try and close up the blood vessel. Within 24 hours, they will know if this is working or not. There are some risks associated with the medication as it can also close up other arteries such as those to the kidney, meaning that this process is monitored carefully. In the worst case scenario, surgery is sometimes required to close the artery, but typically the baby is able to self correct the condition over time. PDA is fairly common, occurring in about 8 cases out of every 1,000 premature births, and it is generally treatable with no long-term side effects.
In other news, all of the tests for infections came back negative today and Josh was also able to do kangaroo care (although not too long, because he gets cold). Becky is also going to start sleeping with a small blanket that they will put in the incubator with Josh so that he is able to be comforted by her smell. They also received a donor breast milk pump, which they can use until Josh is out of the hospital - a great program. Grandpa and Grandma Yeager have continued to come down to the hospital to offer support and lunches. Grandpa and Grandma Jorgensen are offering assistance from afar on many items that they can do remotely until they can get an extended period of time to come out to Colorado - likely to be at the end of the month.
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