Trying it off the c-pap part two

A week has passed since the last attempt off of the c-pap so they are trying Josh again on the high flow nasal cannula. We hope that this time he will do well enough to stay off the c-pap but if he has a lot of bradycardia they will put him back on the c-pap for another week.

Josh just hit the five pound mark and is growing well. He's still puffy so they are trying to give him the right amount of calories without too much extra fluid.  But, his growth remains on the 50th percentile line which is right where they want to keep him.

Update: Josh is back on the Cpap. After trying to change his gavage to his nose he got upset and was no longer tolerating the high flow.

Exciting Weekend

An exciting weekend was had by all;
 Josh was moved to a crib since he is now able to maintain his body temperature. He is closing in on 5 lbs, clocking in at 4 lbs 13.8 oz yesterday. This week they will try him off the c-pap again and see if he does better this time. He will also get his two month vaccinations at the end of the week.

About to get weighed

Yesterday we learned how to give Josh a bath and did that with some nurse supervision. Although he regularly gets a bath we have just missed all previous bath times. The technique they use at the NICU is a swaddled bath. So we wrap him in a blanket inside the bath tub and just wash one extremity at a time. This helps keep him calm and from flailing around but it is definitely a two person job to keep him wrapped up and bathe him at the same time.

The Saturday nurse had an exciting day as Josh had two diaper blowouts in his bed, requiring new sheets twice and a thorough scrubbing of the wall next to the crib.

Josh's new digs

Two Kilos

Josh is getting big and has surpassed the two kilo mark weighing it at a whopping four pounds and eight ounces. He is able to maintain is body temperature fairly well and will be ready to move to a regular bassinet as soon as he is able to permanently transition off of the c-pap. He was able to stay off the c-pap for 14 hours on Monday before struggling with bradycardia episodes. They will leave him on the c-pap until at least next Monday before trying him on the high-flow nasal cannula again.

Evan, Josh, and I have now spent 52 days in the NICU (just over seven weeks). You know you are a regular visitor to the hospital when most of the valet workers recognize us and our cars and comment on how we drive two blue Toyotas :).

Trying it off the c-pap

Much to our surprise the doctor decided to try Josh off the c-pap yesterday and he was doing pretty well. They will continue to try him on the high flow nasal cannula but keep the c-pap machine handy just in case he gets too tired or has problems. He really likes being off the c-pap and having the ability to move his head around. He showed us how strong he was by turning his head from the left to the right while on his tummy. If he tolerates the nasal cannula they will give him a new feeding tube, one that goes through his nose, and is supposedly easier for him to handle. Update:Josh was able to stay off the c-pap for 14 hours. They will try it again in a few days.

First Eye Exam

Last Friday Josh had his first eye exam and the results were good. The doctors found that he has immature eyes (to be expected) but currently no signs of ROP (Retinopathy of Prematurity). ROP occurs in about 50% of premature babies, especially those with a low birth weight. It is caused by the disorganized growth of blood vessels and can lead to scarring or retinal detachment. Because his eyes are still developing they will do another eye exam in two week, but the news is good for now.

Josh is continuing his strong growth rate pattern and now weighs 1900 grams or 4 lbs 3 ozs. He is still getting extra calories, protein, iron, and minerals added to his milk to help him continue to grow and mature. For now he will remain on the c-pap which he still needs to help him breathe. The next step will be to transition him to a high-flow nasal cannula which provides extra oxygen and some air flow to help keep his lungs open.

We have also been trying to get him interested in his pacifier and in turn feeding from a bottle. So far he has shown zero interest in the pacifier. After trying to give it to him yesterday he just stared at us like we were crazy and then passed out for a long nap.

Josh's clothes are just a "little" too big still.

Josh with Frog Take Two

Josh at Four Days Old

Josh at Forty-Four days old

Closing in on Four Pounds

Will today be the day Josh hits the elusive four pound mark? He currently weighs 1760 grams or 3 lbs 14 ozs. In the last few days he has gained an average of 40 grams a day but some days he only gains 10 while others he gains 75! Yesterday his cpap was turned down to a lower setting again and the doctors seem to think he may be off the cpap in the next week if he does well. He's been going through the same problem as last week of having larger aspirates after they feed him so his feeds have been decreased slightly. Once he is off his cpap he should have less air in his belly and more room for his food. Part of the problem is every few days he has difficulty stooling and needs a glycerin enema, and even though he might not like the enema it does help him.

Last night we had our first experience with dressing him inside the isolette. This is definitely a two person job because we have to reach through the armholes and then maneuver around all the tubes. The one help is that he is still swimming in his clothes which makes it easier to snap around him when he is being a squirmy monkey.