The doctor rotation changed again today. His primary neonatal doctor is off and who I previously referred to as Dr. Gloom is back on. I respect this doctor and think he's good, but I still prefer to let Cody speak with him and just listen in. Cody chatted with him today and he had good things to say about Rhys. He is happy with his progress from six weeks ago when last he saw him and thinks Rhys has come a long way. The fact that Rhys' brain bleed seems to be resolving and hasn't caused swelling in his brain is very encouraging to him. His strategy is to keep weaning Rhys off the vent and let him pack on the pounds. At this point potential infection is Rhys' greatest challenge other than his lungs so please pray from Rhys to stay healthy and free from infection, and continue to gain good weight and grow like a weed!
Monday, September 29, 2008
Another good day today
The doctor rotation changed again today. His primary neonatal doctor is off and who I previously referred to as Dr. Gloom is back on. I respect this doctor and think he's good, but I still prefer to let Cody speak with him and just listen in. Cody chatted with him today and he had good things to say about Rhys. He is happy with his progress from six weeks ago when last he saw him and thinks Rhys has come a long way. The fact that Rhys' brain bleed seems to be resolving and hasn't caused swelling in his brain is very encouraging to him. His strategy is to keep weaning Rhys off the vent and let him pack on the pounds. At this point potential infection is Rhys' greatest challenge other than his lungs so please pray from Rhys to stay healthy and free from infection, and continue to gain good weight and grow like a weed!
Saturday, September 27, 2008
V Day
Somehow he worked his arm underneath the tubes.
How he managed this is anyone's guess.
How will anyone ever be able to discipline this child
when he looks so cute? I can hear it now... "But Mom!"
Well, it's done. Rhys received two of his three vaccines today - the 5-in-1 vaccine for diptheria, tetanus, pertussis, hepatitis B and polio, as well as the pneumococcal conjugate vaccine (PCV). The haemophilus influenzae type b vaccine (Hib) was on back-order so I guess he will get that once it comes in. The needles were tiny and he barely noticed the shots, it definitely hurt us more watching it. Immediately after Cody got to kangaroo, and then he and Rhys enjoyed some bonding time watching football. In case you're asking yourself "is he really watching TV?" the answer is yes. My brilliant other half has the computer rigged to turn on the cable box and watch from his computer. It's pretty nifty.
Other than that nothing super exciting to report. The inspriatory pressure was increased to 20 (up from 17) and all other settings are the same. His O2 has been in the 50s most of the day and he still has his arm board and IV from the blood transfusion. Take a look at the picture of him lying on his tummy... the boy means business. He loves to stretch his arms above his head and somehow he managed to squeeze his arm board under the vent tubes. He is such a worm. He is weighing in at 1480 grams (3 pounds 4 ounces).
Friday, September 26, 2008
Quick update
Wednesday, September 24, 2008
10 weeks today
Little man is 10 weeks old today! Wow, where has the time gone? He was having a little problem breathing last night and his blood gases weren't good so they increased the settings on his vent a bit. He is now at 30 bpm (up from 25) and inspiratory pressure of 21 (up from 18). He needed a few albuterol treatments to help him breath a little easier, and also got a dose of ativan to help him relax. He looked so pathetic today at lunch. He was lying on his Zaky and just looking like he was so sad. He was so zonked out he didn't even notice he was having blood taken for another gas. Rhys needed the rest though, he has been restless too much for my comfort the last few days - he's burning those valuable calories!!
His echo results revealed no changes from the reading in late August. So awesome, thank you Lord! The PDA is still small and his heart isn't enlarged. The eye doctor came by this afternoon as well and Cody was there for his exam. I got there as she was finishing her report. We were so worried about his eyes based on previous exams and the fact that she wanted a follow-up visit so soon. The doctor said Rhys' eyes look good and she assured us she wouldn't just tell us this to make us feel better. She will continue to follow him closely with weekly visits, but as of now his eyes are "growing" properly so please pray this continues. Again, THANK YOU LORD! God has smiled down upon Rhys with positive EEG/echo results and eye exams this week. We are so grateful.
Vaccines were brought up again today. We spoke with Rhys' head neonatal doctor about them this afternoon and I think Cody feels better after the conversation. The doctor told us he wouldn't recommend the shots if he didn't feel Rhys was in a position to handle them. So, we are planning to sign the consent on Saturday so we know we'll be there and also so we know he will have a familiar face in his weekend nurse. I'm sure the doctors and nurses think we're crazy for worrying so much about our son being stuck with a needle, after all most of these kids get stuck more in one day than most of us do in a whole year. :o)
Tuesday, September 23, 2008
Not much is new
The last few days Rhys has been very alert. He will have his eyes open and just look around for 10-20 minutes at a time. He seems to be taking it all in. He also has figured out how to get his thumb in his mouth to suck and he looooves the pacifier. He can mostly do this now without desatting, though he still has a bit of trouble. During his echo today he was very calm (except at the end) and didn't need his oxygen bumped up. This is amazing since he hasn't previously tolerated the echo very well. Still no follow up eye exam, I will ask again tomorrow. Oh, and he is 1410 grams today (3 pounds 2 ounces).
Monday, September 22, 2008
Mom's first day back at work
It was hard to leave at lunch today because Rhys was at 90% oxygen (down from 100%!). Last night he had a few episodes of desatting and dropping his heart rate. A few times he had to be hand bagged to bring up his sats. His vent tube wasn't taped very well so they corrected the position (it was too far in) and taped the heck out of it to keep it from moving. The nurse today said he hadn't had any more episodes of dropping his heart rate since the tube was repositioned, but he was still occasionally desatting into high 60s, which is better than dropping into the 30s! He did require a little ativan today, but that seemed to help him relax enough to calm him down. Needless to say we are holding off on the vaccines until he feels a little better.
His vent settings were increased a tiny bit. One increase was related to the pressure at which the machine helps him take his spontaneous (breaths he takes above the vent) breaths. Think if you were trying to breath through a straw. It is more difficult and requires a greater amount of effort. Rhys' vent has support that helps him when he breathes on his own and this is what was increased. His albuterol is now at every 6 hours and they are assessing his caffeine dose because the doctor doesn't think he's maintaining a constant level of bpm over the vent. Actually I don't think we've mentioned this before, but he is getting a maintenance dose of caffeine to keep him consistently breathing over the vent. So much for not giving him sodas. I asked the doctor if this was Rhys being lazy and he got a good laugh and said it was him acting his age.
EEG results are back and they are clean thank goodness. No signs of seizure activity. The eye doctor hadn't rounded on him when we left this afternoon, but I am hoping she was going to see him tonight. I am anxious to see what this exam reveals. The last notes I saw were stage 2 ROP in both eyes. Again, this isn't surprising, and it doesn't necessarily mean he will need surgery, but he is definitely in the high risk category. They are also increasing the calories in his milk. He will now have his milk fortified to 27 calories per ounce instead of 24.
Cody and I are starting to feel the exhaustion of the NICU. I felt a huge wave today. We are so happy that Rhys is doing better, but it is so mentally exhausting having to live this life. No one truly understands unless they've been through it. You can try and you can think you understand, but unfortunately you just don't. I am also tired of seeing every pregnant person in the hospital and every twin stroller. A twin came into Rhys' pod yesterday. I saw a little girl with a "thing 2" shirt on in the hall (Dr. Seuss, incidentally the theme of one of my baby showers that would have been in August). A lady in the elevator today commented on a set of twins who'd gotten off at the previous floor. How crazy that must be and how much of a handful and how much trouble they were. It took every ounce of restraint I possessed to not rage at her. It is times like this that I especially miss Bentley. I miss him as our second child, but also I miss him for what he would have been to Rhys. It just doesn't seem fair because I did everything right in my pregnancy. I took care of myself and of the babies and of my body and look what happens to me when there are idiots out there who beat and neglect their children. I know I shouldn't but I get so angry at the people who have it so good and just don't appreciate it. Why do bad things happen to good people? I have seen that countless times in the relationships we've formed in the NICU. Parents who desperately want their babies and tried so hard to get them, only to have them born much too soon. It just is not fair.
Sunday, September 21, 2008
Weekend update
Rhys is still dropping is O2 sats, he's back and forth from 100 to the 40s and then back to 100. Now he is also dropping his heart rate while he does this. Not so exciting to see your child turn blue and then watch his heart rate drop from 180 to 80 in a matter of seconds. This is apparently not uncommon for preemies born at his gestation, but it is still a little freaky to witness. He is still getting hot frequently and is requiring the isolette "doors" to be opened to cool him down. The nurse last night got very concerned that he was getting a fever so blood work was ordered, but came back fine. We've mentioned before that they like to wait until the babies are 1800 grams (4 pounds) before they remove them from the isolette, but we're hearing he might have to be moved sooner if this continues. The real concern is that he will burn valuable calories regulating his body temp. MY other concern is that he will be exposed to everyone touching him. Contact infections are a big deal in the NICU and even though I might be wrong I feel like the isolette prohibits people from wanting to reach over and touch.
Rhys had another eye exam last Thursday, with a follow up in 2-4 days. She saw the beginnings of ROP, which isn't good, but nonetheless isn't a surprise. We are in good hands with the eye doctor so I am confident she will be able to keep him from having major eye sight issues later on. As is true of most of the others, this doctor is one of the best.
Friday, September 19, 2008
Day 65
Today was more of the same for Rhys. Still no word on the results from his EEG. His inspiratory pressure is now at 18 (down from 20) and he is holding at 25bpm. He is getting really good at pushing his tubes around. He likes to get his hand up underneath them and then stretch and push out. Not to say he exactly knows what he's doing, but he does this quite often. He is also very much a wiggle worm. He is constantly fidgeting and working himself out of his contained/tucked in positions. He is also trying really hard to move his head more than I'm comfortable with - especially when we hold him. We're hearing "extubation" mentioned more frequently now, so we're headed in that direction. Hopefully little man can maintain his progress and we'll get there sooner rather than later! Hope all is well with everyone who stayed through Ike. We finally got power late last night and even though we didn't have damage it feels like we have so much to do.
Thursday, September 18, 2008
It's alive... IT'S ALIVE!!!
Wednesday, September 17, 2008
Today marks week 9
Tuesday, September 16, 2008
Happy 2 months to Rhys!
Sunday, September 14, 2008
Day 60
Saturday, September 13, 2008
Still loving Ike
We made it to the hospital late this afternoon to check on Rhys. I wasn't sure what to expect, but the calm emergency room was definitely not it. The hospital is still on lock-down so all visitors have to go in and out of the emergency room. It wasn't nearly as chaotic as I would have imagined, I was thinking something from Grey's Anatomy. :o) Anyway, Rhys is doing much better. The nurse said he is having as good a day today as his bad day was yesterday. *sigh* Big relief. He is now 2lb 14oz and he looks so big. He got to wear his clothes for the first time yesterday. His super tiny preemie clothes look so small until you get them on him and they swallow him. Our camera is currently in the car, so we will post pics of that tomorrow. He is still the poster child for the Zaky, and now he is using two of them, one to lay on and the other to support him. Anyway, just wanted to give everyone a quick update. Cody and I are both exhausted and seriously looking forward to having our power restored so we can rest up. It is challenging enough to live the NICU life, but to throw a hurricane into the mix is beyond crazy.
Friday, September 12, 2008
More fun with Ike
Sheesh, what timing. Since Rhys had been doing well for the last week and we got kicked out of our hotel near the hospital, Cody and I decided to stay at the house vs piling in on top of the crazy amount of staff in the NICU. Big mistake. Now I am stressing about the fact that we won't be able to get up there for at least another day, if not more. At least Rhys has his weekend primary nurse there for the storm. I know she's taking good care of him.
Thursday, September 11, 2008
Stinky Ike
Another good day for Rhys. No changes to the vent today, but his blood gas was good this morning so they are going to try to sneak in and wean down his pressure by one early Friday morning and see how he handles that. We saw his primary neonatal in the hall today (though he isn't on schedule until the second half of the month) and he smiled at us and said "he's looking pretty good". Rhys is now on no morphine, except as needed. He is so funny to watch and it is amazing to see his personality coming through even at this stage of his life. He doesn't open his eyes so much except when he's really awake (usually after he's been moved and well messed with). Occasionally he'll take a peek for a second or two and then squint his eyes really tight like he didn't like what he saw. Most other times he raises his eye brows reeeeally high like he's in the middle of a dream and almost waking up. I could stare at him all day long. He is going to be a handful for certain.
Wednesday, September 10, 2008
8 weeks today
Rhys continues to make progress. The doctor is very happy with how far he's come. His vent settings are at 31bpm and the pressure is the same. The doctor said she was going to make one more decrease on the bpm setting tomorrow and then try to start weaning the pressure. Rhys' feeds are at 24cc, so he's getting close to one ounce (~30cc)! Since he isn't getting his sedatives he is much more feisty. Apparently he gets that from me? :o) He was seriously attacking his tubes today and was sucking on them like a pacifier. He squirms a lot and moves enough to get himself in an uncomfortable position. It almost seems like he's frustrated that he can't move more, but I am not really sure he is capable of that emotion right now. Anyway, another good day for little man. We are preparing for the hurricane that seems to be determined to keep inching its direction towards Houston. So, for everyone in the potential path of the hurricane stay safe!
Tuesday, September 9, 2008
Day 55
Rhys' morphine has been decreased from every 6 hours to every 8 hours, so they are still making progress with the weaning. He also had a little time with his pacifier. The nurse said he really seemed to like it, but when he started desatting she had to take it away.
Monday, September 8, 2008
More Progress
Rhys is still tolerating his feeds very well and he is up to 23cc every three hours. In addition to the caloric additive his milk is now being fortified with phosphorous and calcium for his bones. Does anyone notice anything different about little man's arms? Anyone?? To those who answered "he has no IVs" you are paying attention! They removed the IV used for the blood transfusion, but that's not such a big deal. The big news is that he no longer has a PICC line. He lost his two remaining med pumps for the versed and morphine yesterday so they were able to remove his PICC line. At one time he had 8 meds going into the PICC line so this is amazing, NO PUMPS! This eliminates a source of infection, and we're happy he no longer needs it. His O2 today has ranged from 40% when I got here to about 65% after his vitals were taken and diaper was changed. The vent rate is down to 34bpm (wow!) and the pressure remains the same. I was told they are going to try alternating between lowering the pressure and rate settings a couple of times a week. We're very excited at his progress and hope he keeps it up. Please continue to pray for little man to stay strong and keep making forward progress.
Sunday, September 7, 2008
Rubber Ducky you're the one, you make bath time lots of fun!
Today we gave Rhys a bath! Check out the videos there's a bunch of 'em! More Kangaroo time for daddy today as well. We were greeted with lowered vent settings today, which was a pleasent suprise!
Saturday, September 6, 2008
Sweet baby boy
He got more kangaroo today as well, nearly three hours worth. He was mostly good though he desatted a few times, but I think his tummy is bothering him a little. And, nurse was able to suction up a good amount of gunk from his lungs. Overall a great day for us at the NICU. Tomorrow we are going to try to give him a bath if he is up to it. We went and bought him some lotion tonight. His Nonna (my mother) has reeeeally been wanting to lather him up with lotion since he has all his little crusties. I opted for the organic variety and got laughed at. The way I see it, at this point this is one of the only things I can control so nothing but the best for my baby boy.
Rhys also got some visitors today, cousins from Nacogdoches. They brought him a gift from Build-A-Bear. This is his TAMU ninja (really karate but ninja sounds better) bear! Cody has decided that at each of Rhys' milestones in the NICU we are going to upgrade his belt. Now he is a yellow belt and when he gets to come home he will progress to a black belt. Whoop! Also, he recently received TWO of his very own Zakys from SP (you know who you are). He says thank you, thank you, thank you!
Lastly, please pray for Olivia and Parker. Olivia recently underwent eye surgery and Parker is currently battling an infection. And thank you again to all who read and follow Rhys' blog, especially those we've never met who are sharing their similar experiences. Words can not describe the connection you feel with others who've ridden the NICU roller coaster. We've been amazed at the number of people logging in and blessed by your support. Keep the comments coming, we love to hear from you all.
Friday, September 5, 2008
Day 51
He received more blood today, although I'm not sure why. He just had a blood transfusion a few days ago and they are only doing labs once a day now so I was surprised he needed more blood already. At least this time the IV is in his hand and not messing up the other foot. I will have to pay more attention next time because I should have noticed his little foot tilted at the wrong angle and made someone fix it. The pressure is up a bit on the vent, but all other settings are the same. I guess we're starting to see the effects of discontinued steroids, though his O2 is in the 50s, which is great for him. He's still on scheduled doses of albuterol, full feeds and they are starting an oral steroid to see what that does for him. Yesterday they were able to suction a huge amount of what I will call gunk from his lungs. Hopefully the diuretics, albuterol and tummy time are helping to loosen some of the nasty stuff that is hindering his breathing.
Thursday, September 4, 2008
Day 50
His vent settings are the same as they have been and the doctors just made the rounds and are pleased with where he is at. His x-rays are now scheduled for Mondays and Wednesdays only, instead of once a day. And, they have started what the doctor called chronic diuretics, instead of the occasional lasix which is used to treat acute conditions. He is also taking treatments of albuterol every six hours. We've mentioned previously that his last dose of steroids was yesterday, so please pray that he can handle everything without requiring more.
What else can I tell you...? Oh, there was just an almost emergency in the pod and it was very reassuring to see that (literally) a dozen doctors, nurses and respiratory techs made it into the room in less than 15 seconds.
Wednesday, September 3, 2008
7 weeks old today
Oh, Rhys has been upgraded to the preemie-small diapers instead of the XS. They are a little big, but the others were getting a little tight.
Tuesday, September 2, 2008
New doctor rotation for Sept
Today they decreased the pressure a small amount again and his O2 is up a bit to high 60s/low 70s. They continue to decrease his morphine and versed and he seems to be taking that well. He is a sensitive little guy and still doesn't care to be messed with, so I think it's good they are able to wean on his sedation. His milk is up to 20cc per feed, and he has little to no residual which is fantastic. Little man likes to eat! He had two really dirty diapers this morning so his tummy is feeling much better I'm sure. No kangaroo yesterday or today. He has an IV in his foot from his blood transfusion so I haven't asked about it. The IV makes me nervous. I know I didn't like anything touching my IV so I would rather not mess with him while he's got one.
Monday, September 1, 2008
Whew
Around 5pm he got fed again. After his feed was finished the nurse changed his diaper and it was a massive dirty diaper. I would say it could easily be considered a blow out in preemie terms, I think some even ended up on his blanket. His O2 is now in the low 60s and I bet his little tummy is feeling a lot better. He still has a little roly poly belly so I am thinking there might be more to come.