Monday, April 14, 2008

The NICU




Monday, April 14, 2008

Holden Neonatal Intensive Care Unit

Hello Everyone! I am sorry it took me so long to let you know what is going on in the NICU. I am going to backtrack to let you know about the babies' first few days in the NICU up until now:

Tuesday, April 8th, 2008 BABIES' BIRTHDAY

When babies are first born they get apgar scores after one minute and five minutes. There are two possible points for each of these categories: heart rate, respiration, reflexes, muscle tone and color. Here are the scores for our little peanuts:

Aidan: 8/10 at 1 minute and 9/10 at 5 minutes
Brooklyn: 4/10 at 1 minute and 6/10 at 5 minutes
Calahan: 4/10 at 1 minute and 8/10 at 5 minutes

(We are not sure of the categories that the kids were marked down in).

As for the missing lengths from yesterday's update: Aidan was 14' 7" and Brooke was 14' 6". They still don't have a measurement for Cal because he is fragile.

The first day or two are hard to remember because we were given so much information. From my shotty notes here is what we were told...

All of the kids were put on ventilators (mechanical breathing machines for babies that are not completely ready to breathe on their own). This requires a small tube inserted through their mouths into their windpipe so that air can be sent directly to their lungs and secured by tape to their face. At 6 o'clock that evening Aidan was removed from the ventilator and put on a CPAP. This is great news! A CPAP is short for continuous positive airway pressure. This means that Aidan takes each breath by himself, but a steady flow of air comes into his airway to keep from collapsing after each breath. We also found out that Aidan is anemic and needed a blood transfusion.

Aidan was in a different room than his brother and sister strictly due to space. We requested that he be moved into Brooke and Cal's room as soon as there was an opening.

Wednesday, April 9th, 2008

Once again we are blessed with amazing doctors and nurses. One of them being Dr. Vartanian. She grew up with our good friend, Sara, and has been fabulous in explaining things to us (pictures and all). She also would bring me pictures of the kids when I was still in the hospital. There was probably new information on this day, but I have no record of it and I was still pretty loopy from the percocet, motrin, morphin from epidural etc. I was super itchy and couldn't stop clawing at my face.

Thursday, April 10th, 2008

On this day Paul went to work and my Mom stayed with me. She shaved my legs for me and helped me take a much needed shower. Then we went to visit the babies. They were all doing well. Aidan was just chilling with his eyes open which was amazing to see. He also had a feeding tube in and was taking 1/10th of a teaspoon of my breast milk an hour. Brooke was sleeping, but the nurses told me that she is a wild one. No surprise to me as she had been kicking me and her brothers every day for at least the past two months. The nurses call her princess. I think Paul and I are in for some excitement with this little girl. Cal is hooked up to (what seems like) a million machines. He is so beautiful! Words can describe the love we feel for these three little ones. Later that day, Aidan had a setback of a heart arithmia He also took a step forward and they moved him from the CPAP to the nasal cannula which means he is breathing entirely on his own and just needs some extra oxygen. This is done with a small set of prongs under his nose. Brooklyn is also on the CPAP by this day. They tried the nasal cannula on her today, but she wasn't ready for it. She did have a healthy poop (our first pooper) and Daddy happened to be there with a camera. It was a proud moment for Daddy! Cal tried the CPAP today, but had to go back on the ventilator because he was working too hard to breathe. He is such a little fighter.

The babies also had echocardiograms today. It turns out that Brooklyn and Calahan both have heart murmurs. These are caused by PDA. PDA stands for patent (which means open) ductus arteriosus (which means arterial canal). This is a blood vessel near the heart and lungs that is supposed to close on its own a few days after birth. Cal's symptoms of this show through in his numbers so he started on ibuprophen today. Brooklyn's numbers are not showing the PDA causing a problem today, so they will continue to observe her for now. For Cal, they will do a round (1 loading dose and 2 more doses 24 hours in between each) and then reassess. If after two rounds this vessel doesn't close itself they will need to have a surgery to "clip" the vessel closed. We are praying that they will close on their own with the medication.

When Paul and I went to visit in the evening Aidan was lying on his belly and he has the cutest little backside ever. Nurse Bonnie gave him a bath today and he looked so clean, tired and peaceful sleeping there. Nurse Bonnie said Aidan was tolerating his feedings so well that she needed more milk. YAY AIDAN! It just so happens that Paul and I had brought down 6 little bottles of milk. YAY BOOBIES! Brookie was also sleeping at this time. She was on her right side with her right hand under her little head. SO CUTE! Cal was getting his second blood transfusion when we were there and the big tube of blood on his isolate made me so sad. It just seems so scary to know that he is getting blood from someone I don't even know. Nurse Tonya said he "liked" the transfusion and he seemed very calm and content. My little guy is so amazing!

All three of the babies are jaundiced so in the past couple of days they have been passing around the bililights. They have to wear these little shades that protect their sweet little eyes. It looks like they are sun tanning. According to the stats, up to 60% of full-term babies and 80% of preemies develop jaundice within the first few days of life. This is reassuring to Paul and I and is not something that we need to be worried about at this time. Thank God!

Today Paul and I got to hold Aidan. He cried some of the time, but it was the most wonderful feeling in the whole world. He is so tiny with soft blond hair and we treasured every second that we were able to hold him in our arms. We are so anxious to hold all of the babies. What a God has given us!

Friday, April 11th, 2008

Today Brooke got her first bath. We still can't believe that she has dark hair. My sister had dark hair when she was born. It all fell out and she had white hair like my brother and I. So time will tell.

This morning the babies' had ultrasounds of their heads. It turns out that Aidan and Cal have "brain bleeds". The technical term for this is IVH (intraventricular hemorrhage). The reason for this in premature babies is because their brains are not quite ready to withstand all of the stress of living outside of the womb. Some tiny blood vessels rupture and bleeding occurs in or near the ventricles. There are different grades of this problem: one through four, four being the worst. Aidan has a grade 1 IVH on the right side of his brain. Brooklyn showed none at this time and Calahan has a grade 1 on the left side of his brain and a grade 2 on the right side of his brain. The doctors will keep an eye on this and they will have another ultrasound on their tenth day of life to see if they are resolving themselves or getting worse. Please say prayers that these hemorrhages will fix themselves and have no lasting effects on our sweet peas.

Aidan has developed apnea which is a pause in breathing for 20 seconds or more. He is still on the nasal cannula.

All of the babies are on Total Parenteral Nutrition (TPN) which is sugar water and other nutrients through IV. This is the way they eat and get what they need until they are feeding fully on breast milk (which won't be anytime soon).

Saturday, April 12th, 2008

Last night they discovered that Aidan has a heart murmur, specifically palmar pulses (can be felt in the palm of his tiny little hands). This means that he too has a PDA. He is going to start on ibuprophen just like his brother and sister. This also means no more of Mommy's milk for Aidan at this time. The reason they discontinue the milk for PDA's is because they want to restrict all fluid.

I may have forgot to mention that all of the babies are also on low doses of dopamine. I am not sure if I mentioned the blood transfusions, but to date, Aidan has had one, Brooke has had one and Calahan has had three.

Aidan's sodium was too high today, but his oxygen is at 21% which is good. He is also on the bililights again today. The nurse said that Cal and Aidan are playing a game of switching the bililights back and forth.

Brooke's PDA is mild to moderate and her blood pressure dropped last night due to the PDA so she had her second dose of ibuprophen and dopamine is being continued.

Calahan's potassium was low today and he got his third blood transfusion. His dopamine was lowered from a 3 to a 2...good news. Cal's sodium is also high. He had his third round of ibuprophen today. We are praying that his PDA will close without a second round. Cal was on two bililights at once today and a blanket. Poor baby!

With the ibuprophen doses, the nurses continue to check their urine output, platelet levels and potassium levels. Paul and I are so thankful for these caring, devoted, knowledgeable nurses. For the last few days Nurse Melissa has taken care of Brooklyn and Nurse Stephanie has watched over the boys. They are fabulous people and so informative. The babies are lucky to have them!

Sunday, April 13th, 2008

Today we checked on the current weights of the babies to compare them with their birth weights (it is normal to lose weight during the first week of life).

Aidan: Current weight 2 lbs. 12 oz. Birth weight: 2 lbs. 14 oz.
Brook: Current weight 2 lbs. 8 oz. Birth weight: 2 lbs. 10 oz.
Calahan: Current weight 2 lbs. 6 oz. Birth weight: 2 lbs. 9 oz.

Today Aidan sucked on a pacifier for a minute or so. This is to promote non-nutritive sucking which is to show him that eating involves sucking. Aidan is still on the nasal cannula. Once his PDA is resolved they will try him without any breathing apparatus. We are looking forward to that day.

Brooklyn tried the nasal cannula again today but her numbers started to go down so they had to put her back on her CPAP. Her little body has to work too hard. One of the nurses said that she just doesn't feel like doing it. I hope that is the case and she changes her mind some time very soon.

Cal tried the CPAP today and he kept his numbers up. They call this a sprint to see if they can keep their settings on hold. He was able to do it on his own, but was working too hard so he continues to be on the ventilator at this time. Cal gets chest x-rays every day to check the lungs to see if the ventilator is doing any damage. Dr. Lauren told us that there is some evidence of lung damage from the tube going to far into his lungs. This is very upsetting to me and I am really hoping that he is able to switch to the CPAP soon without working too hard. He is a fighter and God is watching over him, so I have no doubt that he will.

As for the dopamine, Cal is off of it. Brooke is getting 4 micrograms and Aidan is getting 5 micrograms an hour to help with their blood pressure.

All of the kids have IV's. Here are the types:
Arterial line (Cal) - this line goes into the artery instead of the vein. This line is used to measure blood pressure and draw blood for blood tests, it can also be used to deliver fluids and nutrition. This line goes into Cal's belly button (umbilical arterial catheter-UAC). It can only be used for a week or two; after that it has to be taken out to prevent blood clots or infection.

Arterial line (Brooke) - Brooke also has an arterial line, but hers is an umbilical venous catheter- UVD. This line goes into a vein in the umbilical cord.

Central line (Aidan) - Aidan has a PICC line which stands for Peripheral Central Venus something. This is a central line that is close to the heart.

O.K. That is about all that we know at this time. Please excuse any spelling mistakes or incorrect information. This is how I understand what the doctors have told us and the research I have read. As Dr. Salmeen says I have placenta brain times three.

I will try to update daily on the babies' conditions. Our master plan until I can drive is to visit the babies every day when Paul gets home from work around 2:00 and stay until 8:00ish.

Thanks again for your prayers and support! We are so appreciative for any and all prayers for our peanuts! Love to all!

6 comments:

AZReamHQ said...

What a cute trio!

We wish you all the best from Arizona.

www.azream.us

Melissa said...

Hi Sissy and Paul,

I LOVE the new pictures! I love Aidan and Brooke with their eyes open and it looks like Cal is smiling, so CUTE!! They are just too precious. I know it seems like there is so much going on but they are getting stronger every day. Within the next few weeks, you'll look back at these pictures and be amazed at the progress they've made. Keep your faith in God and hand all your worries to Him, He'll take care of you all!

I LOVE YOU GUYS!!
Mis
XOXO

bormdi said...

Truly beautiful! It's so great to see them with their eyes open. I'm amazed with every update. I say a prayer daily for all of you.
Diane

Nancy said...

I am soo glad the babies are doing well, and the pictures of them are ADORABLE!! I love you all soo much and pray for you everyday! I can't wait to come meet them and visit you guys! Hope you are feeling good too Kristin! Love you!
Love,
Lauren

Karen H. said...

Kristin and Paul,

We have been watching closely all of the news about you and the babies. We just wanted to let you know that you are all in our prayers everyday and we know that those cute babies are going to be just wonderful. The two of you are the most deserving people we have ever met and God will be with you on this wonderful journey.

God Bless and you are in our prayers,

Karen, Ron, Erich and Lauren Heiser

Sue said...

Krisin and Paul,

They are all so cute. We think about you all each day and continue to say many prayers. We can't wait to see them! We are so happy for all of you! Love, The Fairchild's