Alyssa is over 7 weeks old, 51 days in the NICU and almost 33 weeks corrected age...She really had a great week last week. She was out for skin-to-skin every day, and even twice a day sometimes. I still try to get to the hospital twice a day, but it's been harder lately because of Emily. She's going through this phase of not wanting to go to sleep, and it's usually well past 9 before she's settled. So for the most part I go after this, but other days it's too exhausting...but I feel guilty when I don't make it in.
In the middle of last week, Alyssa's central line called it quits. This is a line she has had since the second week she was born to administer most of her medications and her TPN feeds. This line passes from a vein in her arm all the way up to heart to allow concentrated solutions to be infused with less complications. She was actually lucky to have it last for so long without infection or falling out. Because she has been doing so well on her feeds, they decided to keep it out, and put in a peripheral IV to continue her feeds for the short term, since they thought she would probably be strictly on milk soon enough. She was up to 29 ml of milk every 3 hours and doing great...She was free of all IV's for one day. But then we get one of those "dreaded phone calls" in the evening....Alyssa got another infection. We're so lucky to have excellent primary nurses. Charlotte and Sharla started the ball rolling immediately when they noticed Alyssa not behaving like herself, and sent off cultures for her secretions, had blood work done, and started her up on antibiotics ASAP. Then less than 12 hours later, after getting a blood transfusion and some antibiotics, Alyssa opened her eyes up and was behaving more like herself. Keith and I were shocked to come in that morning and actually see her ventilator settings lower and Alyssa breathing on room air. We expected her to be having more difficulty so were pleasantly surprized.
She will be on the antibiotics for a total of 7 days, and continues back on TPN and lipids plus her milk. They stopped all her feeds when she got sick, so restarted again at 5 ml. Today she is up to 10ml, and this increases again by 1 ml every 6 hours as tolerated. Her RR has decreased to 20 breaths per minute, she normally breaths another 30 on top of this. So if all goes as planned, another couple of steps before extubating. Dr. H is the neonatologist on for the next 3 weeks. She is the Dr. we met with in my hospital room when I was 23 weeks to discuss survival rates of twins born that early. She is very sweet and kind, and told us that they would like to get Alyssa's rate down to 10 before extubating, however if she pulls the tube out herself, they will keep it out and see how she does. This is a little scary to me, as I really don't want anything happening that isn't planned, but she does love to grab that tube, and she's very strong.
For anyone that is wondering, we did warm up to Dr. G by the end of last week (we only went to a couple of days of rounds with him...because of Jessica). It's unfortunate for us and also him that he just happened to start his rotation when he did. Although, I really didn't like how cold and harsh he seemed to be, I probably wouldnt' have liked the situation no matter who the neonatologist on was.
So that's the update for now...Alyssa continues to grow, and thank God this last infection was nipped in the butt quickly, a little set back, but we're still ok.
I feel another rant coming on in the next couple of days...
In the middle of last week, Alyssa's central line called it quits. This is a line she has had since the second week she was born to administer most of her medications and her TPN feeds. This line passes from a vein in her arm all the way up to heart to allow concentrated solutions to be infused with less complications. She was actually lucky to have it last for so long without infection or falling out. Because she has been doing so well on her feeds, they decided to keep it out, and put in a peripheral IV to continue her feeds for the short term, since they thought she would probably be strictly on milk soon enough. She was up to 29 ml of milk every 3 hours and doing great...She was free of all IV's for one day. But then we get one of those "dreaded phone calls" in the evening....Alyssa got another infection. We're so lucky to have excellent primary nurses. Charlotte and Sharla started the ball rolling immediately when they noticed Alyssa not behaving like herself, and sent off cultures for her secretions, had blood work done, and started her up on antibiotics ASAP. Then less than 12 hours later, after getting a blood transfusion and some antibiotics, Alyssa opened her eyes up and was behaving more like herself. Keith and I were shocked to come in that morning and actually see her ventilator settings lower and Alyssa breathing on room air. We expected her to be having more difficulty so were pleasantly surprized.
She will be on the antibiotics for a total of 7 days, and continues back on TPN and lipids plus her milk. They stopped all her feeds when she got sick, so restarted again at 5 ml. Today she is up to 10ml, and this increases again by 1 ml every 6 hours as tolerated. Her RR has decreased to 20 breaths per minute, she normally breaths another 30 on top of this. So if all goes as planned, another couple of steps before extubating. Dr. H is the neonatologist on for the next 3 weeks. She is the Dr. we met with in my hospital room when I was 23 weeks to discuss survival rates of twins born that early. She is very sweet and kind, and told us that they would like to get Alyssa's rate down to 10 before extubating, however if she pulls the tube out herself, they will keep it out and see how she does. This is a little scary to me, as I really don't want anything happening that isn't planned, but she does love to grab that tube, and she's very strong.
For anyone that is wondering, we did warm up to Dr. G by the end of last week (we only went to a couple of days of rounds with him...because of Jessica). It's unfortunate for us and also him that he just happened to start his rotation when he did. Although, I really didn't like how cold and harsh he seemed to be, I probably wouldnt' have liked the situation no matter who the neonatologist on was.
So that's the update for now...Alyssa continues to grow, and thank God this last infection was nipped in the butt quickly, a little set back, but we're still ok.
I feel another rant coming on in the next couple of days...
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