Since those of you who know me well know that I believe "Math is everywhere" I thought it fitting to start off with some stats:
DOB: June 28, 2010, 12:07 a.m.
Weight: 640 grams (1 lb 6.5 oz)
Length: 12" (?)
Gestational Age at Birth: 23 weeks, 5 days
Day 25 of life
Weight: 860 grams (1 lb, 14 oz)
Feeding: 2.4 ml of breast milk per hour (continuous feeds)
Peeing and Pooping like a champ!
Today was a good day. Actually, we've had mostly good days for over a week now. They talk about the NICU roller coaster, so we are wondering when he is going to have a down day again. For me, a planner, this is one of the toughest things about the NICU - not knowing what is going to happen tomorrow, much less weeks from now. For now, his doctors seem pleased with his progress. There are two big, general areas of concern for most preemies at this age - respiration and feeding/nutrition. We get daily updates from the nurses and his doctor regarding his progress, what they'd like to see happening next, and what is coming up with his care.
His feedings (though a tube into his stomach) have been going really well - they continue to increase the amount he is getting and he is tolerating the breast milk well. Finally, all the pumping I am doing (I'm am attached to the pump night and day, it seems) means something! I truly hate it, and usually end my last pump of the night cursing to John about it. He hates it too - ask him how he's spent most of the past three weeks, and I'm sure he'd say washing pump parts! But, it is so good for Andrew - they say that the benefits are even more important for preemies than full-term babies - that it is something I intend to keep up with at least until he comes home. The nurses closely monitor how he is tolerating his feeds - there are some very scary issues for preemies around digestion, their bowels, and feeding - by observing (and recording) all wet/dirty diapers, measuring his girth around the stomach (to see if it is distended at all), feeling his belly, and through daily x-rays of his intestines. Luckily, it seems so far Andrew has inherited his mom's healthy bowels, and has been providing at least one dirty diaper a day. J & I have the pleasure of changing many of his diapers - I'm surprised every time how much can come out of a baby that weighs less than 2 pounds!
His respiration isn't quiet as stellar as his feedings. He's been on a ventilator since birth - not really unexpected, since at his age his lungs are not fully developed yet. The ventilator provides help in several ways - it can increase the amount of oxygen he gets (we breathe 21% O2; he can get up to 100%, but has ranged between about 24 and 50% O2.) In addition, the vent provides pressure to help the little guy inflate his lungs. Finally, the machine can initiate the breaths for him if he is too weak or tired to do it on his own. We've noticed over the past few weeks that the amount of breaths he is taking on his own have increased, indicating less reliance on this aspect of the vent. His settings at this time (and really his entire life so far) have been moderate, but he's not quite ready to move to the next level down in the breathing department - the CPAP machine. We are looking forward to this step down in assistance, b/c usually babies on CPAP are stronger, and can be held more often.
Yes, one of the most difficult things about the NICU so far is that J & I haven't been able to hold Andrew yet. 25 days old, and no snuggles, no cuddles, no kisses! We are able to touch him (he likes when we cup his butt/arms/or head - it is soothing to preemies b/c it simulates the containment of the womb) and we both helped lift him up when they changed the bedding after one of his baths, but it is not the same thing as holding him. We are getting closer to this moment (I asked the doctor today) but as Dr. K put it "There is going to have to be a well-coordinated effort to make that happen." We need to be careful of his tubes, IVs, and monitor leads (and make sure he doesn't get too cold outside of the isolette) but I can't wait for that moment!
Enough for tonight...my pumping is finished and I'm going to try and get some rest. Tomorrow is a big day - three of my best friends are coming to visit and to meet Andrew. We all need to be on our best behavior, and we've warned Andrew of this already! I know their visit will do a lot to rejuvenate me too. I'm looking forward to seeing them all!