In all, this past week for Andrew has been very steady. We continue to be encouraged by his progress, and are thankful no serious backslides have occured. We love you, Andrew, and are so proud of you!
August 14, 2010
Slow and Steady...and some A's and B's
The past few days have been steady for Andrew - just how we like it. His weight is hanging about the same, his feeds are up a little bit to 6.2 ml/hour, and he's been an active little guy when he is awake. The nurses all say that is a good sign that he is feeling well. His strength is amazing...he continues to tap into his inner zen to practice the downward dog position - where he straightens his legs and lifts up his hips to a pike position. Nurse L yesterday said when she put him on his back he was doing some leg exercises too...bicycling his legs into the air. My mom and I even saw him push up with his arms and lift his head up for a few seconds! It's all quite hilarious to see.
A few changes have happened in the few days. They have begun to supplement his feeds with various nutrients that he needs. So, a few times a day he get iron added to his feed, sometimes he gets sodium, and he also gets his daily dose of caffeine in one of them. These changes are all based on lab work that show any deficiencies he may have in his nutrient levels. Since he can't take a multivitamin yet, this is the next best thing until his body kicks in and starts regulating his levels better. He also needed to get the replogle tube back in - he couldn't expel enough gasses and his belly began to blow up. We knew this was a possibility and don't consider it a step back. His O2 levels are kind of up and down - from about 29% to the 50's, depending on the day, his position, and how he is handling stimulation. His blood work continues to look good. All normal things for his age (now 30 weeks!). We've each been able to hold him more often, and Andrew's been a little more tolerant of it (less desats). We love our cuddle time!
Another "normal" occurrence for preemies that Andrew has begun to do is having A's and B's - apnea and bradycardia. Apnea in preemies is just like adults - they forget to breathe sometimes. Usually this is caused by missed connections in the brain, not any obstruction in the airway. Bradycardia (or a Brady) is a decrease in heart rate to low levels, usually caused by the apnea. A's and B's are common, but still a bit distressing to witness. Usually you can get them to begin breathing again with mild stimulation - rubbing their back or pinching their hands or feet. Once the breathing goes up, the heart rate follows. Andrew has been having several of these episodes a day - mom is getting good at predicting when one is coming! Of course, the monitors alert the nurses right away when they happen, and are right there to get Andrew back on track. They all tell us that these are normal, and will eventually just stop when he gets closer to going home (and his brain is more mature). Hopefully his won't become more frequent, and while we don't like them we realize it is just part of the NICU rollercoaster!
Mom-mom came to visit again this week - and got to hold Andrew for the first time! It was so sweet to see, and we are all so happy she got some time with him one-on-one!
A good thing too - we were told last night that the NICU is going on visitor restriction of parents only for the time being. There is a bacterial outbreak of MRSA in another room, which is a very serious bacteria because if it causes an infection the bacteria is resistant to antibiotics. Everyone is on high alert with washing, and cleaning everything down, since it can be spread by contact. If a baby gets a MRSA infection, they are put on isolation (away from the "general" population) for the rest of their NICU stay. We want to avoid that for Andrew at all costs - and especially avoid the infection! Hopefully, it will all be under control soon, and the visitor restriction lifted.