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the eric update - day 14: baaaack in the CPAP saddle! and more kangaroo care.

lots and lots of things going today. he was doing so well on the vent and they were so quickly dialing back the "assist" settings that they put him back on the less abusive CPAP regime last night! w00t! again, they thought it wouldn't be unusual for him to stay on the vent for a few weeks, so this is a great sign that he's recovering quickly.

his white blood count differentials are looking better. they still haven't found a specific bug and nurse practitioner dawn and i talked about the meaningfulness of the tests for quite some time today. they are useful as a "barometer", but not as useful as compared to full-term differentials, since there seem to be so many special exceptions to the rules for micropreems, as their immune systems simply respond differently or not at all. n.p. dawn has apparently seen micropreems close to death with no differentials at all and perfectly healthy babies with big swings "to the left" ( she kept referring to a "swing to the left", which i'm sure refers to a change in the standard differential graph, but i never bothered to clarify the point so i could be wrong ). so, in the continuing saga of making Educated Guesses, since they've not found anything in his cultures ( again, you might not ever find anything in the cultures ) and his insulin has stabilized, they feel that he could be: 1. responding appropriately to the antibiotic regime. 2. stabilizing after being Just Plain Tired and the differentials were a Big Red Herring 3. stabilizing after having a bout of the earliest stages of necrotizing entercolitis (NEC), which is an inflammatory response in his gut that we talked about the other day and which could cause the differentials that they were seeing. 4. stabilizing after "aspirating" his food back from his stomach into his esophagus, which - for reasons that aren't well understood - can cause apnea, bradycardia and differential shifts to the left.

when eric went back on the vent, they stopped his feedings, which would have reduced the potential inflammatory response ( just one of the many variables that changed ) and/or the potential aspiration events, so they are now moving away from the yeast infection theory and towards the theory that he's not tolerating his feedings. to that end, the observant among you will notice that he now has a green "o.j. tube" ( oral-to-jejunum ) inserted through his mouth ( can you guess where an "n.j." tube originates? ) and threaded down his esophagus, through his stomach and directly into his intestines ( you did remember that jejunum is the name for the beginning of the intestines, didn't you? of course you did. ). the o.j. tube will reduce the chance that he will aspirate his food.

the potential NEC is a little trickier to manage ( and much, much more problematic if they don't catch it in time ). about the only thing they can do is reduce the amount of milk they give him in the "gut primings" and watch him very closely.

anyway. the greatest part of going off the vent and back to the CPAP is that we can start the kangaroo care again! and this time kris had him on her chest for over 1.5 hours and completely hogged all the time. i think she needs to learn how to share :-)

the biggest excitement of the day came at the end of the kangaroo care when eric decided to surprise everyone by pulling out his endo-tracheal and o.j. tubes. i can't imagine that it was very pleasant, so hopefully he'll realize not to do that too often. he was quite unhappy with nurse donna when she abrupty had to wisk him away from kris to start rethreading tubes.

oh, and it shouldn't go unmentioned that as of 8:36 tonight, he'll be two weeks old, which brings his overall survival stats to closer to 85%, which is certainly a lot better than his chances when he first came into the nicu.

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7/18/2004 05:58:00 PM 7 comments


I was wondering if the "digestion" issue could have had something to do with the signs of infection, but I thought "what do I know" but I just thought, "what if there is milk in there curdling - surely the immune system might see that as a menace and start fighting it. Well, a theory perhaps tied with the theories 3 & 4. At any rate, it sounds like things are looking up. Did you know if you google "born at 25 weeks" you will get several great links that I found very reassuring. Well, you can say I was bored the other day. Many of the babies had things like collapsed lungs, pnumonia, severe bouts of bradycardia (turning completely blue) among other hardships, yet, they still survived and got to get out of the hospital. It makes me think that E4 is at the top of his class, so to speak. He'll graduate with flying colors I'm sure! So glad to see him back on the CPAP and I hope all goes well with the o.j. tube. What a strong little guy to yank those tubes out! Won't be long and he'll be clawing at your neck leaving nice little scratches... branding you as his parents. :-D

By Anonymous Anonymous, at 7:54 PM  

Happy 2 week birthday Eric IV, my sweet strong nephew! Great to hear the good news today. I won't be able to check in for the rest of the week as I am traveling to Europe, but I will be thinking of you all every day. All my love, Monica

By Anonymous Anonymous, at 7:54 PM  

E3, Kris, and E4
Hey guys! That is really good news today! We just realized, that we both check the site everyday religiously, and don't bother to post a message, but we read them all. We are sorry to say that we haven't had any strange preemy dreams lately, nor have we had any breast feeding experience, except when we were really young, we think???. but we just wanted to let you know that even though we have been quiet, we are still praying everyday, and hoping you all the best. We cannot wait until we can make a trip to GR and see the happy parents and our new little nephew. Love Uncle Keith and Aunt Francesca

By Anonymous Anonymous, at 10:58 PM  

Happy Birthday Eric. I don't know you, or your parents, but I have twin girls who were born at 24 weeks. I just stumbled onto this website and everything sounds so familiar. My girls turned 6 months old this week. they were 1lb 4oz, 1lb 5oz and now right at ten pounds each and doing well. We spent 4 months in the NICU in Dallas. I'll say a prayer for you and your was prayers that got us through. Hang in there. it gets better.

By Anonymous Anonymous, at 11:03 PM  

today was a good day. thanks for the comments. it's interesting - i can tell from the site statistics that more people are visiting every day, but even less and less are commenting. i thought maybe people were getting bored :-)

have fun in europe, monica.

By Blogger e3, at 11:07 PM  

thanks to the anonymous visitor who posted the story about their own experience. i know from emails that there are more than a few people visiting who have had experience in the nicu and it's nice to hear your stories.

having been born a 26 weaker myself and spent 3 months in the nicu, i understand the ups-and-downs, but it doesn't make it any easier to have to experience them as a parent. still, it helps to hear from others who have had similar experiences.

By Blogger e3, at 11:13 PM  

This is an amazing site! Happy Birthday Eric. Stay strong my thoughts and prayers are with you and your familiy!

By Anonymous Anonymous, at 9:48 PM  

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