Samuel, Jacob and Charlie are 10 days old today. Wow! It feels like it was just yesterday that they were born. I thought I’d give an update on each boy today.
Sammie’s doing good but he’s still lagging behind his brothers. He’s now 3lbs, 3oz today, and he’s eating pretty well. He’s also spitting up quite a bit too. Preemie’s are known for reflux, and he’s got it. He also is the person who has the most “desats”, or desaturations of oxygen. He has more when he’s on his back, and almost none when he’s laying on his belly. So the nurses are keeping him on his belly most of the time. He got his IV out today (yay!), so he only has his feeding tube still in him, plus the vapor therapy tubes. Since he’s had some desalts, the nurses have bumped him up to 25% oxygen. 21% is normal – what we all breathe daily, so it just means he needs a little extra help. He still has the heart murmur, but that’s nothing to be concerned with as the artery is closing. (see more on this below) All-in-all, Sammie’s doing great for a gestational age of 32 weeks, 1 day.
I got to change Sammie’s diaper on Friday, and let’s just say it was the gift that kept on giving. The more you wiped, the more he produced. That’s my boy!
Jacob is setting the gold standard. He’s been off all tubes for several days now and he’s really well. He has maxed out on his feedings via his feeding tube 28mL every three hours), and today we hope to start breastfeeding him. We don’t expect much the first day or so. It’s mostly just an introduction to the breast. Kristen tried about 1pm today and he was more interested in sleep than getting some food.
Jacob is also leading the way in throwing up. The reflux is really uncomfortable for him, I guess, but he’s quite possibly the funniest spitter-upper I’ve ever seen. He gets a funny look on his face, slowly opens his mouth and it just comes out. He doesn’t make a sound. He goes right back to sleep after. It’s typically right after the feedings, so now they’re working on stretching the feedings out to 45 minutes with hope that it works well. Still, he’s keeping most of it down and digesting well.
He still has his heart murmur, but the doctor’s say it’s getting better, which means that artery is closing. Jacob’s also suffering some desats here and there, but not frequently. He has some apnea and brady’s (bradycardia) episodes, so the doctor’s are watching that. But once again, for his gestational age, he’s well above all standards.
Charlie’s doing really well too. He’s up to 2lbs, 15oz. today, and he’s taking 15mL of food every three hours. He still has his IV, but my guess is it will be out by Monday. He’s also doing really well on the vapor therapy and I would also guess he could be off the nasal cannula by Monday too. He’s having the same reflux issues, though not as significant as Jacob. I got to hold Charlie today when we came in and he took his feeding like a champ. He did the same yesterday, though he decided to share some of his breast milk dinner with my chest last night. Lucky for me I had a blanket on to protect me.
Charlie’s heart murmur is a bit more significant than the others’, but it’s not a cause for concern. The doctor’s did an “echo” on Friday afternoon and the pediatric cardiologist put him on some medicine. I explain all this a bit further below. All-in-all, the boys are doing great and Kristen and I will be able to relax a bit for sushi tonight.
Kristen: Kristen’s doing really well. She hopes to try driving on Sunday, and maybe by Monday morning she can drive herself to and from he the hospital. She’s pumping furiously – about every two hours during the day and every four hours at night. It’s really tiring, but she’s doing great. I remember when we started dating, I envied how she would sleep for 8 or 9 or even 10 hours. I can usually be really functional on 6. Welcome to my world, hun!
Heart Murmur or Patent Ductus Arteriosus
The National Heart, Lung and Blood institute has a great explanation of what this is on their site, but effectively the heart murmur our boys have is related to an artery that typically closes within minutes or days of being born. Of course that’s under normal circumstances for a 40-week-term baby. But in preemie’s, the schedule is thrown off and the baby may take a bit longer for this artery to close.
Samuel and Jacob have this closing more rapidly than Charlie, so Charlie’s getting some medicine (Indomethacin) to help it close faster. Hopefully the medicine, and time, will close it. If it came down to it, surgery could be an option but he’d have to be transported to Oakland Children’s Hospital. That’s about the “worst case” or most extreme thing that could happen. The doctor’s don’t think it’s likely, but they’ve educated us on it too.
We’ll watch it closely for all three, and Charlie will get two more doses of the medicine before another Echo on Monday. If the results show it’s closing, more medicine may be in order, or just more time.