Calen's weight is down today. There has been several new changes that will have taken place or will be taking place tomorrow with Calen. Just to get started, he is still holding up very well and he is still doing most of his own breathing and we continue getting to hold him, and we praise God for all those things.
So we got to talk to the nurse and doctor today about what is new with Calen. Two days ago I posted that he was having some breathing issue's that were affecting his heart rate and they had been monitoring it. I called them Saturday morning because we were not going to make it to the hospital and at that time he was continuing to have some breathing difficulty and then I called again at like 1230am on Sunday and they said the breathing problems were still continuing but at that point no changes had been made. So we made it back to the hospital today around 3pm and the above picture is what we saw when we got to him. They are preparing him for space travel, okay maybe not but it is a bit more of a complex bipap machine that I had never heard of called a SiPAP. I looked up a little information on and it and they told us about it, essentially it is a non-invasive (not inside him) breathing machine that let's him breath as much as he can on his own but when he stops breathing adequately which would normally drop his heart rate, it kicks in and gives him breathes, right now set to 10 times a minute. This is an in between measure from the CPAP and a ventilator. It has really been helping, as soon as he stops breathing and his heart rate goes down, the SiPAP gives him a push of air down the mask that is sealed around his nose that causes his lungs to expand and his heart rate goes bak to normal and it kinda gives Calen the realization that he is not breathing and he picks back up on his own. They took his hat off so the mask straps would fit better so I like being able to see his hair and his eyes. He is going through some testing now, so they ensure that they are not missing any reasons why he would be having breathing problems outside of him just being tired. They are checking his blood with a complete blood count (CBC) a couple times a day, they are looking for a possible increase in white blood cells (WBC) to see if he may be getting an infection, so far nothing is showing up, his hemoglobin (HGB) , oxygen transporters, to see if they are down which would indicate the need for a blood transfusion. His HGB is down on the low side, so they are planning to give him blood transfusion tomorrow. This is another thing that is extremely common with neonates at his size so it was just something that was coming. The doctor said that he is starting to have a audible heart murmur that has definitely changed in the last couple days. They are planning to do another ultrasound of his heart tomorrow to check on his patent ductus arteriosis (PDA). They said the murmur could be there because the hole is getting larger or it could be there because the whole is getting smaller and it is causing some turbulence through the hole. If the ultrasound shows a smaller hole then great, if it shows a larger hole, treatment starts with giving him a medication called indomethacin to attempt to close the hole up.
The machine above is the SiPAP. From what I can tell this machine is only used on infants with respiratory disease's or premature babies with inadequate lung function. It seems to be doing the job for Calen so we are really happy about that. I really want him to stay off the vent if he can work through all of this.
So this is Calen's feeding pump. This is what has been pumping Holly's breast milk into Calen's belly. The feedings have been going great, they have had nothing but good increase with them. The problem is when his blood counts are low (his HGB low, which it is) his body will start to shunt blood away from non important organs to vital one's (brain, heart, lungs, kidney, liver) this will result in less blood going to his extremities (arms,legs), and stomach. So with that the feeding pump is not running now and the are not going to resume feeding's until they know his blood counts are back to normal, perhaps 24 hours after his blood transfusion. If they were to continue pumping milk into his belly and his body was shunting blood away from it, the milk would run a great risk of not being metabolized and causing Necrotizing Enterocolitis (NEC). NEC is a bacterial infection that infects the lining of the stomach wall, this can kill the tissue in the stomach and cause issues with the babies intestines. Other plans this coming week will include an ultrasound of his brain, this is standard among premature children and it is to check for any bleeding on his brain. So far there has been no signs of that as of now, but it is a routine test that will be preformed.
We really like all the staff here at Miami Valley. The nurse in this picture Stephanie is one of our favorites so far. She is awesome, she explains everything to us right away, she let's us do as much as possible for him ourselves so we get time to touch him and be close to him. She is very attentive to our needs as well while we are here. She is starting to work on taking her GRE so that in 2012 she plans to start the Neonatal Nurse Practitioner program. Holly is holding Calen, you just can't see him buried under a bunch of blankets.
I took these pictures while Holly was holding Calen. He had his eyes open for me. He does so well when he is on Holly, he doesn't cry or anything, he could probably lay there all day. I got to touch his head since he doesn't have his hat on now.
Another one of Calen once he was resting comfortably.