In case you haven't been reading all the postings...this will get you caught up:
August 18 (Day 35): PIC line removed; off the IV; up to full feeds with gavage
August 15 (Day 32): Passed hearing test; had ROP test done
August 13 (Day 30): CPAP removed; put on nasal cannula; classified as Level II care
August 11 (Day 28): T gets to hold Evan for first time
August 9 (Day 26): Got his first bath by mom
August 8 (Day 25): Moved into the 3rd pod
August 7 (day 24): Respirator removed; put on nasal CPAP; held by Jen for the first time; moved into a crib
August 5 (Day 22): Oscillating respirator removed, put on conventional respirator
August 2 (Day 19): Arterial line removed
July 31 (Day 17): PDA healed
July 28 (Day 14): PDA discovered
July 25 (Day 11): Off the bilights; bi-carb burn on his right foot discovered; Jen's first diaper change
July 23 (day 9): PIC line inserted
July 21 (Day 7): mild IVH grades detected in brain
July 18 (Day 4): Pulmonary hemmorhage detected; put on ocillating respirator
July 14 (Day 1): Born by emergency c-section in Sierra Vista Hospital and air-evac'ed to University Medical Center in Tucson
Showing posts with label IVH. Show all posts
Showing posts with label IVH. Show all posts
Friday, August 18, 2006
Friday, August 04, 2006
8/4/06: Day 21 (Fri.) 3 Weeks Old!
Wow, three weeks...it has sort of flown by, but in some ways still has been like an eternity for us. His September due date (hopefully around the time he will come home)...seems like a year away at this point. I was joking with the attending physician today that Evan will be walking by the time he decides to come off the respirator!
I had a good talk with the new attending physician (Dr. Cahan)...she told me the steroid treatment hasn't been normalizing his CO2 levels as she had hoped. He's had really good results on his blood gas lab results, then they'll adjust (turn down) his respirator settings, but then his next lab results will show that they need to turn the respirator settings back up. She is planning on finishing this course of steroids on Sunday, and maybe starting another course of small doses if he still doesn't show the results they are looking for. She is thinking of maybe testing him and putting him on the regular respirator in a few days. She doesn't want to be too hasty in doing that since she doesn't want to risk his lungs deflating. They are attributing his slow weaning to that darn pulmonary hemorrhage he had during that first week he was admitted.
The doctor said no change to the IVH conditions I posted about earlier. That's good news...no change is good. His chest x-ray was also looking fine. His primary nurse Marianne was working today and she has figured out why he seems to be so fussy at times. Normally, the nurses will only suction his lungs about every 4-6 hours. Marianne found that when he starts getting fussy, he needs suctioned...about every hour. He calms right back down after she does it. They are feeding him 1 ml every three hours now, so he is tolerating the breast milk.
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UMC Charges: $6,591.05
Running Total: $207,160.84
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I had a good talk with the new attending physician (Dr. Cahan)...she told me the steroid treatment hasn't been normalizing his CO2 levels as she had hoped. He's had really good results on his blood gas lab results, then they'll adjust (turn down) his respirator settings, but then his next lab results will show that they need to turn the respirator settings back up. She is planning on finishing this course of steroids on Sunday, and maybe starting another course of small doses if he still doesn't show the results they are looking for. She is thinking of maybe testing him and putting him on the regular respirator in a few days. She doesn't want to be too hasty in doing that since she doesn't want to risk his lungs deflating. They are attributing his slow weaning to that darn pulmonary hemorrhage he had during that first week he was admitted.
The doctor said no change to the IVH conditions I posted about earlier. That's good news...no change is good. His chest x-ray was also looking fine. His primary nurse Marianne was working today and she has figured out why he seems to be so fussy at times. Normally, the nurses will only suction his lungs about every 4-6 hours. Marianne found that when he starts getting fussy, he needs suctioned...about every hour. He calms right back down after she does it. They are feeding him 1 ml every three hours now, so he is tolerating the breast milk.
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UMC Charges: $6,591.05
Running Total: $207,160.84
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Wednesday, August 02, 2006
8/2/06: Day 19 (Wed.) Arterial Line Removed
When T and I go up to visit, we really try to be drama-free. Our visit started out to be that way, but of course, Evan had to give us a little scare. His primary nurse Marianne was on duty so it was nice to have someone give us all the news without having to pry it out. On the days she isn't working, Evan will get some random nurse who isn't always the most forth-coming with info. Marianne had overheard the doctors say they may switch him over to the conventional respirator in a few days. Although the conventional respirator is a bit harsher on preemie lungs, it will give Evan more of a chance to breathe on his own. Right now, he is trying to breathe against that oscillating respirator and that is a hard thing to do. They have continued to turn down the amplitude on the oscillating respirator, so he isn't vibrating as badly anymore.
As for Evan giving us a scare...I had thought he had scratched his stomach since I saw a thin line of blood appear on his tummy. He had started to be fidgety again, so I thought he scratched himself with his right arm (his right arm has the art line and a catheter-like thing where they take blood from him). As we stood and watched him, we saw more blood appear on his stomach when he touched his right arm to his stomach and we figured out the blood was coming from the art line.
T told Marianne about it and she ended up getting the doctor on call to come take a look. Evan has had that art line since he got there, so the doctor ended up taking it out, cleaned up his right arm since it was covered in blood and planned on reinserting it later. They also use that art line to monitor his blood pressure, so they put this little blood pressure cuff on his leg to keep monitoring his levels. While the doctor was taking out the art line, Evan's heart rate went sky high (I think I saw it hit 190 at one point). The doctor wasn't too concerned since she said his oxygen saturation was still in the good range. After she was done fiddling with his arm, he calmed down a lot. They said Evan's vital signs are interesting...he'll have a big jump in his blood pressure, but his heart rate will stay normal, or his heart rate will shoot up and his blood pressure stays low. They aren't sure what is causing it, but it isn't something that is alarming them.
Tomorrow Evan will get another head ultrasound and chest x-ray. The head ultrasound will check again on the IVH areas in his brain...since the last result showed no change to those areas in his brain, they anticipate this one will show the same. The chest x-ray will reveal if his lungs have completely healed from that hemorrhage about 2 weeks ago. He is still getting breast milk feeds every 12 hours. So, things are starting to look up...the next stage will be moving him back to the conventional respirator. Hopefully more good news after tomorrow!
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UMC Charges: $6,738.00
Running Total: $193,567.49
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As for Evan giving us a scare...I had thought he had scratched his stomach since I saw a thin line of blood appear on his tummy. He had started to be fidgety again, so I thought he scratched himself with his right arm (his right arm has the art line and a catheter-like thing where they take blood from him). As we stood and watched him, we saw more blood appear on his stomach when he touched his right arm to his stomach and we figured out the blood was coming from the art line.
T told Marianne about it and she ended up getting the doctor on call to come take a look. Evan has had that art line since he got there, so the doctor ended up taking it out, cleaned up his right arm since it was covered in blood and planned on reinserting it later. They also use that art line to monitor his blood pressure, so they put this little blood pressure cuff on his leg to keep monitoring his levels. While the doctor was taking out the art line, Evan's heart rate went sky high (I think I saw it hit 190 at one point). The doctor wasn't too concerned since she said his oxygen saturation was still in the good range. After she was done fiddling with his arm, he calmed down a lot. They said Evan's vital signs are interesting...he'll have a big jump in his blood pressure, but his heart rate will stay normal, or his heart rate will shoot up and his blood pressure stays low. They aren't sure what is causing it, but it isn't something that is alarming them.
Tomorrow Evan will get another head ultrasound and chest x-ray. The head ultrasound will check again on the IVH areas in his brain...since the last result showed no change to those areas in his brain, they anticipate this one will show the same. The chest x-ray will reveal if his lungs have completely healed from that hemorrhage about 2 weeks ago. He is still getting breast milk feeds every 12 hours. So, things are starting to look up...the next stage will be moving him back to the conventional respirator. Hopefully more good news after tomorrow!
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UMC Charges: $6,738.00
Running Total: $193,567.49
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Thursday, July 27, 2006
7/27/06: Day 13 (Thurs.) IVH Status Unchanged
Another trip to Tucson today...I had the opportunity to talk with the resident doctor who is looking after Evan. The resident is really nice and easy to talk to...but she makes me feel old. Are doctors getting younger or am I just getting old!? :-)
They did another head ultrasound today to re-check those two areas I wrote about in an earlier post. They didn't see any change from the original ultrasound, so that is a great thing. It means it isn't getting worse and chances are, those two areas will just heal as his brain grows.
The doctor predicts (if all goes as it has been going), that he will be weaned off the oscillating respirator possibly late next week. She can't predict if he will go back on the normal respirator or if he will be able to go onto the CPAP. A little speck of light at the end of the tunnel...but, don't be surprised if he relapses again (all part of what preemies do).
One odd thing is that they did a genetic test on him (as they do will all newborn babies at UMC)...and he had two abnormal results. The doctor told me they will re-do the test later since they think the results aren't correct due to Evan having a blood transfusion prior to the test. One abnormality is with his thyroid level...that result didn't surprise me since I've been hypothyroid since '99. The doctor wasn't aware of my medical condition and wrote that into his chart. The other abnormality I can't remember what it was...all is remember is it's a long word. The doctor said Evan was only off by a point or so on the optimal range for that test (again, showing that the results are probably off due to his transfusion). Both result abnormalities aren't something short-term to worry about anyway according to the doctor.
The doctor told me down the road they may have to do some sort of plastic surgery on Evan's foot due to that bicarb infustion burn. She assured me the burn/wound specialists are keeping an eye on his foot everyday and are working on healing it the best they can. I didn't get to see his foot today since it was bandaged, but even his day shift nurse Marianne says, his foot will look worse before it looks better. We're still in the looking worse stage.
They re-started feeding him micro-doses of breast milk today. He is still getting complete nutrition through his IVs, so they are still just testing him to see what he will tolerate.
That's it for today!
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UMC Charges: $6,971.50
Running Total: $145,503.49
-----------------
They did another head ultrasound today to re-check those two areas I wrote about in an earlier post. They didn't see any change from the original ultrasound, so that is a great thing. It means it isn't getting worse and chances are, those two areas will just heal as his brain grows.
The doctor predicts (if all goes as it has been going), that he will be weaned off the oscillating respirator possibly late next week. She can't predict if he will go back on the normal respirator or if he will be able to go onto the CPAP. A little speck of light at the end of the tunnel...but, don't be surprised if he relapses again (all part of what preemies do).
One odd thing is that they did a genetic test on him (as they do will all newborn babies at UMC)...and he had two abnormal results. The doctor told me they will re-do the test later since they think the results aren't correct due to Evan having a blood transfusion prior to the test. One abnormality is with his thyroid level...that result didn't surprise me since I've been hypothyroid since '99. The doctor wasn't aware of my medical condition and wrote that into his chart. The other abnormality I can't remember what it was...all is remember is it's a long word. The doctor said Evan was only off by a point or so on the optimal range for that test (again, showing that the results are probably off due to his transfusion). Both result abnormalities aren't something short-term to worry about anyway according to the doctor.
The doctor told me down the road they may have to do some sort of plastic surgery on Evan's foot due to that bicarb infustion burn. She assured me the burn/wound specialists are keeping an eye on his foot everyday and are working on healing it the best they can. I didn't get to see his foot today since it was bandaged, but even his day shift nurse Marianne says, his foot will look worse before it looks better. We're still in the looking worse stage.
They re-started feeding him micro-doses of breast milk today. He is still getting complete nutrition through his IVs, so they are still just testing him to see what he will tolerate.
That's it for today!
-----------------
UMC Charges: $6,971.50
Running Total: $145,503.49
-----------------
Friday, July 21, 2006
7/21/06: Day 7 (Fri.) One Week Old! IVH Diagnosed
O.k...back to the little guy...celebrating one week today! That puts him up to 32 weeks gestational age as of Saturday. Today was one of those days we hope we have more of...absolutely nothing extreme to report about. He was pretty much in the same situation as yesterday...sedated so the oscillating respirator can do its job. His blood gases keep improving and they did feed him with a drop of milk today...steady gains! His chest x-rays are also clearing up....each one is better than the previous one, so his lungs are slowly healing.
The doctor did tell us his head ultrasound showed a mild (for you medical techies...grade 1 and 2) intraventricular hemorrhage (IVH) in his brain. They say this is very common due to the trauma of a preemie birth. There is little risk of any complications since his grades are so low (low grades are good in this case). ;-) IVH grades range from 1 being very mild to 4 being severe. They will do another head ultrasound in about a week to see if the hemorrhage is growing or shrinking. Since his vital signs are so good, they anticipate that it is healing itself. It was great for the doctor to tell us that Evan's case isn't anything they haven't seen before, so he's not unique (for once it's good to not be unique)!
We got a book called "The Essential Guide for Parents of Premature Babies" and has been a great read to get us caught up on all the NICU terminology. It's reassuring to read that Evan fits right in line with a lot of the book, which helps answer many of our questions.
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Chronological age: 0 months 1 week 0 days
Adjusted/Gestastional age: 31 6/7 weeks
------------------------
UMC Charges: $8,019.90
Running Total: $102,283.04
-----------------------
The doctor did tell us his head ultrasound showed a mild (for you medical techies...grade 1 and 2) intraventricular hemorrhage (IVH) in his brain. They say this is very common due to the trauma of a preemie birth. There is little risk of any complications since his grades are so low (low grades are good in this case). ;-) IVH grades range from 1 being very mild to 4 being severe. They will do another head ultrasound in about a week to see if the hemorrhage is growing or shrinking. Since his vital signs are so good, they anticipate that it is healing itself. It was great for the doctor to tell us that Evan's case isn't anything they haven't seen before, so he's not unique (for once it's good to not be unique)!
We got a book called "The Essential Guide for Parents of Premature Babies" and has been a great read to get us caught up on all the NICU terminology. It's reassuring to read that Evan fits right in line with a lot of the book, which helps answer many of our questions.
----------
Chronological age: 0 months 1 week 0 days
Adjusted/Gestastional age: 31 6/7 weeks
------------------------
UMC Charges: $8,019.90
Running Total: $102,283.04
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