All of you who have kids (especially boys), I give you permission to laugh when you read this. T and I got to experience being peed on twice during diaper changes! What is with little boys??!! During Evan's 6pm feeing, I was holding him and we heard a big rumble down in his diaper area. I feared the worst since my hand was in that area holding him and I could feel it too. We thought that maybe we would just leave it for the nurses, but we were nice and decided to change his diaper after the feeding. It wasn't a total blow-out, but close. Alas, that won't be the last time we deal with that!
So, enough of the bodily function issues...everything is continuing on track. The nurses have been turning down his oxygen flow as he tolerates it. They knocked him down to .30 oxygen flow (but they move it back up when it's time to change his diaper and change the dressing on his foot). He tends to get worked up during those times and his O2 levels drop a lot. But, that's o.k. that he needs a bit more during those times.
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UMC Charges: $3,800.00
Running Total: $300,121.44
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Showing posts with label bicarb burn. Show all posts
Showing posts with label bicarb burn. Show all posts
Monday, August 21, 2006
Saturday, August 19, 2006
8/19/06: Day 36 (Sat.) Cranky Day
Our little guy is four weeks away from being a full-term, 40-week baby! Hopefully that means he'll be coming home within that time. It's been so much nicer since we can put him in clothes (he's starting to look like a normal kid). Thanks to those of you gave us baby clothes as gifts, they are now coming in handy.
We were at the hospital for his noon, 3pm and 6pm feedings, so it was a long day! Almost all the babies in pod 3 were cranky today, including Evan (he was the least cranky out of all of them). He is getting a lot more sensitive to when his tummy is empty, and he lets everyone know that. Once the milk starts hitting his stomach through the gavage tube, he's happy. Since we were there for so long today, we both had good quality time holding him. He loves tugging at the tape keeping his nasal cannula in place, so we have to wrap him like a burrito to keep his hands down. While we're holding him and he is in sleep-mode, he has been putting his hands to his face and mouth, which the nurses say that's a sign he is able to comfort himself.
Nothing new on the medical front aside that his burn foot is still getting treated and they are still increasing his feeds 1ml every 3 hours. I think he was up to 40+ml today and the new goal is to get into the 60mls per feeding.
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UMC Charges: $4,000.00
Running Total: $296,321.44
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Friday, August 18, 2006
Timeline
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
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
8/17/06 & 8/18/06, 2006: Day 34 & 35 (Thurs. & Fri.) 5 Weeks Old!
Apologies for not posting last night, I was just exhausted from being in Tucson almost all day. I have been trying to be at the hospital as much as possible during the day before I have to go back to work at the end of next week. I'll take time off again when Evan comes home. The only bummer is that T hasn't been able to be at the hospital the past three days since I'm there during the work day.
Evan has already reached full feeds (they are still increasing 1ml every feed), so I am happy to report that Evan is off the IV! Another surprise is that they took out his PIC line also, so his left arm is now free! The only wires left are the ones attached to monitor his heart rate, breathing rate and oxygen saturation. Of those three, the one they are watching the most is the O2 saturation. They have periodically tried to turn down his oxygen flow, but he still isn't tolerating very well. His O2 levels will start to drop into the 80s and lower. At this point, it's nothing to worry about, it just shows his lungs are still growing, so they aren't in any rush to push him.
Evan got a bath today, which was a bit easier since his PIC line was removed. It turned into a three-person job. We had to wrap his burn foot in plastic to make sure it didn't get wet and one person had to hold his foot out of the tub. His burn is healing very well according to the nurses. The black part of it has fallen off and the new tissue growth looks very healthy. So, chances are, he won't have a scar that is too noticeable. Now that he is IV free, we can put him in baby clothes like onesies, so he's starting to look like a normal baby.
Evan is becoming more vocal around feeding time, which is showing he is more aware of hunger feelings. He was so mad and fussy, but as soon as the milk started going through the gavage, he was super-calm. A few days ago, his O2 levels would also drop after he would be fed, but now, his levels are steady during and after feeding (in the upper 90's).
5-Week weight check: 2295 grams = about 5 lbs. 2 oz.
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UMC Charges (8/17): $4,074.85
UMC Charges (8/18): $4,000.00
Running Total: $292,321.44
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Saturday, August 05, 2006
8/5/06: Day 22 (Sat.) On the Conventional Respirator*
A very good day today! Another small hurdle has been cleared...Evan was taken off the oscillating (high frequency) respirator and is now on a conventional respirator! Fingers crossed he won't have to go back to the high frequency respirator!
Evan's primary nurse, Marianne, told us that Dr. Edde made the decision Saturday morning to switch him over. The doctor just had a feeling it would work, and she was right. When they switched him over, they had to manually give him oxygen (with that squeezy-bag-thing, for a lack of a better term)...but, Marianne said that he was breathing on his own during that time. Another good sign that his lungs are maturing. Now, the next step is to keep monitoring his CO2 levels and if they remain in the good zone for an extended period of time, then they can wean him completely off the respirator onto the nasal CPAP.
He was in a much calmer state today...Marianne has continued suctioning him more often which is helping (although Evan gets so mad in his face when she is doing it). She is also keeping him in a swaddled condition with a thin blanket. She said this is also helping him stay calmer and keeping his arms and legs from flailing around so much. They also say he is keeping his body temperature consistently at a very normal level, and that means he may be able to move into a crib soon. When that happens, it will be much easier for us to finally get to hold him.
Now that he is on the conventional respirator, the respiratory technician (RT) has to do "treatment" on him to help get all that gunk loose in his lungs. While we were there, one of the RTs, Roy, did a session on him. All he does is tap this cup-like thing on his back for a few minutes, then suction him. Evan didn't like it at all and it was evident in his face (he turned bright red and looked like he was trying to cry). It's all progress though!
Momma changed his diaper while dad watched...T still hasn't done a diaper change by himself yet. Hopefully that will change soon! He's still getting his feeds (3ml every three hours). So far, no adverse reaction to the breast milk. Now that they took out his arterial line a few days ago, they are taking all his blood gas test from his heel (which he doesn't like very much either). The burn on his right foot is still healing (it is classified as a third-degree burn, ouch). Hopefully it will be completely healed by the time he leaves the hospital. When Marianne was switching his Pulse Oximeter from his foot to his hand, Evan gave her a big fight...he refused to open up his hand...we were all shocked at how strong his little fingers were. She eventually got the monitor placed properly, but the kid's got grip!
Lots of good news today on Evan's 34-week mark (6 weeks away from being full-term)!
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UMC Charges: $8,171.05
Running Total: $215,331.89
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Evan's primary nurse, Marianne, told us that Dr. Edde made the decision Saturday morning to switch him over. The doctor just had a feeling it would work, and she was right. When they switched him over, they had to manually give him oxygen (with that squeezy-bag-thing, for a lack of a better term)...but, Marianne said that he was breathing on his own during that time. Another good sign that his lungs are maturing. Now, the next step is to keep monitoring his CO2 levels and if they remain in the good zone for an extended period of time, then they can wean him completely off the respirator onto the nasal CPAP.
He was in a much calmer state today...Marianne has continued suctioning him more often which is helping (although Evan gets so mad in his face when she is doing it). She is also keeping him in a swaddled condition with a thin blanket. She said this is also helping him stay calmer and keeping his arms and legs from flailing around so much. They also say he is keeping his body temperature consistently at a very normal level, and that means he may be able to move into a crib soon. When that happens, it will be much easier for us to finally get to hold him.
Now that he is on the conventional respirator, the respiratory technician (RT) has to do "treatment" on him to help get all that gunk loose in his lungs. While we were there, one of the RTs, Roy, did a session on him. All he does is tap this cup-like thing on his back for a few minutes, then suction him. Evan didn't like it at all and it was evident in his face (he turned bright red and looked like he was trying to cry). It's all progress though!
Momma changed his diaper while dad watched...T still hasn't done a diaper change by himself yet. Hopefully that will change soon! He's still getting his feeds (3ml every three hours). So far, no adverse reaction to the breast milk. Now that they took out his arterial line a few days ago, they are taking all his blood gas test from his heel (which he doesn't like very much either). The burn on his right foot is still healing (it is classified as a third-degree burn, ouch). Hopefully it will be completely healed by the time he leaves the hospital. When Marianne was switching his Pulse Oximeter from his foot to his hand, Evan gave her a big fight...he refused to open up his hand...we were all shocked at how strong his little fingers were. She eventually got the monitor placed properly, but the kid's got grip!
Lots of good news today on Evan's 34-week mark (6 weeks away from being full-term)!
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UMC Charges: $8,171.05
Running Total: $215,331.89
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Friday, August 04, 2006
Some new pics
The pictures still look bad through the incubator glass. I had to get a shot of this....Evan loves to cross his feet. On his right foot, Marianne made a little sock to cover his burn wound. He would keep kicking the dressing off with his left foot. Now with the sock, he can't do that. You can see his right arm is free from the arterial line, but he still keeps his arm in position like it's still on. His left arm has the PIC line in it. This is the view we see of Evan most of the time since the respirator tube is on the opposite side. We know the back of his head very well!
In this shot I was trying to get a picture of Evan with his "guard dog", Sarge. Sarge keeps an eye on him when we can't be there.
I was trying to get a full-length picture of Evan on his respirator side. As you can see, he's not as wired up now as he was before. That tube in the forefront is the suction tube they use in his mouth. The suction tube they use for his lungs is in front of his left hand. Evan loves to have his hand resting on the respirator tube.
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
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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
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Wednesday, July 26, 2006
7/26/06: Day 12 (Wed.) PIC Line Adjustment
We're almost settled into our hospital routine (not something I'm overjoyed about though). Today I drove up earlier in the day without T since it seems the past few days we've been so rushed to get on the road after he comes home from work, visit with Evan before shift change at 6:45 and then have to turn right around and head back home. It was nice to have a bit more time to sit with him and talk with one of his primary nurses, Marianne.
A tiny bit of good news is that they are slowly turning down the amplitude on his respirator. I didn't have the chance to talk with any of the doctors to ask them what signs they look for to take him off that oscillating respirator and onto the nasal CPAP or regular respirator. Now, it seems like we just have to be patient and let time mature his lungs.
The burn specialists looked at his right foot this morning and they are applying a special dressing to the burn. I got to see the wound and it looks really bad...the skin is all black in a square shape. They have to change out his dressing every 4 hours. Hopefully, he won't have too bad of a scar.
He had an x-ray today to check on the PIC line (to make sure it's in the right position). Marianne said they pulled it back a bit since it wasn't sitting in a optimal position. She wasn't sure if they were able to see the condition of his lungs on the x-ray...but she is sure they are healing well since she doesn't get much discoloration when she suctions his lungs.
Evan was really fidgity today, the most I've seen him move around. Marianne told me they are cutting back on his Fentanyl which is for pain and he is probably becoming more sensitive to the environment. In his right arm/hand is the catheter that monitors his blood pressure (the ART line). Since he's been moving around more, he kept flat-lining the ART line and setting off an alarm. Marianne just moves his arm and the monitor corrects itself. She laughs since he always wants to have his arm up (he usually keeps both his arms up, likes he's being held up at gunpoint). She'll put his arm down by his side, but he'll immediately put it back up. He likes to have his arm near the respirator tube.
That's it for today!
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UMC Charges: $7,035.25
Running Total: $138,531.99
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A tiny bit of good news is that they are slowly turning down the amplitude on his respirator. I didn't have the chance to talk with any of the doctors to ask them what signs they look for to take him off that oscillating respirator and onto the nasal CPAP or regular respirator. Now, it seems like we just have to be patient and let time mature his lungs.
The burn specialists looked at his right foot this morning and they are applying a special dressing to the burn. I got to see the wound and it looks really bad...the skin is all black in a square shape. They have to change out his dressing every 4 hours. Hopefully, he won't have too bad of a scar.
He had an x-ray today to check on the PIC line (to make sure it's in the right position). Marianne said they pulled it back a bit since it wasn't sitting in a optimal position. She wasn't sure if they were able to see the condition of his lungs on the x-ray...but she is sure they are healing well since she doesn't get much discoloration when she suctions his lungs.
Evan was really fidgity today, the most I've seen him move around. Marianne told me they are cutting back on his Fentanyl which is for pain and he is probably becoming more sensitive to the environment. In his right arm/hand is the catheter that monitors his blood pressure (the ART line). Since he's been moving around more, he kept flat-lining the ART line and setting off an alarm. Marianne just moves his arm and the monitor corrects itself. She laughs since he always wants to have his arm up (he usually keeps both his arms up, likes he's being held up at gunpoint). She'll put his arm down by his side, but he'll immediately put it back up. He likes to have his arm near the respirator tube.
That's it for today!
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UMC Charges: $7,035.25
Running Total: $138,531.99
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Tuesday, July 25, 2006
7/25/06: Day 11 (Tues.) First Diaper Change
Another relatively good day for the little guy. His nurse told us they are only checking his blood gases every 6 hours (instead of every 3 hours). This measures oxygen, carbon dioxide and acid content in a small blood sample taken from his artery. That's a good thing since it shows his respiratory system is slowly starting to kick in and they don't need to check it so often.
He was off the bililights (again)...so hopefully the jaundice is all gone. The burn on his right foot (that I wrote about yesterday) is going to get looked at by a specialist. The nurse told me those burns happen due to the bicarb infusions they do. If the IV isn't placed precisely correct (which is hard due to preemies little veins and arteries), a chemical-like burn can happen. At least it didn't happen on his forehead as is the case with other preemies. This burn is on top of his foot, so even if he gets a scar, it won't be that obvious.
I did get to change his diaper today! It's my first diaper change! He hasn't had a bowel movement yet, so it was pretty easy despite doing it through the incubator. The even weigh each wet diaper and it gets charted with the rest of medications and information. His eye lids didn't look so puffy today, so hopefully his swelling is decreasing. I was assured by the nurse that the odd shape to his head will go away (since he lays on his side all the time, his head is getting narrow and flat on the sides).
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UMC Charges: $6,863.45
Running Total: $131,496.74
-----------------
He was off the bililights (again)...so hopefully the jaundice is all gone. The burn on his right foot (that I wrote about yesterday) is going to get looked at by a specialist. The nurse told me those burns happen due to the bicarb infusions they do. If the IV isn't placed precisely correct (which is hard due to preemies little veins and arteries), a chemical-like burn can happen. At least it didn't happen on his forehead as is the case with other preemies. This burn is on top of his foot, so even if he gets a scar, it won't be that obvious.
I did get to change his diaper today! It's my first diaper change! He hasn't had a bowel movement yet, so it was pretty easy despite doing it through the incubator. The even weigh each wet diaper and it gets charted with the rest of medications and information. His eye lids didn't look so puffy today, so hopefully his swelling is decreasing. I was assured by the nurse that the odd shape to his head will go away (since he lays on his side all the time, his head is getting narrow and flat on the sides).
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UMC Charges: $6,863.45
Running Total: $131,496.74
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7/24/06: Day 10 (Mon.) PIC Line Moved
Another non-drama day (yea)! I did forget to mention in the previous post that Evan gained a bit of weight (even though they think it's due to water retention). As of Sunday he weighed 4 pounds, 2 ounces (up from 3 lbs. 8 oz. when he was born). Weight has never been an issue with him since he was a decent size for his age to begin with, but it's good to see the numbers go up. When we were there on Monday, T and I were commenting on how much bigger he is looking (especially his feet). Evan has a "neighbor" who is one of a set of twin boys who are 26 weeks old and weigh a little over 2 pounds, so he's the big kid on the block!
Not sure if I mentioned before, they had to move his PIC line from his foot to his left hand, so now his feet are totally free of catheters and lines. But, both his hands are pretty much bundled up since they use his right hand to draw blood and the left hand for the PIC line. Almost every time we see him, he always has his hand on the respirator tube, so he must be feeling the sensation from it. They think his lung issue has cleared up since when they suction his lungs, they have been clear (aside from a little bit of pink tinge which they aren't too worried about). His right foot did get some sort of burn on it that they are healing with this blue gel-like stuff. He's still on the bililights, hopefully it will clear out his system this time.
One thing I have to complain about though...on Sunday, I drove the Trailblazer to the hospital...someone stole my Steeler antenna ball!! Oh, the humanity!! Can you believe!? I noticed he was gone when I was driving home... Bummer! We have found that entering and exiting the UMC parking garage is a lesson in defensive driving since no one watches where they are going.
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UMC Charges: $7,561.25
Running Total: $124,633.29
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Not sure if I mentioned before, they had to move his PIC line from his foot to his left hand, so now his feet are totally free of catheters and lines. But, both his hands are pretty much bundled up since they use his right hand to draw blood and the left hand for the PIC line. Almost every time we see him, he always has his hand on the respirator tube, so he must be feeling the sensation from it. They think his lung issue has cleared up since when they suction his lungs, they have been clear (aside from a little bit of pink tinge which they aren't too worried about). His right foot did get some sort of burn on it that they are healing with this blue gel-like stuff. He's still on the bililights, hopefully it will clear out his system this time.
One thing I have to complain about though...on Sunday, I drove the Trailblazer to the hospital...someone stole my Steeler antenna ball!! Oh, the humanity!! Can you believe!? I noticed he was gone when I was driving home... Bummer! We have found that entering and exiting the UMC parking garage is a lesson in defensive driving since no one watches where they are going.
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UMC Charges: $7,561.25
Running Total: $124,633.29
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