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 diaper. Show all posts
Showing posts with label diaper. Show all posts
Monday, August 21, 2006
Sunday, August 06, 2006
8/6/06: Day 23 (Sun.) Test Results Looking Good
Wow...what a great weekend it has been! Not only did Evan get moved onto the conventional respirator, but he is about a day away from being moved into a crib! Marianne was hoping to move him into one today, but the NICU seems to be in short supply of cribs. Hopefully by tomorrow he'll be in a big-boy crib! Since Marianne has been wrapping him up like a burrito, his incubator has been way to warm for him. He doesn't have trouble maintaining his body temperature (since he has built up some baby fat), so the attending physician says he can move into some new digs. She also said his chest x-ray looked great (no deflation of his lungs on the conventional respirator), so it's looking like his lungs are finally getting mature!
His blood gas test results have been right on the mark...so fingers crossed he keeps those numbers steady. According to Marianne, he has been a lot calmer although he still hates when she has to move him, change his diaper or take blood from his foot. Basically, he hates when anyone makes him move out of his comfortable position. We even got to see him open his eyes just a little bit. It seems hard for him to open them completely since he's so sedated. I was shocked to look at him and actually see him crack his eyes open a bit.
So proud of dad today...T changed Evan's diaper (with a little help from me)! Marianne said last night Evan even had his first BM (even though it was very small). The breast milk feedings must be moving his intestines to get all that meconium out. So I guess we should cherish these easy diaper changes before the big BMs arrive!
We'll keep the video camera at the ready in case he decides to open his eyes a bit again! BTW...we added some videos to past postings...there is one below and there are 2 other videos on July 17th and 18th.
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UMC Charges: $7,580.85
Running Total: $222,912.74
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His blood gas test results have been right on the mark...so fingers crossed he keeps those numbers steady. According to Marianne, he has been a lot calmer although he still hates when she has to move him, change his diaper or take blood from his foot. Basically, he hates when anyone makes him move out of his comfortable position. We even got to see him open his eyes just a little bit. It seems hard for him to open them completely since he's so sedated. I was shocked to look at him and actually see him crack his eyes open a bit.
So proud of dad today...T changed Evan's diaper (with a little help from me)! Marianne said last night Evan even had his first BM (even though it was very small). The breast milk feedings must be moving his intestines to get all that meconium out. So I guess we should cherish these easy diaper changes before the big BMs arrive!
We'll keep the video camera at the ready in case he decides to open his eyes a bit again! BTW...we added some videos to past postings...there is one below and there are 2 other videos on July 17th and 18th.
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UMC Charges: $7,580.85
Running Total: $222,912.74
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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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Thursday, August 03, 2006
8/3/06: Day 20 (Thurs.) The Snot-Man
A rainy day up in Tucson today...luckily I got to the hospital before the downpour. It was neat though since we could watch the rain roll in from Mt. Lemmon from one of the NICU windows.
I had a good visit today (not like I ever have a bad visit)...Evan was lucky to have 2 nurses work with him today. Today Marianne was off so he had Karen and Mary. Karen is a nurse at St. Joe's Hospital on the other side of town and was called in to UMC since they had so many babies to take care of. Karen was a real hoot, someone who had a great sense of humor despite all the stress in the NICU. Small world, but she has relatives who live in Hereford and Bisbee, so she's well aware of the boring drive to Sierra Vista from Tucson.
Evan did have a head ultrasound and chest x-ray today, but they didn't get the results interpreted yet. I'll check tomorrow on those results. His right arm was still free from the art line...they are taking blood samples from his left heel instead. Now that his right arm is free, I noticed his upper arm is really chunky! He still tends to keep his arm in an upright position (he doesn't seem to know that he can put that arm straight down now).
Evan's oxygen saturation all of sudden dropped into the 70's...as it turns out, he needed to be suctioned. Karen squirted a bit of saline solution into the suction tube and ended up pulling out a big glob of snot (as she called it). Sorry for the lack of a better medical term! It was amazing to see his O2 levels go right back to normal after she did it. The nurses have been rotating him from his belly to his back and have been noticing a lot more gunk coming up from his lungs (according to them, that's not a bad thing). The oscillating respirator also shakes a lot of the stuff loose. Since he can't cough it up due to the respirator tube, it has to be suctioned out manually.
While I was there, the respiratory technician (RT) made some adjustments to his ventilator. The nurses were about to test his blood gases when the RT appeared, but they decided to wait about a half hour, then pull his blood sample to see how the adjustments affected his results. I was still around when they got the results back from the lab and according to Karen his results were excellent....so they expected the RT to come back and make some more adjustments. So, more positive steps to get Evan onto the conventional respirator (and eventually off it entirely).
I got to change his diaper again...according to Karen, that was the heaviest diaper he has had (it was absolutely soaked). He was acting really fussy prior to the diaper change, so he definitely doesn't like to be wet, even in his sleep stage. The nurses also let me "feed" him through the tube...he's now getting 2ml every 6 hours, which is a step forward.
Evan seems to be having less and less IV drips running...so that's another good sign. All he is getting now through the IV is Fentanyl, Adivan and TPN (which stands for total parenteral nutrition). Once he gets off the respirator, he should be IV free (as long as he can tolerate the breast milk feeds). Fingers crossed we'll get to that point soon!
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UMC Charges: $7,002.30
Running Total: $200,569.79
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I had a good visit today (not like I ever have a bad visit)...Evan was lucky to have 2 nurses work with him today. Today Marianne was off so he had Karen and Mary. Karen is a nurse at St. Joe's Hospital on the other side of town and was called in to UMC since they had so many babies to take care of. Karen was a real hoot, someone who had a great sense of humor despite all the stress in the NICU. Small world, but she has relatives who live in Hereford and Bisbee, so she's well aware of the boring drive to Sierra Vista from Tucson.
Evan did have a head ultrasound and chest x-ray today, but they didn't get the results interpreted yet. I'll check tomorrow on those results. His right arm was still free from the art line...they are taking blood samples from his left heel instead. Now that his right arm is free, I noticed his upper arm is really chunky! He still tends to keep his arm in an upright position (he doesn't seem to know that he can put that arm straight down now).
Evan's oxygen saturation all of sudden dropped into the 70's...as it turns out, he needed to be suctioned. Karen squirted a bit of saline solution into the suction tube and ended up pulling out a big glob of snot (as she called it). Sorry for the lack of a better medical term! It was amazing to see his O2 levels go right back to normal after she did it. The nurses have been rotating him from his belly to his back and have been noticing a lot more gunk coming up from his lungs (according to them, that's not a bad thing). The oscillating respirator also shakes a lot of the stuff loose. Since he can't cough it up due to the respirator tube, it has to be suctioned out manually.
While I was there, the respiratory technician (RT) made some adjustments to his ventilator. The nurses were about to test his blood gases when the RT appeared, but they decided to wait about a half hour, then pull his blood sample to see how the adjustments affected his results. I was still around when they got the results back from the lab and according to Karen his results were excellent....so they expected the RT to come back and make some more adjustments. So, more positive steps to get Evan onto the conventional respirator (and eventually off it entirely).
I got to change his diaper again...according to Karen, that was the heaviest diaper he has had (it was absolutely soaked). He was acting really fussy prior to the diaper change, so he definitely doesn't like to be wet, even in his sleep stage. The nurses also let me "feed" him through the tube...he's now getting 2ml every 6 hours, which is a step forward.
Evan seems to be having less and less IV drips running...so that's another good sign. All he is getting now through the IV is Fentanyl, Adivan and TPN (which stands for total parenteral nutrition). Once he gets off the respirator, he should be IV free (as long as he can tolerate the breast milk feeds). Fingers crossed we'll get to that point soon!
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UMC Charges: $7,002.30
Running Total: $200,569.79
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Sunday, July 30, 2006
7/30/06: Day 16 (Sun.) Head IV (Ouch)
A picture of Evan and his dad talking...it's really hard to get any good pictures while he's in the incubator. Not much to report today...when we got there we noticed he had an IV in his head (ouch). The nurse took it out while we were there...she thought they had put it in during the prior shift to give him more blood. His blood pressure went sky-high when she took the IV out (they had taped it to his head really well), but he calmed down a lot after she finished.Evan was really fussy again while we were there...how nice of the nurse to tell us he was fine just before we got there. It doesn't help that every time we're there, they are rotating/repositioning him, which gets him a little upset. I changed his diaper and it was sopping wet, which is probably why he was fussy. He was breathing a lot against the respirator, so it's looking like he really wants to get that tube out. It's still better if he relaxes and just lets the respirator do it's work.
We're driving back up tomorrow, so hopefully there will be more good news to share. We're anxious to hear on Tuesday about how that medicine is doing on healing his PDA. The nurse told us he weighs almost 4 1/2 pounds, which still could be water weight, but he's looking bigger.
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UMC Charges: $8,240.55
Running Total: $171,250.64
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Saturday, July 29, 2006
7/29/06: Day 15 (Sat.) PDA Treatment Started
Although Evan celebrated his 2-week birthday yesterday, he is 33 weeks (adjusted gestational age) as of today...so getting closer to that 40-week full-term target age. We had a good talk with his resident (Andrea) today, but were bummed to hear she will be shifting over to TMC in a week or so. The residents switch locations every 30 days. She assured us the resident taking her place will be fully informed of Evan's condition.
Evan was even more fidgety today than we had seen him in the past. The nurse thinks that he's reached that tolerance point for the Fentanyl and is starting to feel things a bit more. They bumped up his dosage to get him to settle down a bit more. They also took an upper-body x-ray to make sure his PIC line is in the correct location after his nurse noticed that when she touched the area on his arm where the PIC line is, he became more agitated. The x-ray came back with no indication that his line was out of place, so he was just not a happy guy today! He kept opening his mouth wide like he was trying to yawn (or trying to get that respirator tube out).
They started him on the medication to help close his PDA problem. He'll get that medication over the course of three days. We'll know more on Tuesday when they do an ultrasound on his chest. The ultrasound will be able to tell if the medication worked or if he has to have the PDA ligation surgery. He did get a little blood transfusion today since his platelet counts were down a bit. Although he's A+ like both T and I are, he gets O- blood during the transfusion.
We had a good long visit with him today. I got to take his temperature and change his diaper again. Most of the time T and I had our hands on him trying to get him to settle down, but it didn't work too well. Hopefully tomorrow we can get an updated picture of him to post. :-)
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UMc Charges: $7,680.65
Running Total: $163,010.09
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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
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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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