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

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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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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7/22/06 & 7/23/06: Days 8 & 9 (Sat. & Sun.) Still Working on His Tan

Two days with little to write about (and that's a good thing). The little guy is back under the bililights...I think he's just working on a tan! They saw his bilirubin counts go up again and thought it was best to get him back under the lights. The yellow-ness looks to me to be mostly in his legs.

They removed the two UVC and UAC lines going into his umbilical cord. I think they both could only stay in for about a week anyway (due to potential clotting). Now he has a line going into his foot instead that is doing the job of those two lines (called a PIC line...Percutaneous Intravenous Catheter). So now he's not looking so wired-up. The PIC line can be used for several kinds of injections and infusions so he doesn't have to be poked so many times.


Today his nurse said they took an abdominal x-ray since she had felt a hardness in his groin/leg area. It turned out to be a minor thing...the PIC line they put in his foot needed to be adjusted since it was causing the edema in that area. It's a common thing from what they tell me.

His blood platelet counts have been steady, so they haven't had to infuse him. He's also tolerating breast milk down his feeding tube. He gets that every three hours. They are increasing the amounts every day to see how much he can tolerate. They plan on feeding him 30ml every day, which is a pretty good amount.

He is still on the oscillating respirator and his CO2 level is looking good (they fluctuate in between the 40s and 50s). I think earlier I posted his CO2 levels should be in the teens, but that number is wrong...the nurse told me his CO2 monitor was probably not on tight and had room air slipping under it, causing the reading to be so low.

That's it for this weekend...we'll be driving up tomorrow after work.

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UMC Charges (7/22): $6,832.35
UMC Charges (7/23): $7,956.65
Running Total: $117,072.04
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7/20/06: Day 6 (Thu.) Chin-Butt Alert

Busy day today...thanks to my Doctrine co-workers for throwing me a baby shower/luncheon at Johnny Carino's. I'll go out to eat anytime, just give me a call!

We drove up to Tucson around 2:30pm...getting there sometime after 4pm. Evan is off the bililights (yea)! The nurses say the jaundice could come back, so no need to worry if we visit another day and he's back under the light. Now we could sort of see his face without the eye covers on. His eyes (and face in general) are swollen from water retention.

From the picture you can see that Evan does have a little inkling of a chin cleft (or "chin-butt" as we call it), indicating that he is indeed momma's boy! Score one for mom! His hair is still a mess since he hasn't has a bath yet, so we can't really tell what his hair color is.

He is still on the oscillating ventilator which is giving him 500 breaths per minute, but they have reduced the amplitude settings (meaning, the breaths aren't as forceful). We got to speak with one of the resident doctors and she said they hope to start feeding him through a gavage (instead of the umbilical cord) maybe Friday. What they will do is test him to see if he will tolerate being fed through the gavage (feeding tube through the nose down into the stomach) and increase the amount given to him. If he doesn't tolerate it (if he is showing too much bile in his system), they'll put him back on the umbilical cord IV feed line.

His CO2 levels are still coming down (I think they were in the 40's), which is good. They took another chest x-ray and it is slowly getting clearer. They are still trying to determine what caused the Tuesday episode by doing a culture of some lung fluid. In the lab, they'll work with it to see if any viral or bacterial stuff appears. It takes a few days to do it, so no results yet. With all the people in and out of the NICU and different people handling the babies, it's a wonder more babies don't catch a little bug.

His red blood cell counts are going up, so he didn't have to have any blood transfusions. While we were there, we got to see the nurse do the fun job of flipping him from his belly to his back and rotating him (his bed is slightly slanted so he needed to be upright). It took a team of 3 people all having to pitch in and help since he is a tangle of IV lines and his respirator tubes. His poor little head is all misshapen since he has to keep his head turned to the side for the ventilator. You can sort of see in the picture (that was after they flipped and rotated him) that the side of his head is flat.

So, overall, it was a good day...no major bump in the road.

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Chronological age: 0 months 0 weeks 6 days
Adjusted/Gestastional age: 31 5/7 weeks
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UMC Charges: $$8,176.30
Running Total: $94,263.14
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7/19/06: Day 5 (Wed.) Lungs Healing

First off, Happy Birthday to my Mom down in Florida!! I don't think we're planning a trip up to Tucson today. I'm working on getting paperwork done for medical leave, Evan's birth certificate and other stuff.

I spoke with Evan's nurse this morning (Marianne). She was the nurse on duty yesterday when he had the bad day. She said he is doing much better now. His morning chest x-ray still was a cloudy-white, but not as bad as yesterday. She said the doctors are just letting him run his course, there's not much worry at this point.

She said last night when they suctioned his lungs there was a little bit of a pink tinge indicating some blood, but this morning when she suctioned him again, he was all clear. Yesterday, prior to his episode right when we got there, Marianne had given him a dose of blood platelets which they think may have helped him heal faster. They think he had some sort of scratch in his lungs that caused all that blood to appear yesterday (which is a common thing due to that darn respirator). Last night, his red blood count was low, so he got a little bit of blood again. They are continuing to check his blood gas counts every few hours.

They hope to take him off the bililights maybe tomorrow since the jaundice is working its way out. Marianne said his leg bruising is almost gone also. So all in all, it's a good day so far. I'll call the night shift nurses this evening to see how all goes today and post more later.

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Chronological age: 0 months 0 weeks 5 days
Adjusted/Gestastional age: 31 4/7 weeks
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UMC Charges: $9,506.05
Running Total: $86,086.84
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7/17/06: Day 3 (Mon.) First Visit*

We drove up to UMC on Monday to see our little guy...not sure what we were in for. I was scared to go in, but everything was just fine. Evan is right on track for a preemie his age, sort of a "textbook" case so to speak. We got to talk to the doctor who was in the NICU at the time (Dr. Wispe)and he gave us a lot of reassuring information. He still thinks he won't be home until his expected due date, but he hopes that if he reacts very well to his treatment, he could be transferred back to the Sierra Vista Hospital to be taken care of there (but we're still talking a long ways down the road).

He has a nurse dedicated to taking care of him (well, there are more than one, but we met the one taking care of him during the day shift). The nurses are more than happy to get us educated on what all the monitors and tubes are for. We had a lot of information overload yesterday we're still trying to digest. But basically the steps are for him to come off the respirator later this week...then he'll go on the CPAP (to force pressured air into his lungs), and then just to the nasal cannula (with just continuous oxygen). We we're with him before and after lunch, and even in that time, they dropped his oxygen down from 28% to 26%, which is a good sign.

He is still a bit sedated since he was fussy Sunday night. They would rather have him sleep and let the respirator do the healing than him fighting it. His legs are looking so much better. They put a different IV line in his body so they don't have to draw blood samples from his feet. Funny, his blood is A+ just like both his mom and dad! He is under the "bili-light" to get the jaundice out of his system. The nurse told us we could be holding him if it wasn't for the bililight....they need to get his sytem cleared out first.

We did finally get his birth length...this kid is 41 cm which is about 16 1/4 inches long. If he would have been a full-term baby, we would have had some issues!! Even his nurse thought he was an older baby. So many things are going in his favor. His weight is still the same (which is to be expected).

So, we'll be going back up today...they are hoping to get him on a feeding line (through his nose directly into his stomach) in a day or so. Currently, he has a feeding line directly into his umbilical cord. They'll be able to start using breastmilk down that feeding tube, so hopefully that will give him a good jolt of nutrients.

I'll post more later! Thanks for all the supportive e-mails. It's hard to get back to everyone, but you pretty much know, no news is good news from us. We're managing well, so don't worry about us. Since we can't hold him yet, there's no rush for us to be there 24/7; so T's still doing some hours at work and we'll go up in the afternoon. I get to chill with the pups in the morning, which they like. I'm recovering really quickly from the surgery, ...the cankles have arrived people!!

P.S....The photo is a bit overexposed due to the bililight.



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Chronological age: 0 months 0 weeks 4 days
Gestastional age: 31 2/7 weeks
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UMC Charges (7/15): $11,187.90
UMC Charges (7/16): $8,541.50
UMC Charges (7/17): $6,414.05
Running total: $66,081.19
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