Not much new to report. We made it through our first night with all three boys at home.It wasn't easy, but we made it. Tyler went to the doctor today for his first checkup. So far, so good -- he's down about 1 ounce to 6lb 14oz, and he's a bit jaundiced, but nothing really remarkable. He goes back for another weight check and bilirubin check on Monday.
I promised some more pictures of Tyler, so here you go. I've added one shot of Tina holding Tyler after his nasal tubes had been removed, and one of me holding him as well. Enjoy!
January 27, 2011 -- 9:30pm
Like most folks in the DC area, we spent most of yesterday afternoon and evening in the car, trying to find a way home. We had it better than some, thanks to 4 wheel drive and a very creative route through Montgomery county, but it still took us over 5½ hours to get home from the hospital.
Today started with a lot of shoveling, and thankfully, a lot of snow blowing as well. From there, we went to my parents' house to pick up Curtis and Kyle. They had been there since last Friday when Tina's contractions started so close together, and I think my parents had just about as much as they could take. So we picked them up and took them to the hospital with us today. On our drive, we received word from the hospital that Tyler was ready to be discharged. So what we thought would be a quick trip to the hospital before going home with our two older children turned into a full family ride home.
Tyler is doing great. He's taking his feeds orally. He's alert when he should be, sleeps a bunch too. He soils diapers and screams when he's hungry -- everything a healthy newborn should be doing. I guess we'll see how the night goes. If all goes well, there will only be one more entry in this blog post -- one to add some new pictures. I know I promised new ones yesterday, but the last 30 hours have been pretty crazy. Hopefully I can catch up a bit tomorrow.
January 26, 2011 -- 1:30pm
Well, Tyler performed a bit of medical care on himself this morning and removed his NG tube. It makes me cringe to think about it, but no big deal. Tyler is doing well taking his feeds orally now, and he doesn't really need the tube any more. He took a small feed for breakfast, only about 10cc, but then took 35cc for lunch. His next feeding should happen around 2:30. We'll see how he does with that one.
His discharge still isn't imminent, but he could be coming home this weekend if all continues to go well. No pictures right now, but I may have another one later this evening.
January 25, 2011 -- 9:45pm
We achieved several milestones today. Tina was discharged from Montgomery General this morning and made her first trip to the Georgetown NICU today. Tyler was breathing well enough that the doctors decided to remove the nasal canula, and even let him take food by mouth this afternoon. His heart rate and oxygenation levels looked real good -- an indication I believe that the ductus is closed, and that all of his blood is now flowing from his heart to his lungs for oxygenation. He still has bouts of fast breathing, and he's still using his belly and chest a bit to inflate his lungs, but he also goes through periods where his breathing is relaxed and moderated. So it seems the tachypnea is subsiding as well.
Tina had the opportunity to hold Tyler for the first time today. She also fed him his from a bottle during our visit. And he did remarkably well for his second oral feeding ever. He took about 1/2oz of milk in less than five minutes, with no aspiration or spit up, and probably would have taken more if he had been allowed to do so. And while he was in Mama's arms, the nurses replaced his warming bed with a more traditional neonatal bassinet. When we left him this afternoon, he was resting comfortably in his new bed, and he was wearing clothes for the first time -- a little blue Sleep & Play with footballs on it.
We don't yet know when Tyler will be ready for discharge, but he's looking a lot more like a regular newborn than he was a couple of days ago. Hopefully it won't be long.
(By the way, there are a few pictures along the right-hand column now. Click on a picture to view the full-size version.)
January 24, 2011 -- 7:45pm
So I got to spend a few more minutes with Tyler after my last posting. Interesting in that the hour or so that I was away, his condition seemed to visibly improve. He looked a little stronger and a lot more relaxed (or at least less stressed) when I returned for my afternoon visit. He fussed for a few minutes, then settled in with his pacifier. He was barely fazed by his 4pm blood draw and tolerated a very clumsy diaper change by his dad (in my defense, try changing a diaper on a 7lb infant connected to a breathing tube, an NG tube, and at least four electrodes).
Not that he was lethargic -- to the contrary, he was quite alert -- but rather generally content. Then came his mid-afternoon snack: another dose of Mama's milk. As his belly filled up, the proverbial lights went out. It was nap time. I snapped the picture below before I left. (There's a full-sized version here.)
Incidentally, the neonatologist mentioned to me that children with symptoms like Tyler's tend to bottom out at around 48 hours, then show steady improvement. That's pretty much what I observed. From last night to today, and even for the few hours I spent with him today, Tyler showed noticeable progress. So assuming he's over the hump, two things remain. First, he needs to breathe on his own at a "normal" rate. Once he can do that, he needs to show he can feed by mouth -- sucking and swallowing without aspirating his meals. When he can do that, he gets to come home.
January 24, 2011 -- 2:47pm
I figure this may be the best way to keep everyone up to date. Sorry, no pictures right now -- I'm writing from the Georgetown University Hospital NICU Lounge...
Tyler looks better today than he did yesterday. His breathing looks stronger. Though he's still using his chest muscles to breathe, he seems to be taking deeper breaths, and he certainly needs fewer to keep himself well oxygenated. He's also looking more alert. I got to hold him for about an hour this afternoon, and he spent the first 30 minutes awake with eyes open, just looking all around. After that, he settled in for a nice nap.
The doctors and nurses told me that the "murmur" from the ductus has disappeared, an indication that the ductus is closing or completely closed. He's wheezing a bit, but his lungs sound like they've cleared up nicely. At this point he probably just needs some more practice breathing on his own before the doctor can remove the nasal canula. The nurses began feeding him through an NG tube (a tube inserted through the nose and routed into the stomach) this afternoon. He got a nice dose of Mama's milk for lunch, and they are going to continue feeding him milk and formula through the tube until his breathing is strong enough to take food by mouth.
He was quite agitated by the his first feeding. Lucky for me, he started screaming right at the start of "quiet hour", so they let me hold him to settle him down. He wasn't in my arms for two minutes before I felt his belly and diaper rumble, and then he settled right down. Breathing may still be a bit of a challenge, but he's got no issues with peeing, pooping, or passing gas.
I'm going to spend a little more time with him today, then it's back to MGH to take care of Mama. She gets discharged tomorrow, and then she can visit Tyler at Georgetown too.
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