Week 13 Update - Thursday, August 28, 2008

Justin had his first exam with urology to look at his hernia as well as determine whether or not he has hypospadias. In short this condition deals with the incorrect positioning of the urethra, but in case you're interested I've posted a link to an article about this below. But because he's so small they couldn't confirm for sure but they do believe he does have it so he will need to be seen by them again in November/December. Surgery will be performed on the hernia and hypospadias approximately 6 months after his original due date of September 14th, unless complications arise.
http://www.urologychannel.com/pediatric/hypospadias.shtml

Justin's head ultrasound showed that the grade 1 bleed has resolved itself.

In anticipation of being discharged Justin's oxygen is being weaned. He was switched from a 2 liter flow where he was receiving 21-29% oxygen to a 1/8th liter at 100% oxygen. I can't really explain much else because I don't totally understand it myself but the nurse practitioner said this is a good thing so that's all that matters to me.

Justin's eye exam looked good for 1 week post op. Although the disease is still present the doctor saw a pattern of regression. He will continue to monitor the progress on a weekly basis but he was happy with the results so far.

Justin now weighs 1476 grams (3 lbs 4 oz) and his feedings were increased to 30 ml every 1 1/2 hours. The doctors are very happy with his weight gain. But since he continues to have some residuals they've reduced his caloric intake and are trying to find a good balance between the two. Justin is now nippling 3 times a day and each time I've fed him he's taken all of his bottle. Hopefully it won't be long before he's on full bottle feeds.

Week 12 Update - Thursday, August 21, 2008

Since Justin's doing so well nippling once a day (in addition to his mom's persistence, lol) he is now being nippled twice a day. He's doing pretty well with the 2 bottle feedings and takes most if not all from the bottle.

Justin had surgery on his eyes on Thursday. Unfortunately he was intubated and put back on a ventilator for the surgery. Since he's so little the anesthesia often makes it hard for smaller babies to breathe on their own. But in true Justin form he pulled the tube out only an hour after being brought down from the operating room. Overall he tolerated the surgery pretty well but was a little groggy afterwards and his eyes still seem to be a little irritated. We won't know if the surgery was a success for a few weeks but the doctors will examine his eyes next week.

Justin now weighs 1357 grams (2 lbs 15 oz), only 4 grams shy of 3 lbs. His feedings have been increased to 28 ml every 3 hours.

Requirements for Discharge

Since many people are asking when Justin can come home I thought I'd post the requirements for discharge:

• is gaining weight at a rate of 15-30 grams per day
• is able to maintain his body temperature in an open crib
• has had no significant apneas (stops breathing) or bradycardias (heart rate under 60 beats per minute) for at least five to eight days
• is able to take all of his feedings from a bottle or breast

Since they started adding Polycose (sugar supplement) to his feedings Justin's weight gain has been pretty consistent and ranges from 8 grams to 111 grams.

Justin won't be put in an open crib until he reaches approximately 1,500 grams and is taking all of his feedings from a bottle.

Justin has had a few apneas and bradycardias since they stopped the caffeine treatments but nothing too significant.

Justin is being nippled for two out of his eight feedings but he may not always take the entire bottle. I never really thought about it but it takes a lot of work for a baby to eat, trying to coordinate sucking, breathing and swallowing. So sometimes he's too tired or has been overstimulated from eye exams, physical therapy, etc.

Justin's Nursery

Justin's airplane and helicopter nursery is finally finished and Carl and I are really happy with how it turned out. We decided not to paint his room the traditional nursery/baby colors because we wanted something that could hopefully grow with him. But now Justin's room looks better than the rest of our house so we need to redecorate, lol.

Bath Time

Saturday was my first time giving Justin a bath. It went pretty quickly and it actually took longer preparing for it than actually giving him the bath, but it was still pretty neat. I can't wait until this weekend when Carl and I both get to give him his bath. It's a good thing we get to do this now in the hospital and get some help from the nurses before we bring him home and have to do it on our own.

Week 11 Update - Thursday, August 14, 2008

Justin did pretty well with this weeks physical therapy. He tolerated more of the developmental exercises, showed interest in nippling (feeding from bottle) and they noticed that his sucking reflex is pretty strong so they started nippling him once a day. The first few times didn't go so well but when I fed him today he took 18 of his 23 mL feeding from the bottle.

Justin's eye exam this week showed the beginnings of stage 3 ROP. Last week it was in one eye and was only located along the ridge of his nose but now it's in both eyes and has spread around the eye. It hasn't reached the + stage which requires treatment but they'll examine again early next week as they are concerned at how quickly it's progressing.

Justin's current weight is 1035 grams (2 lbs 4 oz). His feedings were increased to 23 mL every 3 hours. Even though he's reached 1000 grams he will remain on full formula feedings until he's 90 days old (only 13 more days to go). The main reason is that they want him to gain more weight, but also at that age he should be able to better tolerate additional supplements or fortifiers that may need to be added to my milk.

JUSTIN'S FIRST FEEDING

Week 10 Update - Thursday, August 7, 2008

Justin did well with his physical therapy this week. He's showing more interest in his pacifier and is moving his head and legs pretty well. I'm no doctor but it doesn't look like he'll have any developmental delays the way he's moving around. But then again he is his mother's child and I've been told I was a very busy/active baby.

Justin had his 4th eye exam this week which showed stage 2 ROP so he will be monitored more closely from this point on.

Justin's current weight is 910 grams (2 lbs). His feedings were increased to 19.6 ml every 3 hours. At the beginning of the week he was losing weight so he was switched to full formula feedings until he reaches 1,000 grams. At that point the doctor said he can have whatever he wants, lol.