36 1/7

Well, Emma has had a good couples days. She continues to grow and is awake and active for pretty long periods of time. She continues to do well without her ventilator, however, she seems to have slowed down on the pace she had been making with her lungs. At this point the doctors have not changed Emma's nasal canula flow and it does not appear that they will be taking Emma off her lung meds (lasics, i believe) for a while yet.

Emma did have an eye exam this week, and it went very well. The doctor deemed that Emma has great eyes, and she does not need to see the doctor again for a month. The eye doctor also told the nurses that there was no way that Emma was born at 23 weeks because her eyes are in way too good of shape for a baby born that premature. I was told the nurses told the doctor that he didn't see Emma when she was born, and she was definitely a 23 week baby.

Overall, Emma is doing very well. On average, Emma is eating ~60ml a day via bottle / breast, which is great. Emma consumes 320ml/day at this point, but you have to start somewhere. Emma also seems to be more cognizant of her surroundings and the people around her, as she is interacting more with people and will look around at moving objects or when she hears something new (like someone's voice, or a piece of machinery).

And, now... on to the pictures... as a treat today, we have a comparison of today and ~11 weeks ago...

TODAY

NOT TODAY

TODAY

NOT TODAY

TODAY

NOT TODAY

Mom and Emma...

Again, Mom and Emma... and next, is a video of Emma's first bottle feeding!

Another One Bites the Dust

Ok... after writing the title of this post, I realized that it may appear insensitive or have connotations that I did not intend. Sorry. Believe me that the post title is meant as only a positive thing.

That being said, I can't believe I haven't posted since Tuesday. That being said, I have barely seen Emma since Tuesday because Liz and I took a trip to visit Liz's family and our friends in Omaha. It was great seeing Mark and Sarah (along with Gavin and their new addition Maya Jane) and Tyler and his son Carter (we'll see you next time Nicki!). In addition, some of Liz's mom's friends threw Liz a baby shower this weekend, so that was nice. Unfortunately, it only pushed us further behind in writing thank you notes (I am embarrassed by that fact, and we are working to remedy it... SORRY!).

Well, Emma has had a big week. First, they upped her feeds over the weekend... she is now eating 38ml / 3 hours (up from 34). In addition, she now weighs 2100 grams (4 pounds, 10 oz). Also, we are going to start trying to feed her sans feeding tube this week! It should be an interesting learning experience for Emma, Liz and I.

As I posted on Tuesday, she started Nasal CPAP and Nasal Canula trials last week. They went very well overall. Over the course of the week Emma continued to go for longer periods of time w/out the CPAP, and instead solely on canula. For those of you who are not experts in the medical field, nasal canula is a steady stream of oxygen that is introduced at the end of the nose. not invasive at all.

Well, Emma has surprised us all. Over the weekend she was going for 16-18 hours, and the doctors decided to push her some... and she has now been on nasal canula since 5am on Sunday morning... so, for about 30 hours from the time of this posting. more impressively, the doctors took Emma's ventilator away. there is no turning back now... only nasal canula and room air!

So, Emma has now accomplished two of the three tasks required to go home - maintain her own body temperature, breath on her own (although she still has some work to go on the breathing part... she is currently at a rate of one liter per minute with 45% oxygen... although that equates to ~ 30% oxygen once it gets to Emma's lungs; we'd rather take Emma home w/out oxygen if at all possible). The only task left is maintaining / gaining weight by eating solely via breast / bottle, and as I stated earlier in the post, we are starting that this week. Pending on how quickly Emma picks up eating, she may be home soon. Smart money is she'll be home around or before her due date (March 21).

So, in the spirit of so many different pools, etc, I am encouraging everyone to post their guess for the date in which Emma will come home. There is no prize at this time, aside from me noting in the blog that you guessed correctly. I'll go first, and I'll be aggressive because I want Emma to come home soon... so, I'll guess March 5.

And now, some pictures! My apologies for not having recent pictures... they are all from Wednesday or Thursday last week. I'll get some new ones in the next day or so.

The reason Emma looks so mad here is that she has learned something... when Mom and Dad hold her, everything is good... but, when we put her down, it is time to put the nasal CPAP back in (which she hates... luckily she doesn't have to deal with this anymore).

One Small Step for Emma

First off... I should have changed the title... it should read "One Large Step for Emma"

Well, Emma has had a great couple days. While she continues to hover around the same weight (~ 1900 grams), she is making great strides in other areas. Primarily in her lungs. As I stated before, she extibated herself on Thursday night. While some of her preliminary bloodwork was not real promising, she has turned the corner and is doing very well. So well in fact that Emma's weekend nurses talked the doctors into letting us put Emma on nasal canula a couple times a day when we hold her.

When originally given this permission, it was for a 1/2 hour slot... now we are able to keep her on nasal canula as long as she can handle it. Right now we know that she can handle at least 2 hours, twice a day at a rate of 1 liter per minute of 50% oxygen (the numbers sound high, but don't be concerned... the 50% oxygen is just what is delivered to Emma's nose and is diluted by the time it gets to Emma's lungs). Emma really enjoys the nasal canula at this time.

That being said, Emma HATES the nasal CPAP. I guess something about putting long tubes up her nose isn't pleasant. Go figure I guess. But, she has been doing very well on CPAP also. The doctors have been continually reducing her setpoints (rate of 10 (was 20)). The amazing part is that when you redue the amount of assistance the ventilator provides, one would expect that Emma would require a higher oxygen requirement. But, Emma is suprising us once again - Emma's oxygen requirement continues to drop, and has been as low as 30% (normally now about 32-35%).

Update - Emma spent three hours this morning on nasal canula, and the only reason why the doctor decided to put her back on nasal CPAP was because they wanted to ween her more... so, now Emma no longer has a forced rate breath on her ventilator! She now only has a constant pressure (also known as PEEP) of 6, and other than that, Emma does all the work herself. The doctors said that they will continue to do longer "trials" (yes, they are now trials i guess) on the nasal canula so she can move toward being solely on nasal canula.

Emma also continues to mature - you can tell that when she looks around, she is really looking at things and is acknowledging sounds and shapes (or something along that). I may be just a proud dad bragging about his daughter, but I am really impressed with her maturity at this stage.

I love nasal canula... although sometimes i still cry (inaudibly at this time).

Hi!

Now everyone can see what I look like... the question is, do I look more like mom or dad?

A great family photo!

Emma is now the most senior baby in room #1 (although not in the whole nursery). This picture depicts where the two babies that had been in the nursery longer than Emma. It seems empty without them here anymore, but we are glad that they are both in the process of going home (they are currently in room #2).

And, just for a visual aid, this is where Emma has live the past 11+ weeks. It may not look like much, but it has been great for Emma, Liz and I.

Hope you enjoyed the videos and pictures. More to come as usual.

Blast from the Past

I was looking through my computer today and I stumbled upon some videos from the last time Emma was on CPAP... So, here we go... they really show how much we have come since mid-December.

Bring the Noise

Emma did a good job scaring us tonight. Here's how it began. Nurses say that it is a good experience to see your child turn purple in a controlled environment, I'm not entirely sold. Wait a second, let's go back a bit further.

Emma has had a knack for pulling on her breathing tube. In fact, she often had the "death grip" (or as I have colorfully named it) on the tube. On a different note, Emma is usually very calm, even when we change her diaper and take her temperature. So, it came as a big surprise tonight when Emma was really flustered while Liz was attempting to take her temperature. Actually, it started with some arm flailing, and then Emma's temperature gradually went from pink to grey to purple. Her heart beat dropped and she wasn't breathing much or moving. Luckily the nurses jumped into action (it is actually quite impressive. the NICU / SCN is a very relaxed place overall, but the nurses can really get going when they need to).

Well, what happened was what we were all waiting for - Emma extibated herself (i don't think I could get more words that started with "w" in one sentence). Emma was briefly put on nasal cannula (basically just oxygen) before she was put on nasal CPAP. She has done well with the change so far and she enjoys her new found freedom (she can move her head side to side!). She is also getting used to not having the breathing tube in her mouth, so it has been fun watching her so far.

Tonight was a great night for us. In addition, this means that Emma is that much closer to being able to breath on her own. Also Emma will soon start eating out of a bottle / breast. Great news all around.

Hi Emma... Nice to see your cute face!

Emma looking happy to have no breathing tube!

Hi baby girl!

The irony of this picture does not escape me. Emma finally gets her breathing tube out, and Liz and I are wearing masks due to my cold.

On to the nasal CPAP. The doctors switched Emma to this because they wanted to make sure she succeeded. The fear was that part of her lung may collapse on just oxygen.

Emma looks peaceful here, but it took her a while to calm down after getting the nasal CPAP in. Something about having tubes shoved up her nose made her agitated. Go figure.

Eventually Emma did relax a bit.

Emma is happy to have made this big step. Now for a weekend of relaxation!

Home Sweet Home

Well, nothing beats a good home. While I wouldn't state that where Liz and I live is a great place, it has more than served its purpose. That being said, everyone gets attached to where they live after a while. So, it goes without saying that coming home to something like this is a bit of a suprise.

Fire trucks?

Apparently there was an electrical fire in the wall near one of the entrances. Oddly enough, I saw the maintenance guys working in the wall there earlier today. Coincidence, I think not.

Well, Emma had a big day today also. Her gestational age is now 34 weeks... which was the earliest that we were told that Emma could go home. Needless to say, Emma is not going home today or anytime soon. However, Emma did have a couple things happen in the past couple days.

Yesterday Emma had her eye exam and it went well. The doctor told us that Emma's eyes are progressing really well (we were told she has good eye genes). In fact, the doctor said that if Emma wasn't on the ventilator he wouldn't do anymore check ups. That was about as good as we could ask.

Emma has also had her feedings increased to 33 ml / 3 hours, and she weighs 1890 grams (well over three times her birth weight). In addition, Emma's ventilator settings are currently 20 breaths / minute and a pressure of 19/5. My uneducated guess is that if everything continues to go well, Emma will be on nasal CPAP early next week.

However, Emma's big news came early this morning. As I was holding Emma, the nurses looked as if they were going to change Emma's isolette (something that occurrs every week or so). But, instead, Emma got a crib! Emma has grown enough that she can now maintain her own body temperature! So, Emma has now accomplished one of the three things that Emma must do in order to go home (the others being breathing on her own or with only oxygen assistance and get all of her nourishment from bottle/breast feedings). Emma had a big day and we were very excited for her.

Awake and happy... although still in the isolette.

An artsy picture for those of you who appreciate that sort of thing.

Emma on the scale... also a pose we haven't done in a while the "Emma with Hands on Each End"... I think the last time we took this picture my hands were a bit further apart.

Emma being held and trying to look around...

Liz and Emma

Emma's new home!

Emma's foot and my hand

Emma holding my thumb