Showing posts from October, 2021

10/31 NICU Day 69

Happy Halloween from Olivia and her patients!  We had a fun time getting dressed up and having a candy bowl out for the staff. Of course it was filled with candy bar minis and sour patch kids…! Olivia   was all decked out with her surgical cap, badge (RN-registered nugget😆), and stethoscope.  Our little nugget may not grow up to be a nurse, but we thought this was a great way to show our (and her) appreciation to all our nurses!  Olivia did have some difficulty today with lots of desat events/episodes. Mostly associated with feeding and reflux. The doctor assured that lots of preemies do have these events and may need oxygen during feeds until they learn to eat, breath, swallow. It’s a lot for preemies .  She will have speech therapy tomorrow who will help her with the swallowing process.  We will see what happens tomorrow! For today she was able to continue to stay off the oxygen. We will continue breast feeding and practice bottle feedings tomorrow as well. Overall very excited and

10/30 NICU Day 68

  No updates for Olivia today. She had a really good day today. While I was out attending a family event, Olivia even enjoyed reading hour with one of her nurses. It seems like she is already planning her first adventure!  Praying for a good night tonight and then planning on lots of fun tomorrow. We have Olivia’s costume washed and ready to go and have our ‘trick or treat’ table for the nurses and care team. Never thought NICU would be fun, but really thankful the staff adds fun and lightheartedness to the journey. 

10/29 NICU Day 67

  After yesterday evening’s phone call, I was anxious to get in to see Olivia first thing this morning. I was relieved and thankful to find that not only did her temperature remain stable, but she remained stable all night-still on room air.  Because Olivia is not having her temperature regulated by the isolette, I am able to get her out and hold her more often. Pretty sure I held her 8+ hours total. Also, because of her weight and not needing the temperature control…Olivia moves to a big girl crib!  Olivia has been able to practice breast feeding and hopefully will continue with that/taking a bottle. We were told today that is the next big hurdle. Some babies have a hard time with feedings and eating enough to keep gaining weight. So far, with how she has been cueing, I am hopefully she won’t have too much of an issue.  Kevin was able to give Olivia her bath today :) which of course she loved. I can not get over how much she already loves her dad! It’s so sweet. Just continuing to tak

10/28 NICU Day 66

  Olivia’s eye exam yesterday went well. She is progressing into zone 2…which basically means the blood vessels are becoming more mature. She has another exam next week so we are continuing to pray for good results. The reason for the eye exams are to look for retinopathy. One of the risk factors for retinopathy (which can cause blindness) is increased oxygen. So, it is a blessing that she has been off oxygen since yesterday! She is also very proud of herself…and so happy to have one less thing in her tiny nose! Olivia has continued to do amazingly without the extra oxygen. She has not had any events/episodes and has been breathing comfortably-even continuing to tolerate long kangaroo times (I cuddled with her for a little over three hours today in one sitting!). I was in the middle of telling Kevin how great she is doing, and how everyone is still so amazed how well she is doing when I got a phone call from WakeMed. Apparently around her 6pm care time she had spiked a temperature of 1

10/27 NICU Day 65

I waited to write my blog until this morning because I was hoping to have more cute bath pictures! Last night was bath night so I st ayed late at the hospital to be there for that. But just like the other day…it was so fun I forgot to take pictures (and Kevin wasn’t there to serve as my photographer!). Yesterday’s big news was that Olivia practiced breast feeding. I didn’t want to write my whole blo g around that since…my brother reads this. So! Those are my excuses for waiting until today.  More ‘small changes’ for Olivia…but to me they are huge! Olivia is having another room air trial. Yesterday she almost never had the nasal prongs in her nose…this is her right before bed (after her bath).  So this morning right after rounds I was able to take everything off :)  She still needs to have her eye exam this morning but I plan to spend the day snuggling her afterward. Such a blessing that I have this time.  Not only to watch her progress, but to have time to comfort, soothe, and be apart

10/25 NICU Day 63

Not many changes to Olivia’s plan of care today. We’ve learned that she doesn’t like a lot of changes at one time. Her one big change was that her oxygen was turned down to 0.5 liters! She did great all day. If she continues doing well overnight, she may have another room air trial tomorrow.  Olivia also gained some weight back today after her doses of lasix. She’s back up to 3 lbs 8 oz! Hopefully she will avoid any hiccups that will hinder her from gaining weight appropriately!  Olivia’s next eye exam is Wednesday. She continues to be so alert-and has such big bright eyes :) I’m anxious to hear what this weeks results will show.  Feeling very thankful today for so many things…Obviously one of them being Olivia. I was reminded today of how greatly we have been blessed and how much God has done. Kevin and I have started praying over the other NICU babies and families. We have been blessed with a huge family and community of believers. We’ve felt God’s presence-His comfort, peace, and st

10/24 NICU Day 62

  We are so happy to report all of Olivia’s labs came back perfect! I’ll spare all the details and medical jargon…but the doctor was very pleased.  The only change for little girl today was condensing her feeds to run over 90 minutes instead of two hours. They are hoping she tolerates this as it’s one step closer to a more normal feeding schedule.  Also, the dips in her oxygen seem to happen around when her feeds are running. The doctor was not concerned and feels she still grow out of the reflux stage eventually. In some ways it is reassuring that the oxygen drops are not thought to be related to low blood levels or the fact she is dependent on the oxygen.  Lastly, she is holding her temperature well. Once she hits 1600 grams she should be able to be in an open isolette  (it’s the type of bed she’s in…for now it’s like a little box). Very exciting! Means she’s growing and just a little closer to discharge day. We are so proud of Olivia and so thankful for how well she is doing! We jus

10/23 NICU Day 61

No changes to Olivia’s plan of care today. She did lose some weight which is attributed to the lasix medication. Her rate of breathing seems to be improved-she isn’t breathing so quickly. However she did have some dips in her oxygen today again. The nurse felt that it could be related to her blood levels. She advocated for some additional labs to be drawn tomorrow morning. We will see…Olivia may need another blood transfusion. Her dips in oxygen could also be related to her feeds increasing in frequency. She does still have some issues with reflux. For now it’s a waiting game to see what may be the cause. She is still a premature baby-which I forget sometimes.  Her and I shared long snuggles today while Kevin finished working on our home remodel. We (Olivia and I) FaceTimed with dad…she seemed very confused by the concept. She can definitely tell the difference between voices and knows Kevin’s voice! She was so happy hearing him. This picture is from yesterday-Kevin picked out her outf

10/22 NICU Day 60

  Today was spa day! Kevin and I got to give Olivia her first tub bath. It was honestly so much fun. And I think our little nugget would agree.    Ha! I just love her facial expression.  As far as her plan of care…her care times were increased to every three hours vs every four. This means she is being fed more often. So far she is tolerating it well!  Olivia did have a lot more dips in her sats today and some edema noted on her assessment. Because of this, she was given a diuretic (lasix) to help relieve her body of extra fluid. The doctor feels this will help her breathing. Both the doctor and NP explained that the need for diuretics is common for preemies at some point during their stay. We are hoping that she won’t require extra oxygen and will still be able to be weaned off soon. It was somewhat disheartening seeing her have difficulty keeping her oxygenation levels up. But she is moving in the right direction. We were warned lots of small changes to her care plan would take place

10/21 NICU Day 59

  Thank goodness for another uneventful day! I’ve been praying that over the next several weeks we have uneventful days so that Olivia can continue to grow.  The only change today was weaning the oxygen. She is now on 1 L of oxygen through her nasal cannula. She didn’t have any events today and is continuing to tolerate her condensed feeding schedule. Hopefully that will be further condensed tomorrow. If she tolerates that, she will be moving to oral feeding very soon.  With Olivia doing so well, I allowed myself a long afternoon break from the hospital to celebrate with my coworkers, (ha!-ironically at another hospital). My manager, who we all love, is moving to another position so everyone got together to throw her a going away party. It was so much fun to see my work family again. Feels like it’s been forever. It was also nice to be gone from Olivia’s hospital for awhile and not feel stressed or anxious about not being at her side.  She has been doing great with all the small change

10/20 NICU Day 58

  Yawn!  Super boring day today! Olivia had her eye exam. It was very routine. Although she has some premature blood vessels and some minor abnormalities-the doctor and NP say this is normal. She will have another eye exam next week just to continue close follow up. So we will continue to pray her eyes develop without any abnormalities as she grows closer to her due date.  Her feeds were condensed to run over two hours and were increased. She has having to learn how to manage a full belly and breathing. So far she is doing really well. No dips in her oxygen and no reflux!  We are just being thankful for a boring day. A nurse today reminded me of how far we have come from when Olivia was just a little over 24 weeks (gestation) old. It’s amazing! I love looking back and being reminded of our journey. So so thankful. ❤️ Praying that Olivia continues to grow. That her lungs, heart, eyes…all develop appropriately. Still praying that she will be able to come off the oxygen soon. Thankful tha

10/19 NICU Day 57

  Minor set back today. Early this morning Olivia became tachypneic (she was breathing very quickly) and required a nasal cannula with 2L oxygen. I was warned yesterday that sometimes babies don’t tolerate their first room air challenge so even though I am sad, it wasn’t a huge shock. The doctor today during rounds reassured that he wasn’t concerned, that this is normal, and that it was great Olivia lasted as long as she did breathing completely on her own. She’s still considered on the early side for doing room air trials (I suppose it’s usually closer to 34 weeks). Hopefully slowly weaning the oxygen demand through the week and trying again this weekend.  Olivia did gain weight which is wonderful. She’s up to 3 lbs 5 ounces! Little nugget is also tolerating her feedings. She is starting ‘cues’ that she may be ready for food by mouth so hopefully we will get to start working on that soon. Then maybe she will stop trying to eat her fingers!! She also got a great report from OT (occupat

10/18 NICU Day 56

 The doctor rounded very early this morning and I missed rounds. So I was shocked when this is what I walked into this morning… Notice no breathing tubes, nasal cannula, or CPAP?! I could not believe it.  During rounds the doctor decided that we should do a room air trial with Olivia. The NP and nurse explained to me at bedside that this was a good time to trial since she hasn’t had events and has not required oxygen for quite some time. They warned me that sometimes a trial fails and that babies may need to go back on the RAM cannula, CPAP, or may need to go on a regular nasal cannula for some additional help. So far Olivia has been off of everything since 1130am (it’s now 830pm) and she has done kangarooing and care times not requiring oxygen and has not had any events.  The doctor also decided that since her murmur is so much quieter they will hold off on an ECHO. He came and spoke with me and after discussing I agreed. It made sense to not do the ECHO because if she has symptoms th

10/17 NICU Day 55

Well…most of my post from yesterday apparently was wrong. I was mistaken and misunderstood. Olivia has her eye exam 10/20 so on Wednesday. Her ECHO will be Tuesday. I think some of that is not knowing what date or day it is! They all just run together right now. So today Olivia did well. She did lose weight and was slow to gain weight the last few days. Some of that may have been because she wasn’t being fed last week and just reached full feeds yesterday. Tomorrow nutrition will be involved in rounds so that the team can work on a plan to help get her growth velocity back on track.  There was a moment I was worried while holding her. Her oxygen saturation kept dropping. I couldn’t help it I just started to cry. I was so frustrated after her having such a good last few days. I don’t want any set backs. Fortunately the nurse noticed after several dips, that it was the oxygen probe acting up. Once changed everything was back to normal. I felt relieved but also felt dramatic. I think that

10/16 NICU Day 54

  Super short post! Yay!  Another good day for Olivia. No changes. She’s doing really well with her feeds, well with the RAM cannula, no events, and her murmur is still very quiet. The nurse today said she has been very alert. It’s almost like she doesn’t want to miss out on anything. The longest she actually slept was while I held her this afternoon. She has another eye exam on Monday so I am hoping her eyes continue to develop appropriately so she can visually take in everything around her.  We are happy with a nice boring weekend because Monday will be busy! Besides her eye exam, we will also find out how her PDA has progressed. Hopefully it has closed or at least is significantly smaller and won’t require surgery.  Continuing to pray for a nice boring weekend. Praying that Olivia stays stable and that she grows healthy and strong. We are so thankful for how well she has done :) 

10/15 NICU Day 53

32 weeks! Getting closer and closer to her due date which means closer and closer to Olivia coming home! They say her due date is an estimate for her discharge date. Being that she was born at 24 weeks…we are halfway there today.  Olivia had a good report today. No changes other than increasing her feeds to full feed. Her murmur is still difficult to hear which is just amazing. No events. Hasn’t required an increase in FiO2. I can’t contain my joy and thankfulness. I sat with her basically the whole day today. She has really enjoyed snuggling without the bulky CPAP (and without the bulky bow!) It’ll be fun when I can bring in some of her bows from home. And I do love being able to see her face. She’s very expressive.  It’s been easy to be thankful during this time and easy to forget we still need to lean on God. We continue to pray for Olivia’s health but specifically her heart and lungs. Praying that she tolerates her feeds and grows. Thanking God that we can snuggling her and that

10/14 NICU Day 52

So many changes today! Olivia was switched to a RAM cannula. It’s a nasal cannula that still has some CPAP settings. She has still been on 21% FiO2 (room air) and just gets a little extra support to help open her lungs. She definitely seems happier without the big bulky CPAP! Olivia’s feeds have continued without any issues, like high residuals or spitting up. She has not had a ny events either. They are still slowly increasing the amount of milk and adding calories. Also, she’s officially broken the 3 lbs barrier! I was told today if she continues doing well, in the next week or two, we will move to bottle/breast feeding.  Lastly Olivia’s heart murmur continues to be more difficult to hear. I am so thankful. We will see on Monday during the ECHO how much her PDA has changed.  We had some of our favorite nurses today so it was very fun sharing in all the good news with them. Day shift was the one who put Olivia in her huge bow hat. Night shift put her in an outfit. Both had a lot of fu

10/13 NICU Day 51

  Sweet girl did so good today I am really proud of her. She had her first eye exam today which has come back normal for her age. Olivia has continued to remain on bubble CPAP on room air and not having events. Her feeds were restarted (which she was happy about) and so far no spit up or reflux! The doctors are considering down grading her to a special nasal cannula tomorrow called a RAM cannula. I’ll figure out tomorrow exactly what that means…besides being able to see more of her sweet face :)  Most exciting news of the day was that her murmur is already harder to hear. Where as before her murmur was able to be heard over the bubbling of her bubble CPAP and sounded like a washing machine, it’s much quieter and the bubble CPAP has to be silenced to hear it. The doctor was amazed and made the comment “wow okay one dose of Tylenol and already a change.” Obviously we won’t know until Monday via ECHO how much the diameter of the hole has changed, but, this is a promising assessment so far

10/12 NICU Day 50

  50 days. I keep saying I can’t believe things but…wow. It is hard to believe 50 days have passed since Olivia arrived here. (Also hard to believe she’s getting a double chin!!) Today I saw the other side of a family meeting. I have only ever been a part of family meetings as the nurse. We discussed the plan of care and course for Olivia and her PDA.  For now Olivia is on acetaminophen. The Tylenol will  hopefully help to close the hol e. According to the doctor we have about a 20% chance it will close and 40% chance it will shrink. Not great odds, but I do believe in a God who doesn’t work with our odds.  The plan is to trial the medicine route and have another ECHO Monday. The results, and if Olivia is having symptoms the PDA is affecting her will determine the course. I don’t really want to go into treatment options at this point because we aren’t there yet. It was a ton of information for us.  Olivia has remained without events and on room air since Friday. It has been a relief th

10/11 NICU Day 49

So far, there have been no signs of infection for Olivia! If she continues as she has her feeds will be restarted Wednesday. It’s such a blessing. The doctor that was on today shares my confusion as to what was really going on. He, like the weekend doctor, isn’t completely convinced it was pnematosis. He says she would have been much sicker…or sick..if it was. So maybe they caught it early on accident and stopping the feeds resolved everything? Or maybe it wasn’t an infection and just poop? Either way I’m so thankful for the quick thinking on the medical team’s part and thankful for all the prayers!  The doctor did put an order in for another ECHO of Olivia’s heart today. Sometimes the PDAs (hole in the heart) can cause a lot of issues for preemie babies. One issue that PDA’s are linked to is pnematosis. I’m not sure the direct link. Anyway, the ECHO today did show that the PDA is even larger then the last ECHO from about a week ago. It breaks my heart. She isn’t having any obvious com

10/10 NICU Day 48

  Other than being hangry (that’s angry because you’re hungry) Olivia has done really well!  Here she is trying to suck on her fingers :)  The X-rays from today show whatever may have been an infection is resolving. To continue to be safe Olivia’s feeds are on hold until Wednesday. She is getting IV  nutrition, but did lose some weight having not been fed since Friday. So she still hasn’t reached 3 lbs yet but we know she will get there soon!    Olivia hasn’t had any events/episodes since FRIDAY! I know some of that (probably all of it) i s due to not being fed. But this has been amazing. She has been on room air on her bubble CPAP and tolerating hours of kangaroo time. Hopefully when she does restart her tube feedings on Wednesday she has grown a bit more so that she will continue to have no or very limited events. We are continuing to pray that whatever is left of the infection (the doctors still weren’t 100% convinced but whatever it may have been) is completely resolved. Praying

10/9 NICU Day 47

Our little girl is doing good today. Her exam, assessment, and labs all suggest that she does not have an infection. However, the X-ray shows what the radiologist is calling “possible pneumatosis “. The doctor is not convinced. His exact words were “my level of concern for infection is very low” but because of the radiologist they will “remain cautious” and watch her closely for any changes. Because she was placed on fluids she was changed to the intensivist team (the team of doctors she was previously with before being downgraded). I feel like maybe there are other qualifications but according to the nurse today, just being on IV fluids can change your status.  Olivia was very calm today during our visit. She didn’t appear to be in any discomfort or pain. In fact she was all swaddled and happily sucking her pacifier when we arrived early this morning. She didn’t have any events the entire time we were with her and was even back to room air on her bubble CPAP. I know that this is yet a

10/8 NICU Day 46

The last two days have been rough for me. Wednesday afternoon I felt a little under the weather (most likely from stress and severe lack of sleep) and made the decision to skip the hospital yesterday and today. I felt much better yesterday (after allowing myself a much needed sleep in) but was still planning on waiting until tomorrow to see her. In the meantime Kevin has been spending time with Olivia in my absence. Even though I know she’s in good hands it has been hard for me to stay away.  Little Olivia has been doing okay. She has had some more “dips” in her oxygen. The doctors feel her periodic breathing is the contributing factor so have increased her caffeine slightly. Periodic breathing is common in premature babies-hopefully she grows out of it soon. The hardest part about being away from the hospital is not being at the bedside when doctors deliver news. I received a phone call this afternoon that on an ordered X-ray to check her OD (feeding tube) placement, the doctors noti

10/6 NICU Day 44

No changes for Olivia today. Spoke a little more in depth with another doctor and NP today who both continue to feel Olivia is doing great. I continue to struggle with “her oxygen continues to drop, but she’s doing great!” or “the hole in her heart is larger but she’s doing amazing!”. The nurse today explained I need to think in terms of Olivia being 30 weeks gestational age-that YES she is doing amazing considering her preemie status. I keep forgetting that everything she is doing is not what a typical baby of this gestational age would be doing! Changing my perception helps me to better appreciate how well Olivia is growing. I’ve also embraced maternity leave. I spent the entire day today with her, minus a short break I took to go out and enjoy the weather with a short walk. It’s nice to not have time constraints on how long I can kangaroo with her or how long I can spend just being near her in her room.  Olivia has gained more weight. Her growth is right on track now which is amazin

10/5 NICU Day 43

Olivia was just as sweet as could be today. I was able to participate in a couple of her care times. She’s been doing well with maintaining her oxygen status and has not had nearly as many events as she had been. Her growth curve is improving, she’s now 2 lbs 13.2 oz, and the doctor is very pleased.  The results of her ECHO came back yesterday evening after I posted. Going into rounds today I already knew what they were going to say. The PDA (hole in her heart) is larger. For now the plan is to watch and wait (I’m noticing this is a common theme in the NICU) and see if she has any symptoms of the PDA causing issues. Like I said before, she is doing well, and other than hearing a louder murmur during her evaluations, there was no indication for a follow up ECHO.  I asked a ton of questions that we just won’t have answers to yet. But basically, if clinically she starts to show symptoms, like increase oxygen demand or swelling, they will treat her with acetaminophen first to see if that h

10/4 NICU Day 42

  Pretty easy going day for Olivia. We met our new doctor who will be on for the next two weeks. No major changes to her plan of care which is great.  The NP today did mention in rounds that Olivia’s heart murmur sounds ‘more harsh’ on exam. So they ordered another ECHO (ultrasound of her heart). Not sure what it will show but I am hoping the hole in her heart isn’t any larger. It’s not atypical for babies to have a murmur (which is caused by a hole in the heart-the blood flow causes the murmur sound) it usually closes on its own. So we will see what the repeat test shows. As usual I am a little nervous so I’ve been praying for no change or for improvement. I will hear the results tomorrow in rounds so hopefully will have good news for tomorrow.  For me, I was informed I have to start maternity leave today in order to receive the paid benefit from work. It’s bittersweet. I was just getting used to a modified schedule at work, I enjoyed the breaks from this hospital to go work at my hos

10/3 NICU Day 41

I can’t wait until she’s big enough for bows 🥰. Okay, a, short update today!  Olivia’s milk drip was increased to 8ml an hour. According to the doctor, Her growth velocity is improving. Hopefully the trend continues as she is up to 2lbs 10 oz today!  No other updates other than she continues to have a moderate amount of events and has continued to require oxygen. I’ve continued to pray that this improves as she continues to grow and develop. I know it’s normal but it still freaks me out if I’m being honest. I’m trying to leave all my worries and concerns in God’s hands. He’s blessed us so much I shouldn’t have any doubts of His goodness.  Here is some artwork one of the nurse’s posted in Olivia’s room. A giraffe..I like to think it’s a reminder to Olivia to grow-although she won’t get any height from my side of the family. 

10/2 NICU Day 40

  I know!! I missed a post yesterday. I think between getting my flu shot, working, and then spending almost 6 hours with Olivia…I was just so exhausted.  Olivia has jumped up in weight to 2lbs 8 oz. I am so glad! She does continue to have events both yesterday and today. She has had a decrease in events today though, which again, I’m so thrilled. Both today and yesterday I held Olivia for almost four hours (in one sitting!). She was able to tolerate the time out of her incubator without issues. I downloaded a virtual library so we spent a lot of time reading. I’ve upgraded her to some of my favorites when I was younger, including The Bailey School Kids and The Babysitters Club books. It’s been fun being able to spend so much time snuggling…even if it wears me out. Go figure snuggling a baby would make you sleepy and lazy the rest of the day!  The picture I posted is actually from her bath on Friday with one of her many favorite nurses. I just love being able to see her face! Yesterday