As of 11/4/12, Miss Olivia Paige is 3 weeks and 5 days old.
She corrects to 31 3/7 weeks gestational age. We have now spent every day for
the past 26 days in the NICU, most of those days we were there for the vast
majority of the day. Yesterday was Josh’s first day back to work so I spent the
day with the big girls and only spent a little over an hour with Olivia while
Josh watched Ems. I already have the guilty, bad mama feeling because of how
little time I spent there today. Logically I know that she will never know but
I still feel like I am doing her an injustice when I am not there all day. When Emma was in the NICU she was discharged
on day 24. We are now 2 days past that duration with Olivia and fully expect
her to spend another 7-8 weeks in the hospital prior to being discharged home.
All in all I cannot complain about how her progress has been. A few bumps in
the road here and there but she is definitely on the right path. For that I am
truly grateful, and I know her brother is looking out for her.
I have been keeping notes about everything that has been
going on so I wouldn’t forget. As the days are pretty much the same details
tend to blur together. She was born 10/9/12 and immediately placed on nasal IMV
which is a fancy way to ventilate a baby through their nose rather than them
needing to be intubated. I am so happy she never needed intubated, that would
have made things so much harder. She had 2 doses of surfactant on her day of
birth which unfortunately didn’t seem to help her RDS as much as one would have
hoped but she has done well regardless. She is currently still on the nasal IMV
but on such low support she likely does not need it any more but they don’t
want to force her off of it so she can get off all respiratory support as
quickly as possible. She is actually doing very well for a 27 weeker from the
respiratory status. She had a picc line placed and was started on tpn (total
peripheral nutrition) along with tiny breast milk feeds through her OG tube 4
times a day. She was getting 1ml 4 times a day, 4mls… not much but it has been
shown to greatly lower the risk of necrotizing enterocolitis (NEC, one of the
most common complications of extremely low birth weight babies). So far her gut
is doing awesome. Tolerating full feeds through her OG tube and pooping like a
pro (amazing what you get excited about in the NICU, a poop is a wonderful
thing). Her tpn was discontinued on 10/25 because she was doing so well with
her feeds and her PICC was pulled on 10/30. She is currently without any IV
which makes getting her out so much easier. Because she was so early she had an
echocardiogram which showed a pda (patent ductus arteriosus). For those not in
the medical field this is normal in fetuses, it shunts the blood from artery to
artery to avoid the lungs because a fetus is not oxygenating blood by its
lungs, it is preoxygenated by mom. This shunt typically closes within hours or
a couple days after birth in full term babies. Olivia’s was pretty wide open so
they decided to medically close it so we would not have to worry about it
possibly causing problems a few weeks down the road. This was found on 10/15
and she had 3 doses of indomethacin every 8 hrs then was re-echoed. The
indomethacin did it’s job and closed the pda and she was restarted on feeds on
10/17. On 10/23 she had her routine cranial ultrasound that all babies born
before 30-32 weeks gestation get. Unfortunately this did show a small bleed in
her ventricle on the right side. IVH grade 2 because there was a very small
amount outside of the germinal matrix. These bleeds are very common in preemies
and actually somewhat common in full term infants as well, but most babies
aren’t scanned to look for them. Grade 1 and 2 typically have no effect on
outcome of the baby for their development lifelong. Grades 3 and 4 are the ones
you want to be concerned about. Olivia’s bleed is tiny, our NICU attending said
that with the size of hers he believes she will do just as well as she would
have done without it. Something that is there, but should not affect her at
all. I do believe that he is correct and she will not have any change in
outcome because of the bleed but I really felt at that moment that we will
never catch a break with this pregnancy/these babies. She has a repeat ultrasound on Nov 6th
to follow the bleed. So far she has required 2 blood transfusions which I am
told is very normal for extremely low birth weight infants. She was found to
have some desaturations and bradycardia episodes in relation to her feedings so
her feeds were put on a pump so she gets her 24ml of breast milk pumped into
her stomach over 45 minutes. This started on 10/31 and has really improved her
episodes of desaturation. We have had 3 days now of her being almost a perfect
baby in that regard (but don’t tell her or we will jinx it).
So that is where we are in Miss Olivia’s short life. She is
up to 2 lbs 12 oz, 11 oz above birthweight. All in all she is doing very well
and we have had no major setbacks. We
continue to pray for her strength and growth as we never know what could happen
over the next several weeks.
“Before I formed you
in the womb I knew you, before you were born I set you apart.” –Jeremiah 1:5
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