Week Nine
Sunday, January 26, 2003
Weight:     3 lbs. 12 oz. (1694 grams)
Feedings:  26 cc of Breast Milk (30 cal)
Bailey had another wonderful day today.
Today I really felt like a dad.  I was in the process of replacing a wet diaper with a new one when bailey decided to poop.  It sprayed so hard that when it hit my hand it splashed on my shirt.  I'm sure this is the first of many times that this will happen.
The respiratory therapist was able to turn Bailey's minimum set breath rate down from 32 to 28.  This is a sign that Bailey's body is learning to breath on its own.  The minimum set breath rate is the lowest number of breaths the vent will allow Bailey to take in one minute.  They also lowered Bailey's pressure settings.
Bailey continues to take care of that gas problem.  While mom was holding her this evening she audibly let it go several times.
I must have fallen asleep while holding my daughter (the second picture).  I don't remember this picture being taken.
Monday, January 27, 2003
Weight:     3 lbs. 14.5 oz. (1772 grams)
Feedings:  29 cc of Breast Milk (30 cal)
Ab. Girth: 29 cm
We heard Bailey cry for the first time tonight.  I never thought I would be so happy to hear a baby cry.  She was very horse so it didn't sound like much.  It sounded almost like a faint wheeze.
The evening started out normal.  When we arrived we were glad to see that her set breath rate had been reduced to 26 and that her vent pressures had been reduced as well.  We gave her a bath and Stacey got to hold her when we were all finished (first picture).  I then held her for a few hours.  When it was time for us to leave we weighed her and put her back in the Isolette.  It was at this time that the respiratory therapist told us that she was going to change the tape on Bailey's breathing tube and asked us if we would like to see her without any tape on her face.  Although it was late, we said yes and watched as they removed her tape.  I, of course, took another picture (picture two). Almost as soon as the tape had been removed Bailey turned her head and extubated herself.  This happened at about 11:20 pm.
As soon as the tube came out they scrambled to get all the equipment needed to "bag" Bailey.  In the mean time, Bailey responded very well.  In fact, once she was bagged (picture three) her saturation stayed in the 90's.  To see if Bailey was ready to move to a nasal CPAP they would remove the mask and see how her vitals looked (picture four).  This was when we heard her cry for the first time.
Because Bailey did so well the doctor decided to try her on nasal CPAP.  CPAP stands for Constant Positive Air Pressure.  Instead of delivering air through a tube down Baileys throat, the nasal CPAP fits over her nose and supplies a constant pressure of oxygen rich air.  This means that Bailey has to initiate all her own breaths but that she will receive help from the constant positive pressure once the breath is initiated.  She only lasted about 10 minutes on the nasal CPAP (picture five).  She was on it from 11:35 pm until 11:45 pm.  Bailey was so upset that she couldn't stop crying (you can see how unhappy she was in picture five).  Also, while Bailey was on the nasal CPAP she kept burping up all the air that was forced into her stomach by the bag.  Bailey's CO2's never stopped rising and she had to be reintubated.  While they reconfigured her vent they attached the bag to the tube and gave her breaths from the bag (picture six).
As soon as she was intubated she calmed right down and laid quietly awake in her bed.  Although the CPAP wasn't a success it did show that Bailey is stronger than we have been giving her credit.   Mom and I left at about 1:30 am.
Tuesday, January 28, 2003
(Click here to go to Father's thoughts)
Weight:     4 lbs. (1825 grams)
Feedings:  30 cc of Breast Milk (30 cal)
Ab. Girth: 28 cm
Bailey has broken the 4 pound mark!!!
The doctor called this morning to inform us that Bailey extubated herself again at about 6:45 am.  She handled it well and was given no Valium.
Bailey's set breath rate was lowered to 25 and her pressure settings were also lowered.  Her x-ray looked so good today that doctor thought he was looking at the wrong x-ray when he was making rounds on Bailey.  They were both clear and well inflated.
I held Bailey for about three hours today, mom held her for about two hours in the evening, and I held for another hour right before we but her to bed in her Isolette for the night.  She had a really good day today!
Wednesday, January 29, 2003
Weight:     3 lbs. 15.5 oz. (1792 grams)
Feedings:  30 cc of Breast Milk (30 cal)
Length:     15 inches
Bailey's set breath rate was lowered again today.  It went from 25 to 20.  It is great to see her body assume more of responsibility for breathing.  Her vent settings were not changed today.
Bailey has been spitting up today.  The nurses weren't exactly sure why, but they were optimistic that it was only a temporary thing. 
The ophthalmologist came by again this evening to check on Bailey.  He said that she was developing some ROP (Retinopathy of Prematurity).  Rather than try to explain what this is, click here to find more information.  If untreated, this condition can cause blindness.  The condition is rated on a scale from stage 1 to stage 5.  One is a mild case and 5 is when the baby is blind due to retina detachment.  They eye is also divided up into three zones that are almost concentric around the optic nerve.  Each zone includes the previous.  In other words, zone one is the area just around the optic nerve.  Zone two is slightly bigger than zone one.  And zone three includes the entire retina.  In Bailey's case she currently has stage 1 ROP in zone 2 of both eyes.  40% of all babies born under 2 pounds develop ROP.  The ophthalmologist will check Bailey every week now instead of every other week.
Thursday, January 30, 2003
Weight:     4 lbs. 1.5 oz. (1855 grams)
Feedings:  30 cc of Breast Milk (30 cal)
Not much to report today.  Bailey had another great day besides the fact that she has had a lot of gas (let's just say she didn't smell very good today).  Her set breath rate was again reduced from 20 to 13 breaths per minute.  In addition, Bailey has finally learned to maintain her body temperature.  Her bed warmer was turned off today and as long as she is covered up she maintains her body temperature beautifully.
Friday, January 31, 2003
Weight:     4 lbs. 1 oz. (1844 grams)
Feedings:  30 cc of Breast Milk (30 cal)
Bailey's trend of good days ended today.  Her set breath rate was raised from 13 to 20 and her oxygen needs have been anywhere between 55% - 65%.  The respiratory therapist tried to wean the vent's CPAP from 7 to 6, but had to turn it back up to a 7 after a short while.  Bailey didn't get much sleep today because of her gas.  They have started giving her Simethicone (Gas-X) to help her get rid of some gas.
I haven't posted any pictures in a while so I though I would include this one.  It is a little blurry because we had to use a low light (slow shutter) setting and Bailey wouldn't stop moving.  I have also included another video that can be seen by clicking here.  Bailey had some hiccups in this video.
Saturday, February 1, 2003
Weight:      4 lbs. 2 oz. (1870 grams)
Feedings:  30 cc of Breast Milk (30 cal)
Bailey is about the same today as yesterday.  The partial pressure of CO2 in Bailey's blood was too high because she wasn't taking enough breaths so they turned her breath rate up to 20 BPM.  In addition, her CPAP went up to 8.  Bailey's oxygen needs have been higher (55 -65%) and her x-rays haven't been looking so good.  To try and combat all of this, Bailey was given deep suction again today.  As you might recall from earlier mention of this procedure, this requires that they remove Bailey's breathing tube, suction her lungs and then intubate with a new tube.  The doctors want to make sure she isn't developing another case of pneumonia so they sent all the mucus they suctioned from Bailey's lungs to be cultured.
On a note good news, we were informed today that all the tests that were taken a few weeks ago for congenital lung disease (such as Cystic Fibrosis) came back negative.  I was a little frustrated to find out that the test results had been back for about a week and no one told us, but I was happy to find out the results were all negative.
On a slightly humorous note, the doctors informed us today that Bailey was going to be short.  My reply was, "Have you seen her parents?  She didn't have much of a chance."  Bailey's head and abdomen measurements are equal to what is expected of her age, but she is in the 5th percentile for her height.  The doctors took x-rays and had them sent to Primary Children's Hospital to get an expert opinion on her height.  The verdict... she's going to be short, but not abnormally short.  Again, my response... Duh!
During the deep suction I took some pictures of Bailey.  She was very upset.  She makes all the expressions of a drying baby but no sound.  The last picture shows Bailey's favorite way to sleep.  She loves to keep one hand right up by her mouth.  We are told that this is a god thing developmentally for her to do.  It has something to do with feeding instincts.  Unfortunately, it also makes it really easy to grab her tubes and pull.