Day 33 - Smooth Recovery

Monday, February 1, 2021

Morning: James is having a great start to his day. “Any day without bad news is a great day!” According to the doctor taking care of James right now ... and I agree!  This roller coaster ride of ups and downs has been an emotional ride (to say the least) and a little plateau is a chance to catch a breath.  This doctor is truly doing a great job with James, and has great bedside manner with mom and dad. She sits down when she speaks with us and expresses true empathy. This approach has been refreshing and unique.  She will be ending her care with James on Wednesday, but she will return to him the following Thursday. She will be our first repeat doctor. 

There’s 11 doctors in the rotation and she was our 5th. We will get a new doctor this week, being our 6th, and then return back to who we have now. We feel comfortable with her approach, so it’s slightly refreshing. What we also like is how all 11 doctors communicate regularly about every baby in the NICU.  Their systems and structure is an excellent approach to providing care to the parents and the babies. 

A few updates on James:  His FIO2 has been between 44-48% which is a steady improvement. His pressure is at 18.4-18.6. His amplitude is at 23.  I asked about the pressure being higher than a few days ago and the reason is this is the level that’s needed for now to open his lungs. The adjustments take place according to what James needs. (I approve this response 👍) 

James is getting full feed of 26 calories and 18 ML and will be raised to 19 ML later on today. James has and ECHO done this morning and we should have those results tomorrow morning in our update. His blood levels look good. His blood gas looks good. His bowel movement is good. There’s still a possible chance at another blood transfusion in a few days, but we will see. James officially weighed in last night at 1000g (1 kg, 2 lbs 3 ounces) which is an exciting benchmark and milestone!  This is one of the few that he must be at for his first skin-to-skin with mom. We still have a little ways to go to reach the other milestones, but progress is worth the celebration!  😁 

A few other side notes:  Due to being born 3.5 months premature, there’s certain developments that happen in the womb during the third trimester that needs to be replicated as close as possible for James. The two that the doctor spoke of today were his bone development and eye development. 

For bones, the placenta provides the perfect balance of calcium, vitamin D, and phosphorus for the bones to develop and strengthen. By not getting these, the bones become under mineralized. This is this case for nearly 100% of premature births. This creates nutritional rickets causing the bones to be more soft. To offset this, they will add and monitor the balance of Vitamin D, Calcium, and Phosphorus for James.  A test result on these levels will be back in a few days.  The doctor assured that this is NOT correlated to any of the previous false assumptions of any skeletal dysplasia. 

For eyes, small amounts of sunlight during the day helps with eye development and James sleep cycle, paired with darkness at nighttime. There’s a little diagram posted by the light switch that shows a flow. There’s a balance between completely mirroring the womb and also helping James get acclimated with the actual environment he’s in. What will help him get better, can also irritate at times. Finding the perfect balance between these two is what the doctors work daily to create. 

Evening: Weigh-in at 1050grams (2lb 4.96 ounces)

Praise the lord!