Blood Transfusions = Red Bull for Babies

So last Thursday Samuel received a blood transfusion, which I'm sure I mentioned is very common for babies as early as Sam.  Well, it seems to be doing exactly what it was meant to do, which means it is a kind of "red bull" for babies in that it jump started his development again.  Here are some examples of what it did for Samuel:

• It turned him back to his usual skin tone.  Before the transfusion he was looking kind of pale which translates to red for preemies.  Now he is back to his usual skin tone which definitely looks much healthier!
• It made him a more content baby.  During the days before the transfusion Samuel was getting quite fussy, but you would be too if your body had to work really hard to pump the blood through to get oxygen everywhere!  On Friday he was about the most contented and happy that I've ever seen him.  Yesterday and today he's fussed some, but he always has a reason for the fuss ("I'm hungry," "my diaper's dirty" or "I'm tired of laying like this" for example).  So seeing that our baby is happy makes me happy!
• He's gained some weight.  Our little baby's cheeks are definitely chubbing out and he's slowly becoming a more typical chubby baby.  He was 2# 14oz at the time of the transfusion and last night he weighed in at 3# 3oz.  Way to grow Samuel!
• He's been keeping his stats up much better.  This means we've had much fewer A/B spells.  (Again A-apnea-breaks in breathing; B-bradycardia-drops in heart rate).  In fact he's kept his stats up so well that they decided instead of taking him off of CPAP and putting him on Vapotherm the doctors decided to just take him off of CPAP and put him on nothing!  This means that as of about noon today our son has been doing all of his breathing on his own with no assistance.  Way to go Samuel!

Those are some basic ways Samuel has improved since the transfusion, those aren't all his improvements, but some of them.  Now just because he is not on oxygen support right now does not mean he will not need oxygen support again.  He is doing well, but could definitely use some prayers that he continues to do well and improve without oxygen support.  The normal process of oxygen support starts with a ventilator (which he had for less than the first 24 hours of life), then CPAP (which he's been on ever since, with about a 5 day break on vapotherm), then vapotherm and final a nasal canula.  I guess Samuel decided he need to speed up the process and skip some of those steps!  If he can do it, then why not let him?

I am continually in awe at Samuel's progress.  Never did I imagine we'd have a month old baby already, nor did I imagine after he was born that he would progress this fast!  He is doing great.  All the nurses here love him and keep saying how cute and sweet he is and how much they love working with him.  Now this, of course, could be something they say to most parents, but I still take it as a good thing.  :-)

Sam's Breathing and Emotions

So not a whole lot has happened since I last posted.  On Friday they upped Sam's milk feedings to 25mL from 24mL because of his growth and then yesterday they upped it again to 26mL.  Four more milliliters and he'll be at an ounce!  He's been growing very nicely.

So last Tuesday they moved Samuel off of the CPAP and onto the Vapotherm as I explained in that post. I also mentioned that he had been having more A/B spells again (apnea, bradycardia).  Well, he kept having them, but generally these spells didn't drops his stats much and he practically always pulled himself out of it pretty quickly on his own.  Yesterday he actually had very few spells during the day, so that was great progress!

That is until last night.  Now before I go any farther, I just want to say these things are completely NORMAL in the NICU.  That is to say, nothing to cause alarm about.  Last night his spells were deeper and he struggled getting out of them himself, which was basically him telling us he's not ready for Vapotherm.  Thus he went back to CPAP early this morning.

Some people might think this "setback" should make me emotional and I'm sure it does make some people emotional if it happened to them.  However, please try to look at this from my perspective:

Sam was born at 27 weeks gestation, which means to go full-term, he should have stayed inside of me until about 40 weeks, which is approximately another 13 weeks.  Samuel's now just over 3 weeks old, which means he should still be inside of me for another 10 weeks or so.  Now being inside of me, I should be the one taking care of most of his essential body functions.  He's not supposed to be breathing yet!  But he's been born and now he has to.

Imagine if you moved to a foreign country that speaks a foreign language.  BUT you haven't learned the language yet.  This is going to be a rough transition at first.  Yes, some people will know English and be able to aid you, but it is still difficult.  This is kind of like Sam's situation.  He hasn't been given the full time to prepare for the experience of life out of the womb.

This takes time to adjust to and to allow time for his body to mature.  This is why they say to expect babies to be in the NICU until their due date.  Discharge is not a word we'll hear about Sam for a while yet!

When I process things emotionally I always have to look at the big picture.  Where are we going compared to where we are and how does that process look like?  What is normal?  What's not normal?  For Samuel having A/B spells, taking steps forward then backwards is completely normal.  It is normal for babies in his situation to need a blood transfusion.  It is normal to move him down on oxygen interventions then have to move him back up.  We won't know fully if he's ready until we try!

The staff is also just wonderful.  The doctors, nurses and respiratory therapists are constantly asking if we have questions and they answer any questions we as thoroughly as we ask them to.

Now what does this mean to my emotional state?  It means that I don't worry, I am relaxed and happy.  I don't worry because I know he's being well cared for.  I am relaxed because I am doing what I can and that's all I can do.  I am happy because we have a healthy, happy and active baby boy, who will one day come home.  Which is why I am not falling apart emotionally.

Why?  Because I know that God is giving us strength and the resources needed to deal with Sam's 13 week early arrival.  :-)

Tuesday, Valentine's Day 2012

Yesterday might not have been a very mushy Valentine's Day for Ben and myself, but that's ok!  He had a very busy day at work and we had a somewhat busy day in the NICU.  That is a somewhat GOOD busy day!

So lately Samuel has been protesting the CPAP rather vehemently.  As in any time we had to readjust something on it he would start crying a little and we had to readjust things often!  Why?  Because Samuel wouldn't keep his hands off it!  He would constantly be grabbing the head gear, undoing the straps, pulling on the mask or prongs (I don't know how many times over the weekend and on Monday we would find the prongs were in his mouth and not his nose, not helpful at all in his mouth!).  So we were constantly going into his isolette to get the CPAP functioning again!

Well, to doctors and nurses had been talking about moving him off of the CPAP and onto something called Vapotherm.  Vapotherm is not as high level of oxygen intervention as CPAP, which means they only move babies off of CPAP and onto Vapotherm if it seems like they will be able to handle it.  Considering he's had a lot few A/B spells and when he does he brings his own heart rate and oxygen back up with no help, they decided to give it a go.

Overall he's been doing fine on it.  He has been having more A/B spells again, but most of the time he gets himself out still.  He has needed some extra stimulation a few times.  They are going to keep monitoring this and if they feel he needs stimulation too much, Sam's beloved CPAP will be coming back.  So please pray that his "device of torture" does not have to be replaced!  I call it that because that's what he acts like it is...  A device of torture...

This morning they took an X-Ray to make sure that the Vapotherm is keeping his lungs expanded just right.  Well, it turns out they are slightly under expanded, but the doctor didn't seem too concerned about this.  He wants to keep monitoring his spells and if things are work, back comes the torturous CPAP.

Kangaroo time was a little different yesterday.  He kept lifting his head and moving it down my breast...  We are thinking he smelled the milk, if that is the case, way to make that association!  The other thing that made it interesting is we forgot to put the call button by me...  The nurse and I both forgot.  So I am sitting there kangarooing and by the point we'd been cuddling for about an hour and a half, I started thinking that I need to pump soon, I'm hungry and soon I'll need to make a run for the restroom...

So I texted my husband to ask him how he thought I should get out of this situation.  His ideas were look for the call button and see if I could reach it and/or try to call out verbally and see if they hear me.  Well, I had been looking for the call button, but I finally found it after he texted me back.  Unfortunately it was on the floor and the cord was most definitely out of my reach.  So I tried to say our nurses name out loud to see if she'd hear, the only problem is I didn't want to actually yell, as Sam's ears are still sensitive...  No luck there....

So I texted Ben to call the NICU and tell them I'm ready to put Sam back.  Which he did.  My next step, if he was unwilling to call for me, was to unplug a cord.  I was already quietly debating which cord I could unplug briefly to get the nurses attention, but not cause too much trouble.  When our nurse came in she was extremely apologetic.  I didn't blame her, because I could have easily said something too.  With these little guys there is so much to be thinking about, that at times something like the call button slips your mind.  The important thing was that I had other resources at my fingertips, so if there was a real problem, I could have gotten help.  Our nurse yesterday was very good and I think she did a great job with Sam.  So instead of getting angry about the one slip up, we laughed about it.  :-)

Some notes to leave you with:

• Sam is a strong little boy!  When on his belly he sometimes tries to lift up his body, I like to think he's practicing his push-ups.  He can also lift his head for short periods of time.  Not sure when most babies start lifting their heads, but he's ahead of the game I think!
• Sam does not like people messing with him and definitely does not like diaper changes!  He hasn't realized that bending and stretching his legs CAN help it go faster, but not when he's doing the opposite of what is needed right then...  When wiping his butt, stretching the legs is much more helpful than bending them!  I've had to wipe off his little feet because of that....
• Sam knows when it's time to eat and will let you know that he knows.  He's got a schedule and by golly, he wants to keep to it!  Time to eat, give him food!  Time to change position, move him before he gets completely tangled and himself completely out of alignment!
• Sam detests his food line while goes through his mouth down to his stomach.  I wish our little boy would realize that pulling it out, just means he has to go through that awful process of having it shoved back down his throat again...  He can sure get upset when it is put back in!