Days 42-46 - March 6-10

Sorry for the long delay in posting.  The past few days have been pretty eventful for both girls.  Let's start with Aubrey first.

Aubrey has taken a few steps backward, and one forward since I last posted.  On Wednesday morning while Andrea and I were getting ready to go down to the hospital, we got a phone call from Kaiser.  Every time we see a 619-528-XXXX number on caller ID, we have a mini panic attack because we know it's the NICU calling us.  They only call us when bad things happen, so we prefer that they don't ever call us.  We thought for sure that something had happened with Paige since she had just been extubated the day before, but the doctor said that they had noticed blood coming out of Aubrey's stomach vent and feeding tubes.  They thought it was due to one of two things.  The first possibility was gastritis, which is basically an irritation of the stomach lining, kind of like an ulcer.  Gastritis isn't really that big of a deal.  The second possibility was necrotizing enterocolitis, which is basically a hole in the intestines.  Necrotizing enterocolitis is very serious and requires emergency surgery.

After doing some X-rays, and based on the fact that Aubrey wasn't showing any signs of distress, her doctor and the pediatric surgeon determined that she had gastritis.  It seemed like Aubrey lost a pretty good amount of blood, so she was given two blood transfusions and two plasma transfusions.  She also got an IV line inserted in both arms, and a PICC line in her left leg.  Her feedings were stopped, and a suction tube was put into her stomach to suck out blood from the gastritis.  Here's a close-up of her face.

The tube in her mouth is the suction tube.  You'll notice it is tinted red due to her stomach bleed.  Poor girl was free of IV lines, and then had 3 all of a sudden.

Gastritis is treated by giving medications that reduce stomach acid production.  Aubrey was given Zantac at first, and has since been switched over to Prilosec.  On Thursday, her bleeding had stopped and the stomach tube was taken out.  The cause of her bleed is unknown.

On Saturday her milk feedings were started again, and as of this posting she is getting 10 mL every 3 hours (down from 24 mL fortified from last post).  Also, both arm IVs have been taken out, but she still has the PICC line in so that she can get IV nutrition until she is at full feedings again.

Aubrey has been breathing really well.  This morning the medical team did a trial to see how she would do without the nasal cannula (in other words, normal breathing like you and I).  She lasted a little over 2 hours, but then her oxygen levels started to decline, so the cannula was put back on.  As of right now, her settings are 1 liter/minute on room air (meaning she is not getting any extra oxygen), which is pretty minimal support.

Paige's turn.

She's been doing well.  Here she is in her first outfit.

That's a preemie shirt(?) and it's huge on her.

I think I forgot to mention in the last post that when she was extubated, she got a steroid called hydrocortisone for 3 days just like her sister did.  Her nasal cannula high flow settings have come down just a little bit from the last post.  Right now she is on 5 liters/minute and 32% oxygen.  I guess progress is progress, though.

Paige is now on full feedings!  She gets 21 mL every 3 hours.  It is half-fortified, meaning it has an extra 10% calories.  Her IV nutrition through her PICC line is still running at a rate just low enough to prevent the PICC line from clotting in case they need it for something in an emergency situation.

On Friday Paige had her second eye exam.  She still has no signs of retinopathy of prematurity (ROP).  We deferred Aubrey's exam because she was having a bad day (I think her PICC line was put in that morning, so she was extremely ticked off).  I watched Paige's eye exam, and that was some pretty gnarly stuff.  The opthamologist uses eye retractors and, well, it basically doesn't look very fun to be examined.  The nurse holding Paige's head still couldn't even watch the examination because it grosses her out.

Andrea and I have both been holding each girl almost every day now.  One day we even did dueling babies -- Andrea was holding Aubrey at the same time that I was holding Paige.  Still not close enough to get a sister-sister photo yet, though.  I scoured through our photos, and apparently Andrea hasn't taken one of me holding Paige yet.

Both girls have been crying a lot lately.  It's kind of cute in a way.

Weight and Height time:

Aubrey:
     Day 1 -   2 lbs 2 oz     14 inches
     Day 8 -   2 lbs 7 oz
     Day 17 - 2 lbs 11 oz
     Day 27 - 3 lbs 1 oz
     Day 36 - 3 lbs 4 oz

     Day 46 - 3 lbs 7 oz     16 inches

Paige:
     Day 1 -   1 lbs 13 oz   14 1/2 inches
     Day 8 -   1 lbs 12 oz
     Day 17 - 2 lbs 2 oz
     Day 27 - 2 lbs 10 oz

     Day 36 - 2 lbs 13 oz

     Day 46 - 3 lbs 5 oz     16 1/2 inches