Must....get....out....

Yesterday's escape attempt thwarted -- she made it out of the blanket-pod, but not out of the incubator's closed doors -- today Sara set her mind to disassembling the oxygen-intake equipment in her continuing struggle for freedom and independence.

She's on three different antibiotics until the bacteria found in her bloodstream is identified. In addition, according to yesterday's spinal tap, high white blood cell count in the spinal fluid MAY be evidence of spinal meningitis, though no bacteria was identified there. She's on meds for that condition as well, though civilians remain skeptical that the bacteria entered the spinal column.

One Step Forward...

... half a step back.

Low white blood cell count and tachycardia (very fast heart rate) signal a possible infection, spurring yet another halt in feeding, yet another round of meds, and blood transfusion #4. Diagnostic blood culture comes back Fri pm.

On the bright side, Sara's now 2 lbs 4 oz, and she passed both her eye test and her second head ultrasound (checking for bleeding in the brain). She's joined the 1000-Gram Club!

Baby Aghast at Blago's Hubris

A hitherto proud citizen of the Land of Lincoln, Sara listened to our governor's protestations on this morning's chat shows and, saddened by what she heard, took time out to reflect.

Happy Friday

Off the respirator as of yesterday morning, and on only a minimal amount of oxygen. AND NOT DESATURATING AT ALL, THROUGH MORE THAN 24 HOURS! Ha!

Today was a good day.

Extubated

Sara's now got a breathing tube down her nose, which she hates. If all goes well, she'll switch to a mere nasal cannula tomorrow.

Secondary infection: negative.
Hypothyroidism: positive, started meds.
Lungs: Continued improvement.

And Now We Are Two

2 lbs, 2 oz!! FATTY!

However, too many desaturations, high white blood cell count and ‘poor weight gain’ lead them to believe she might be fighting an infection in her blood. ("In addition to the pneumonia? Maybe she's just fighting the pneumonia," I say. "But we're already treating the pneumonia," they say. What do I know? I studied English and philosophy.) Test results on the blood culture come back tomorrow pm.

Also, possible thyroid issue – might also be related to her fighting off a secondary infection (or, uh, could be nothing). They’re seeking the advice of thyroid expert to check whether/how to follow up.

Baby Finds 'Open' Button for Eyelids

She's desaturating constantly (dip in level of blood oxygenation), but that's to be expected when one's lungs are below par. Doctors are happy with her progress.

:)

Thumbs up on the stomach situation. No NEC! They say that the digestion problem was likely related to the pneumonia. Preemies don't multitask very well.

So far so good, on the lungs.

Pneumonia

Yep. 10 days of meds. Thankyou, respirator.

Tummy trouble

Sara isn't digesting the milk properly, and they think the problem might be necrotizing enterocolitis, a potentially lethal bacterial infection in the intestine. Test results won't come in til tonight, but antibiotics were started yesterday afternoon just in case. Meanwhile, she's got a huge belly and isn't happy.

*sigh*

Rock star!

I know those sound like my words, but they're not... that's what her doctor called her, seeing how she's clearing all the hurdles in such fine style.

Sara's on continuous feeds now, weighing in at 1 lb, 12 oz, and the doctors think she'll be extubated by the end of next week.

She's started a 3-week regimen of nitric oxide (no, not nitrous), designed to prevent the long-term damage to her lungs that could result from spending such a long time on a respirator. Interestingly, it's essentially the same compound as Viagra.. only it stimulates the blood vessels in the lungs as opposed to the... well, you know.

Thankyou!

Thankyou, everyone, for the good wishes. We're lucky to have a crowd like you.

Special shouts out to.....

Drs. JL, SG, and especially the esteemed MS for preventing Sara from being born at 24 weeks,
the lovely and helpful staff at NWM Hospital,
Mom and Dad for unbeatable chauffeur and c-section recovery services,
Auntie M for parking assistance,
Auntie K for pregnancy books,
Lisa for advice and counsel,
Faby for unflagging moral support, and
Eric for plowing the driveway, the walk AND the steps so I can get out!

PDA

Today's echo showed that the ibuprofen was effective, and the hole in the heart has closed... so no surgery needed!

Played 'kangaroo' again today. It's a little jarring, given how incredibly light she is. But she has a mighty grip, so I was able to make a connection that way. :)

In the Pink

On day 8, absent the lines in her belly button (which have been replaced by IVs in her arms), I got to hold her for the first time! They call it 'kangaroo care,' for reasons best known to the medical community. They untangle all the tubes and wires, tape them to the chair, and perch her on mom's chest to keep warm while also beginning to learn to regulate her body temp outside the 91 degree incubator. Just getting her out is a two-nurse production.

Day 10 -- 1 pound, 9 oz.
Echocardiogram showed PDA still present, so started 3 days of ibuprofen (along with Zantac to prime her stomach, since ib. has been known to burn through babies' stomach lining).

Day 11 -- Chromosome test results show that the abnormality was limited to the placenta, and not present in her! Hoorah!

Her anticipated departure is March 9, the original due date (and Chaica's birthday!). But really, it depends on her ability to do 4 things:

Keep herself warm outside the incubator.
Breathe on her own.
Eat on her own.
Weigh at least 4 pounds.

I hope her growth and bloom will echo the weather's progression, in which frozen brittle stasis will give way to tender buds and sweet-smelling air.

Meanwhile, I've been off pain meds for 3 days now and am feeling fine, thankyou.

Arrival

Sara Chaica Smyth H____ arrived at 6pm on December 27 via c-section at the ripe old age of 29 weeks, weighing in at 1 pound, 6 ounces, and 12 inches long. 'Sara' is her great great grandmother (paternal). 'Chaica' is her great grandmother (paternal). 'Smyth' is her great grandmother (maternal).

The early birth was forced by a failing placenta -- full of blood clots, as it turns out, thanks to a chromosomal abnormality -- which prevented her from growing at a normal rate. Daily biophysical profiles (ultrasounds to check her oxygenation, movement, and amnio fluid) started at Thanksgiving in anticipation of early delivery, so although it was not scheduled, it was not unexpected.

The first week was full of awful, albeit typical of preemies, surprises:
* An underdeveloped liver led to high bilirubins and jaundice. 7 days of blue-light therapy, for which she donned chic little cloth sunglasses and bared her butt.
* High levels of procrantin (?) led to worries about kidney function. OK as of day 10.
* PDA (hole in heart) suspected. If it doesn't close on its own, meds and/or surgery will be needed.
* Routine scan for bleeding in the brain is negative.

She was bright red and feisty, blonde and blue-eyed, with well-defined biceps due to an utter lack of fat.