Mikaila's Hitting the Bottle Already! I didn't start until I was 10.....

Ok, I am tired. Very tired. Just got back from a trip to Rochester a minute ago that began with my drive west more than 16 hours ago. I almost didn't do a post tonight but I wanted to keep my Ripkenesque (you have to be a baseball fan to get the reference) streak going and there really is news to report. My mind is very mushy so please lower your expectations. This morning Mikaila's feeds were increased to 22 mls. She handled the additional calories without issue. The real news is that Mikaila was bottle fed for the first time with her 2pm feed. Nurse Amy was astounded by both her instincts and her progress. Mikaila was able to take 16 mls from the bottle! Remarkable. She was given the balance through the tube. Amy made everyone that entered the room aware of Mikaila's feat. Of course, I wasn't there to see it. Luckily, Kim had Amy snap a few pictures of this epic event. Enjoy. Quick addition Thursday morning, Mikaila gained 35 grams and now stans at 1140 grams or 2 lbs 8 ounces.

Back on O2 but that's OK

Last night Mikaila had a few more episodes of de-satting so her team put her back on the trickle of oxygen. Again, she is taking the slightest amount possible and it has helped her immensely. Her sats are stable in the high 90's. In short, the supplemental oxygen allows Mikaila to direct her energy toward growth rather than breathing. This focus on growth spearheaded another tremendous growth day. Mikaila added 40 grams to her slight frame and currently stands at 1105 grams or 2 lbs 7 ounces. She is now up almost 500 grams from birth.

We've included a little video of Mikaila taking her binky to school. It's a short clip that was recorded on our camera (not our camcorder) that only caught the tail end of her session. Enjoy.


I'd like to ask everyone to add Mikaila's little friend Maddy to your prayers. Maddy is a former resident of the Albany Med NICU and has progressed very well since her release. She had a little episode and had to spend the day next door in the PICU. Little Maddy looked great when we saw her and will be going home very soon. Mikaila asked me to pass this along.

Productive Day

Mikaila gained another 20 grams today. At present, she stands at 1065 grams or 2 lbs 5 1/2 ounces. Today Mikaila attempted to breast feed for the first time. This was a practice session really but Mikaila displayed outstanding instincts. Breast feeding is great deal of work for her at this point so they limited the session to just 10 or 15 minutes. They will probably wait a few days before they try again. She really needs to direct her calories to growth.

She was taken off of caffeine today. Apparently, she is beyond the point of concern as it relates to apneas. She had a little de-satting today but as is her way, she bounced back nicely. She did have a slight episode during breast feeding and required a little blow by oxygen but had no problems after that. They will be adding iron tomorrow to her supplementation regimen.

That's about it. All told it was a productive day for our little peanut.

Very Strong Day

Mikaila had a very good day today. Early this morning, her team decided to try her on room air again. She had been satting in the high 90's so their decision was completely supported by her parents. She has performed like a star today. Her satts have consistently stood in the mid to high 90's. Initially, they left the canula in during the test. After a few successful hours, they decided to take the canula out completely. This is a very good sign related to her BPD.

She was weighed prior to her 8pm feed. She is up another 35 grams to 1045 grams or slightly under 2 lbs 5 ounces.

Kim will be attaching pictures any second now (that's her job in this process.) Enjoy.

Very Quick Update

As expected, Mikaila bounced back nicely gaining 30 grams yesterday. She now stands at 1010 grams. Note to the Milestone Crew and you know who you are, she has already passed this threshold and you have rewarded her appropriately with gifts; no need to celebrate this again.

She had a very strong night; no aspirates, apneas or de-satting. They will likely try her on room air again today.

Quick Update

Mikaila’s feeds were bumped up to 21 mls every 3 hours. I will save you the math to avoid condemnation from my friends in teaching (apparently I’m a much better practitioner than I am a teacher) but I will say that she is up to roughly 150 calories per day. They started her at 8 calories/day a scant 33 days ago. She had no problem fully absorbing her additional calories. I failed to mention yesterday that her team added a multivitamin to her daily regimen to help her to better absorb the calcium and phosphorous.

We don’t have any news to report on her BPD. It appears that they will hold off x-raying her again if they can to minimize her exposure to radiation. They will instead monitor her vitals to ascertain her bronchial status. She had a strong day respiratory-wise. We spent 2 ½ hours with her today and she consistently satted in the 99-100% range. Her heart rate was back to it’s typical 158-162 bpm. She is still on the slightest amount of oxygen. From our perspective, she really doesn’t need it.

I kangaroo’d her today for 90 minutes. Other than requiring a bit of suction to eliminate a little congestion in her nose (she can’t blow her nose on her own), she had a very comfortable session.

They didn’t weigh her at 8 so I will have to update later with her weight. I expect a nice little bounce back

BPD

Today, for the first time in quite a while, Mikaila had an issue that caused us a bit of concern. This morning her team took a chest x-ray to further explore the de-satting issue. When they examined the film they noticed that Mikaila had extra fluid in her chest likely indicating a condition known as bronchial pulmonary dysplasia. Essentially, BPD is an abnormality in the lungs caused by the ventilators, sipap and canulas that are designed to serve her. Her attending sees Mikaila’s case as being very mild and expects she will bounce back after a course of diuretic. The diuretic should help to rid her lungs of the excess fluid. Only through growth will Mikaila actually correct the underlying issue. She was given the diuretic today and as you might expect, she gave back the gains she made yesterday. She is back down to 980 grams.

Independent of her need for a diuretic, her team, during rounds decided to bump up the calories. As of this morning she is on the 27 calorie blend. Once she has passed the BPD, she should resume her tremendous growth spurt. She had no problems today with aspirates.

One last thought on the BPD. More than half of low weight preemies experience some form of respiratory issues. Fortunately, Mikaila’s issue is considered mild and shouldn’t cause any issues down the road.

That's it for tonight.