Wednesday, September 14, 2011

Continued Steps of Growth

The days are really long, but the weeks are going fast. Last Saturday Harrison turned 6 weeks, 33 gestation. A lot has gone on the past few weeks and all of it good. We've had visits from Erin's mom and Josh's folks. And tomorrow Erin's dad is coming.

Last Friday September 9, Harrison went from the CPAP mask to the High-Flow nasal cannula. It's a regular clear tube that you would see an adult would wear. He has been very stable and comfortable on this. The cannula falls second on the tier of respiratory assistance.

1-Low-flow Cannula - no additional pressure, only mixed O2
2-High-flow Cannula - small amount of pressure with mixed O2
3-CPAP- substantial amount of constant pressure
4-Si-PAP- substantial amount of constant pressure, with pulsating bursts, with mixed O2
5-Ventilator Intubation - tube installed in trachea breathing, completely breathing for patient.

This is the ladder Harrison has climbed. Over the last 3 weeks Harrison has gone to the High flow cannula from the ventilator and has been showing great signs of strength and growth. Prayerfully, he will continue to progress and only need a little mixed O2 as he continues. Today they lowered the pressure by 1/4 the strength to ween him some and continue to encourage him to do more on his own. He will probably be on low flow until he leaves the hospital. It is likely he will need assistance until we descend from altitude.

Another exciting sign of progress is that Harrison has been eating like a champ. One of the nurses told us, generally speaking, a pre-mie usually has digestive issues or respiratory issues and rarely both. If the doctors and nurses could pick they would want a baby to have respiratory because over time the lungs do develop. But if a baby doesn't eat, or can't digest it obviously makes it very difficult to grow, develop and gain weight. So Harrison has needed help breathing but he is getting stronger in this area. We are glad he has a Smith appetite.

Monday Harrison actually nursed with Erin for the first time. It was a trial run and we did it simultaneously while he was being fed through his feeding tube. He goes as long as he can, usually until he falls asleep which is about 10 min. But it was a huge success!! Nurses were so impressed since he is only 33 wks. And they say this is huge milestone, because he may be able to go to a bottle or nurse sooner and consequently gain weight at a quicker rate.

Harrison needs to start producing his own red blood cells. Last week, his hematocrit was 27. Just on the edge of being normal. So they didn't transfuse him or give him any epogen shots. They want to see if he can do it on his own. This week he has not shown any signs of being anemic. Good color, good O2 saturation, and not laboring too hard while breathing.

We haven't had a bad night since the night he went on the ventilator several weeks ago. It's been a steady rate of progress. We just want him to keep gaining weight. Last night, he was 1405 grams or 3lbs 2 oz.

He is doing great and we don't want to get too far ahead of ourselves. We've kind of had 34 weeks in our mind as a goal to reach because doctors feel comfortable delivering a baby early if there are any complications in-utero. So we are almost at that point now. All his vitals, head ultrasounds and blood work has been really good.

Please continue praying:
-Weight gain
-Progress on nursing and bottle feeding.
-Good respiratory development and strength and that there would be no set backs in this area.
-That his hematocrit (red blood cells) would develop on his own.
-Our attitudes and homesickness as we continue on for potentially 6 more weeks.

Josh and Erin

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