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March 26-April 1



Sunday, March 26, 2000

Today we found out that Andrew does have ASD, which is a congenital heart defect. Congenital heart defects affect 1 in 175 live births. 50% of premature babies have ASD and it is usually resolved within a few months to a year. If after his first year of life Andrew is not better we will have to consult with a cardiologist. For now he will be put on diuretics since one side effect of ASD is fluid retention. Mom and Dad gave him a tub bath tonight. He was so cute he just opened his big eyes and looked around at everyone. Mom finally decided that Andrew needed to be started on bottle feedings. He was loving his binky and not the breast. He did really well on his suck-swallow-breathe. He did spit up some of his feeding, but the nurse told Mom that with preemies sometimes you need to burp them in the middle. It was so great to see him eat like that on his own. We will get to do this twice a day. If he does really well and is continuing to gain weight the times we can bottle feed him will continue to increase until he is only bottle feeding.

Cassie has continued to swing in her oxygen needs. The therapist told us that what she is doing is holding her breath, but that she doesn't have the reserve that we all do when we hold our breaths because her lungs are immature. It is not a sign of lung disease, just immaturity. So, she just needs to grow and she will grow out of the swinging. Cassie also got a bath tonight and loved it! Her PERC line should come out in the next few days when she finishes her antibiotics.

Elena self-extubated his morning and after a vapor treatment still did not look good so she was re-intubated. The neonatologist also heard a murmur on her this morning so tomorrow morning they are going to check her for ASD. Mom held her for a long time this afternoon and she loved it. It calmed her down so much that the nurses let Mom hold her a little longer than usual. Last night she did something really cute while Mom was holding her. They were just staring at each other, but anytime Mom would look away Elena would start to fuss until Mom looked at her again. What a smart girl!!

Monday, March 27, 2000

Andrew: 3 lbs, 7 oz.

Cassie: Not weighed by the time we left.

Elena: 3 lbs, 11 oz.

Andrew's hematocrit was low. He looked really pale. He will get a lab drawn in the morning to see if his body is going to increase the red blood cells on their own. If not, he may get some blood.

Cassie will be put on CPAP if she self-extubates to see if she can do it. She is still the swinging machine with her oxygen needs.

Elena is being given a steroid to help her airway. If she self-extubates, they will try CPAP. If not, they will do a controlled extubation and do CPAP sometime tomorrow.

Tuesday, March 28, 2000

Andrew is doing well on his feedings. The lab looked OK so they are just going to wait and do another hematocrit on Thursday. Andrew has not figured out yet the he is a triplet. If he wakes up in his incubator, he cries until he gets held. It is OK for him to be asleep in there, but not awake. One of his nurses got a baby swing out for him to be in since he cannot be held all of the time. He liked it.

Cassie had less swinging today. She got really hot in her incubator so she got to get a tub bath. She loved it!

Elena was taken off the respirator and put on CPAP. She was doing fine the first few hours and then when she was repositioned her CO2 levels began to climb. They will continue to watch her and may have to re-intubate if she does not improve.

Wednesday, March 29, 2000

Andrew: Not weighed by the time we left.

Cassie: 3 lbs, 10 oz.

Elena: 3 lbs, 14 oz.

Andrew is now getting his feedings by bottle every other time. He is doing a great job. In a few days he will go to 2 out of 3 feedings by bottle and then a few days after that to full bottle feedings. He has to show that he can tolerate the feedings and gain weight. That is why they wait a few days. He was co-bedded with Cassie to see if that would make him less upset when he is awake in his incubator. The first thing he did when he got in bed was spit up 1/3 of his feeding on Cassie. After that he was fine. Cassie was very confused. She had no idea what this thing was in her bed. She then spit up, not on Drew, though. After that, Andrew fell asleep and Cassie laid awake with a confused look on her face. She finally fell asleep too. When Andrew woke up he was ravishingly hungry since he had lost 1/3 of his feeding. He was sucking on his binky like there was no tomorrow. When his binky fell out, he saw Cassie's arm and starting sucking on that. What a fun guy! Needless to say, he was very excited to get his bottle. He had to be paced because he was so hungry he would forget to breathe and his face would turn purple. However, at his next bottle feeding he was not so hungry so he paced himself well. If all goes well, we should have him home in 2 weeks. He just has to be over 4 lbs and every feeding should be by bottle.

Cassie had a fun day with her brother, as stated above. She was doing less swinging for a little bit, but then started up on it. We are told she will grow out of it.

Elena had to be re-intubated early this morning. She was quiet and slept most of the day. Later, she was upset so Mom got to hold her. She likes sucking on a gloved finger. Hopefully she will be a great eater like her brother.

Thursday, March 30, 2000

We are sorry these updates have been late. As always, we are very busy with the babies and with just plain life. We are glad you all take the time to read about these guys.

Andrew could come home at 1800 grams or just around 4 lbs. It could be in twelve days. His murmur was not heard by the doctor today so we hope it is closing. He is doing well on his eating. He may go to 2 out of 3 bottle feedings tomorrow.

Cassie self-extubated today and turned dusky, so she was re-intubated. The occupational therapist worked with her to strengthen her neck muscles in hope of strengthening the trachea.

Elena also self-extubated today and was re-intubated. She also had her neck worked on.

Friday, March 31, 2000

Andrew did go to 2 out of 3 feedings today.

Cassie is doing better on her oxygen needs and is off of her antibiotics.

Elena will be tried off of her respirator on Tuesday. They may try caffeine (like Andrew) to assist her brain in remembering to breathe.

Saturday, April 1, 2000

All of the babies had their eyes checked today for retinopathy of prematurity. ROP occurs since the retina stops developing at birth. At about 6-8 weeks of age the babies have a growth spurt and the retina finishes developing. If the retina does not develop properly, in the most severe cases it can detach. The babies all look really good. Their retinas are 75% developed and chances of them not continuing to develop properly are there, but are slim. This is really good news!

Andrew will go to full feedings tomorrow if he does well on the rest of his feedings.

Cassie had a quiet day with not too many swings.

Elena is doing well.



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(c) Dane Seeley, 2000