We're Not Out of the Woods Yet

Oh boy...you'd think I'd learn, one of these days, to get the "we're out of the woods now" idea out of my head after a good day!  Last night, James was able to feed Joshua 17 mL of milk from a bottle.  He was so alert, and he just guzzled it down...suck, swallow, breathe.  No problem.  That's about half of what he needs in a feed, and it was only his second attempt trying, so we were pretty excited.  In retrospect, I should have waited until he was more awake when I tried yesterday because he was half asleep, so it didn't work as well for me.  After that good feeding episode last night, I was fantasizing about how we might go home soon...

This morning I got to the hospital all excited to feed Joshua again, but I didn't get a chance to feed him.  He was tachypneic (fast respiratory rate, a sign of distress), and he was having to work a lot harder to breathe, showing retractions, using his chest muscles and other "accessory" muscles, to help get the air in, also a sign of distress.  The nurse and I were concerned, so she called the NNP (neonatal nurse practitioner), who came and evaluated Joshua.  Long story short, she ordered two more doses of Lasix, since that helped last time.  Lasix is a diuretic to get rid of extra fluid.  He has some holes in his heart (not alarming for a preemie), and it can't handle pumping that amount of fluid, so it back flows into the lungs. The lungs, underdeveloped due to prematurity, can't handle that extra load, so that's why he had increased work of breathing.  After one dose of Lasix, he looked so much better, as good as he has been over the past few days, so he didn't need to go back to high flow oxygen.  {Side note: I just called in, and the nurse said he's tachypneic with retractions again.  He's due for his next Lasix dose in an hour, so hopefully he'll bounce back quickly after getting that dose like he did this morning.}

I was able to feed him 3 hours later with his next feed, but he was tired again.  He sucked about 6 mL from the bottle and swallowed about 5 of that.  I tried to breast feed him, and he just played, which is to be expected at this stage of the game.

The elevated liver test follow up came back decreased (great!), so they won't need to do a full GI workup, just recheck it in 2 weeks.

He lost weight last night, to under 4 lbs 3 oz.  Tonight he gained a little but still weighs in at 1920 grams, or 4 lbs 2 oz, about the same size as his friend Melia Robertson.

A little ditty about Jeremiah...I get such a kick out of him.  It's so fun to have him talking now.  Yesterday when I left the house, I said, "See you later, alligator!"  Today, as Jeremiah and I were leaving to go for a walk, he looked back at the house and said, "Bye bye, alligator!"  At first I didn't get what he was talking about, and then I remembered he was trying to repeat what I said the day before.  He almost got it right; not bad having only heard it that one time. 

Bye bye, alligators!