James update - Ten days old

Thursday, July 24: Today marks what would have been 33 weeks in my belly. I'm still getting the emails about what size fruit he would be (durian fruit) so I should probably unsubscribe from those soon.

The update from the nurse practitioner today was great. To quote, "respiratory wise he's doing spectacular." Any use of the word spectacular is pretty great in my mind. He's now totally breathing on his own with the vapotherm machine having been removed on Tuesday morning. This was just giving him some added pressure to help keep his lungs open, otherwise he was breathing room air and had been since last Tuesday. Two big thumbs up!

He was having some episodes of bradycardia (slowed heart rate) and was started on a caffeine drip on Monday (I think, the days blur together..). The theory is that the caffeine helps 'wake him up' and keeps his heart rate up. I call it his Java drip. Good news is that it worked! I haven't heard much from the nurses regarding any drops or increases in his heart rate so we're pleased there.

We got some kind of scary news on Monday regarding his heart. The staff had found a heart murmur early on and we were kept in the loop on it on a daily basis; they thought it was something common and related to being a preemie that would likely close on its own as he grows. However, an echocardiogram on Monday revealed something different. They found a small hole in the area dividing his heart into the two ventricles called VSD or ventricular septal defect. They told us his hole is quite small and that they are not very concerned as this is a common congenital defect that may require a rather routine surgery, likely when he is a toddler, to repair if symptoms appear. He doesn't show any of the symptoms right now and is otherwise doing very well so it's just something to monitor and follow up with as he grows. We were reassured that he may very well just live with the defect throughout his life and be symptom free as many people do who have VSD. Fingers crossed, just scary to here that there is anything wrong with your baby, let alone in his heart.

He still has a PICC line (kind of like a semi-permanent IV access point) in his head as they had difficulty putting it in his arm where they are normally placed. This is where he receives TPN and lipids which serve as added nutrition for the time being or until tonight at 6 pm when they will stop them altogether as he's now getting enough breastmilk. This is through his NG tube (nasogastric tube) which runs through his nose to his tummy and hopefully within the next few days or week at the latest we can actually try feeding him 'normally' through the bottle or via momma. I was told today that I can let him wander towards my breast and he can suck if he wants while holding him which is exciting news and feels like a big step forward. Babies don't normally develop the coordination required for feeding until about 34 weeks so we don't expect too much from him as sucking, swallowing and breathing all at the same time is hard work for a little dude. We're also told that this is the reason that some babies stay in the NICU so long: they've met all their other milestones but can't quite get the coordination down and get as much milk in as they need. So fingers crossed he does well!

James' weight has topped his birth weight of 3 lbs 10.2 oz as he is now 3 lbs 10.8 oz! He dipped down to 3 lbs 4 oz at his lowest but has steadily been gaining which is great to see! We've got a growing boy on our hands. They expect about an ounce a day on average and the minimum weight to go home is 4 lbs. 

In the meantime we're just doing kangaroo care as much as possible for bonding and good tummy time on our chests. Kangaroo care is where we take turns holding him in just his diaper while we are bare chested so there's lots of skin to skin contact. He can hear our heartbeats, smell us and just have some good quality connection time.

We're working on diaper changes and experienced one blow out that almost hit momma. Aunt Caitlin, Marcus and I had a good laugh while Daddy just looked on in horror at the mess in his isolette. I didn't know babies could poop with such a force! James also did a fountain pee onto his own face and Grandma's hand giving mom a good laugh. Good times and I'm sure there are lots more of these incidents to come.

Following pictures are from yesterday, July 23. 

The following are from July 20-22:

Grandma was lucky enough to be the first to person to hold James other than Mom and Dad. She was in the right place at the right time (I had to get up and go pee) so he got passed off to her and snuggled right up.

Big stretch during nursing cares

Thanks for checking in!