Baby Steps

Morgan is continuing to get better. She seems to be taking small steps to improving. She was weened off of all of her blood pressure medications this morning. They also took her catheter out (although the nurse tonight said that has a good chance of returning). They are watching the latter closely because of the fluid on her lungs.

We got the first 24 hour culture back and it was negative for any infections and they will read it again at 48 hours. They still think she has an infection since her CBC test from the other day came back with elevated white blood cells. They are also going to do an ultrasound of her abdomen tomorrow to make sure there isn't an abcess there.

Monday is the last round of the neonatology doctors that are on staff. They rotate every so many weeks since this is a teaching hospital and Tuesday will be a new group. We have yet to have any doctors or nurses that we don't care for and have had many that we are really impressed with. It will be interesting though to see who the new ones are and if their opinions differ.

Here is a picture of Morgan holding tight to her breathing tube. The nurse said that she probably wants to touch her face or put her fingers in her mouth because that is a self-soothing technique for babies.

A little better!

Morgan is doing a little better today. She is continuing on her antibiotics and is down to dopamine and epinephrine for her blood pressure. She is still on the oscillator ventilator along with some morphine to keep her sedated so that the ventilator works better. Her blood sugars are stable again and they didn't have to do an insulin drip. There hasn't been any real big changes but at least she is doing better than yesterday.

Alan (John's brother) and Cara came to visit her today. Despite being sedated, she still managed to open one eye to see her visitors. She already has such good manners.

I used to like roller coasters...

Since Morgan was born we have heard doctors, nurses and other parents all describe having a baby in NICU as "it's like being on a roller coaster". The phrase "two steps forward one step back" is nearly as popular. Unfortunately we are getting our first-hand experience with why that is.

After a week of positive news and new milestones, Morgan started having some difficulties again on Thursday afternoon. Currently she is back on the oscillator and most of the medicines that she was on a couple of weeks ago. The doctors believe she may have an infection and have started her on antibiotics as well. We'll have to wait 24-48 hours for the results of her culture to come back (and even that isn't always conclusive) but because she got sick so quickly the doctors seem pretty sure an infection is behind her problems.

If this is the case, hopefully she will respond to the antibiotics and she'll soon be headed back in the right direction. Also, the echocardiogram done earlier this week showed that her PDA had gotten smaller but not closed. However, the good news is that it didn't seem to be causing any problems for her at the time. If that is still the case after this probable-infection is resolved, they should not need to close it surgically. Of course they would re-evaluate if it did start hindering her progress.

Thanks again to everyone for keeping us in your thoughts and prayers.

Dad's got next.

So today was a pretty big day for Morgan (and her mom). For starters, Shelly got to sit in the NICU and hold Morgan on her chest for more than an hour. I think all three of us enjoyed it. Morgan didn't have any problems tolerating being out of her isolette, Shelly couldn't stop smiling, and I got to hang out with both of them and look forward to my turn in the next day or two.

In other big news, she also got her first feedings of breast milk today. They started her this afternoon with 1cc every three hours and will gradually increase the amount as long as she doesn't have any problems digesting it.

She seemed to do better on the ventilator today as well. They weaned her settings down quite a bit during the day. She is scheduled for another echocardiogram tomorrow to see if her PDA has closed or improved. Hopefully it will have progressed enough that she won't need surgery to close it. We should know one way or the other late tomorrow or Thursday.

Somehow after Shelly got to hold her all afternoon, I got the pleasure of conducting a much needed diaper change. So, it's been 2 1/2 weeks since she was born and Mom hasn't changed a diaper since early in week 1. And even then she let the nurse do all the work. I'm starting to wonder if she is ever going to change one again.

Video of Shelly & Morgan during "Kangaroo Care"

PDA Caught on Video!

Morgan is still doing well, no big changes. She finished her first round of indomethacin yesterday. Today she had an echocardiogram done on her heart and her PDA isn't closed yet. They have started another round of the medicine to see if that helps.

Below is some video of the echocardiogram and the nurse moving Morgan from her stomach to her back so that they could do the echo. Stanley (my brother) and Julie (his fiance) couldn't believe how "rough" they were with her. They had to leave the room with a queasy stomach. That was funny. My mom (Karen) got to touch her and see her open her eyes. John's mom (Jeanne) got to change her diaper...now if only we can somehow continue that when Morgan comes home.

Turning over

Echocardiogram

More progress and more comfortable

We're happy to report that Morgan continues to head in the right direction. The doctors decided to treat her patent ductus arteriosus (PDA) with indomethacin yesterday and so far it appears to be helping. Since starting the three-dose treatment she is making excellent progress with the ventilator. After spending several days needing 80% oxygen, this afternoon she was down to 30-40% oxygen as well as lower pressure and frequency settings. The goal is to get down to 21% (the same as regular room air) with minimum support from the ventilator at which point they will try to wean her off of it completely.

Despite the obvious progress, we won't know for sure if the medicine has fully closed the artery until we get the results of another EKG. This should come in the next day or two.

With the the improvement on the ventilator and the fact that she is no longer on all the medications that she needed last week, the nurses seem to have a little more flexibility to move her around and find the most comfortable position for her. Apparently she favors lying on her tummy. It was definitely a nice surprise to see her lying that way. We both enjoyed seeing her looking a little less like a patient and more like just a baby, with most of the wires and sensors hidden beneath her.


We also have another milestone in sight. The nurse explained that if Morgan continues to progress as well as she has we should be able to begin "Kangaroo Care" soon. In short, we would be able to hold her on our chests for an extended period of time. If all goes well this could be an option as early as next week. And there is no question that we are both very excited and hopeful she will make the necessary progress quickly.

What are you looking at?

Morgan had another good day today. She is off all of the medications that were treating her blood pressure and blood sugar issues. And she is no longer on the morphine that prevented her from fighting against the oscillator. It was nice to see her moving around again since the morphine had kept her pretty sedated and inactive. So, for now, she is only recieving her IV fluids and lipids for nutrition but no other medications.

In other progress, Mom and I saw her open her eyes for the first time this afternoon. Well it started out with just the right eye, but by the time we left she was peeking through the left one as well. This was quite a relief considering the number of eye patches that can be seen at a one of her parents extended family gatherings, *cough MOM *cough. (Okay it was only two, but that's still two more than expected.) Anyway, family secrets notwithstanding, today was definitely an exciting step for all of us.



The next step seems to be a decision by the doctors on when to treat her PDA. It's a relatively common problem in preemies and the doctor has told us that if he thinks it is impeding her progress they will start her on indomethacin to close the open vessel rather than wait for it to close on its own. If the medicine does not work, she would require surgery which is also not uncommon in preemies as early as Morgan.

We were also told that if she continues to do as well as she has the past two days they would probably begin giving her breast milk soon. This would be another small step in the right direction. However, if they decide to treat her PDA they would need to hold off on the feedings since the medicine could interfere with her ability to digest anything. Hopefully we'll have a better idea of where she stands with all of this tomorrow.

Back on the regular ventilator.

Morgan is having a good day today! Her blood sugar and blood pressure are finally back where they need to be and stable for now. She is down to just one blood pressure medication and completely off of insulin. In fact her blood sugar was getting a little too low so they are giving her some more sugar in her fluids.

She has also been switched from the oscillator back to the regular ventillator and is requiring less oxygen support. They said her lungs sounded really good tonight and are not needing to be suctioned much.

Also, I'm sure she enjoyed her visit from Nana and Papa.