Check out my new toy!

We visited Morgan again today after taking a day off from the NICU yesterday. Shelly decided to finally let me hold her again since she had somehow managed to hold her three times since my last turn...she's pretty conniving like that you know.

Anyway, I was obviously excited to see her and hold her again. Since being moved to the CPAP on Friday she has done really well. They have already weaned her from her original pressure setting of 8 all the way down to 6 and an oxygen rate of about 30 percent. Best of all she really hasn't had any apneas since coming off the ventilator so that is a really good sign. She'll have to get down to a pressure of 4 with oxygen in the 20-30 percent range before she'll be ready to come of the CPAP completely, so she still has some progress to make but she's headed in the right direction.

Morgan continues to do really well with her feeds, which are up to 23cc. She is now 2lbs 9oz and has grown to 14.5 inches.

The nurse taking care of Morgan today likes to give her a pacifier after she is fed so that she associates sucking with food. Apparently preemies that were intubated for as long as Morgan don't always like the pacifier at first, but she seems to know exactly what do.

Morgan with her pacifier.

A Tiny Cry

Morgan received the steroid shots for her lungs last Thursday with the reasoning that the side effects of the steroids will be less than that of long term ventillator use. Because of the shots she has been moving right along. Within about a week and a half she went from the oscillator ("rescue ventillator") to the conventional ventillator, and now to the CPAP (continuous positive airway pressure). It's not the most attractive thing but it gets the job done. She also hasn't had any apneas and has been doing very well on it. Since there are no tubes pressing on her vocal cords, we also got to hear her cry for the first time this week. It is very faint and we haven't been able to get it on video because of that. I'm sure in a few months when I get the real deal I will look back at that faint cry and laugh.

Since she has been doing so much better we have had and should have many more opportunities to hold her. I have managed to hold her four times now and poor John is still at one. Ha ha. :) Maybe when the newness wears off I will share? I'm just kidding. I will share this week. We also now get more consistency with nurses Before, the nurses who had trainees were caring for Morgan since she offered so many "learning" experiences. Most of the time we didn't mind but I prefer to have the consistency of just a few people.

This last week has been so great for Morgan and us! I am getting very excited about all she has accomplished and all the good things yet to come.

What a Fun Day!

Morgan is doing well on the regular ventillator. She has a small leak in her tube but it isn't causing any problems besides a faint wheezing noise so they are going to leave it alone for now. They are weaning her bit by bit on this ventillator. They have also discussed giving steroid shots over a course of ten days to boost her lung progress. There are some side effects to it but they believe that those may be less than having her on the ventillator for much longer.

John got to hold Morgan today for the first time. She did really well with it, all three hours of it! She seemed so peaceful and comfortable.

Morgan also got some new bed sheets. One of the nurses told us we could bring in some receiving blankets to dress up her area. So the sheets with all of the flowers are new for her. She is also wearing a hat given by Aunt Sherry which came with matching "NICU" outfits. The outfits are designed to easily open with velcro and not get in the way of any cords and IVs. Two volunteers came in and traced the outfits to use it as a pattern to sew additional outfits for the other babies. I guess Morgan is a trendsetter which is a far cry from me and my sweatpants.

Kangaroo Care, Here We Come

What a great surprise it was to walk into Morgan's NICU pod today and find that she had been moved back to the regular ventilator around 11:00 am this morning. And, if that wasn't enough good news for the day, they had already weaned her settings once since the change, and were able to do so again while we were visiting.

Who knew seeing this hooked up to your daughter could be a welcome sight?

Morgan really has come a long way in the last couple of weeks. In addition to being on the regular ventilator again, she is staying around 50% oxygen. She is completely off all the IV medications and now on full feeds so they removed the IV line from her arm today. Her feeds are up to 21cc, which is the max for her current weight. And most exciting of all, she should be ready for kangaroo care again in the next day or two. Once again, thanks for all the prayers and support through all of this.

This feels good, but I think you should hold me for real tomorrow.

The Big 3-0

Happy Birthday Morgan...she is six weeks old today and has reached 30 weeks gestational age. She is still making progress with her oscillator settings but isn't quite ready to go back on the regular ventilator. The doctor told us the goal was to get her switched over to the regular ventilator sometime this weekend. Hopefully Morgan decides to cooperate.

She continues to do really well with her feeds and is now up to 11cc every three hours. She is no longer on any IV medications, just her nutritional fluids and occasional doses of Ativan if she gets too active and her breathing interferes with the oscillator.

Nana and Papa are dealing with allergeries/colds so they decided to play it safe and not try to visit Morgan this weekend. We'll tell her she needs to do a lot growing over the next week so she can really impress them when they're feeling better next weeknd.

Before & After

Morgan continues to do really well post PDA surgery. Her feeds are up to 6cc every three hours and her oscillator settings were weaned some today. She is now up to 2 lbs 7 oz and measures in at 13.5 inches. Also, the nurse mentioned that during rounds this morning the doctors were discussing moving her back to the regular ventilator tomorrow if she continued to do well. Of course nothing has been decided, but it is nice to know that making the transition seems to be in the near future even it doesn't happen tomorrow.

And now for some cool before and after photos:

   Morgan @ 2 days old              Morgan @ 47 days old

   Before diaper change              During diaper change

As you can see, Morgan has come a long way, and Shelly has a long way to go...at least where diaper changes are concerned.

More Progress

We're happy to report that Morgan is starting to make some significant progress again. It definitely appears that she has recovered fully from her PDA ligation surgery, and she is beginning to show signs of improvement thanks to her newly closed ductus.

Her blood pressure and urine output have both continued to be excellent even without any medications. She is still on a low dose of Morphine and Versed, both of which are meant to keep her comfortable on the oscillator. However they have been weaning her down on them both and yet she still seemed more comfortable tonight than she has been lately.

Not only was she less squirmy, her oxygen saturation was much more stable. Normally, she would go up and down quite a bit and often desaturate temporarily when touched. Tonight, she stayed in the targeted 85-95 percent range for nearly the entire visit. The nurse said this is definitely reflected in her blood gasses which determine if they can wean her ventilator settings. They were able to wean her some earlier today and could do so again during the night if she continues on her current path. It's still going to be a pretty slow process but at least she is moving forward again.

We were also excited to hear that they started her feeds again yesterday. She initially got 2cc every four hours and around noon today they decided to go up to 4cc every four hours. So far she has been tolerating them well which is, of course, great news.

Finally, Shelly has been trying to catch this on video for a couple days and finally got her timing down tonight.

All this progress is making me sleepy.

Really Squirmy

Morgan is still doing okay! She is off all her blood pressure medicines. They've put her on Lasix to help with her fluid retention but her urine output seems to be doing well. She is still needing a lot of ventilation support but they said that will take a lot more time before that improves. She got another chest x-ray today and her right lung doesn't look as collapsed as yesterday. She also got another blood transfusion and that usually helps some with her oxygen levels.

Morgan was very squirmy today. She was constantly moving her arms and legs. We have some video below of her quite a bit more calm just laying there with her eyes open.

eyes wide open

Recovering nicely

It's been almost 48 hours since Morgan's PDA ligation surgery and she is already showing signs of improvement. As expected, she initally had some trouble with her blood pressure and kidney function, but she responded to the medicine they gave her pretty quickly. As of today she is still on a very low dose of dopamine to maintain her urine output, and a couple other medications to keep her comfortable on the oscillator, but that is all.

They had told us they needed to compress one of her lungs during the surgery to access the ductus and today they said the same lung was partially collapsed. However they said it was not uncommon following PDA surgery and since she is already on the oscillator, it wouldn't require anything other than laying her on her left side a little longer than they otherwise would. She would need another x-ray to confirm, but this afternoon the nurses said they could tell that it was already improving. Despite the collapsed lung, they have also been able to wean her down on the oscillator a couple of times to the point that she is on less support than prior to surgery. Right now we're very happy that she seemed to handle the surgery about as well as we could expect, and that she is showing some improvement thanks to the closed PDA.

Successful PDA Surgery!

Other than getting pushed back from 11:30am to 4:00pm, Morgan's surgery to close her PDA seems to have gone as expected. She was still recovering from the sedation when we left the hospital this evening around 8:00. Otherwise she was doing well and had not yet started the back slide that the doctors have repeatedly told us to expect in the first few days following surgery. We're still hopeful that her recovery will be relatively smooth and that they'll be able to begin weaning her from the ventilator soon.

So for now it's more of the waiting game that we've been getting pretty good at playing. They'll be keeping a close eye on her blood pressure and kidney function since those are the most likely of problems to occur after surgery. Thanks again to everyone for all the prayers and support, especially leading up to this surgery.

In other news, at last check Morgan was up to 2 lbs 3 oz. Some of this is due to fluid build-up which should subside some thanks to the closed artery. But it's also obvious that she is growing a little every day. Also, Shelly said she was really active this afternoon prior to surgery and was keeping her eyes open  for longer than she had seen before. Of course, she took the opportunity to take some photos.

"What's the deal, I thought I was having surgery today?"

Big Day Tomorrow

After two relatively quiet weeks the excitement is starting again, whether we're ready or not. Based on the results of Tuesday's echo and a surgery consult today, Morgan is scheduled for PDA ligation surgery Thursday morning at 11:30. The procedure will close the artery that is currently allowing her oxygenated and deoxygenated blood to mix rather than travel through her heart and body properly.

The actual surgery only takes about 20 minutes and will be done bedside right in the NICU. During the surgery she will either be placed back on the regular ventilator or vented manually with a breathing bag, and afterwards she will go back on the oscillator.

Apparently it’s a pretty routine procedure that is usually harder on the parents than the baby. However, along with the risks you would expect with any type of surgery, we have also been told to expect her to have a rough couple of days following the surgery. It was explained to us that her body has adapted to the open ductus and will need time to adjust to the change in blood flow that results after closing it. Most of the time this means the baby gets pretty sick for the first 72 hours or so after surgery. The good news being that she should eventually adapt again and begin to recover, not only from the surgery, but also from the problems she is currently having with her vent support and fluid on her lungs.

Overall, I think we’re both ready for her to have this surgery since it is necessary for her to eventually come off of ventilation and oxygen support completely. Also we’re both looking forward to once again being able to hold her, seeing her activity increase sans the sedation required for the oscillator, starting her feeds again, and everything else that comes with her continued progress.

We really enjoyed our time with her this evening, as she seems to be getting more comfortable with us placing our hand on top of her and has taken to grabbing our thumb when we do so. Shelly also got a big kick out of watching her yawn since she had never seen her do so before.

Happy Birthday Morgan!

Well, its been one month since Morgan was born and honestly it seems to have flown by. Hopefully the next few months will do the same and we'll have her home before we know it. Although I'm sure the closer that day gets, the more impatient we will be.

Still nothing significant to report. She should get her echokardiogram today or tomorrow so we'll know more after that. Also they are doing some equipment upgrades in the NICU so she was moved to a new pod yesterday but they said she tolerated it without a problem. And Nana and Papa were impressed with how much she had grown since their last visit a week ago.

Other than that, her feeds are still on hold but mainly as a precaution until they get her PDA resolved. Her blood pressure has been good but they still have her on small dose of dopamine to keep her urine output where it needs to be. She is also still on the oscillator but they did lower her morphine dose today.

No news is good news this week...PDA surgery likely next week.

Morgan has had a pretty quiet week. She seems to be fully recovered from her infection but has not made much progress as far as her ventilation is concerned. She is on dopamine again to help her urinate, morphine to keep her from squirming, and of course the oscillator. Today is her last day of antibiotics and then she will receive another echocardiogram tomorrow. From there they will most likely confirm that she needs surgery to resolve her PDA. From all reports it's a pretty routine procedure as far as preemies are concerned. And in most cases babies tend to have much better progress on the ventilators once they have had a few days to recover from the surgery. John and I are eager for her to have it so that her breathing improves.

She is also gaining weight bit by bit although they temporarily took her off her feedings because she was spitting them up. Her stomach is also big and round but since the x-rays show everything to be okay they said they'll probably start back up tomorrow and see how she does.

Below is a picture of Morgan on her tummy. Next to her is a rattle that my boss gave her.

Pink and Princesses

Morgan is doing pretty much the same. She is still having problems with fluid on her lungs and receiving high oxygen levels. But we're grateful that she seems to be stable. They have also increased the amount of milk she is getting and she is tolerating that well.

Morgan received a handmade blanket today from a group called Project Linus. It is so adorable. John's niece Adison is over the top with princesses so I'm sure she'll like it also. The picture doesn't do the blanket justice.

Morgan also has this new "Zaky" in her incubator. It's basically a bean bag that is in the shape of a hand. Since she is squirming so much again even on morphine, they place it around her and partially on her to keep her still so that the oscillator can work better and so she feels more "safe". A neat side note, it was invented by a woman here in Houston who had a preemie. It's not easy to spot in the photo below unless you are looking for it. It is the tan thing covering up her legs.

Feeding Again!

We just got home from visiting Morgan at the NICU. She seems to be recovering well from what was most likely an infection although the culture they took is still negative. They told us it wasn't that unusual for the culture not to show anything despite an actual infection, but they will keep watching it for five days and she will stay on the antibiotics for at least seven days.

Also, the abdominal ultrasound came back completely normal so they have resumed the breast milk feedings she started before she got so sick. She got her third feeding of the day while we were there and so far she is tolerating them without any problems. They were also finally able to weigh her again and she is up to 790 grams or, for those of us with no use for the metric system, about 1 lb 12 oz.

Now that she is doing better we are hoping she begins to make some progress on her oscillator settings. She has been pretty much stuck at her current levels for the last three days and I know Shelly and I would both be thrilled if they are able to start slowly weaning her off of ventilation support again. 

Another highlight of tonight's visit was getting to see her open both eyes with a little more frequency than we have before. She is kept somewhat sedated while she is on the oscillator, so mostly it's been fleeting moments of her squinting through a barely-cracked eyelid. However, tonight she was opening both of them pretty wide and leaving them that way for a while.