Taking a Mulligan

Tuesday morning Morgan was moved to the Level II NICU at a hospital just down the street from our house. Thursday morning she was moved back to the Level III NICU in the medical center. It appears that even though we discussed the move with all of the doctors involved, we forgot to clear it with one very important person...Morgan.

The neonatologists in the medical center and the nearby hospital both agreed that Morgan was stable enough to make the transition and her needs were well within the capabilities of the Level II NICU. Also, Shelly and I would be able to visit even more often and have more opportunities to give Morgan her bottle feedings.

Well, Morgan must have really bonded with her nurses and doctors in the med center because by Wednesday night she was requiring more oxygen and actually had to be moved back to the CPAP. As you would imagine, this resulted in Shelly and I second-guessing our decision to move her in the first place. Fortunately for us Morgan's new neonatologist was more than willing to discuss our concerns and, of course, only wanted what was best for Morgan.

So, even though she did improve overnight, we met with her doctor first thing this morning and decided to move her back to the medical center. It seemed like she was walking the line between Level II and Level III and rather than wait for a setback to force a move, Shelly and I decided to move her immediately. By 2:00 this afternoon she was back in the Sheep Pod in the medical center.

While it didn't quite work out the way we hoped, I think the whole experience was good for us. It gave us an even greater appreciation for the doctors and nurses at the medical center. For them, Morgan is a now a pretty typical NICU baby with pretty typical requirements. At the Level II she seemed smaller and more tempermental than the "feeders and growers" they are used to caring for. And when the people taking care of her are more comfortable, it makes Shelly and I more comfortable.

As I mentioned, she did have a small setback during her time at the new hospital, but nothing to be too concerned about. She'll stay on the CPAP for the time being, but is stable and hopefully will make her way back to the nasal cannula sometime soon. The bottle will have to wait until then, but otherwise her feeds are still going well and she continues to grow. Now, we just have to be patient and know that the next time she leaves this hospital it will be to finally come home.

When's the next road trip?

Transfer

Morgan is still doing really well. She has hit the 4 pound mark and is now wearing clothes, including those Aunt Sherry bought her three months ago. I think the nurses have voted the camo hat as their favorite. She is now maintaining her body temperature well and has been in an open crib for a few days now.

My mom (Karen) came to Houston this weekend for her birthday. She got to hold Morgan Friday night for about three hours. Morgan was asleep the entire time and just wouldn't open her eyes. I convinced my mom not to pinch her as she suggested. I will have to watch my mom. Just kidding. When my brother Steven and his wife LeighAnn came to see Morgan on Saturday, she was wide awake for about fifteen minutes. I think she had to check out the people who brought down lots of clothes, blankets, etc. from their daughters. I love hand-me-downs.

John's mom is finally feeling better and she and William went up there on Sunday to see Morgan. John or I have to be present for someone to hold Morgan so we have made plans for them to hold her next weekend. That will be a lot of fun especially around Halloween.

The eye doctor explained on Thursday that Morgan had Stage 2 ROP (Retinopathy of Prematurity, goes up to stage 5). This is when the normal vessel growth becomes abnormal from high oxgyen support and a few other factors. Considering the high oxygen levels that Morgan has been on, we have been ready for eye problems. Stage one and two only require monitoring and it is likely that she may need nothing more than that.

This morning Morgan was transferred to the hospital closer to us. We have been pretty nervous about it but having her closer will mean that we will be able to be there more frequently to participate in her care. She is now considered a level 2 instead of a level 3 so the transfer was possible. They sometimes refer to these babies as "growers and feeders" which is a category we are happy she is in. There were a lot of steps to make sure Morgan would get the care that she needs there. We've met the main doctor and she seems both nice and knowledgeable.

Below are some pictures of Aunt Sherry's outfits and my mom and sister-in-law holding Morgan.

Bottle Feeding!

John's mom called the NICU this morning to check in and the nurse mentioned that she would have another bottle feeding today. John and I didn't even know she had one yesterday so we were eager to hear about it and see for ourselves. Dr. Nawab gave her the bottle yesterday and she did very well with it. Dr. Nawab has been with Morgan from her delivery, through her surgery, and really knows Morgan well. We have been very fortunate to have her. Today they let me attempt it. I felt like it was such a milestone for Morgan. I needed a lot of coaching but the nurse Megan was fantastic and very patient. Morgan doesn't quite have the pattern of suck, swallow, breathe yet. She is forgetting about the breathe part but they said as she matures she will get the coordination down. For now they will do one bottle a day since it takes a lot of energy and the tube down her throat to her stomach will stay and be used for her other feeds.

Morgan had another eye exam today and it all looks normal. She will get these weekly. She is off her Actigall medication and she is 3 pounds 6 ounces!

We have been so fortunate, lucky, blessed....whatever words we choose they all fit. Thanks to everybody for so much support. We can't wait to see Morgan continue along.

Baby Morgan Revealed

Morgan made the next big step in her progress on Monday afternoon when she was moved from the CPAP to the nasal cannula. It still provides a higher oxygen concentration than room air but without the pressure of the CPAP which gave her a headstart on inflating her lungs. Without the pressure, her lungs will have to work a little harder but so far she seems to be adjusting well.

The best thing about the cannula is that she doesn't have to wear the headgear and large nose prongs that were required with the CPAP, so now we get to enjoy seeing her face without them!

A New Pod and a New Room

Morgan has been moved from the Bear Pod to the Sheep Pod. Apparently Bear Pod is typically reserved for more critical babies. They were expecting a new admission and since Morgan has done so well over the past weeks they decided to move her out. Also they said she weighed in at 3 lbs this evening so she continues to grow like she should.

Yesterday they did go down to a pressure of 5 on her CPAP and she hasn't had any problems adjusting, staying in the low to mid 20% range on her oxygen. The day nurse also said that the Respiratory Therapist was actually in favor of taking her off the CPAP completely today and putting her on the nasal cannula. However, the doctor decided not to since she still tends to desat when they remove her from it temporarily to adjust things. At least it seems like a good sign that it's already being discussed.

Here at home, the crib we ordered finally arrived after playing the backorder waiting game. Shelly had been pretty anxious for it since it was the last piece we needed to complete the nursery. Although, I think having it done is just going to make her that much more anxious to have Morgan here too.

Just Growing

Not much news to report but we figured an update was due since we hadn't posted in a few days. Morgan is doing well. Her feedings are still going really well. She is at 25cc every three hours, the max for her weight (2lbs 12oz), and she never seems to have any residuals left. She is also still on the CPAP and seems to stay in the mid-to-high 20's on her oxygen percentage most of the time. She has actually gotten down to 21% (same as room air) a couple of times.

They haven't lowered her pressure any recently, so she is still at six. It's possible they would eventually take her off the CPAP without any more weaning or they could take her down to a pressure of five or four first. Since there is no risk of lung damage with the CPAP like there was with the ventilator, it's mostly just a judgement call by the doctor as to when she is ready to come off and there is not really a need to continuously wean her settings like before.

Since being on the CPAP she has had a few episodes of apnea (lapses in breathing) and bradycardia (slowed heart rate) which are to be expected. It's basically just a consequence of not being completely matured yet, and as long as it doesn't happen too frequently and she recovers from them easily it's not really a concern. They do give her a little caffeine with one of her feedings each day to help combat it, but it sounds much scarier than it really is. Several times it has happened during kangaroo care which the nurse said is common because babies get so comfortable they sleep deeper. If she doesn't recover from it on her own, a little tap on the foot or bottom gets her going again.

Shelly and I have really enjoyed getting to hold her so often. The only downside is trying to make ourselves leave at a decent time during the week. Last Thursday, we got to the hospital a little later than usual and didn't get home until nearly midnight. Oh well, I guess we should get used to a little less sleep over the next couple of months.