Emma had a more difficult evening. She wasn’t very alert for her 9pm feed and her O2 sats were dropping to the point that she needed supplemental oxygen even after settling to sleep. At this point it’s hard to tell if she’s just tired and having an off day, or if something else is wrong. The nurses will be keeping a close eye on her tonight.
Emma had another good day… nothing much to report, so how ’bout a few pics from today, including Michaela giving “My Baby Emma” a kiss 
Emma and I had an amazing evening tonight. She was wide awake when I arrived, having recently been changed and weighed. We cuddled for a while, then Emma made it quite clear that she wanted dinner. She hoovered it down in a record 12 minutes and capped it off with a double belch that would any dad proud. Unlike last night she didn’t require any supplemental oxygen and she’s getting much better at remembering to periodically stop drinking and breathe. After eating she drifted off to sleep and hung out in my lap for almost two more hours (and remained a pleasant pink colour throughout).
Since Michaela started school in September she’s had a near-constant cold and so hasn’t been able to see Emma in more than 6 weeks. As she is now symptom-free, the whole family was able to visit Emma again… Today was a Very Good Day!!!
Emma spent her 84th day in the NICU/SCN sleeping and cuddling with both Mom & Dad.
She did better with her feeds today and only needed a bit of oxygen each time. We also keep trying breastfeeding, although it is a slow process (harder for her as she gets tired more easily than bottlefeeding). Happily, she’s slowly learning to coordinate her breathing and swallowing and hasn’t had a Big Ugly Spell while eating for several days. Keeping in mind that she wasn’t supposed to have been born for another 4 weeks (she’s 36 weeks gestational age today), the team assures us she is doing well.
By the way, she’s up to a whopping 3 lbs., 12 oz today, having gained an ounce and a half (an astounding accomplishment for a preemie) overnight. Way to go, Emma!!!
After progressing by leaps and bounds over the past several days, Emma seems to be having a bit more trouble today. She’s needed extra oxygen during her feeds as she’s had more frequent/notable desaturations and did not tolerate her iron medication (she had a Big Ugly spell afterwards). After much discussion, the team has decided to stop the iron supplementation for a while and will check her hemoglobin levels next week to make sure she isn’t becoming anemic again.
Emma also had another eye exam and it would appear that the retinopathy has not progressed since last week. The specialist will come back again next week to monitor the situation. While the lack of progression is definitely good news, we can’t yet tell whether or not she will have significant vision impairment in the future…it is just too early to say (though he did predict that she will likely be myopic and need glasses).
The other not-so-good news is that Emma did not receive a “pass” on her hearing test today. This was a second-level screening assessment that is a bit more detailed than the standard hearing test given to all babies before they leave hospital. The test can’t discern the extent of her hearing impairment, only that she did not adequately hear the frequency/tone used in today’s test, so we will have another more detailed assessment at CHEO in a month or so.
The nurses tried to reassure me that what Emma is experiencing today is completely “normal” for a 24-weeker, but it is still hard not to see these events as setbacks. I guess it is another example of the “one step forward, two steps back” reality that we’ve come to expect in the NICU.
Emma said goodbye to her incubator today ….
and moved into her new (temporary) house.
She’s just renting the space and may possibly be moving out for good by the end of next week
Emma had another busy day and by mid-afternoon she was a very sleepy girl:
She had one more (and hopefully last!) head ultrasound and it was, as the others have been, completely clear with no evidence of any intracranial bleeding. I must say the possibility of brain bleeds is one of the things I’ve feared most, so it was reassuring to hear today that everything looks good (with the added caveat that they won’t know for sure about her development for months/years to come).
Emma did better at bottlefeeding today and is gradually getting the hang of the “suck-swallow-BREATHE” thing. We actually had her completely off the monitors (until now she’s been attached to various leads which record/monitor her heart rate, respiration rate, and oxygen saturation rate 24 hours daily) while she was eating. Partly this is because she’s doing better, and partly it is so that we get used to “reading her signals” and don’t rely so much on the monitors to tell us how she’s doing.
Emma also had another bath care of Mom (under the watchful eyes of the nurses), and we appear to have passed that test, too
I had a long chat with one of the neonatologists and he is very pleased with how Emma is doing, especially over the past few days. The blood transfusion seems to have made a huge difference… He’d like to see her gain more weight, but he confirmed that (barring any unforeseen occurences) she’ll likely be able to go home within the next 2 weeks (Yay!! and Yikes!!!)
So, there are a few more tests that Emma must pass before discharge (another eye exam and a hearing test will be done later this week) but it looks like we can start to see a bit of light at the end of this long tunnel.
(P.S., thanks for the preemie clothes Nancy…. we think Emma makes a lovely model ;~)
As Eric reported earlier, Emma’s nasogastric tube was removed today. She’s been doing really well with her feeds (bottling all of them in the past 24 hours), so she’s officially tube-free!! (Her oxygen nasal prongs were removed last Friday).
She still has rather significant desaturations while she’s feeding as she tends to WANT TO EAT RIGHT NOW!!! and sucks so hard she forgets to breathe. We have to watch her carefully and pace her feedings over about 20 minutes (she’s getting 26 cc every 3 hours) to give her a chance to breathe between gulps. We’ve been assured that Emma just needs to get a bit bigger before she gets this whole “suck-swallow-breathe” thing down.
The bestest news, though, is that Emma might be able to come home sooner than we thought!! Her nurse said today that Emma will likely move out of her incubator in a day or two. As she is now 35+ weeks, is off oxygen and the feeding tube, is maintaining her temperature well, and is gaining weight, the only other discharge criterion she needs to meet is 7 days without having a spell. She hasn’t had one since Saturday, so she is well on her way to meeting that goal, too.
* We say “whispers of a Homecoming” because we haven’t officially been given a discharge date and we’re being very optimistic. We also have to beware of what is known as “The curse of the NICU.” This happens when you let micropreemies know they’ll be going home soon and they find a way to prove you wrong. As one of her nurses said, “don’t tell her until she’s strapped into the car seat.” So, keep your fingers crossed, and don’t tell Emma, but our little girl might be able to come home in a couple of weeks!!!
Emma is doing so well on the bottle that they have removed her NG tube! Laurie is with her now, and she’ll have more good news to share later. (Like the suspense?)