The Emma Report

Just spoke to the NICU – Emma spit up a bit last night and got some into her nasal prongs, so they took them off and decided to try leaving them off for a while. So far, so good!

Emma is now a Really Big Girl, breaking through the 4 pound barrier. In fact, this evening, she weighed in at 4 lbs., 2 oz having gained over 2 ounces since last night!

After needing more oxygen over the past several days, Emma did really well during her feeds today. We didn’t need to increase her O2 at all (she cruised along at about .05 litres/min.) and she didn’t have a single significant desaturation all day!!!

In other exciting news, Emma was able to breastfeed like a champ for more than 15 minutes today without having any breathing problems (a major achievement for a micropreemie). She was getting pretty tired, so we stopped and offered her a bottle of EBM, not thinking she’d take much more milk. Well, she hoovered down 15 ml and was looking for more, so we gave her another 10 ml. I can’t tell you how exciting/encouraging this accomplishment was, but I was thrilled. Emma definitely made progress today!

We knew our girls looked alike, but could you tell who is who?

Emma is back on oxygen. As we’ve mentioned, most times she needs only a tiny amount, but she’s consistently needing more at feeding time, so they’ve put the nasal prongs back on her. After more than a week of being tube-free, it’s a bit hard to see them on her again. The diuretic she was given on Monday didn’t do as much as the docs had hoped to remove the excess fluid accumulation in her lungs, so they’ve also decided to put her back on bronchodilators (Ventolin and Flovent puffers). Emma was on these for a while when she was in the NICU at the General, but she hadn’t needed them in many weeks. She will likely need them once she comes home, too. We’re not yet sure if she’ll come home on oxygen or not.

Emma also had another eye exam today. The good news is that the ROP has improved somewhat in her right eye. The bad news is that is has progressed a bit in her left eye. It is still stage 2-3 (mild to moderately abnormal blood vessel growth). Stage 3 is when laser surgery is considered, although the opthalmologist said today that this treatment is not yet warranted in Emma’s case. She’ll have another exam next week to monitor the situation. Unfortunately, Emma’s left eye was bruised during the exam today, so she’ll need to be on antibiotic drops for several days now too.

The one positive development of today was the fact that Emma moved into another room in the SCN. It’s the one known as: “The Last Stop Before Going Home Room.” Let’s hope her stay there will be short and sweet….

In an effort to rule out the possibility of another infection or some such nasty thing, the team ran some tests on Emma today.

While the docs were happy with her chest xray (which showed that her lungs have grown nicely since the last xray), it did show evidence of fluid build-up on her lungs. They’ve given her some medication that should help and may lessen her need for supplemental oxygen (Emma needed some O2 for two of her feeds overnight, and then again this evening). Emma’s prelimary blood work results look very good, with no evidence of infection (Yay!!) We have to wait for the rest of the more detailed analysis, but her nurses feel that Emma is simply tired and that nothing more serious is looming. The team has been gently “pushing” Emma the past few days: they’ve slightly increased the volume of her feeds and have asked her to take all of her feeds orally (rather than through an NG tube). She’s also been trying breastfeeding twice a day, which is tiring for her.

As of late this evening, Emma was doing well on just a tiny bit of oxygen. We hope that these little setbacks won’t significantly delay her discharge date…..