It's hard to believe that Isaac is already eleven weeks old! Tomorrow he'll be 34 weeks gestationally. He has been weaning down on his oxygen every couple of days, and as of today, the pressure provided is down to 1 L/min at 21% O2, which is as low as the machine goes. The next step will either be a regular cannula or...room air. We're excited and terrified that he's doing so well. We've enjoyed long periods of growth and success, only to experience sudden and extreme setbacks, so we're trying not to get our hopes too high right now. We're still taking it a day at a time, hopeful that he'll be able to come home by his due date.
Tonight was funny picture night. Isaac was at his photogenic best, sporting his new preemie clothes.
Daddy snapped these pictures of Isaac and I couldn't stop laughing; he's just so darn cute and his eyes were so big! Contrary to how the photos look, he really seems to like wearing clothes. Once he was dressed and swaddled, his belly was full, and he finished practicing facial expressions, he cozied on down to sleep.
Monday
Monday was a day of terrified excitement, as Isaac was officially taken off the cannula for a trial run. His nurse started him slowly, by removing it and placing it on top of his nose, still taped to his face, so that she could easily pop it back in if needed. After several hours of steady breathing on his own, it was decided that it could be removed completely, and the only tube remaining would be his NG (feeding) tube. This accomplishment called for celebration, starting with family photo number two!
After some quality cuddling, it was time to pick out a new outfit and tuck our little boy into bed. Today, he felt like an all-star, so we decided to go with his baseball onesie and try out his very first baseball cap.
Play Ball!
Isaac Signals a Curve Ball
Rookie of the Year
Tuesday
The surprises just keep coming! Isaac is still doing really well off the cannula; so well, in fact, that he was moved to the "B" side of the NICU (aka. the step-down side). When we went in for our visit, we had to enter through the door opposite what we've grown accustomed to. It almost felt like we were breaking and entering into a forbidden zone, but it's the section of the NICU where the "healthy" babies go. This is officially the beginning of our transition toward taking him home. As you can tell, he was so happy, he couldn't contain his excitement.
It's still too soon to make any assumptions, but the chances of him getting to go home around his due date are getting stronger. The idea of him coming home and being ours full-time is slowly sinking in. It's almost like a Pinocchio complex: he's becoming a real boy! And he's ours! We couldn't be prouder.
Wednesday
Isaac was put back on the cannula today, but we don't even consider it a set-back. His weight has gone down 3 oz over the last couple of days, which the doctors feel is from a combination of maintaining his own body heat, breathing on his own, and starting bottle feeds with the speech therapist. In order to give his body an extra little boost, she ordered him back on the cannula, but on the lowest setting, so that he doesn't have to work quite as hard at multi-tasking at this point in his development. He is also being slowly weaned off of his steroids, so the low-level oxygen will aide him as his lungs adjust to the decrease in medication.
I was able to sit in on Isaac's speech therapy for the first time today. The therapist showed me the side-lying technique for bottle feeding, which is the most similar to a nursing position, and decreases the possibility of aspiration while bottle feeding. He ate like a champion, and already showed improvement in his suck/swallow/breathe pattern.
It was Daddy's turn to cuddle tonight, but since Isaac has lost weight, he was hesitant to do kangaroo care. We didn't want to risk Isaac burning extra calories by working to stay warm, so Aaron opted for a semi-kangarro swaddle cuddle instead. Isaac really seemed to enjoy it, and cuddled right down to sleep. After a while, Daddy was starting to nod off too, so I tucked in my little boy, drove home, and tucked in my big boy. Like father, like son.
Two Sleepy Boys
Thursday
Thursday was a day of unpredictability. Too many nurses were on the schedule, due to the number of babies that went home in the last couple days, so Isaac's primary night time nurse was called off. Instead of having our regular nurse who knows and loves Isaac, he had a new nurse, who kept referring to him as "she," and then decided to complain at length about the fact that she wasn't called off tonight. We quickly agreed that it was too bad she wasn't called off as well, and neither Aaron nor I slept very well, concerned about the quality of care Isaac was receiving over night.
Around 3:00am, I decided to call the NICU for an update, and when I asked his nurse how he was doing, her response was, "He's fine." We've grown accustomed to getting more detailed reports from Isaac's nurses. Usually, they inform us of any changes in his breathing patterns or heart rate, how he has done on his feeds, diaper details, any reports from the doctors or therapists, etc. When I asked her on these topics, her response lengthened to, "He's fine. He's sleeping." I decided in that instant to speak with the charge nurse the following day to request that this specific nurse not be assigned to Isaac again. My faith in her was shattered; we need nurses with compassion, not apathy.
Friday
Today was amazing! I went to visit Isaac this morning and ended up staying for four hours. His weight is officially back up to 1500 grams, so hopefully he'll continue to grow without any further regression. He can hold his pacifier in all by himself now (they grow up so fast!) and he drank 20 ml of milk when the speech therapist fed him earlier.
I spoke with the charge nurse and she assured me that Isaac's nurse from last night would be removed from his list of potential nurses. I'm so thankful that the NICU staff is so accommodating and understanding. Considering Isaac is nearing the three month mark, and this is only the second nurse who we've had any major complaints about, I give a very strong A+ to his care at the NICU.
Asleep in Mommy's Arms
While holding him in preparation of his tube feeding, Isaac started showing cues for nursing. The lactation specialist had said that if I pump prior to holding, I can see if he wants to practice nursing, to get used to the idea. I don't think any of us expected him to latch on his first try, especially being as young as he is, but he did! After a bit, he got fussy, so I offered his pacifier, which he gladly took, and was asleep in minutes.
Later in the evening, Aaron and I went back for our night visit, and got a lot of parental care practice in. We were in charge of checking Isaac's temperature, changing his diapers, dressing him, cuddling him, and tucking him back into bed when all was done. We're learning, Isaac's learning, and we're doing it all together, growing as a family in preparation for his eventual homecoming.
Saturday
Saturday was Daddy's turn to practice bottle feeding. Isaac did really well, and drank 9 ml from the bottle before falling asleep. It was a wonderful day for cuddles, a great day for photos, and an amazing day for video.
Where's Isaac?
There he is!
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