CPAP & 1 month old

Cate is 1 month old today and 32 weeks gestation!!! :)

Cate's infection seems to be going away??? The dr felt comfortable enough to get her off the vent Friday night. Her CO2 has been holding steady in the 40's. Today Cate was really upset because the CPAP tubes that go into her nose were coming out and poking her in the face. They decided to take the nose prongs out and put in a nasal cannula. This is much more comfy but requires Cate to breathe all on her own!!! She lasted about 90mins. She just isn't ready to breathe on her own yet. About every 5 minutes Cate would quit breathing (Apnea is very common in preemies, but NOT TO ME!!!) and her pulse would drop from 170 down to 50. The nurse would come in and shake her to snap her out of it. While this was going on the seconds seemed like minutes. Premature babies have immature respiratory centers in the brain. Preemies normally have bursts of big breaths followed by periods of shallow breathing or pauses. This part of the brain is usually fully developed around Week 36. Hopefully Cate only has 4 more weeks left of this. They are giving her caffeine to help prevent these episodes. For now Cate is still on CPAP which does not cause lung damage like the vent and her CPAP settings will be coming down tonight as she had another good CO2!!!! Thank you for your prayers and hope everyone had a great Thanksgiving weekend!

Riding the Roller Coaster

Yesterday was a good day. Cate had 2 good poopies and her intestines started to look a lot better. Her stomach went down a lot. Her blood work was coming back good, so we thought everything was getting better. We had just left the hospital for the day, and we got a phone call from the hospital saying that Cate's white blood cell count was low. They needed our permission to do a spinal tap on her so that they could rule out an infection in her brain. At that point our day went from good to not good. An infection in her brain?! The nurse practitioner called around 11pm to tell us that the gram stain/culture looked encouraging so far (they have to wait 72 hours to know for sure). Today the dr told me that her white blood cell count is still low and that he believes that she for sure has an infection, most likely in her intestines. He is happy that the dr and nurse practitioner stopped her feeds and started the antibiotic the other night. He believes that the infection was brewing and they did what needed to be done just in time. They will continue the antibiotic and no feeds for the next 7-10 days. She will remain on iv fluids. He said her vent settings/blood gas are so good that they may attempt to take her off the ventilator either late tonight or early tomorrow morning. Say some prayers that this happens and that it goes well. Last time we were told that it didn't happen. By the way, Cate is now at 2 lb. 6 oz. and is 4 weeks old!!

Infection???

The day started on a positive note as the Dr said Cate will get another chance to breathe on her own in the next 24hrs pending good xrays. Cate's 8pm xray wasn't so good. Her intestines appeared to have bubbles. Not Good. The Dr said he would be shocked if her morning xray came back normal. Here is what they are currently treating her for.

Necrotizing Enterocolitis (NEC)

Premature infants have immature bowels, which are sensitive to changes in blood flow and prone to infection. They may have difficulty with blood and oxygen circulation and digestion, which increases their chances of developing NEC. The infant is unable to continue feedings and starts to appear ill if bacteria continues to spread through the wall of the intestines and sometimes into the bloodstream. Premature infants may also develop imbalances in the minerals in the blood. In severe cases of NEC, a hole (perforation) may develop in the intestine, allowing bacteria to leak into the abdomen and causing life-threatening infection (peritonitis).

We are still hoping she doesn't have it but if she does hopefully they caught it early. We will update tomorrow when we know more ourselves. There are so many things that can go south with premature babies. Your prayers mean everything to us. Thanks everyone for caring and have a great Thanksgiving!!!

This morning when I walked into Cate's room she had a new i.v. in. They have it in her head. Her pretty little head. So sad. The nurse said she was angry/mad most of the night. Her heartrate was high and she was satting low (her O2 was low). They gave her some ativan to calm her down, and then she was doing better. The x-rays looked good. They stopped ordering her CPTs (percussion treatments to get stuff out of her lungs). They are not ready to take her off the vent yet. The dr said he thinks if they took her off today they would probably have to put her right back on. They lowered her vent settings a little bit more, and the hope is that they will be able to get her off by Wednesday. They keep testing her and she is doing okay, but needs to do a little better to come off the vent. They have upped her feedings to 6 cc's an hour. All in all a pretty good day. :)

Encouraging Day

The Dr said today that Cate may get off the vent on Monday! The Dr keeps lowering the vent settings and Cate's blood gas levels are continuing to stay the same. If her levels remain consistent overnight I think she will get another chance to breathe on her own. Cate is on a steady pace up that mountain in front of her. While my mom and sister threw a shower for Jayne this afternoon, the dads, cousins, Jayne's uncle and my uncle came over to our house and we put a new floor in the kitchen. Thank you everyone for all your hard work, gifts and prayers!! The news is encouraging going into the Thanksgiving holiday. This picture is what Cate looks like when she gets angry and frustrated :) She weighed 2.2 lbs tonight!

3 Weeks Old!!

Another good day... Cate's settings stayed pretty much the same today. No news is good news. I didn't see the dr today. She is now 940 grams (2.1 lbs.). She's a big girl now. Back in the 2 pounder club! No poopies today, so they had to give her a suppository. She didn't seem to mind it much though. :) We got to hold her today. We hadn't held her since last weekend, so it was pretty sweet. The nurses said they put in an order today so that we can hold her everyday, unless she isn't doing well. Woo hoo!! I can't believe we get to hold her everyday. The nurses have to work hard when we hold her. They have to move her vent and all her cords. Cate is 3 weeks old today! Can you believe it?! How time flies... It seems like yesterday, yet seems like a year. Mommy and Daddy love you Cate!

Quiet Day

Today has been a quiet day. That's a good thing. Cate's most recent blood gas was 47 (the lower the better, her's are usually in the 50s/60s). They moved her vent setting down to 20. Her O2% is at 28. She did not gain any weight last night, she's at 870 grams (1 lb, 15 oz.). She pooped twice today. I talked to the dr. today. He said she's doing ok. He said her blood gas is good, and hopefully stays that way. He said her lungs are still hazy. He doesn't think she's ready to come off the vent yet. Maybe in a few days, maybe not. They are going to make a slight adjustment (go down a little) on vent settings this afternoon and see how she does with that. They will be taking another blood gas in a couple hours. The hope is that her blood gas stays at a good level with her vent settings being lowered. We're crossing our fingers. The doc is happy with her weight. Right now he doesn't want her to gain much. He said in a few days he will flip that and will want her to start gaining, but not rapidly. He is going to increase her feeds to 5 cc's today, and probably 5 1/2 tomorrow. He said they will add the fortifier too. He said the reason they do that (besides to give her more calories) is that babies born early do not get that and usually you get that during the third trimester.

We got to watch Mandi, Cate's nurse, give Cate a bath last night. What a treat! She really does love getting a bath. I think the fact that Duke and I don't get to hold her/kiss her as much as we'd like to makes us appreciate the little things so much more. I miss her all the time, even when I'm sitting right next to her. We'll try to post the pictures of her bath later today.

Baby Steps

Early Monday morning Duke and I received a phone call at home from the NICU dr. He said that Cate's intestines looked a little abnormal on her x-ray. He said that because of this they would be taking her off her feedings and putting an i.v. in. He said they would do another x-ray and if everything looked good they would start back on her feedings. They are very cautious because it would not be good for her to get an infection in the intestines. The second x-ray on Monday came out good. They started her feeds back up yesterday, at only 2 cc's. They had to put in another i.v. yesterday because the one they put in on Monday was irritating her. I couldn't watch. Hopefully they will be taking out the i.v. all together today or tomorrow. Her feeds are at 3 cc's today. They keep dropping her vent settings because her blood gases are looking good. Her lungs are still looking a little hazy on the x-ray, but they say they are not too concerned.

For my friend Andi that requested that we make sure to continue to post Cate's weight, oxygen, vent settings :), Cate's weight as of late last night is 1 lb. 15 oz. She got kicked out of the 2 pounder club. It's a good thing that her weight went down. They would have been concerned if it hadn't considering she was not getting any food. Her O2% is at 29 (21 is room air), her bpm (breaths per minute) rate is 30 (This means the vent is giving her 30 breaths per minute, so she is doing most of the work. 30 is pretty good. She was at 50 a week and a 1/2 ago when she wasn't doing so good.). So, all in all, things are looking pretty good.

2 Pounder Club

Cate has now made the 2 pounder club in the NICU! She is up to 5 cc's an hour on feedings, and they are fortifying her milk, which will add some calories (and hopefully weight). Not a lot of news to share today (which is good). She is doing really well. They have lowered her vent settings just a little. She has been sleeping most of the day. She's pooping and her settings are all looking good. Hopefully it stays that way. She had her first bath last night after we left. The nurses say she loved it. She must take after her mom. :)

A Fun Saturday

Jayne had a shower today so Dad was able to hang with his girl. After my long week of work it was awesome to spend the day with her. When I arrived in the morning the NICU team of nurses had just finished putting Cate back on the vent. They are all so great!!! The dr. was encouraged with her 12 hour stint off the vent last night. She held her own, but the numbers slowly headed in the wrong direction. Cate is exactly 30 weeks gestation today and her lungs still have a lot of growing to do. I have to keep reminding myself of this. Sometimes my expectations are unrealistic. Later in the afternoon Mom and Dad held Cate again for the second day in a row. Her numbers were solid today so the vent settings dropped. Today was a very uplifting and positive day. Enjoy the pictures and my chest hair ;) The first picture was taken just after Cate dislodged the vent. This is her first picture with mouth and nose breathing aid free.

Back on CPAP

What a day! Both Mom and Dad got to hold Cate today. It was my second time being able to hold her and Dad's first time. I've never seen Duke so happy. Duke and I left for dinner and when we came back there were five nurses in Cate's room. They said that Cate took her vent out. They said that because she was doing so well, they decided to try CPAP again. This CPAP is a little different than the one she was on before. It is kind of in between the vent she was on and the CPAP she was on before, it gives her a little more of a backup. Please say some prayers that this works. We are a little nervous after last time. Cate is 2 weeks old today. Dad is going to post some good pictures tomorrow. We left our memory card at home and have been staying in Omaha.

Pooping Machine

When I talked to the dr. today he said things look pretty good. They're going to increase her feedings to 4 cc's!! They'll drop her iv fluids (lipids). He said there's not much they can do to change vent settings, but maybe later if her blood gas is in the 40s. He said her belly looks nice and soft. She's been a pooping machine today. (I'm sure she'll appreciate me telling you this when she's 16-years-old.) She's not getting enough salt, but they are giving her some orally. He's hoping that they will be able to take her iv out tomorrow. I asked about her lungs. He said they are still looking a little hazy and they will need to watch carefully for chronic lung disease. More tomorrow....

Better Day

Today has been a pretty good day. They have lowered Cate's vent setting to 45. Her 02 is at 30% (much better than it has been the past couple days). Her last blood gas was at 45. They were in the 60s/70s the past 2 days. She pooped all on her own today!! That's my girl! And she's now taking more milk than she ever has--3 cc's per hour. The max for her size is 4 cc's. She now weighs 1 lb. 15 oz. Keep your prayers coming. It looks like they've been working!

Duke had to go back to work today. We missed him. :( Sunday we moved our spare bed over to my mom's so that we can be closer to the hospital. We are planning on staying there most every night. I slept much better last night knowing we are a little closer to her. Thanks again everyone for everything you have been doing for us. You have no idea how much we appreciate your kindness.

Weary

Cate has been struggling a little bit today and yesterday. Her levels are not where we want them. They have had to up her vent setttings, so the vent is helping her breathe more than it was. She hasn't gone #2 in the past couple days and she has gained a little more weight than they want her to for her size. They are concerned that she could have an infection in the bowels. She is a little bloated right now. They will check her white blood cell count either tonight or tomorrow morning. Please pray that she does not have an infection. This is something we were hoping would not happen. Also, pray that her levels improve. We need her to fight and get better. Thank you everyone for your kind emails and posts on this blog. We love reading them. This is definitely the hardest thing either of us has ever gone through. Your prayers mean everything to us.

Two Steps Forward, One Step Back

Cate is back on the vent today. Her CO2 is up. Right now it's in the upper 50's and they want it to be in the 40's for her to be off the vent. So we need to pray for the 40's. Her lungs are underdeveloped and she's trying to learn how to breathe on her own. The nurses keep reassuring us that all of this is normal. They upped her feeding to 1.5 cc an hour. That's great news. The more she can eat, the more strength she will have and weight she will gain.

Got to Hold Cate

We had another good day today. Cate was able to stay off the ventilator. They are concerned about her CO2 levels. If they get a litttle higher she will have to be put back on the ventilator. We are hoping this does not happen because it causes lung damage. They tell us if she has to be put back on the ventilator, this is all normal for a baby her size. She had her brain ultrasound today and the dr said everything looked normal. We are excited about that. Because she was doing so well, they let me hold her for over an hour. I will post pictures later. Duke may get to hold her tomorrow. What a good day!

Hard Night for Mom

Last night was a hard night for me. We were discharged from the hospital around 9:30 pm. I was so sad to leave. I wish that we had a room at the hospital for the the duration. It was so nice to be so close to Cate. It was also nice to have the the support of the high risk ob nurses and doctors. We will miss them. Especially our favorite nurse, Trista. She did everything right. She was emotionally supportive and was there with us through it all. We will never forget her. We were so happy that Cate had such a great day, but so sad to leave the hospital without her. The drive home was surreal, thinking of how much has changed since before I was in the hospital. What seemed important before is not so important anymore. She makes you want to be a better person.

Big Day!!

Today is a very good day! Cate is a fighter. When we went down to visit her this morning, they said they took her off the ventilator. They have a CPAP in her nose, which helps her breathe, but she is doing most of the breathing on her own. Her bili rubin light is now gone, so she doesn't have to wear sunglasses anymore. With the ventilator off she can cry, so we heard her cry for the first time today. She also sneezed. They started giving her my milk today, which she seems to be taking well. They will be doing an ultrasound of the brain tomorrow. Please pray that this goes well. Thanks everyone for your support!

Heart Valve Closed

We got some good news today. Cate has a heart valve that had not closed that usually closes around 40 weeks (full term). They administered meds that successfully closed the valve, hopefully for good! We are especially excited because this means she will most likely be able to take Jayne's breast milk through an IV in her belly. Her vitals are also good. Although we do not get to hold her, the nurse let me (Dad) change her diaper around noon and she peed on my fingers. :) We will update more tomorrow.

Catherine Elizabeth Perfect

Catherine Elizabeth Perfect was born on October 31, 2008 at 5:35pm cst. She weighed 1 pound and 11 ounces. Jayne had a good night. the baby is doing okay. There will be good days and not so good days so keep Baby Cate in your prayers.