8.09.2009

august 8-9- can we keep the cannula?

this weekend wren's oxygen needs on the cpap went way up to about 50%. that is also what she was requiring on her sprints that she was doing on nasal cannula twice daily. the doctors decided on friday to leave her on cannula until she showed that she needed the support of cpap. obviously the cannula gives less support. (she won't have that high positive pressure opening her lungs.)
they said that if they are getting more support than they need the lungs can not absorb as much oxygen as they were before. (so, if she needed a setting of 4, but was getting 5, her oxygen needs could go up, even though she really needs less help.) one of the docs also explained to me that the measurement that we see isn't the "true" amount of oxygen she's receiving. on cpap 50% is really closer to 40. on cannula it's even lower. so it's better all around to have her on cannula if she can tolerate it. she's now been on the cannula for about 40 hours.... we'll see how it goes...
 
here's wren getting her (ng) tube last night. she likes it SOO much more than her oral one! (og)

 
sleeping on mommy

since thursday (day 1-breastfeeding) i've been able to feed her about 5 times. it's really not that often, but it's a start. she's still having troubles latching. it takes her about 20 minutes every time. it's like i have to talk her into it... convince her to do it! but, once she latches she does perfect! she's still pacing herself, and feeds for about 12 minutes when she's willing to feed at all. this afternoon's second feeding was a bust- only 5 minutes. (so she got half of her feeding by tube.) having the lc there really helps. at one point wren was getting too much milk and her heart rate dropped. (yes, preemies drop their heart rate while breastfeeding if they get too much. all you term mommies are so jealous right? just what a mom needs with the stress of a newly feeding baby- heart rate drops!) anyway, the lc showed me how to occlude some of the ducts to keep her from getting too much. (basically pinch your thumb and finger almost together about a half an inch from the nipple.)

she's had her primary nurses the past few days... and a really nice night nurse. everyone's been doing what they can to help her poor bottom. i'm getting the stuff to make my own wipes, (oils, viva paper towels, and velour swatches to use at home) and they're making a special cream with butt paste, colostomy powder, zinc oxide, and something else... i forget. supposedly it's so thick you can wipe it and it doesn't come off. (which logically leads to the question: how do we get it off?) her poo is like water. i think most of us know what having diarrhea for several days feels like. (and those of you that don't should really live a little... travel to a foreign country and drink the water... eat some spicy foods for goodness sakes.) i hate that she's having to go through that.... and all for that stupid hmf. they've lowered the dose from 24 cal to 22 cal. i don't know what that means other than she's getting less. if this persists i'm really going to have to say cut it out with the hmf altogether. i don't like it to begin with... and just what i was worried about has happened! so today jeanette (her primary nurse) left her little booty in the air with the oxygen mask down by it to promote healing. apparently the oxygen works really well... hopefully the night nurse will be as diligent. (some nurses don't want to do it because of the risk of a projectile poop. understandable, but what's a little poop compared to her bleeding bottom healing up?
 
i swear, she's under there. i have her on her side, diaper open, on a chucks (the blue thing), oxygen pointing to butt,  with the blanket diagonal to cover the most of her. getting her like that is a little time consuming- but hopefully will heal up the bane that is diaper rash.

this past week the stars have aligned and wren has been able to meet many new friends. i'm happy to say she likes them all. sating high with everyone. (imagine the embarrassment- "i'm sorry, you make my child stop breathing, you can't hold her anymore". gasp!)
from friday:

auntie bonnie

 
auntie jen


i want to go to there...
all snuggly
we hopefully will be able to stay at the hospital soon. the transitional period where i'll be feeding her more is quickly approaching... how exciting! i really never thought this day would come!

tonight she weighed in at 4lbs 5oz!

2 comments:

C Lo said...

she looks like she's really chubbing up. :)
so cute!

Audrey said...

Wren looks so good. I just love the pic where she has just nursed and she has a smile and you can see her little double chin! Isn't nursing just amazing! I love it! So sorry about Wren's rash, poor little bottom...Here is a website where there is all sorts of stuff:
http://www.welltellme.com/discuss/index.php/topic,1449.0.html
That particular link is for Homemade Wipes and has quite a few recipes and tips on making your own. If copying and pasting doesn't work I just typed "Homemade Wipes" into the search at www.welltellme.com. Hope Wren feels better soon!