February 16, 2009

Today was an interesting day as I got a lot of new information about Cohen. I was at the hospital when Cohen had a change in nurses (not a shift change, though) so I was able to hear his first nurse go over his history with the new nurse. Apparently Cohen is considered “29 and 3”, which means he is being treated as having been born at 29 weeks and 3 days gestation. However, according to my due date Cohen was 30 weeks and 4 days on February 10. I asked the nurse about the difference, and she said that because due dates are often incorrect by a week or two, with premature babies their treatment is based on the Neonatologists assessment of gestation at birth. So, we are to consider Cohen as a 29 weeker, and thus 11 weeks early!

Cohen tolerated one whole feeding today! His first few feedings ended in the same residual as previous days, but his 2pm feeding he digested completely and only had a “smidge” of residual. He does have an incredible amount of air in his tummy due to the CPAP, and he loves it when the nurse sucks the air out. Complete feeds are back on and he is receiving 2cc/feed. We are praying he begins to tolerate his feeds consistently. The more consistent he is, the more he will be fed and thus the faster he will grow. I realized that it sounds like Cohen is not getting any food because of his minimal feedings. However, in addition to the gavage feedings (tube in his mouth), he is receiving hyperalimentation. This is a solution that goes directly into his bloodstream via IV and gives him necessary nutrients like proteins, carbs, vitamins, minerals and fats. So, contrary to what it may look like, Cohen is getting plenty of sustenance. He is 3lbs 1.2 oz! Now if only he would poop on his own…..he has not had a bowel movement since his first enema so another enema was ordered today. I had the pleasure of cleaning the resulting poopy diaper! The Doctor said his bowel sounds were good, so his little body just needs time to get his system working together.

During the Doctor’s rounds he said that Cohen’s heart did not sound like it had a murmur and because neither he nor the other Doctor and nurses had ever heard a murmur it is very likely that he will not have a PDA. The Ductus Arteriosus is a small vessel which allows blood to bypass the lungs . This vessel is open when the baby is in the womb, but usually closes shortly after delivery. Sometimes in premature babies the vessel fails to close on its own and this is called Patent Ductus Arteriosus. PDA is treated with either medication or surgery to close it. We feel very blessed that Cohen’s does not appear to be open. This is another common preemie complication that he has avoided!

I did kangaroo care with Cohen this morning and again he did really well; no A&B’s while I held him! He did have an AandB this evening, and need a little assistance to come out of it, but again this is very common for a preemie baby. All in all his caffeine is treating him very well.

Now for the best news of the day….Cohen’s bilirubin levels were 4.3 today and his doctor wrote the order to stop phototherapy! He will have his levels checked tomorrow, so absent any major activity with the levels, our baby will no longer be sun tanning! I am so excited to not only to see his eyes all day and get much better pictures, but this also means he can officially wear clothes! The gift shop has micropreemie items so I am going to get him his first t-shirt tomorrow…I can’t wait! There are special shirts that are easy to take on and off a baby with monitor wires and IV’s and it is small enough fitting up to 3lbs.

Oh, and more great news: we now have a long term room at Ronald McDonald House! I will move rooms tomorrow morning. The only difference in the room is the new room is larger, and it is missing the TV and cable! I’m not very excited about the lack of TV…I am hoping there is at least cable so John could bring our extra TV up.