What could he be dreaming about? We came in today and found David all wrapped up in a blanket burrito, snoozing away, looking quite content. It was nice to see. He had eaten a hour or so before we arrived, so he had all his needs met. Julie picked him up and held him for a while. That's when he did his practice smile ( see picture #2). He continues to improve. We hope he'll be home in just a couple more days. He's keeping his food down, and learning to latch onto a bottle nipple. Once the docs feel he can competently nurse, he'll be heading home!
No word yet on the brain scan which was done yesterday. I think that is a good sign. I mean, if there were something bad, some treatment or phone call should have been in order. No? Of course not. I've been in medicine long enough to know that some tests just don't get read/interpreted as soon as we'd like. Julie and her Mom are at the hospital now, so they might get word.
Yes, Julie's Mom arrived on time and very excited to be in Cali. She brought a few things for the little one and Isabelle too. Isabelle got a SpongeBob doll, and a Bob the Builder doll, and some kind of weight management training doll as well ( picture #3). Isabelle was very happy about those new additions to our household.

David is doing very well tonight. He has had no problems with his feedings, and he even took his new medication just fine. New Med? Yes, Nystatin, used to treat his thrush, which I mentioned earlier. It's getting to where we can see him coming home soon. (Not soon enought though!)
Tomorrow we are picking up Julie's Mom from the airport. Julie and I will be out in the morning, and maybe in the evening after we pick up Moms, but I don't know when I'll get a new posting up. I probably won't get two posted to this site. Maybe a few more pictures though! Isn't he cute?

Today's visit was good. We forgot to bring the camera though. I'll make sure Julie brings it tonite for her visit. David has been moved out of his little isolette/incubator, and placed in just a hospital type basinet. So the only real concerns for him now are staying warm without a fryerlator light or warmed air, which he's doing pretty well. He's keeping his temp at about 36.7 C (98 F). Feeding has gone well overnight, too. No more spit-ups, and he sucked down a whole 48 ml ( 2 oz) bottle in 25 minutes just before we got there. I can't remember the last time I took 25 minutes to down 2 oz. Maybe a scotch, neat.
David had a head ultrasound today. They all get it. The doctors want to check for any bleeding in the brain. Actually, they are checking for a intraventricular hemorrhage. I've learned that the blood vessels in little neonates brains are not strong enough for rapid changes in blood pressure. These changes could happen during delivery, or ventilation, or fluid therapy, to name a few. If you want to read more about this, click here. This usually is not big concern in neonates after 34 weeks, due to some anatomy changes, so David is right at the cusp. He also is not showing any sings of an IVH, so the likelihood is pretty low. Even if he has one, he should recover just fine. The radiologist will read the films tonight, and we'll hear word tomorrow. I did watch the scan today, but since I have never seen a brain ultrasound, normal or abnormal, human or otherwise, I could only appreciate the small ventricles. Maybe a grade 1 IVH. Fun to watch though. Wow, I've seen my kids brain. Eeeww!

I just got back from a nightly visit, and David is doing well. He's been oxygenating so well the last few days that the pulse-ox has been taken off. The doctor on call tonite started David on Prevacid to try to help him keep his food down. I suggested he might have esophagitis after having so many stomach tubes and spit-ups. And he may have thrush, which is common in babies that have received antibiotics. Thrush also and lead to esophagitis. He has put on a little more weight, up to 5 lbs, 2.8 oz (2350 grams).
David is getting so cute. I know, I know, I'm the dad and all, but when I just sit and stare at him and his little face, which is less then half the size of my palm, he's just so sweet. And all his facial expressions are a little bit exaggerated since he's so small, which makes them mean so much more. It's also so nice to be able to hold my son, after just kinda looking at him and occasionally touching him for a few days. It's a bonding thing.

Both Julie and I were out for a visit today. David did well over night. We fed him a little while we sat, but then he needed to get all his caloric requirements. The nurse placed a stomach tube and fed him an additional 48 mls fortified milk. Turns out that was a little too much, and he vomited. :(
It's almost a catch 22 when it comes to feeding him. He needs more practice with the bottle nipple to get a good latch, but when he does that, he does not take in enough milk to gain weight. If he gets gavaged, he doesn't get to practice the mouth/suction part. And we can't take him home until he has a good latch and drinks his required quantity of milk. That's our frustration today. I know, baby steps. He'll get there. We are anxious to get him home though.
On the positive side, he does have more energy, and we can see a little bit of David's personality coming through. He has started to smile for us a little. He looks so much better without all the tape and plastic about his face.
I'm headed out to see him again tonite, so I'll update again later.

Isabelle wanted to see herself on the monitor... with her high fashion ladybug sunglasses!

Happy First Week Birthday Little David! He continues to improve. He is still off the oxygen, and he's keeping more of his food down. Today, his IV catheter was pulled, and he was moved to another room of the unit, which is for the less less critical babies. It's nice to be able to hold him now. Just a few more days in the hospital I think. He needs to demonstrate 5 days without apnea bradycardia before he can be discharged. He's had a few little episodes, but only for a few seconds, not enough to be worried about.

HI Everyone
John and I just wanted to express how much we appreciate all of your thoughts and blessings and stories. We are certain that all of your collective positive energy has made a difference in David's progress. We feel so grateful to have such a supportive circle around us.

Our sweet little one is doing very well! He is off oxygen and the supplemental air... no more tubes in his nose, but some mean marks on his little face where the tape was. At my usual 3am wake-up when I talked to his nurse, he had taken both of his full feedings without problems, and had been given a bath! John is with him now, and I'll go back tonight.

Isabelle is doing great. She's her usual happy and entertaining little self. She senses that there's something a little different, and misses John or me depending on who is out of the house more being with the baby, grocery shopping or doing those pesky errands. All in all her life remains her usual routine. That will change for her soon enough, but she's such a great little helper, I think she'll adjust fine.

I'm sure John will have some new pictures when he comes back this afternoon. Thanks again to all of you, for your support and love.
Love Julie

Well, I just got back from visiting the little guy. He's still doing well. But we're sometimes taking two steps forward, then one back. He's occasionally requiring a little supplimental oxygen, but then he'll go hours on room air without any problems. David is eating, but only about half what he needs, so he's lost a couple of ounces, down to 5 lbs, 0.7 oz ( 2288 grams). He is out from under the UV light too. I'm not sure how low his bilirubin is, but it's low enough for now.

I did get to feed him tonight though. He's getting the whole stop breathing, suck, swallow, start breathing routine down, but he still gets tired, or just likes to go slow. I fed him 25 mls and it took 40 min. David also got dressed for the first time in his 6 days of life, and I got to do that for him. Yeah, it's a little big for him now, but just you wait!

Thank you everyone for your kind thoughts and warm wishes. We really do appreciate it, and I think David does too. He's moved down a level in care, from level 4 to level 3, or intermediate. The doctors expects him to come home in about a week! Yeah!

Having worked in a intensive care unit, I know he's not a very exciting or challenging case. But he is our little case. I also worry about iatrogenic or nosocomial complications, rare as they might be. I'm sure that also comes from my experience.

Julie is out visiting him today, and I'll go out later tonight. I'll get a new picture then.

Much of the Kirby family got to visit little David today. He was still quite tired, and needed to be under the lamp, so we didn't all get to hold him. ( We also had a nurse that was a little, shall we say, short and unaccommodating, and wouldn't give us just 30 min outside the light). Isabelle did a good job getting everyone's spirits up for their drive home. Speaking of Isabelle, she sees the pictures, but still doesn't really know that she is a big sister, let alone that our household is now 4.

I went back later tonite and got to hold him and feed him a little. Much nicer nurse. After two days under the light, his bilirubinaemia has lessened, and he is more active. His weight is up a bit too, now at 5 lbs, 2.9 oz., (2353 grams) althought it did fall quite a bit, to 5 lbs, 1 oz (2295 grams).

Little David is making some positive steps. He is no longer receiving any fluids via the IV catheter. He's had to receive a little oxygen here and there, as he does get pretty tired and doesn't breathe as well as he should. His tiredness is also exacerbated by his bilirubinaemia, which is now being treated by the UV lamp. He should only need the light for a few days.

Good news. He's off the ventilator, and breathing room air. Pneumothorax has resolved. We started him on milk, and we're decreasing the amount of IV nutrition. So it looks like he'll be home in about a week or so.

I forgot to tell you some details. He was born Sunday morning at 8:40, after keeping Julie up all night. He's 5 pounds, 4.6 ounces (2410 grams), and I think 19 inches long. After starting out OK on Sunday, his little lungs just were not ready to keep it up, so he was then moved to the bigger hospital at 3 a.m. Monday.

TTFN-
John

Julie and I have had our little boy. We've named him David Coffman Kirby

He was born 6 1/2 weeks early, so he's been moved to Sutter Children's Hospital in Sacramento. He is on a ventilator at this time for hyaline membrane disease, which resulted in a minor pneumo on his left side, and pneumomediastinum. He's also on TPN as he doesn't have a suckle/swallow reflex developed yet. They plan to introduce mom's milk tomorrow though. And his pneumo is resolving. Should be off the ventilator soon.

For those of you without any medical training, that means his lungs were too premature, and he got air in his chest outside of his lungs, where it doesn't belong. He also gets all his nutrition through an intravenous catheter.

Otherwise, he's doing well. And so are we. But we'd all love a few positive thoughts sent this way. I'll update you soon again.

So here we go. We're gonna try out this blog thing to see how everyone likes it. The first couple of posts will just be rehashes of emails I have sent out.