Those Pesky Lungs

We've known from the start that the boys' lungs would be at the forefront of their issues, but other than remaining either intubated or on CPAP we haven't really focussed too much on their breathing because it has been overshadowed by Asher's bleed and both of their PDAs. Well in an attempt for each to upstage the other, the boys have given us a stressful few days. Things seem to have settled now, but I have been a bit nervous to say that in case things change again (which they no doubt will).

Let's start with Nolan. As I reported, they decided to try him on CPAP and that lasted less than a day before they re-intubated him late in the night. When we got to the hospital the next morning, we found out that it had all been a very dramatic event, including a very long spell of low heart rate and no breathing. Additionally they found blood in his tube and mouth so over the next couple days they did endless tests including blood work, an echo to ensure his PDA had not opened up larger to cause this, and a chest x-ray, and none of these found any abnormal results or gave an answer to why the bleed occurred. What's more is that he continued to fill his diaper appropriately and therefore proved that neither his gut nor his kidneys were adversely affected which would be expected in this case. In short, everyone was stumped and there was a lot of head shaking by the neonatologists. So here we are, 4 days later, and the bleeding continues. It is not getting any worse, but it hasn't stopped. It is not presenting like a "normal" pulmonary hemorrhage, first because of all the excellent test results, and secondly because there is far less blood than expected. So now we just wait and try not to worry and hope the bleeding stops. He is very stable, seems happy and unbothered until he needs suctioning, and then he's fine again.

So now comes Asher. Apparently he didn't like how much attention his brother was getting so he decided to try to outdo him. He was cruising along on the ventilator until two days ago when he decided he was going to self extubate (i.e. yank his own tube out). Panic ensued but they decided that since the tube was out they may as well try him on CPAP. Well so far so good, he is handling it fine. We are crossing fingers that he knew what was best for himself and maybe, just MAYBE he'll be on CPAP for good now. I am trying not to get my hopes up too high but it seems to be a step in the right direction.

Other than that both are feeding well. Nolan had his feeds stopped temporarily with the whole lung trauma but is back to full feeds and tolerating well. Asher is finally up to full feeds and off the TPN so now neither of them have a permanent IV line in them. Poor Nolan however needed various IV meds and TPN while they were figuring out what was happening with him, so when they ran out of hand and foot sites they had to shave him and put one in his head :( He now looks like he has a receding hairline! Asher seems to be taking after his sister and is a bit of a beast in the feeding department. He gets incredibly agitated when it is approaching feed time and actually gets so angry (HUNGRY!) he needs his oxygen turned up significantly. He then eats, settles, and the whole process starts up again 2 hours later when he's up for his next feed. He's a bit of a champ though because while he is throwing his tantrum he also decides he wants to suck - either his fingers or a soother - and generally continues sucking while he's eating. This is a very good sign that he is already associating eating with sucking. Both boys are gaining weight and weigh more than 2.5 pounds each.

Tomorrow they are 4 weeks old. Maybe we're almost a third of the way through their stay??