01/12/10 Surgery

The opthamologist called this morning after the eye exam to tell us that he wanted to operate again. So, Juliana had her second eye surgery this evening. He operated on both eyes, and now we are back to the waiting game. Apparently her left eye is in really good shape, and he expects no further problems with it. He isn’t as sure about her right eye. During her first surgery, two weeks ago, he had a difficult time because she was so small and her eyes were so undeveloped. Also, she was on the CPAP at the time. Now, she is larger and on the nasal cannula, so it was much easier for him to access the blood vessels that he needed to laser. So, he feels much better about the outcome of this procedure. However, we will need to wait until next Tuesday for the follow-up exam. Thanks to everyone for your thoughts and prayers. Now, we need to allow the vessels time to heal properly.

Something positive: all of her medications have been discontinued except for her multi-vitamin and eye drops for 3 days following the surgery.

We didn’t try breastfeeding today because she needed to reserve all her strength for her surgery. But, we’ll try again tomorrow, twice!

01/11/10

Today Juliana and I got to try something new and wonderful: breastfeeding! Although this can often be a challenging obstacle for preemies (and even for some full-term babies), Juliana seems to know exactly what to do, and she loved it! We are only going to try once a day for now because it really tires her out, but once she completely gets the hang of it, we will slowly increase to more feeds every day. In the meantime, she is receiving her milk through gavage feeds every 3 hours. She is still digesting it very well. We are so proud of her! It felt so wonderful to bond with her in this new way. I can’t wait until we can nurse for every feed, every day.

Juliana continues to do well on the nasal cannula. She is still on very low settings, but she occasionally needs her oxygen turned up at the end of her bolus feeds, because when her stomach is full, it presses up on her lungs and she desats for a few minutes. As she gets used to having a full tummy, this problem will go away. Even with her oxygen turned up, she is rarely over 30%, and most of the time she stays around 23%, basically room air.

Her length is measured every Sunday, and she was 40.5 cm last night. Today’s weight was 1780 grams, basically 3 lbs, 15 oz. She has nearly reached the 1800 gram mark which indicates that her body is ready to self-regulate its temperature, and she will be moved from her isolette into a crib. She’ll probably reach that milestone by the end of this week.

She was supposed to have her follow-up eye exam this morning, but the eye doctor canceled all of his Monday appointments. So, please pray that at her Tuesday morning exam he will find good results from the surgery.

Jason is at home working this week, so I’m in Baltimore by myself (although I’ve had some wonderful visitors to keep me company. Thanks Ansley, Alita, and Zach!), and I haven’t been able to keep up with the posts as well as Jason since he can post from his phone. However, I’ll still try to keep you all updated as often as I can. I appreciate that you, dear readers, are still so interested in our precious baby girl. Every day that goes by gives me more and more hope and excitement for the day when we can finally bring her home.

01/07/10

Today we begin the process of compressed feeds (we thought this might start earlier this week, but it was put on hold). We are counting down the days to breastfeeding! This afternoon Juliana will begin receiving 30 ml over 2 hours, every 3 hours. (15 ml = 1 hr). If she handles this well, she will probably continue to wean down each day and be ready to try breastfeeding by next Tuesday. The occupational therapist gave her a quick evaluation yesterday and said that she is ready to try sucking and swallowing. She was 35 weeks gestational age on Wednesday, so she is at the point where she should be able to accomplish these challenging tasks. She continues to make use of the calories from her feeds: yesterday she weighed 3 lbs, 11.2 oz! Big girl!

She is also still doing well on her nasal cannula. Today her oxygen is hovering around 23%, which is fantastic. They have to turn her up occasionally during cares or during her eye exams, but she generally tolerates a very low level of O2. It is our hope that she won’t have to come home from the hospital with an oxygen tank, like some extremely premature babies do.

Yesterday Juliana received some packed red blood cells because her hematocrit was low. Even though her blood draws are few and far between, her little body still has a hard time producing enough blood to keep up. We hope that this will be her last transfusion; as she continues to grow, her body will be able to sustain itself better and better.

We also got an update from ortho yesterday: her leg is healing well. The splint has been off for a couple of days now, and she is moving her leg freely with no pain. We are so glad that it is doing so well. We don’t have to worry about it so much now, which is especially helpful now that we are dressing her. See photos below.

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01/04/10

Sorry that we haven’t updated in the last couple of days. I guess slow news days are good for us! Juliana had a follow-up eye exam today to see the results of last week’s surgery. Apparently her left eye is good, and the surgeon wants to reevaluate her right eye in another week. He couldn’t quite tell how well it was healing, so he’ll be checking again soon. So, we will continue to pray for complete healing for both eyes and no future complications.

Today Juliana weighs 3 lb, 9 oz. She is growing so rapidly! Tomorrow she will begin her compressed feeds, the next step on the way to breastfeeding. She has been receiving 10 ml/hr for 11 hours at a time, but the compressed feeds will begin to simulate the “bolus” that a baby receives when they eat for 15-30 minutes. So, the goal is to make sure that her stomach can tolerate the larger amounts of milk at a time. Once that goal is accomplished, they will work on her sucking and swallowing skills. Very exciting!

She has also been doing very well with her breathing. She’s been on nasal canula for 2 days now and tolerates it very well. When we get home again we’ll try to upload some photos of her in her little outfits. So cute! Also, I think she’s been smiling at me. Probably just a muscle twitch. 🙂

01/01/10 Happy New Year!

Juliana is starting off the new year well. Her feeds are now 11 ml/hr, and she is doing very well on her 3-hour nasal canula trials. Hopefully those will continue to get longer and she can get off the CPAP permanently soon. She is digesting all of her milk and really using it to help her grow. Today she graduates into a different kind of isolette, one for babies who aren’t as sick. Although we still have some worries, she is definitely out of the acute phase of her care and is making steady progress every day.

The year 2009 had many ups and downs for the Payne family, and we are happy to begin anew today. Thanks so much to each of you who has been following the blog and offering your support in various ways. We are blessed.