Tuesday, March 31, 2009

Update from the doctor

Got a call from the doctor in NICU today, he called to update me on Reyes's progress which I wasn't aware of. Apparently the attending nurse doesn't give a proper update, I've decided to look for the doctor on duty to give me an update.

I was told that since that vomitting incident, although the test result came back not indicating any infection, they still did a blood transfusion for him as he appeared a bit pale. I was quite taken aback as I wasn't told of this although we've already signed the consent form, I still expect to be updated when there's a need for anything like this.

I was also told that his previous problem of PDA is back, although the last dose of medication helped to close the PDA, it is now opened again. Doc will not be administering medication to him this time round due to the side effects on the tummy but instead wait for Reyes to beef up a little before deciding what to do as the chest muscle might have developed a bit more.

There was also a cranial ultrascan done yesterday and the cyst is still present even though there's no mention of the flares. I'll be visiting him in a while and hopefully I'll get a proper update.

Monday, March 30, 2009

Opened his eyes!

Was at NICU visiting Reyes yesterday and was pretty active and was crying when we were there.

He went back to his EBM feeds but at only 4 ml/hr. I guessed they are taking it easy for now and not load him with too much in case he vomit again. The attending nurse mentioned they might remove the glucose drip if he appear stable today. His weight as of today is 1130g.

When I reached into the incubator to touch him, he was trying very hard to open his eyes and I realised its the CPAP thats hindering his other eye from opening. haha, we adjusted the tubes and viola! My boy was looking at us with his big big eyes.

I thought I saw his dimples when he managed a smile. Cute!



Saturday, March 28, 2009

Results are back!

Hubby made a trip to NICU earlier and was told that the blood test and x-ray did not indicate any signs of infection so Reyes is fine. :P

So perhaps its just a case of too much gas in the tummy that caused him to regurgitate.

But they are still putting him on drip today and will only resume his EBM feed tomorrow. They had to monitor him closely as the drip is causing his blood sugar level to rise.

His weight dropped to 1140g today. Lets hope that everything will be ok and he can go back to his feeds soon.

Vomitted

Was at the hospital seeing Reyes last night, but I was surprised that he is no longer on EBM feed and there was only a glucose drip.

I thought he looked kind of pale (Hubby thinks I'm too sensitive). His weight increased a little to 1156g.

As we were wondering what's wrong with him, the doc came in to explain to us. Reyes vomitted twice yesterday and the tummy looks bloated so they stop his EBM feeding and put him purely on glucose water. There was tummy x-ray taken as well as blood samples taken to test for infection.

The test results were not back yet when we were there but I was kind of worried. Doc did comment that he is a little less active then usual. So if they diagnose it to be some kind of infection, he will be treated with antibiotics.

Was a bit down but hubby tried cheering me up and telling me Reyes will be ok as he is a very strong boy and that nothing will happened to him. Thanks dear, for your encouraging words.

Prayed with Regan before his bedtime for God to watch over Reyes and help him get through this ordeal. This morning, when Regan woke up, he came to my bedside and told me this, "Mummy, last night God helped Didi, God is Handy Manny helper!". He is such a darling! By the way, Handy Manny is a cartoon character on his disney playhouse channel.

Hubby will make a trip at lunchtime today to see Reyes and hopefully give me a positive update.


Thursday, March 26, 2009

To "Full Feed" very soon

Went to see Reyes last night at the hospital, the CPAP is back on and he's got a new hat, The attending nurse said he just occasionally forget to breathe so they thought its safer to put it back on but on very very low supply of oxygen, encouraging him to breathe on his own.

He has increased his EBM intake to 6 ml/hr! It has increased so much over the course of 2 days. So now he needs abt 144 ml for 24 hrs. My EBM supply for now is about 50-60 ml per session, I'm achieving about 6-7 sessions a day so I gathered it should be enough for him for now. :)

He is also off the TPN (Total Parenteral Nutrition) as this was fed through the IV tubes to him and it will decreased accordingly when the EBM intake increases. When he is fully on EBM, the term for it is "Full Feed". He is still on glucose drop though and the attending nurse said they will probably remove it today or tomorrow. so happy, then he won't need the long line (IV tube) anymore.

He now weighs 1145g, increased about 30 over g over 2 days. Checked with the attending nurse if there are any new cranial ultrascan results but was told there isn't any done these 2 days.

Anyhow, we've decided on a chinese name for him, his name will be Reyes Lee Yu Zhe (李宇吉吉). Pretty cool eh!



Wednesday, March 25, 2009

Man Yue (Full month celebration)

I was thinking how to organise this event and when. If I based on the actual age of Reyes, he probably won't be home yet by 16 Apr. So I was actually contemplating to do it one month after he is back home or alternatively I can count based on his EDD, to determine when to have this Man Yue celebration.

I'm not a traditional person but I would like to have people around to shower Reyes with blessings and it would be such a joyous event.

Neither me nor hubby went to the hospital yesterday. Did I mention he is already 1112g the last time we saw him 2 days ago. I wonder how's Reyes doing, what's his weight now? But I'll be making a trip there today though and also to top up his EBM supply.

Tuesday, March 24, 2009

Cranial Ultrascan

Went to see Reyes last evening, he was lying on his tummy. The CPAP was off him since 10:30 am and he seemed to be coping alright.

He has also increased his milk intake to 3.5 ml/hr.

There was a report on cranial ultrascan which came back today. I was not aware of it and no doc has ever explaint it to us before, in fact, it is already the 3rd time he has done this cranial scan, the first time was on the 17 Mar, subsequently was 19 Mar and then yesterday 23 Mar.

The attending nurse had to call the doc to explain the report results to us. We were told that there's a cyst that is 0.2 cm present in the left germinal matrix of his skull. Its a grade 1 intracranial bleed. Doc told us not to worry since its grade 1.

Another finding from the cranial ultrascan is that there are periventricular flares at the side of his skulls as well but they noticed that those have not thicken so there's no worry for that as well.

So we asked if surgery would be necessary if the flares were to develop into cysts but doc said won't recommend that but probably Reyes' brain development might be impeded. Doc mentioned they will be monitoring and doing more scans and keep us updated.

I'm praying real hard that all will be well. But deep down I know my Reyes is a strong baby and all will turn out fine.

I put my hands into the incubator, touched him and told him to be strong and mummy will be back to see him again.



Monday, March 23, 2009

Thoughts..

Order off a online store yesterday, some nursing bra and nursing top. I plan to breastfeed Reyes for a longer period of time. I only did it to Regan for 5 mths but I guessed Reyes probably needs it more and needs it longer so I'm guess I'll be targetting for at least 6 mths.

The online store is pretty efficient, today they delivered the items intact and I paid with a cheque upon delivery. No fuss.

I also had my first massage session today and its damn painful lo! The auntie used all her strength man! But I guess its like that, first time sure feel a bit of pain but she said after 2-3 times will be better.

Really looking forward to seeing Reyes tonight! I will give another update later in the evening when I'm back.

Sunday, March 22, 2009

Off most medications already!

Hubby brought EBM to the hospital earlier before attending a friend's wedding. Just called him to get an update.

Basically, Reyes is off all medication except the caffeine for Apnea. Apnea of prematurity is defined as the cessation of breathing by a premature infant for more than 15 secs and this is a result of his central nervous system immaturity.

Reyes has increased his milk intake to 2.5 ml/hr. He is still on the CPAP though, but will probably have it removed tomorrow and see how he respond to it.

Hubby also commented that he opened his eyes earlier and viola! He had double eye-lids! Like me!! So happy to hear that!

Yippee, I can see him tomorrow again!

EBM woes

I've been having hard lumps in my left breast because it hasn't been drained well due to the fact that I'm using a electric pump and dun have my baby around to latch on directly. I tried using hot compress and cold compress, it did help a little but still its a bit sore and hard and painful.

I'm now able to achieve about 45-60 ml per session and I tried to increase the frequency of my pumping session hopefully I can "drained" off the milk ducts properly. I've also repacked the milk into bottles of 30 ml so that it doesnt get wasted as he is now utilising 24 ml every 12 hrs.

Learnt from the attending nurse in NICU that I can only latch Reyes on when he hits about 1.7 kg, so I guessed it won't be anytime soon. But the next milestone I'm looking at is for his to hit 1.2 kg, get him off CPAP and the long line so that he can move on to Special Care Unit.

I'm gonna try cold cabbage leaves today to see if it can help alleviate the situation a little and possibly I'm gonna get more comfortable nursing bras online.

For mummies or mummies-to-be out there who are looking at breastfeeding your baby, my adivse is not to give up, it may be tough at first (practically nothing much for 1st 3 days) but everyone is sure to have a supply. Demand = supply, the more you express or get baby to suckle, the more supply will be generated. Please do not believe that you have "no milk", drink more liquid and soup and persist! Everyone can make it!

Further updates

Was at the hospital last night with Mum and Hubby to see Reyes. Noticed that the CPAP is back. -_-'
Upon getting an update from the attending Nurse, was happy to learn that he is now taking in 2 ml/h and I still have loads of supply of EBM for him. He is also off the phototherapy light as his bilirubin level is at a normal level already, however we were told they will monitor him for another 2-3 days to see if the light is needed again.
We were also told the PDA medication worked on him and that the PDA is able to close and thus causing him to breathe better. The CPAP is on 5% and giving him 21% oxygen just like normal air, its just to help him a little and not entirely pure oxygen.
I also noticed the 2 little patch on his chest, it's the sensory patches for ECG, that is to monitor his pulse.
His weight is now at 1075g, dropped a little but not too bad.
This little fellow kicks a lot and he was even able to kick off his tiny pampers. ha!
Generally, seeing his good progress lifted my spirits!
I also noticed that he last toe is longer than his fourth, just like me!
Reyes, be mummy's good boy and grow strong fast!!



Friday, March 20, 2009

Good Progress!!

Hubby just sent my latest batch of EBM to the hospital and he called to give me an update on Reyes' condition.

He is off CPAP again and I hope this time is for long term. His bilirubin level (jaundice) has also dropped to 85 which is a good level but the Docs want to put him under phototherapy for another day or so to make sure.

His current weight is at 1110g, 10g more than yesterday. Any little progress is wonderful news to my ears and I'll be seeing him tomorrow!

Phototherapy

Went to see Reyes last evening, there's this blue light on top of his incubator and his eyes are covered. That is because of the high bilirubin levels in the blood due to an immature liver. The level of bilirubin in him is now 115 down from 119 but he has to reach 75 for his current weight. He has made some progress on his weight gain, he is now back to 1100g.

Remembered I mentioned the CPAP was off him, now its back on, I guessed he needed some assisted ventilation. But I do see some abrasion and dried blood on his nostrils and that made my nose twitched a little holding back the tears.

I was told that the 2 umbilical Artery and Venous Catherer was removed from Reyes at about 4:30 pm and they are monitoring to see if he is coping ok and if there will be any bleeding. He is digesting my EBM well and thats a very good piece of news.

Again, I reached into the incubator to touch him and talk to him and he was murmuring something. Are you talking to mummy, Reyes? Be strong for mummy ok?



Thursday, March 19, 2009

Trivials

Made an appointment for the Jamu massage lady to come by next mon, for 10 sessions, it is going to cost me $550. But in fact, I didnt put on a lot for this pregnancy but just a little tummy that's all but I wanted to make full use of the massage session for relaxing as well.

I gathered I'll be commuting from home to hospital and vice versa these 2 mths until Reyes can come home. I would want to spend more time with him when he is back. So I'm looking at utilising 14 weeks of my maternity leave leaving 2 weeks for any other childcare matters that may crop up.

Initially when I created this blog template it was meant for me to update on my two angels, Regan who is coming 4 yrs old and of cos Reyes who was still in my tummy then. But now it has become a blog for me to update on Reyes' development progress in NICU as he is premature at 28 weeks. But I will still post any interesting episodes on Regan if there is any.

EBM emergency

Attending nurse in NICU called at about 10 am asking how's my milk supply and that Reyes is running out of supply. I was told that he is taking 1 ml hourly and I need to keep my supplies coming.

Luckily I managed to gather about 67 ml of EBM since last evening. In fact, Hubby was getting ready to send down the milk. I planned to visit Reyes tonight and am wondering how is he doing.

Wednesday, March 18, 2009

PDA?

Hubby just called after he left the hospital transporting only 10 ml of milk. The neonatal Doc spoke to him about Reyes's latest condition. He has having this condition call Patent Ductus Arteriosus (PDA) whereby it allows the oxygenated blood from the left heart to flow back to the lungs, this might cause the infant to be short of breath. Apparently this condition is very common in premature babies and Reyes is put on medication 12 hourly for this.

http://en.wikipedia.org/wiki/Patent_ductus_arteriosus

When I heard this, I couldn't help worrying but Hubby seemed pretty positive about it. Reyes now weighs abt 900+g after shrinking from his birth weight.

I don't want to think too much, I just wanna concentrate on getting my milk supply up.

Going home

I'll be discharging today but the thought of not being able to bring Reyes along dampens my mood. How I wish he is like the other babies in the nursery, waiting to go home cos they are all fit and healthy.

Tried establishing my milk supply and miserably the best I managed was a 2-3 ml per session. But I'm not gonna give up, this is probably the best gift I can give to Reyes and what he needs most at the moment.

Bro-in-law and wife came visiting at about 10, I showed her Reyes' pics and she shedded a few tears. I actually had to comfort her telling her everything is ok and he is progressing well, when I'm not entirely sure myself. I tried hard to fought back my tears too.

Some social workers came by and I gathered from the conversation that after NICU, Reyes will be transferred to Special Care Unit and the visiting hours will be more flexible then. He can probably only be discharged when he is 35 weeks weighing at least 2 kg.

Hubby arrived at about 11 am and I sinfully had carrot cake. haha, talking about confinement food. I dread the thought of it.
Went back to NICU to see Reyes again after all the discharge procedure has been completed.

He was off the CPAC and he has a crown full of black black hair. I was a little happy to see his progress. The attending nurse mentioned that they are starting him on the EBM (Expressed Breast Milk) and the supply I've given them is not quite enough. Bearing that in mind, Hubby and I went home straight after that for me to express enough milk to bring to Reyes in the evening.

I put my hands through the incubator doors and touched him, he was moving his little left hand around and he grabbed my finger!! The grip wasn't very tight but I'm glad for that moment of interaction we had there.



Tuesday, March 17, 2009

Seeing Reyes the 1st time

Hubby came to the hospital about 10 am today, he mentioned that the neonatal docs called him past midnight last night to ask if he is still around in the hospital as they have already settled Reyes. That made me kind of anxious to see him.


I was feeling fine even though I just delivered last night. We proceed to the the NICU at about 11 am, but only managed to speak to a nurse and not see my baby cos they are kinda strict with visiting hours. 12 noon to 2 pm and 6 to 8 pm are the visiting hours and only parents and grandparents are allowed.


So I went back to my ward, finished my lunch and went back to NICU again and this time I saw Reyes! He is small and boney as he has not plump up yet. We were taught how to sanitize our hands before opening the doors of the incubator to touch him.


Was told by the attending nurse that there was high level carbon dioxide in his body so an extra oxygen tube was administered to him the night before. But because he was getting better today, it was removed in the morning thus it left a bit of a abrasion redness on his nose.


Both maternal and paternal grandparents also had a chance to see him today. There was even a tiny episode of Regan throwing tantrums not being allowed to see his brother due to his age but that soon blew over.

These are some of his pics we took:













The blue and white tube going to his nose is called CPAC (Continuous Positive Airway Pressure) - Oxygen (or air) is delivered under a small amount of pressure through prongs that fit into the nostrils. Delivering oxygen under pressure helps to keep the air sacs in the lung open.

There's also 2 tubes running into his umbilical code. After the umbilical cord is cut at birth, newborn babies have the short stump of the cord remaining. Because the umbilical cord stump is still connected to the baby's blood and circulatory system, a catherer (small flexible tube) can be inserted into one of the two arteries or the vein of the umbilical cord. After placement of the umbilical catheter, x-rays are taken to check the location in the baby's body.

The umbilical venous line is used to give the baby medication, glucose water and parenteral nutrition.
The umbilical arterial line is used for blood sampling and blood pressure monitoring.

*extracted from Parental Information on Important Procedures Carried Out in Neonatal Intensive Care Unit (NICU), Department of Neonatology, KK Hospital

Arrival of Little Reyes

It all happened too quickly for me.

On the 15 Mar 09, I was experiencing contraction pain throughout the day, after having been discharged from KKH just several days ago and still on Addalat (medication to stop contractions), I didn't think much of it. Tried calling my Gynae in TMC but its out of office hours for her. sigh!

My little one is only 28 weeks and 5 days gestation and its certainly too early for him. But deep down somehow I know the time is near. My parents and sister came over to visit and we had dinner but the contraction pain was getting from bad to worse. Went to the toilet and realised I'm already having a "show" (show = blood signifying onset of labour).

Told hubby and he went on to pack and drove me and with my sis to KKH while my parents drove Regan to Woodlands to leave him with my in laws.

Upon reaching the delivery suite, I was examined by a doc and was told that I was already 4 cm dilated but they will still try to delay the labour by putting me on a drip to stop the contractions. So I was admitted to delivery suite 31 at about 9:30 pm, coincidentally it was the same one I was in the week before. I was immediately put on the drip and it helped a little. The pain was not as intense and the contractions gets further apart. Doc also warned me of racing heartbeat as a side effect of the drug taking into consideration that my heart has a pre-existing condition of having extra beats, my pulse and BP had to be monitored rather closely.

There's one point I thought my water bag had burst as I felt trickles of water, Docs came in to check and was told that they can see the membrane still intact but I'm probably 5-6 cm dilated already.

But at about 5 am, I feel the contractions coming back and at about 30 mins interval and is still bearable. I tried to get some rest but the drug was making me uncomfortable, I was feeling a little breathless, my chest felt congested and I'm generally weak and tired. Hubby was with me all these while sleeping by my side on the couch. We called in the nurse and asked if anything can be done, after consulting the docs, they decided to turn off the drip temporarily. This happened at about 10 am.

I did contemplate on the risk of turning off the drip, I guess it would probably means the contractions will come back and true enough, the contractions came back!! At a interval of 20 mins now! I didn't recall having so much pain for my last pregnancy. Hubby had to make a trip home to shower and to pick up some stuff. After he left, my contraction intervals reduced to every 15 mins! I tried to sleep away the pain but was to no avail. I ask for options to numb the pain, was told by Nurse Ailine I could go for a jab on my thigh so I went ahead with that. The jab made me sleepy but still the pain is there. Hubby came back about 4 pm and by 5:30, I was already having contractions at like 5-10 mins interval and I have this bad urge to wanna push or should I say poo?

Nurse Ailine went ahead and prepare the necessary apparatus and I guessed they gathered I'm delivering. I was asked to use the Entonox and I hate that, it gives me the groggy feeling. Docs starts rushing in and everything was in a trance, I remembered telling my hubby I can't hold on any longer and I pushed and out came Reyes!

Everyone was kinda taken aback as I think they didnt expect it to be so FAST. Reyes was then carried to the little incubator and the neonatal Docs are not even here! But soon enough, abt 1 min or so they too rushed in to take a look at him. I thought I saw hubby shed a tear. I didnt have a chance to see him and he was already sent to NICU. I delivered him at exactly 1820hr and he weighs 1180g.

I carried on with the rest of my procedures and proceed to rest in the ward. In my mind I was thinking how is the little one..