My Angels

Reyes Latest Pics

2009-08-18T00:08:00.004+08:00

These pictures were taken last week or week before last. Its Reyes' latest look. haha he is looking kinda chubby now. Think he is about 5+ kg. Everything is looking good! :)

Jabs and stuff

2009-07-20T00:24:00.001+08:00

Brought Reyes to his PD, Dr Yong on Fri to get his jabs. It was so coincidental that we met a mummy there having 2 sons same name as mine! She has a Regan and a Reyes and the order of birth is the same too. Haha!

I overheard she's rushing for time thus I offered for her to see the doc first. She was so grateful about it that she bought us a cake thereafter but I forgot abt the namecard she left in the bag and my maid threw it away. Probably has to get his number from the clinic to say once.

Reyes is about 1.5 mos old now and he weighs 4.7 kg. Not bad at all. Discussed with Dr Yong and decided that it seemed like we can skip the 2 am feed as he is growing well and most of the time sleepy for the night feeds. For the past few nights it wasn't very successful cos I still have to get out of bed a few times but I guess I would soon be having my much needed sleep! :)

Regan specifically asked not to be included on this visit to the doctor, when I asked him why, he replied saying he doesnt wanna see Reyes cry. I guess he was traumatised when we brought him along the last time when Reyes has to draw blood from the sole of his foot for blood test.

Reyes was so strong, he only let out a short loud cry after each jab and soon he drifted off to dreamland. In fact, the same goes for Regan as well, I remembered when he was a baby, he has no problems for these jabs, crying stops like after 3 seconds. Perhaps they both inherited my high threshold for pain. For both my deliveries, I didn't have epidural and for Regan it was even an induced labour which is supposedly more painful than a natural one. :)

We are going back KKH this Wed for Reyes' cranial scan. I'm praying that the "echo" gets lesser now. Lets hope for the best.

Review

2009-06-26T02:58:00.004+08:00

Brought Reyes to KKH for a review checkup and blood test yesterday. Hubby and Regan went along.

Poor Reyes shriek when pricked in the sole for blood samples and Regan was slightly taken aback by the sight of blood oozing out didi's foot. But we explained to him what its all about then he felt better.

After we got the blood test results, we went back to Clinic P to see the physio therapist. The lady had to assess Reyes' physical development. In fact, to date, his corrected age is about 3 weeks old and he weighs about 4 kg now. Was quite happy that his weight gain is good. :)

The therapist feedback that his physical development is pretty apt for his age but we have to give him more tummy time to strengthen his neck, haha but he doesnt quite like it though.

Next stop is to see his neonatal doc, Dr Khoo, she looked at the blood test report and we were told that his blood count is a bit low. -_-' She recommended for us to increase his Iron intake to 2 times a day and also he needs to take some folic acids.
Then she went through the report from the cranial scan last month with us. The cyst on his left ventrical has disappear but the one on the right is now 4 mm. Dr Khoo didn't think much of this but she is more concerned about the part in the report that states that there are plenty of "echos" in the scan. -_-' I asked her what is the impact of having all these echos and was told that it could affect development so we have to monitor Reyes carefully, probably for stiff muscles in the thigh and stuff.

Next, the umbilical hernia, it seemed to have grown bigger. Dr Khoo is not that concern about the size of it but rather the possibility of intestine getting entwined in it. So, she instructed to watch if Reyes is throwing up a lot and if that's the case I have to bring him back immediately. Luckily, he doesn't do that too often, only once in a blue moon.

So, the next review appointment will be next month, coupled with a cranial scan and also blood test. -_-'

I've decided to listen to mummy and put a binder over Reyes tummy to hold down the "ballon", hopefully this might help.

I'll be back to work on 6th Jul but the feeds for Reyes has to be maintained, think I'm gonna have a hard time coping and am not sure if my EBM supply will be enough. But I've gotten a preemie formula, NeoSure and gonna introduce that to him soon, this will supplement my EBM.

When I'm back to work, my maid will be taking care of him for me in the day, didn't really have a choice but she's trustworthy. Right now, she's helping with the 5 am and 8 am feed while I sleep more since I have to do his 2 am feed. Lets hope everything works out the way its supposed to be. :)

Regan has got "double" infection

2009-06-08T23:59:00.003+08:00

Regan ran a fever at 38.7 degrees celsius last night, today he was all up and well but I kept him at home to monitor him. He seemed alright, active and all.

It puzzles me as the onset of the fever must have been brought on by something. upon further probing by my mum, he revealed that his penis feels painful when he passes urine. I checked and discovered that his privates is a bit red at the tip. So I was thinking this could be an infection that led to his fever last night.

Brought him to the doctor in the evening and he was asked to do a urine test and the doc found that he is indeed having a urinary infection as well as a throat infection as his throat is all red.

So, he was given antibiotics and several other meds to be consumed at home. I discussed with the doctor on how he could have gotten this urinary infection, doc commented that for boys, its actually quite hard to contract this and since its hard to contract, its hard to heal as well, so we have to go back next week for a review and another round of urine test.

The enrichment school Regan is attending does not have proper toilet facilities for kids his age, in fact, they uses the adult toilets and all the boys are required to stand by the toilet bowl to pee. My boy being small in size have a bit of difficulty and it is no wonder that his penis might have touched the edge of the toilet bowl or something. hm, I'm gonna talk to the teachers in charge about this and hopefully they can come up with a solution for me before I put him into another school.

But frankly speaking, this school is pretty good except for this issue.. sigh..

Some Updates

2009-06-08T12:15:00.003+08:00

Reyes has been home for almost 3 weeks. I think he is around 3 kg now as his last known weight was 2.7 kg on 28 May 09.

So far he has been to 2 reviews already. Did his cranial scan, the 0.3 cm cyst is still there but doc said its nothing to worry about. He also did his eye test and everything was fine. It was quite shocking to discover that preemies actually have 3 times higher risk of getting short sightedness, lazy eyes and other eye ailments then a full term baby. Reyes is scheduled for another eye test when he turns 6 mths old (corrected age). I'm glad things are ok for now and his next review will be in Aug with the cardiologist. Hopefully, that will be ok as well.

I've been real busy taking care of him, feeding him 8 times a day, expressing my EBM almost 6 times a day, bathing him twice a day, taking my own meals. I'm left with very little time to sleep and to do my own stuff. Tough tough! But seeing him growing bit by bit as the day goes by, that is satisfying enough.

Everyone is saying he looks like Regan. This little boy is kinda sensitive to any noise, everytime I express milk in the room, he would be tossing and turning and making noise in his bed to protest. haha, blame it on my medela NOISY pump.

Here are some of his recent pics:

Reyes is home!

2009-05-20T10:42:00.004+08:00

After having spent a total of 7 weeks in NICU and a week in Special Care, Reyes is finally home.

We picked him up from the hospital on Fri. Initially I was glad that I can finally put my pump aside since he is coming home but it didn't seem the case. He has a whole lot of stuff to add to his EBM for every feed, the vitamins, MCT oil, protein powder and iron drops. So, I still have to express my breastmilk for him to be bottle-fed with all these goodies for the next 2 mths not to mention the various follow up appointments with the cardiologist, eye doc as well as a cranial scan. He was discharged weighing 2.16kg.

He is now fed 3-hourly, starting from 8 am every morning round the clock. I practically didn't get much sleep. -_-' I was down with mastisis, inflammation on my right breast, it was so painful and I developed a 40 degrees Celsius fever in the middle of the night on Sat. Went to see doc and was given antibiotics as well as some panadol. Its now better already.

Brought Reyes to the PD on Mon and was glad to see him now weighing 2.35kg. Generally he is ok but needs to beef him up a little and the rest of the vaccination will have to wait till he is at least 3.0 kg. But we need to go back every week for review though.

Everyone says he looks like the brother.. hee :)

Latch-on Breast Feeding Begins!

2009-05-13T20:48:00.003+08:00

I've been busy these past 2 days. I was at the hospital during the afternoon to try latching Reyes on for one of his feeds, his weight fell from 2010g to 1985g and is now 2022g and taking in 42 ml every 3 hrs. The nurse commented that the initial drop in weight is due to the introduction of bottle that takes up more of his energy. I also did some diaper change for him, practicing since I haven't done it in years. hee.

He suckles pretty well, but he falls asleep so frequently that it seemed like its more comfort suckling than suckling to satisfy his hunger. Since I dunno how much he is taking in, I'll have to feed on demand when he is home.

I was told that he should be able to disharge on Fri if nothing arises so I had to attend the CPR training today. I had to call my mum to join me last minute as I thought having 2 person learning it would be more beneficial than one.

Now, I'm compiling the list of to-buys and I'll be off on a shopping spree tomorrow to get the necessities for Reyes. a little anxious about him coming home but I bet I'll be much busier... :)

Bottle Feeding!!

2009-05-12T00:21:00.003+08:00

Reyes is now in the "Growing Prem" room in SCN. We couldnt find him in his usual spot today.. haha.

Glad to see that he is now off the tube and is fully on bottle feeding, taking 36 ml every 3 hrs. His weight is now 2010g and he looked so much better without the tube, his chin is cute!

I carried him for a while and the attending nurse asked if I would like to bottle feed him, I said yes to that immediately. He suckle on the bottle for a while, and paused for a while and suckle on it for a while, in no time, the bottle of EBM was almost finished. I took the bottle out of his mouth and let him rest a little..

But viola, the next thing I know, he vomitted all over himself and me. -_-'
Then I checked with the nurse and was told that I should burp him occasionally through out the feeding session. oh.. I felt so bad.. Reyes, so sorry, mummy didn't know I have to do that cos I thought 36 ml was very little. I'll be more careful next time.

The attending nurse decides not to give him anymore EBM until the next scheduled time so I placed him back into the crib while I wipe myself dry. The nurse changed his swaddling cloth and he was pretty restless. He looks as though he is still hungry so the nurse asked if I want to try latching him on direct. I'm like all wided-eyes, "can I??", I was so excited and anxious about the thought.

I sat down and tried latching him on direct. So cute, each time he suckle, I can see his dimples. I think he did get some breast milk but not a lot as he keeps stopping after suckling for a while, but I stopped after a few mins as I didn't want to overwhelm him and was afraid he might throw up again.

I enquired when I can bring him back as he is already more than 2 kg and he is now more than 35 weeks. But apparently it seemed like it will only be possible after we, the parents have learnt some important skills dealing with premmies. We need to go through a CPR class and also some basic childcare skills sessions.

I'm having mixed feeling now. I'm happy and yet worried at the same time, I'm happy that Reyes is coming home but I'm also worried that I might not know how to take care of him properly. But like what hubby said, I should just take care of him like how I would a normal full term baby, perhaps if I think this way, I might feel less pressured.

Reyes in Special Care

2009-05-09T02:29:00.004+08:00

I received a call this afternoon from KKH that Reyes has been transferred to Special Care Nursery (SCN). I was elated! Finally, another milestone reached.

I visited him with hub at SCN in the evening, first time to SCN, was a bit disoriented but finally managed to find Reyes. He was sleeping in a bassinet and I carried him for a while. The staffing ratio at SCN is not as high as that of NICU but I managed to get hold of a nurse for an update.

Reyes weighs 1900g today and he is on 30 ml of EBM every 3 hourly. They have stretched his milk intake to 3 hours as of today, I hope he is coping well with it.

I just realised that I'll not have a chance to step into NICU at KKH again. I really wanna thank all the nurses and doctors in NICU for taking such good care of Reyes during his stay. They have been such wonderful people, giving me updates and assuring me that my baby is fine. A big thank you to all of you!!

Took some pics of Reyes today, he was smiling a lot and we managed to capture that in that last "smiling" pic of his. haha, he was smiling and squinting his eyes at the same time. hee.

When?

2009-05-07T23:38:00.003+08:00

Reyes is now 1865g, he was supposed to be transferred to Special Care yesterday but there's no bed available there. Another full house case. -_-'

He is now on staggered feeding taking in 23 ml to 27 ml of EBM every 2 hours. This will give a total of 300 ml per day. My EBM supply on a daily basis is about 500 - 600 so I guessed my supply is still enough for him.

Reyes is growing well in NICU in fact, the only difference from what I can see now is the charges involved keeping him in NICU. Special care will be cheaper.

He was sleeping when I was there earlier, he smiles in his sleep. Haha. Cute! After he woke up, I carried him for a while and fed him today through the syringe and tube. Here are some pics!

Yeah!! Good news!!

2009-05-06T11:03:00.002+08:00

Reyes is off the air hood and now on room air totally!! He looked so cute without the CPAP! But damn, my mobile batt went dead on me when I was about to take a pic of him. Will try to take some today. :P

His weight as of last evening is 1840g. The attending nurse did mention that if everything is fine, he should be moving on to Special Care very soon. I carried him for a while and he was straining to poo.. haha, stinko eh!

Yeah!! He would be home soon!! Yippee!

Ups and downs...

2009-05-06T10:47:00.002+08:00

On Mon, when I visited Reyes, he was having another of those blood transfusion, the attending nurse told me that was necessary becos his haemoglobin (red blood cells) level is getting low.

It could be due to the fact now that he is on one hr CPAP and 3 hrs of air hood. His heartbeat was about 180+ probably due to him pumping his heart faster to supply more oxygen to the rest of the body and the fact that he has to breathe harder. I also learnt that he has got some abnormal vessels in his right eye at Stage 1 and he is due for another eye test next week. I was a bit disheartened when I left the hospital. His weight was at 1740g then.

I held him for a while and he was sleeping so soundly. I was secretly praying under my breathe that all will turn out well.

Cycling begins..

2009-05-03T01:36:00.002+08:00

Visiting Reyes in the hospital nowadays is so cumblesome due to the swine flu, we had to have our temperature taken after we park our car at the B2 carpark, then after the lift to level 1, we have to sign in and get a pass, followed by signing in again at NICU and only one parent allowed to visit at a time.

Reyes weighs 1683g as of today. He is put on air cycling starting today, meaning an hour of air cap followed by 3 hours of CPAP and we were told he tolerated the cycling pretty well. Tomorrow it would be likely to be 2 hours of air cap followed by 2 hours CPAP. Air cap is just a plastic cover that covers half the cot, with oxygen supply. Very soon, he would be wean off CPAP and then it will be an hour of room air, followed by 3 hours of air cap.

Once he is on room air and when his weight reaches 1.8kg, he would be transferred to Special Care and very soon, once he hit 2 kg, he can be home! I can't wait for that to happen.

I know he can do it, he would be off CPAP in no time. God has always been watching over him and this time God would be with him as well. Reyes, mummy knows you can do it!

Bath time!

2009-04-29T23:45:00.003+08:00

When we arrived at KKH today, we had to register and get our temperature tested and put on a mask before we were allowed into NICU. These are the precaution procedures for detection of swine flu.

We were pretty late today, but we were in time to witness Reyes taking a sponge bath. hee. The attending nurse updated us he is now on 2 hourly feed of 18 ml. I hope he tolerates well. :)

He is now 1640g, so happy to see him grow. We watched how the nurse sponge him and I managed to see him without CPAP again. She started with sponging his head with balls of cotton wool soaked in sterile solution, followed by his face and body. He also had a change of diapers and clothes. We noticed that he had hernia for his belly button, its like a small swollen ball but the nurse said it is not of much concern since it is soft and they will normally leave it as it is unless the docs ordered for a surgery to remove it.

His face is chubby! I also had a chance to carry him while the nurse set up his bed for him but only for a while as he had to be place back on CPAP again. I think he would be able to come home soon once he weaned off CPAP. Took some pics as well. Check out his chubby cheeks!!

Feeds

2009-04-28T22:50:00.002+08:00

Reyes now weighs 1575g, his feeding has been changed to hourly. Previously, he was on constant feeding at 9.5 ml/hr, now they are feeding him hourly with 7 ml and 14 ml. They will also stretch the timing to 2 to 3 hrs in time to come, this is to allow him to accomodate longer intervals between feeds as thats whats gonna happen when he is home.

He is still on tube feeding though. I had a go holding the syringe that was attached to his feeding tube and also carried him for a good 30 mins today.

Was told by the attending nurse that they will try removing his CPAP this coming friday and will try letting him on an hour of either oxygen cap or room air to see how well he can tolerate.

I was hoping he can be weaned off CPAP soon as that would means I can start latching him on to breastfeed him direct as the CPAP will not be in the way. Let's hope he grows and beef up a bit more so that it will not be too physically straining for him. :)

Yeah, another milestone reached!

2009-04-25T23:01:00.008+08:00

Today's visit was a very pleasant one. Reyes upgraded to the open cot!!

Just when I was pondering when he could do that, I was pleasantly surprised that he weighs 1530g today already. When we were there, the attending nurses was about to change the bed for him and I was given a chance to carry him. I was so excited as I sat near the incubator waiting for the nurse to swaddle him and hand him to me. When he was finally handed over to me, I was so happy! This is the first time I could physically hold him in my arms since I delivered him, the feeling is great!

As I was carrying him, his eyes were wide opened staring at me and occasionally looking at daddy who was taking pics of him nearby. Cute! I realised his double eyelids like gone eh.. haha

I asked the nurse when will I be able to latch him on directly for breastfeeding and was told that he has to be off the CPAP to do that. They will be removing the CPAP on a trial and error basis starting Mon to see how well he can tolerate. Let's hope he gets off the CPAP soon. The nurse also mentioned that he would probably need to be moved to the Step Down Unit first before proceeding to Special Care.

I took some pics today, I'll let the pictures do the talking. :)

Open cot?

2009-04-24T22:24:00.000+08:00

Reyes's next door neighbour has just "upgraded" to a open cot. I looked forward to Reyes moving on to that. We were told that the baby has to hit 1.5 kg before that can happen and when the baby is in an open cot, then they can be carried.

The attending nurse updated us that Reyes weighs 1450g now. Very soon he would hit 1.5 kg and I would be able to carry him. We were also told something interesting when we enquired if Reyes poo today. The attending nurse told us that he did twice and large quantity as well, and he makes noise everytime he poo so the nurses will change his diapers. haha, seemed like he is a baby that likes to be clean, not like his brother, Regan doesn't even care if his whole butt is smeared with poo. :)

Regan is now able to sleep in his own bed at home with the maid in the same room, which means I can rest more. I'm glad that I have one less issue to stress about. :)

Off the drip

2009-04-24T11:51:00.002+08:00

When we visited Reyes yesterday, he was waiting for us wide awake! I was glad that he was off the drip and his EBM intake has been increased to 9.5 ml/hr.

He is still on the ventilatior machine though. But upon checking with the attending nurse (the nurses there is always different), we were told that it's just 21% oxygen which is normal air and the only reason why he is put on that is that this ventilator machine has an alarm that will go off when there's any leakage, meaning when active Reyes pulls on any of the cords. The previous apparatus was not able to sound an alarm when that happens and its actually safer to be on this machine. In fact, its the same as per before.

I was relieved to hear that as I thought it was some condition that requires for him to be on this new machine. Probably the previous attending nurse did not explain to us clearly I guessed.

His weight dropped a little though, now at 1419 g. Hopefully he puts on more and can breathe on his own without using CPAP. We are also making daily trips to see him, stroke him and hopefully that helps. :)

Was not able to upload any new pics or video of him as they are all taken with Hubby's phone and he hasn't the time to pass it on to me. Will upload when I get a chance.

Roller coaster ride

2009-04-22T22:56:00.005+08:00

I was at the hospital visiting Reyes yesterday with my mum. He was at 1392g and keeps struggling to open his eyes as he seemed so tired. Looking at him progressing well makes me really really happy.

Today when me and hubby was there to see him, we were surprised to see him on a drip and he was having a respiratory ventilator and his EBM feeds was reduced to 4.5 ml/hr. We were told by the attending nurse that he wasn't coping very well with breathing thus they reduced his feeds so that his stomach is less bloated so it doesn't compress the lungs since he is still pretty small in size. The ventilator was there to help him breathe better but being on it is a step backward from his progress.

Now I can fully comprehend what other mummies of preemies meant by a roller coaster ride. Just when I thought things are looking good, it took a backward turn. Hubby reminded me that the social worker ever mentioned that it could be 2-step forward progress one day but 1-step backward the next day.

The only comforting thing is he put on a bit today, standing at 1430g. Perhaps growing bigger will also help him to cope better physically.

Anyhow, I just hope that he can be well enough to be home soon.

Good News!

2009-04-21T10:52:00.003+08:00

Reyes's PDA has closed!! The medication worked!

He had the scan done yesterday and we were totally relieved when the attending nurse told us that his PDA has closed. Yippee! No need for surgery, well, at least for now.

I checked with the Doc on the possibility of the PDA re-opening again and was told that as long as he is not full term (38 weeks), the possibility is there. Reyes is currently 32+ weeks so he would be monitored on a daily basis to ensure that all is fine.

He also did a cranial scan and an eye scan yesterday and the results were all satisfactory.

Whew! We were so glad. Finally, things are looking much better, his weighs 1375 g as of yesterday. Even Hubby commented that, its such a relieve that he doesnt have to go through the surgery. Praise the Lord!

Thank you everyone who kept him in your prayers or have been praying for him. I can't thank you guys enough but I really appreciate it. Sincerely thanking you.

Weight gain

2009-04-18T11:32:00.002+08:00

Hasn't had the time to update these few days. Reyes now weighs 1360g as of yesterday, a tremendous increase in weight from 1286g 3 days ago. His EBM intake has been increased to 8.5 ml/hr. This is the only comforting thing for now. I was hoping he would hit 1400g today.

We were anticipating a call from NICU the whole of yesterday to inform us of the echo scan results on the PDA but no one called. When we were there then we realised that the scan wasn't done, it is likely to be done today though. But according to the attending nurse, through the stethoscope, the doc could still hear murmurs.

I was a little dishearten upon hearing this as it would means that a surgery is inevitable. But as I told my hubby, perhaps God needs a little more time and maybe we'll hear better news on the scan results today. Haha, I know this sounds a little lame but we need every little bit of comfort now.

I'm kind of prepared for it anyway, so I'm just waiting...

Verdict

2009-04-15T19:10:00.002+08:00

OK.. the diuretic didn't work, the retained fluid in his heart is still there, it wasn't drained at all.

The doctor we spoke to was Dr Chua, she updated us that they will be giving him the medication that will try to close up the duct, that's the same one he was given when he was 2 days old. The dosage for that will be a total of 3 doses, once every 12 hrs. Generally, this medication doesn't work 100% for infants more than 14-15 days old but its worth a try since he responded positively to it before and we would prefer to leave surgery to the last resort. There would be another scan on Friday and that would be one to determine if he needs to be operated on.

Reyes's weight was 1286g yesterday. When I stroke him, he struggled to open his sleepy eyes. I stood by his incubator for a good 30 mins, but I feel kind of helpless. I know I can count on the doctors and nurses to take good care of him but my hands are tied as there's really nothing I can do to help.

But I have full faith in God that all will be well. We are praying.

I fear...

2009-04-14T11:49:00.002+08:00

Just got a call from NICU earlier, they wanted me to be there at 5 pm later as the Doc needs to speak to me. I hope they are gonna give me good news but I fear the worse.

It could be the scan results that came back on his PDA that needs to be discussed, I'm not sure. Perhaps they wanna administer the other dose of medication to him or perhaps he needs a surgery or perhaps...

I dare not think much.. I can only pray and have faith in God. Have faith in Him to watch over my boy, to make sure that everything will be fine.

Reyes has dimples!!!

2009-04-13T10:32:00.003+08:00

Yesterday was the 7th day of the administration of the diuretic to Reyes, he will be doing a scan today to see if the retained fluid in his heart gets drained off.

His weight is 1268g, dropped slightly but he is still active generally.

I noticed that his tummy is a little bloated, checked with the attending nurse and was told that his tummy is indeed bloated but he is passing motion regularly so there's nothing to be worried about. They call it the CPAP-tummy, as air could be taken into the tummy to make it appear big but if its soft, she mentioned that's not an issue.

I hope the scan today will reflect some good results.

Noticed that Reyes has dimples! 帅! But that's really hard to capture on pictures. Perhaps when he is bigger ba.

He's growing..

2009-04-10T14:45:00.002+08:00

Technically speaking, Reyes will be of 33 weeks this coming Wed. I remembered being told that his discharge would be possible when he is 35 weeks and at least 2 kg in size.

When I saw him on Wed, he was 1270g, on 7 ml/hr of EBM, hopefully when I see him today, he would be more than 1.3 kg. The diurectic that was given to him is a 7-day course, then they will do a scan on his PDA again. I doubt he can be discharge anytime soon.

Now I'm worried I can't spend enough time with him cos by the time he is home, I might have to be back at work. Perhaps I should exhaust the whole 4 mths of maternity leave. Let's see how it goes.

The reopened PDA

2009-04-08T14:10:00.005+08:00

Didn't have time to update the blog past few days as Regan just went on to a new school and we are all trying to arrange timings and all to send and pick him up from school. He seemed to be enjoying it though with the interesting Montesorri syllabus. It seemed much easier to get him used to it in this new school. :)

Reyes is doing pretty well in KK, when I saw him on Mon, he was 1235g and is on EBM of 7 ml/hr. I hope he gets to 1.3kg soon!! There was a new doctor in, name is Dr Tan and she was explaining to us on his reopened PDA and what are the options & steps they are taking.

This duct is causing blood from the left heart to flow back to the lungs. If this amount is substantial, it causes breathing issues in infants. Infants will also have to work harder breathing and thus use up more energy as well.

We were told the PDA in Reyes has increased from 2.4mm to 2.6mm and he is having some fluid retained in the heart at this point and so they have started administering diurectic to dry him up a little, hopefull the retained fluid will be expelled out from the body and hopefully it might help to close up the PDA a little.

If this fails, they will be administering another course of medication to Reyes and keep on monitoring the situation. The last resort would be to go through a surgery which we are trying to avoid at all costs taking into consideration the risks involved.

He was all wide-eyes when we were there 2 days ago. I hope and pray that the surgery would not be necessary. Be strong, Reyes!

A milestone reached!

2009-04-04T21:20:00.002+08:00

Surprisingly everytime we visit Reyes, he will try very hard to open his eyes when he hear us. I don't think he can see us clearly at this point in time but I would rather think he can. :)

He is 1.2kg as of today!! Yeah, finally he surpassed the 1.1kg mark. To me, this is a major milestone. He has been in NICU for almost 3 weeks and this is at least a little achievement.

But although now he is off all tubes, he is still on CPAP due to his PDA. His progress to Special Care Unit will be hindered by the fact that he still needs CPAP. I was hoping that his chest muscle will get stronger and his PDA condition will get better.

Afternoon Tea Session

2009-04-03T12:40:00.003+08:00

We were invited by the NICU nurses to attend a afternoon tea session for all parents who have their babies in NICU to share with parents whom already been there done that.

We were honoured to have Doreen share with us her journey with Davien's 4 mth stay in NICU. Davien was so cute, he was born a 26 week-er at only abt 600g, he had all the problems and issues of an immature baby but his mummy persisted and took very very good care of him and now he is as normal as any other kids. I admire Doreen's persistence and courage and love for her son.

She shared with us how important it is to not give up and how hard it was for her to pick up the phone when the hospital called in the middle of the night, she actually dreaded those phonecalls and wanted to throw her phone into the toilet bowl. I can understand how she must have felt at that point in time. But Davien has been such a strong boy and he is doing his mummy proud. Although he is going for another ops in 2 weeks time, his mummy is confident that Davien will be ok.

I thought about it, Reyes did not have that much problems compared to Davien. Is he considered lucky? It suddenly occur to me that every single preemies there in NICU are fighters, fighting for their survival.

When I reached into the incubator yesterday to touch Reyes and talked to him, he opened his eyes almost immediately. His weight as of yesterday is 1185g, finally reached his birth weight. He looks pretty good too. I'm praying that his PDA will close soon so he dun have to go surgery for that. Praying...

Summarised update

2009-04-01T10:28:00.002+08:00

Spoke with the doctor on duty when I was there visiting Reyes last evening.

I was glad to see that he is off the glucose drip and on "Full Feed" now. His intake of EBM is 6.5 ml/hr. There's a little bruise on his hand as a result from the needle of the infusion, I hope that recovers soon.

As confirmed by the doctor on duty last evening, Reyes' PDA reopened but as the earlier doc commented, they are not going to administer any medication to him as it might not be effective since he is more than 14-15 days old and also due to the side effects of the drugs. So, they are going to keep the CPAP on him until he is ready, maybe till he is about 1.3 kg.

The cranial ultrascan results from 30 Mar 09 came back to indicate a cyst of 3mm, which is negligible according to the Doc.

So now all we can do is to wait patiently for Reyes to grow bigger. Reyes, you have to jia you oh! Mummy will be here for ya!

Update from the doctor

2009-03-31T17:28:00.002+08:00

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.

Opened his eyes!

2009-03-30T13:22:00.005+08:00

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!

Results are back!

2009-03-28T13:12:00.004+08:00

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

2009-03-28T11:13:00.005+08:00

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.

To "Full Feed" very soon

2009-03-26T10:28:00.006+08:00

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!

Man Yue (Full month celebration)

2009-03-25T11:12:00.003+08:00

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.

Cranial Ultrascan

2009-03-24T13:01:00.003+08:00

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.

Thoughts..

2009-03-23T16:05:00.002+08:00

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.

Off most medications already!

2009-03-22T20:04:00.005+08:00

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

2009-03-22T10:30:00.004+08:00

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

2009-03-22T10:06:00.005+08:00

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!!

Good Progress!!

2009-03-20T19:48:00.004+08:00

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

2009-03-20T15:13:00.008+08:00

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?

Trivials

2009-03-19T16:28:00.001+08:00

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

2009-03-19T12:56:00.001+08:00

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.

PDA?

2009-03-18T21:30:00.001+08:00

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

2009-03-18T15:26:00.002+08:00

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.

Seeing Reyes the 1st time

2009-03-17T21:19:00.001+08:00

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

2009-03-17T11:15:00.002+08:00

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..