Wow, we are really getting to the homestretch here. It's making me a little nervous! I know we have a ways to go with Madeline and Josephine, but Sofia is telling us she wants to come home! Now for the updates...
Sofia is about 5 lbs, 5 ounces already! I am so glad she made the minimum weight limit for our car seats! She's still off breathing assistance with fewer and fewer de-sats. She has a spell every once in awhile, though. Today, the doctor decided we would try to put the head of the bed flat (the heads of the beds have been up for all three girls because of reflux issues). If Sofia was to handle that, they were going to do a 12 hour scan on her tonight, meaning she would go home on FRIDAY if she passed. The scan would be monitoring and recording her oxygen and heart rate. The nurse would record what she was doing if she had a de-sat (it would be more understandable if she were eating or having cares done on her than than if she was just lying there). Well, we nixed doing the scan tonight because she wasn't really tolerating having the bed flat. That was kind of a relief! Friday feels way too soon and I can tell that she isn't ready yet. We did change her feeding schedule to be more liberal about the time. Instead of doing oral feeds only if she is awake at her fixed schedule time, we are waiting longer to see if she wakes up on her own. Before, we would just tube feed her if she was too sleepy, but now we are trying to make every feeding an oral one. We will see how that goes! She might get too wiped out but we never know!
Madeline is 4 lbs, 10 1/2 ounces. She isn't doing as well with her feeding as Sofia. She is showing she is still too immature to get the suck, swallow, and breathe pattern down. She is really eager to feed, but she will spell when she takes too much milk. The speech therapist has started working with her. The therapist decided which bottle would work the best for her, and she will work with Madeline once a day. If there are no improvements, she will have a suck/swallow study. If she doesn't do too well, we might have to thicken her milk. The great news is that she is still in room air with no assistance! She has her de-sats and even spells once in awhile, but is doing fine overall.
Josephine is 4 lbs, 13 1/2 ounces. Since Sunday, she has been on high-flow because she was having a lot more spells. The doctor and nurse practitioner weren't worried enough to do a blood work-up for infection, but they did think high-flow was necessary. She has had a lot less de-sats and spells since the switch. The doctor is planning to try her on low-flow again tomorrow. The neonatologist recruited a pulmonologist to start following her. The pulmonologist asked me a bunch of questions today about our family history (clean!) and our house environment. It looks like Odin could put little Josie (and the others, but especially Josephine) at risk, but if we vacuum very regularly we should be OK. Lets hope Josephine will excel on the low-flow! If we really can't get her on low-flow by term, we could be looking at a trache, but I really think 3 weeks will give her a lot of time to get stronger.
Talking with the pulmonologist was taking a dose of reality... we are dealing with preemies with chronic lung disease, and when they go home they won't have the lungs a regular newborn would have. We have to be really careful about colds/illnesses and keep our house spic and span. We were told that when we start having visitors, we have to tell everyone to wash hands frequently. If there is even a hint of a cold coming on, then they shouldn't even come in the house. I have to be one of those crazy protective moms (at least for the first year or two). I hope everyone will forgive me :)