Bubble Bubble - Day 58

Eleanor - her right eye was irritated by a piece of tape holding her feeding tube in her nose :( our nurse today fixed the tape and it is looking much better already!

Ellie Bean - she is now 2 lbs 2 oz

Ellie's big yawn

Rex just relaxing

Can you see the little creases on his fingers? He looks so much more like a newborn now - he is 2 lbs 10 oz

Rexy baby 

This is the bubble CPAP set up, the little tank on the bottom is what bubbles. In the background on the left you can see their old ventilators, those are gone now! 

Eleanor - 8 weeks old (31 weeks gestation)

Rex - 8 weeks old (31 weeks gestation)

Things have been changing in room 3044! When we got to Spokane our NICU room was filled with the constant vibrating sounds of the oscillators, now it sounds like an aquarium. On Friday morning Rex and Eleanor both moved from NIPPV (Non-invasive Positive Pressure Ventilation) to bubble CPAP (Constant Positive Airway Pressure).

NIPPV is a type of ventilator that senses how often and how big of breaths they take. If they don't take enough breaths in a minute it forces more breaths and if their breaths are too shallow it gives extra amplitude. Bubble CPAP  isn't a type of ventilator but just delivers a little pressure of higher saturated oxygen. Both kids got a trial run on bubble CPAP when they were first extubated. When this happened Ellie lasted 5 hours and Rex only lasted one. They had to put them back on NIPPV because their little brains would literally forget to breathe, then we would have to flick their foot or rub their back to "wake them up" and remind their little bodies to breathe. After about 3 weeks on NIPPV they were hoping they would have the stamina needed to stay on CPAP. Eleanor and Rex both receive doses of caffeine at noon everyday to help stimulate their brains and remind them to breathe. There have been some recent studies that show the benefits of giving caffeine to preemies and how there are many long term benefits, more so than they thought. Our nurse always jokes that they are getting their double shot espressos which is funny since Charlie and I don't drink coffee. 

The doctors didn't say this straight out but I think that they were more nervous about Rex being able to have the stamina needed to stay on bubble CPAP than Ellie. So far he has rocked it. They take what they call blood gasses to check the oxygen and CO2 levels in their blood and Sunday morning Ellie had a questionable blood gas, they drew it again a few hours later and it looked fine. So really we have had the most smooth transition to CPAP that we could hope for. The next stop on the road to breathing on their own is a nasal cannula, the same type I had during my C-section! 

Since the blood transfusions at the beginning of last week there had been talk about moving to bubble CPAP on Thursday or Friday. Since they both had to be NPO (not eat) during and after the transfusions we worked from Monday to Friday to work them back up to the same volume of feeds. We were also able to only fortify their milk 6 extra calories instead of 8. This is good because the less fortification they receive the lower the chance for them to develop the serious gut infection called NEC. We are still battling with reflux, especially for Ellie. They moved Ellie's feeding tube past her stomach and into the beginning of the intestine (Rex's has been this way for several weeks) and she seems to be doing better with her reflux. Basically if we get through the next week without running into a NEC infection we will be mostly out of the woods as far as NEC goes. I'm just holding my breath.