Busy, Busy

We've had a few ups and downs these past few days. When I visited the girls on Saturday the shift nurse informed me that Madeline had "had a really bad night." My heart sank. She explained that Madeline had quite a few problems with her oxygen levels; so much so that they had to turn the oxygen saturation on her ventilator up to 100%. Cadie, on the other hand, was doing just fine; she was having a few issues with her oxygen as well, but her nurse didn't seem as concerned as Madeline's. We have been anxiously waiting for Cadie to have a bowel movement because it is a natural way to control the bilirubin levels in her body. I was relieved when the nurse reported that Cadie, had in fact, pooped. I was also told that both of their feedings have temporarily stopped. I left for home, upset and panicked over Madeline's report. Then, after some sobbing and uncontrollable crying, my mom reminded me that that particular nurse -- the nurses rotate, so she isn't Madeline's nurse all the time, thank goodness -- has a flair for the dramatic. Composure regained, I assured myself that there was no reason for concern until Dr. K tells us we should be. I remembered that during my visit her oxygen levels were better, not great, but better, and she looked good. Before leaving, I had also requested that Maddie remain swaddled as often as possible because it is calming and soothing for her. As long as she is under the bilirubin light, though, she cannot be swaddled because it blocks the effects of the light.
We attended our church baby shower on Sunday. Everyone was unbelievably generous. I confessed to them how much I had been dreading the shower because it is so difficult being around other people right now. They were all very nice, though, and I ended up having a wonderful time.

We visited the girls after the shower. Their oxygen levels had improved even more, and they both looked as though they had gained a little weight. I was thrilled to see that they were both swaddled. They both looked very comfortable, Madeline especially. She doesn't like to be fussed with, but she loves to be bundled.

This afternoon, the girls looked great. They are both back under the bilirubin light because their levels were high enough after this morning's blood work. Madeline is under the traditional bilirubin light, but Cadie is wrapped up in a bili-blanket due to a shortage of lights. I actually prefer the blanket because it allows her to be swaddled. Both girls were weighed last night. Madeline weighed 1 pound 13 1/2 ounces and Cadence weighed 2 pounds 7.3 ounces. They both gained weight! Madeline is finally weighing in above her birth weight. Their chest x-ray results revealed that both their lungs are a little foggy, which can be attributed to a number of things including infection or just the fact that they were so premature. Dr. K ordered a dose of Lasiks -- a diuretic -- for both of them to get rid of some of the fluid, which will, in turn, improve their breathing. They are both taking milk again; they have to restart at the very bottom, which is frustrating, but necessary to make sure they can tolerate it. They are both receiving 1 milliliter every three hours. Madeline got her first feeding at 11 this morning and hasn't had a problem. Cadence got her first feeding during my visit at two o'clock, while Madeline got her second. Maddie had a little smear on her rear end when the nurse changed her diaper, so she is trying to make a poop.
One area of concern is Cadie's head. The nurse, Monica, reported that Dr. K had bumped up her scheduled head ultrasound today because her head had measured a little more than yesterday. My immediate reaction was to attribute the change to growth, so I asked the nurse if that was possible. She and Dr. K had actually discussed that possibility earlier in the day. They agreed that if it isn't normal growth, it is most likely due to hydrocephalus, a complication of IVH that occurs when a blood clot prevents cerebral spinal fluid from draining naturally. If the fluid cannot drain, it builds up in the area that surrounds the brain and can eventually put damaging pressure on her brain. If the head ultrasound confirms that the growth is a result of hydrocephalus, they will continue to monitor her closely. If it reaches a point where intervention is necessary, they can perform a procedure to drain the excess fluid. We are crossing our fingers that this isn't the case, that her head is just growing from all the yummy milk she is getting.