Doing better

Although we’re still waiting for the labs to come back for Colin’s pneumonia (to find out whether it’s bacterial or viral), we have moved ahead with treatment — higher flow on his oxygen and a seven-day course of two antibiotics. And he seems to be responding well.

The biggest fear with the pneumonia (and this will continue to be a fear after he comes home for the first two years) is that he will need to go back on the ventilator. For this reason, no one wants to wait for confirmation before starting the antibiotics. If the labs do come back positive, the doctor can tailor the antibiotics to whatever strain he seems to have. If not, the medications he’s on now provide a broad spectrum coverage that should take care of what ails him.

Because Colin has difficult veins (they’re tiny even for a preemie, and they curve so it’s hard to find one long enough to insert a needle), keeping an IV line open for the full seven days is going to be a challenge. His first IV didn’t even make it 24 hours before it got blocked. And it took three nurses several tries to find a workable vein to replace it. 

Fortunately, I was able to be there and hold Colin’s head and hands while they were working on him, which I think made him feel better. (Not for everyone, I know, but watching them insert an IV doesn’t bother me and I feel much better knowing that Colin had someone there whose sole focus was to snuggle him.) I am hoping and praying that this one lasts for at least a couple of days. 

Because the pneumonia has made Colin’s breathing more labored, we’ve again had to suspend his oral feeds. I am hoping that today he will be back into a more reasonable range with his respiration rate so that we can try again with the bottle and breastfeeding. I don’t want to let that go too long, or I fear we’ll have a hard time getting him used to actually eating (rather than having the food more or less poured into his tummy). 

One discouraging outcome from our meeting with the doctor yesterday was the outlook for taking Colin home. Of course, this pneumonia has eliminated the possibility of bringing him home in September. But now it looks like he may not even be home until late October, and even then may have to come home on oxygen. That's quite an emotional about-face from last week, when we were counting down the days until we had him weaned from the oxygen.

John thinks that as soon as Colin has recovered from the pneumonia, we’ll be able to get him off the oxygen. I’m less optimistic. This is another of those [rare] times where I would love to be proven wrong.

Despite all of these challenges, Colin has continued to gain weight each day. For now, we are keeping him on the alternating feeds of 30 calorie formula and fortified breast milk. If I am able to successfully start nursing him we will have to see if this continues because he will be getting at least one feeding a day that isn't fortified. 

Ultimately, of course, the goal is to get him to a point where he is gaining weight on just breast milk, without any extra calories. But because he is so behind in his growth, thanks to the circumstances of his birth and the two weeks where he didn’t gain or lost weight, I’m in no hurry to pull him off the formula. 

Veronica and I have worked out a short-term system for night nursing that seems to be working for us. After she wakes up for her midnight-ish feeding, I have just been sleeping in the nursing chair for the rest of the night. This is not nearly as uncomfortable as it sounds in print, and it allows me to switch her around for nursing without really waking either of us up. (I tried doing this while in bed, but she isn’t quite ready to nurse in the side lying position — we kept setting her monitor off.)

Of course, we won’t be able to do this after Colin comes home, but for now it provides a way to both feed her and get my sleep.