Saturday, December 25, 2010

Christmas Day

Xmas day marks the start of week three for the little treasures, there has been a little bit going on in the last few days.  Jack was doing really well up until tuesday when the doctors suspected he was developing pneumonia.  They picked up that he wasn't breathing as well as they would like so they took an x-ray and saw some haziness on the upper right lung (I couldn't see anything, I can see why they have to do the training they do!)  He was put back on antibiotics to make sure he was ok, more blood was taken for another culture.  Turns out it was a general infection which although still not great, it was far less of an issue.  The infection responded really well to antibiotics and he will be taken off the antibiotics in the next couple of days.  Jack is up to 4 1/2 ml per hour, very close to full feeds so he is putting on weight pretty well.  Even with the infection he is keeping all the food down!  he had to have his first transfusion on the 24th (14ml), apparently this is common for preemies as they grow faster than their bodies can produce the necessary new blood, plus all the tests etc they have done, all the blood taken out of their little bodies.  (Side note, Jack is B+ blood type, Ella is O-)

Ella has been steadily improving, she is up to 5 1/2 ml per hour feeds which is considered full feed so she is moving ahead really well!  Anthea got to hold Ella today for the first kangaroo care, pics below.  I think it's safe to say it was Anthea's best christmas present!  Jack's not quite ready for this yet, hopefully in the next few days!  Anthea was changing her nappy and Ella had a little cry - the first time I had heard her.  I'm sure in the years to come the sound may not be as easy to hear but it sounded pretty good to me!

The doctors and nurses from the NICU got together with the local fire brigade and children of staff to provide some fantastic xmas cheer to everyone in the NICU.  It was Xmas day so there were lots of people there visiting and itwas a really great moment for everyone to enjoy.  There are parents of kids born years ago in the NICU who come back every year to give little presents to all the new babies over the xmas period, there's even one present from the mum of a girl who was born there 21 years ago!  It just shows the real feeling there is in that little NICU community.

Xmas Day cuddles, what a present!


Anthea wanted to see Ella's hair - she always has a hat on!

Santa came to visit Jack

...and Ella!


The volunteer team from the hospital and the local fire brigade

The amazing gifts given to all babies in the NICU

Jack with his Xmas outfit - it's a tunic, not a dress!
 
Jessie taking a photo of Ella with her new camera from Santa


Saturday, December 18, 2010

Week 2

20/12
Jack is now on 4ml per hour feeds, Ella is still on 2ml as she has a little bloating.  Having said that Ella is now up to 890 grams, having put on 68 grams over the last 4 days!  Come on the kilo mark! With Jack's feeds, he should start putting on weight rapidly too.  I guess a short report is a good one, nothing bad to say!
I like this pic of Jack, he looks peaceful
First pic of Ella with her eyes open!
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
19/12
Jack was weighed yesterday and he has lost 10 grams since birth - not bad, he could have lost up to 10% of his birth weight. When we went in today, the nurse asked if we would like to do the nappy change for him - when we said yes she said "Good coz he's done a bad poo!" And boy had he... Anthea changed the nappy. He still has a little nappy rash so we only loosely put a nappy under him. Jessie was holding his hand and Jack pee'd on her hand! it was hilarious. It was such a good one, he even sprayed the top of his plastic crib! I got to hold my little man again when the nurse had to change his bedding. Ella is still being a good girl, no major dramas and still on CPAP. she is off the jaundice lights again and looking a bit pinker which is nice to see.
       
18/12

We got the results back from the head scan, all normal, no bleeds for both Jack and Ella. This is fantastic news and what we were really hoping to hear! Jack is now back on feeds, 1 ml per hour which he is now digesting so hopefully we'll see some extra weight gain in the coming days. Jack is due to be weighed today so we'll know how much he has gained or lost. Ella is back under the lights to combat jaundice, Jack's colour is fairly normal now, he's quite pink! They're both starting to open their eyes now, just a crack for a few seconds but still nice to see. Jack has fairly blonde hair which is starting to fill out, Ella's is more a light brown colour. 18/12 PS - Anthea went back in to see the little
cherubs tonight and was told a couple more pieces of good news. Jack's now off antibiotics as of yesterday, his infection is all gone. They are also bumping up his feeds so by tomorrow he will be on more than Ella. Yes he's Barry's son!

Wednesday, December 15, 2010

Week 1

11/12
Day two started and we had the news that Jack had a high white blood cell count which indicates an infection.  They were to do a lumbar puncture to check for meningitis along with the normal raft of blood tests they were performing on both Jack and Ella constantly.  They were taking so much blood for these tests that both would require transfusions.  Both babies were fairly active and we had the opportunity to touch their little hands and feet.
12/12
This day marked their first 48 hours, a mental milestone for me which was when I started to let myself think that they may actually be ok as Jack and Ella continued to improve and stabilise.  Jack’s infection was still worrying but the results were expected by the following day.  Ella was still breathing well on CPAP.  They were put under lights for jaundice today so that should help their
colouring.
13/12
Jack’s results for the lumbar puncture were negative in terms of nothing had grown at this stage in the culture so that is a good sign.  We got to hold him, bathe him and change his nappy – tasks which later on will no doubt be seen as chores but to us they were great moments.  Ella was taken off antibiotics today and both babies are starting to tolerate their Mum’s colostrum – liquid gold for them in terms of the body’s development and weight gain.  Their colour looks much better now, although they’re still very pink due to their thin skin.  They did the first head-scan with ultrasound
today which is to check for bleeding around the brain – results tomorrow.  Ella’s chart showed some ‘B2’ events which means her respiratory rate went down to zero and she needed outside assistance
to have her start up breathing again – just a bit of a nudge from the fantastic NICU staff.  If these events continue, Ella may have to be intubated like Jack.
The team in the NICU are the most caring group of people I have ever met.  They give our babies
exceptional around the clock care – that’s their job after all.  But the way they go about their job is the key.  We came in to find a beautiful scrapbook style label on Jack’s crib today that one of the nurses had put together with his name, DOB and even that his sister is Ella.  She then apologised for not having Ella’s label ready yet!  As we sit watching our babies, the team around us bustle around, offering as much information as we want and even leaving us alone when they can see we want that.  I have seen them changing other little babies bedding and giving them a wash, all the time singing soft songs to them.  These guys are there not because it’s a job, they’re there because they truly care.
14/12/10
Today we got the results for the first head scan, both Jack and Ella came back normal – which is to say no bleeding – great news.  We were able to bathe Ella and changed her nappy; she had a little cry which was a beautiful sound.  She has had no more B2 events per yesterday and has remained on CPAP.  She opened her left eye just a crack today.  And yes, they finished Ella’s label for her crib which is just as cool as Jack’s.  Our little man continues to improve, and the doctors are considering putting him on CPAP like his sister. We love having contact with them and doing the normal parent things. And yes changing their nappies was one the best things we have been able to do for them. Barry took off his wedding band and it fitted around each of their feet.
Jessie has been the best big sister in the world.  We first thought it may be confronting for a 4 year old to see these tiny little babies with tubes everywhere, living in what looks like an aquarium – nothing could have been further from the truth.  Jessie saw them from day 2 and has been excited about seeing them every day.  She talks about her little brother and sister all the time, even relating to Anthea a dream she had last night where she was walking to put on her shorty jammies and Jack and Ella were playing in her play house and looking at her through the window.  Jessie never ceases to amaze me in her capacity to care for others even at this age.  Mind you, I’m sure later on down the track when her annoying little siblings have gone into her room yet again it may be a
different story.

We still don’t know quite how to feel about everything.  On the one hand we have these wonderful two new babies that we love more and more each day, on the other we know we are still confronted with a best case scenario of long term care, eventually being able to take them home in 6 months or so – and a worst case scenario that we don’t even want to consider at this point.  The staff advise us to just take it one day at a time – I think to do anything else would drive us mad!
15/12
We are trying to get into some sort of routine for visiting Jack and Ella.  I am still working in the city for another week or so, I will visit them in the morning for a little while before work and Anthea will go in later, depending on if Jessie will go in with her.  It’s probably a bit much to expect that Jessie will want to visit every day!
Jack was put on CPAP last night at around 7pm; this is a move forward from the breathing tube.  He
had a number of respiratory failures last night, but mostly B1’s which means he fixed it himself.  B2’s are when they need a little assistance, similar to what Ella was doing back on the 13th (is it only 2 days ago?).  He may or may not need to be intubated again depending on how he picks up.  This is nothing out of the ordinary so still on track so far.  Jack has not yet tolerated the feeds of Anthea’s colostrum; he has not been able to digest them, whereas Ella is taking them very well.  Again, not a serious worry at this stage – something else we are finding out is that premature girls are almost always more advanced than boys of the same gestation.  Both Jack and Ella have a nappy rash now – it’s almost strange for them to have such a mundane issue.  They’re having some nappy off
time to try to address this.  We got a couple of pics to get a persepective on just how tiny these two little treasures are...  The gold band in the pics is my wedding ring


Ella's tiny foot - note the bruising from the birth


Jacks foot - it actually looks quite big compared to his leg size!













16/12

Jack was intubated again, he was getting very tired trying to do it all himself so he's back breathing with a tube to give him a little bit of a rest.  Both Jack and Ella had their day 7 head scan today, results should be back in the next 24-48 hours.  This one is pretty key in determining their development, so here's hoping for no bleeds.  Ella has been weighed and has actually put on weight in the first week!  Only 4 grams but given they are expected to lose weight in the first week that's a fantastic result!  It's due to the fact she has been able to feed on mum's milk that has given her this growth.



Welcome to the world Jack and Ella

Jack Keith Maitland and Ella Rose Maitland were born at 25 weeks + 2 days gestation on the 10th December 2010.  Jack was the impatient one, he'd sent Anthea into hospital 9 days earlier trying to get out but luckily the staff at The Mercy Hospital in Heidleberg managed to halt the progression into full labour.  Anthea was transferred to Monash Medical Centre a couple of days later as it was closer to home and also the best premmie hospital.  We were hoping they would hold out till Xmas but Jack had developed a slight infection in utero which forced things onwards at about 6pm on the 10th.  Jack was first, a quick normal birth at 10pm - he weighed in at 850 grams.  Ella followed more slowly, she was born breach and need alot of help to come into the world  She was born at 10:08pm and weighed 808 grams.  Anthea was fine after the birth but that night gave us our first introduction to the world of NICU (Neonatal Intensive Care Unit).  It was fairly confronting at first, seeing our tiny babies there surrounded by tubes and people but they had 10 perfect little fingers and toes, their weight was pretty good for their gestation and Ella progressed straight to CPAP (continuous positive airway pressure) rather than being intubated for ventilation.  Jack was a little less advanced, needing to be intubated.  Although this was a difficult time for us as parents, all we knew was that they were here, they had made it past the first hurdle and they were our children.
Our little man, Jack Keith Maitland

Our precious Ella Rose Maitland