Goodbye CPAP?

Caroline had another fabulous day!! If she has a good night, they will likely take her off the CPAP!! She continues to be on 21% oxygen (room air). Her doctors decreased her pressure today to the lowest setting they will use on the CPAP. Once she is off CPAP, they may give her a nasal cannula to help with oxygen. Caroline will then need to prove herself and do well breathing for 48 - 72 hours. After that her doctors would likely move her to the level II NICU. Please say a prayer that Caroline has a good night and gets to take this step forward.

Once the CPAP is removed, they will start working with her to bottle feed. From what I understand, this will be a big challenge. There will be good days and bad days. She is used to not having to work for her food. They will start doing oral stimulation during her feeding times to move her in that direction.

The only other change today was a slight increase in the amount of calories they add to my milk. Her doctors adjust this as she grows to make sure she is getting enough calories to put on weight.

Finally, the picture above is of Caroline on her 2 week birthday. Ryan and I meant to take a picture of us holding the doll, but it's with Caroline and we are home... We will continue to take her picture with her doll.

Child Birthing Class?

First time to hold on Saturday

Mom and C

Wide awake on Sunday night (CPAP not even in and doing great)

I woke up to my cell phone this morning...  There was a reminder notifying me about our child birthing class on Monday night.  Oops.  Katie and I argued about the necessity for me to attend this class.  She told me that I perform better when I am prepared.  Whatever...

Caroline had a great weekend.  She is breathing room air through her CPAP almost all of the time.  They sometimes have to turn it up if she is agitated or when she has a full stomach (harder for her lungs to take a full breathe with a full stomach).  Her pressure through the CPAP was reduced both Saturday and today.  If she continues to do well, she may graduate from the CPAP machine in as soon as a couple of days to a week.

Katie and I both held Caroline this weekend for a couple of hours at a time.  They like us to hold Caroline against our skin ("skin to skin").  Research proves that it is good for the baby and the parents, especially the Mother.  There are actually several benefits.  One of the many issues that premature babies face is regulating their body temperature.  The incubators that Caroline sleeps in are very, very expensive.  In fact, the first incubator that Caroline slept in was worth about $40,000.  She is now in a cheaper incubator - $20,000 or so.  Think about premature babies born in third world countries where they cannot afford this kind of equipment.  Mothers have to sleep with their baby next to them to keep them warm, or hold the baby close as the baby is transported to the nearest hospital that can care for the baby, which may be very far away.  So, when you see the pictures of us holding Caroline, she is against our skin, or in my case, my hairy chest.  Sorry Caroline!  She is actually down the neck of my tshirt.

I have been looking through some of our baby gifts tonight.  As Katie says, I perform better when I am prepared.  She is going to regret saying that.  I decided to give the Baby Bjorn a test run...

I am going to be a great tourist.

Small baby, big bark

Mom holding Caroline

First family portrait

My ring on her shoulder.  It could fit on her arm.

Caroline turned two weeks old yesterday.  I cannot believe it's only been two weeks.

She had a new nurse yesterday.  The nurse thought she was getting a sweet little baby, but Caroline acted up all day.  She said that she acts like one of the bigger babies.  She absolutely hates her CPAP machine.  She tried to pull it out the entire time I was up there.  At one point, two nurses had to come over to get it back on.  They were both laughing and said that they want nothing to do with her when she is full grown.

Her apnea was the same as Thursday - still having to fight it, but she recovers on her own.  Good.

They upped her feedings last night to 19 CC's per feeding.  She is getting close to an ounce each time.  Her weight was up again.  I think it she was 2 pounds, 5 ounces, but they later said 6 ounces.  Either way, she grew again.

Katie is holding her a lot and Caroline really likes that.  I am going to try to hold her this weekend.

I am adding some pictures and youtube videos.  I hope it works.  She is starting to open her eyes a lot more.  I know she cannot see anything, but I like to think she is looking at me.

Caroline awake (8-27)

A few days old

A Better Day

Katie said that I had to update the blog tonight because I am "a better blogger".  I am not really sure how to take that kind of compliment...

Anyway, Caroline had a much better day today.  She did have some spells of apnea, but she self corrected every time.  The doctors think that the apnea will continue until she would have been 34 weeks (31 now).  As long as she self corrects, that is fine.  Again, they expect this kind of struggle with a premature baby.

All of the tests for infection came back negative, so that is obviously good.  It looks like her struggle to breathe was due to swelling in her airway and that was treated with a second small dose of steroids.

She continues to do VERY well with her feedings.  In fact, they are taking her off of her other nutrition (minerals, vitamins, lipids) and she will only eat milk through a feeding tube.  She is now up to 2 pounds, 4 ounces (up 6 ounces).

Her PICC line was removed today.  They gave her the PICC line (http://picclinenursing.com/picc_why.html) on her second day because standard IV's were falling out of her.  They told us that PICC lines usually stay in for a month.  They said that there are sometimes some complications when the line is removed, but everything went smoothly.  It feels good to know it is already out.

Caroline looks really good and more at ease.

I got to show off Caroline today to my good friend, Wolf.  That was exciting for me.  We have some more pictures, but they are not uploaded yet.  I will get them up later tonight or tomorrow.

Dying for Some Attention

Caroline was dying for some attention… On Monday night, she had a several spells of apnea and bradycardia (A’s & B’s). This means that she forgot to breathe and her heart rate dropped. From what I understand, this was her worst night after the beginning few days. They were pretty worried about her Tuesday morning and decided to check for an infection. Basically, a premature baby might act up like this if they had an infection like staph or meningitis. Since she is so small they want to catch an infection right away. In order to rule out an infection, they did a blood culture and spinal tap. These tests take a couple of days so they have her on antibiotics to be safe. I think we may have the results sometime tomorrow.

The doctors also noticed a bunch of “junk” in her airways and speculated that could be the cause of her problems. The CPAP machine is constantly pushing drainage into her throat and she cannot swallow like us. So, they suctioned some of the junk out. After that, the rest of Tuesday was pretty smooth.

This morning she had some bad A’s & B’s again. Her airway was clear (meaning no junk) so they did a chest x-ray and blood gas analysis. These came back okay… They could hear her wheezing and see that she was working hard to breathe, so they began to think her airway was slightly swollen from the breathing tube that she used to have. They gave her a small amount of steroids to help with swelling. After receiving steroids, we have not heard any wheezing and she has self corrected any apnea and only have one or two A’s and B’s. We hope she has a good night and is able to stay ventilator free.

Some other good news - We found out they did a head ultrasound and everything came back normal. She also continues to “eat” well. They have continued to increase her breast milk. She is now up to 10 ccs a feed.

I snapped a great picture of Caroline holding my finger this morning. We were waiting for her chest x-ray and she was so alert and wide eyed.

Caroline's Bed

Caroline had another great day! They increased her caffeine to help her remember to breathe. Her neonatologist said that babies have different tolerances to caffeine and they had not increased her since she was born. Overall, they were very pleased with her today.

I snapped this picture because several people have asked what her bed is like. She is under the blanket in a isolet that they keep dark, warm and humid. She is in "pod" with several other babies. The windows separate the pods keeping the noise down.

Thank you again for all your emails, calls, text messages and prayers!

First Time to Hold

I got to hold Caroline today!! It was absolutely wonderful. She continues to do well. They increased her feedings today and she is tolerating at least half of the food they give her.

I am feeling a hundred times better and plan to spend some time holding her tomorrow. They like me to hold her at least an hour a day. Ryan plans to hold her this coming weekend. Since she has so many bells and whistles, it takes a lot of effort to get her situated. We had two nurses and Ryan helping to get her comfortable. Her bottom and feet fit in the palm of my hand.

The other picture is while they are working to get her back in her bed -- she is a little agitated with all the moving.

New look

It's official.  In just a week, I think that Caroline has more friends than her "old man".   She also continued her streak of good days.  I was able to see her for the first time since Wednesday and her coloring is now perfectly pink.  She was pink when she was born, but quickly turned a little reddish.  I was really happy to see how great she looked today.

Big news today - the doctors were able to take out her breathing tube.  She is now using a CPAP machine, which can give her oxygen and pressure through her nose.  From what I understand, this is used by people that have sleep apnea.  They had to give her a shot of caffeine to remind her to breathe, which is normal for premature babies.  However, she was auto-correcting herself as the day went on.  This is a great step for her and I am really proud.  It is also good news because we can now hold her a little.  We did not get a chance to hold her today, but hopefully we will be able tomorrow.

She has been completely off of her blood pressure medicine for over two days.  They said there was a chance should would have to take some medicine every once in awhile, but now they think that issue has passed.

Here is her picture from today.   A lot of people have told me that Caroline does not look that small in pictures.  I think it's one of those things that you have to see to believe.  You can see the nurses hands in the picture and I think that helps put her size into perspective.  However, she is now over 2 pounds.  I am going to try to remember to get her official weight tomorrow.

Katie feels a lot better today and enjoyed seeing some friends. 

Man, we love hospitals!

Caroline had a wonderful day yesterday. She continues to tolerate some of her feedings. They have been able to drop many of her vent settings and she was at 21% oxygen saturation most of the day. Her nurse yesterday, was the same nurse that checked her in to TCH last Friday. When I talked with her she was really excited to see so much progress in Caroline. She even mentioned that she thought she looks bigger already.

I did not go by to see her yesterday because I felt horrible...

I had a checkup with my OB yesterday and my blood pressure is still very high. They started me on an additional medicine for that issue. Then, last night, my incision looked icky and I called my OB. She suggested I go the ER to check for an infection. Ryan and I went to the Methodist Emergency Clinic on Kirby and 59 - it was wonderful. Turns out I did have an infection and they gave me an IV of antibiotics and then sent us home with more antibiotics. I feel so much better!! As many of you know, Ryan HATES hospitals. While we were waiting for my prescriptions to be filled I could not find him. Turns out he found a nice massage chair to lounge in... here is a picture.

Mmmm...food (and thanks to HS and friends)

Things continue to get better for Caroline.  Her oxygen levels are down to 21%, which is what you and I breathe.  However, when she gets agitated, which is a lot (that's my girl!), they have to increase her oxygen a little.

At some point this afternoon, they were able to take her off of her blood pressure medicine.  She may have to get a little more medicine, but hopefully she has that issue under control.  It is great that she is off of the blood pressure medicine, so they can feed her breast milk.  She has a tiny, tiny feeding at 4 p.m. this afternoon.  2 cc's (30 cc's in one fluid ounce).  She did pretty well with her first feeding - they had to turn up her oxygen a little.  She had another feeding at 6 p.m. and did not do quite as well, but the nurse said that is not surprising.  She said it takes awhile for "the gut" to get going.

Overall, her nurse said she was doing excellent tonight.  That means another good night of sleep for me!

Also, Katie and I would like to thank my work for buying us groceries yesterday.  They could not have come at a better time.  We would also like to thank several of Katie's friends for giving her rides while I am at work.  Very, very helpful.

Talk to y'all soon.

Motivating picture

Katie just sent a picture of a girl named Julia.  She weighed 640 grams at birth (Caroline was 853).  There is a picture of her at birth, at 8 lbs. 3 oz. and then as a 3 year old girl. 

Quick update

When we arrived to TCH this morning, they were doing the echo.  It looks like the medicine worked and that blood will now correctly flow to her lungs.  I am sure we will find out more later today.

Oh, and Katie puked and had to go back home.  Too much, too soon. 

Turning a corner?

Katie was released from the hospital early this afternoon, so we did not get to visit Caroline until late afternoon.  It is great to be out of the hospital after four weeks (our dogs agree).  Dr. Waverly Peakes, Dr. Alfredo Gei and Dr. Angela Earhart were absolutely perfect for our needs and I would send anyone I know to them.  Also, the nurses, their assistants and the Labor and Delivery staff at Methodist Hospital were wonderful every step of the way.  As much as I hate hospitals, I will miss seeing them.  Still, it's great to be home.

Today was Caroline's best day so far.  It was the first time that I have left the NICU after hearing all positive news.  I hope for many more days like today.  They were able to take the light off of her since her liver was functioning better (they may have to put it on again later).  They reduced her blood pressure medicine.  Her oxygen levels are down to 22%!  As we said in an earlier post, 21% is normal and she was at 40% just a few days ago.  They were also able to lower the pressure being applied to her lungs.  If her lungs continue to improve and her blood pressure regulates even more, she will begin to get feedings.  She is on medicine for her heart issue that we discussed last night.  The doctors believed that if they could fix the heart issue, then all of her vitals would improve.  They will do an echocardiogram soon to see if the medicine fixed the issue.  It certainly seems like it is working, but I am still crossing my fingers.


We will start our new routine tomorrow and I hope it goes well.  I return to work and Katie will be spending more time up at Texas Children's Hospital.  She cannot drive yet, so I will drop her off in he morning and then go to work.  Texas Children's Hospital has great areas where she can rest when she needs to.  The NICU has wireless internet, so Katie may be able to provide more updates on Caroline (and maybe more pictures, too).

I have never had a blog and I have never really had a reason to have a blog.  I did not know if anyone would really read Caroline's updates.  However, I keep getting feedback from many people that they enjoy the updates.  Honestly, the overwhelming love and support from family, old friends and new friends has kept me going at times.  So, Katie and I will keep them coming.  Talk to you soon.

Gettin' some sun

We just got back from visiting Caroline and got to snap a picture of Caroline “sun bathing.”  This is very common to do to newborns to help their liver functions.  You should be able to see my hand on top her head to give you a good idea of her size.  They cover her eyes with goggles during this process.  She will likely have the light over her for a couple of days.  I did get to touch her today which was incredibly calming for both Caroline and me. 

Unfortunately, we found out that she has patent ductus arteriosus.  When a baby is in utero, there is no need for blood to go from the heart to the lungs.  Instead, blood is directed back to the placenta.  After the baby is born, there is an artery that normally closes which sends blood to the lungs.  This is a common heart defect for premature babies, since they think they are still in utero.  A lot of the time doctors would just watch this issue in a premature baby, but they think it may have something to do with her lungs not working at full capacity.  The good news is that the doctors have been able to decrease the amount of oxygen she receives to about 27 – 30%.  They would like to get her to 21%, which is what we all normally breathe.  They think they will be able to fix the patent ductus arteriouse issue with some medicine that will help the artery close up.  Once this issue is resolved, the doctors hope that her lungs will improve. 

We were excited to find out that her blood pressure has improved so they were able to decrease this medicine.  Mom and Caroline have the opposite problem; my blood pressure is still high.  I am still in the hospital recovering.  They are watching my platelets and blood pressure and assure me that it’s just taking a while to regulate.

This is harder than we imagined.  Please know that Ryan and I very much appreciate your prayers and support. 

~Katie

After over two days, Caroline is fighting hard as ever.  The nurses and doctors describe her as "feisty".  So far, her main issue is that she has low blood pressure.  The doctors have it where they want it, but by medication.  Before she can eat, she has to be off of the medication (she is receiving nutrition by other means).  She is still receiving about 40% oxygen, but seems to be slowly improving with her lungs.  She is also receiving an antibiotic just in case she has an infection.  This seems to be precautionary.  There are several other issues, but nothing that seems to be unexpected for a baby as young and tiny as Caroline.

Attached is a video of Caroline sucking on a pacifier.  It made us all laugh.  I will try to get more updates as we receive new information.

The Kangaroo Crew

Texas Children's Hospital has a transport crew called the "Kangaroo Crew".  I hope you never have to use their service, but they were absolutely incredible.  They sent a four person crew to transport Caroline from the operating room in Methodist through the underground tunnels to TCH.  There were several unsuccessful transfers from her station at Methodist to the Kangaroo Crew's cart.  Every time they moved her, she got agitated and her wires fell out.  They finally got her on the cart and on her new home at TCH.  

1 hour old

Here is Caroline's first picture about an hour after she was born. 

Birth Certificate

While Katie was in the recovery room, I waited in the operating room as the doctors stabilized Caroline.  A lady in the operating room gave me her birth certificate before I even got my first look.  Seeing the birth certificate helped calm me down, but I was still a mess. 

Welcome Caroline!

The family welcomes Caroline Cooper.  She was born at August 13, 2010, at 12:55.  She weighed 1 pound, 14 ounces and was just under 13 inches in length.