Weekend in Review

Looks like we can declare an early winner for the 2010 poll: Mom. Admittedly, I (Stef) voted that Ella looks like Dad. I was apparently in the minority. In the pictures she clearly has my physical features, but when you see her in person her facial expressions look a lot like Dad. I guess she's a good mix of us both.

Ella had a fairly uneventful weekend. She is off 2 of her meds (the diuretic and antibiotic) and I think that she is more alert when awake. She seemed to be a bit dazed earlier in the week. Whether or not that was related to the meds, I'm not sure.

Ella has upgraded from newborn diapers to #1s already. Her bowels are clearly working just fine.

I've gotten the question many times, "when is Ella coming home?" The answer is "we don't know". I know everyone is anxious for her to get home (and trust me, we're as anxious as anyone!), but it really depends on how she progresses on the bottle feedings. She is taking at least 1 full bottle per day, and is now able to take a 2nd if she wants. The general guideline is that she must take 24 consecutive hours worth of feedings by bottle safely, then the nurses can remove her feeding tube. At that point it's generally a couple of days later when they discharge her. We will continue to keep you posted on her progress.

Someone at work this week told me 'this is something Ella will never remember and we'll never forget'. Simply stated.

Medicine girl

It's been a few days since we've posted and Ella has had quite a bit happen this week.

First, she got an upper GI exam. She drank barium and the doctors evaluated whether or not she had reflux. The diagnosis was that she had a mild to moderate case (on a scale of mild, moderate, severe). So nothing serious, however they wanted to stop it in case it was irritating her esophagus and attributing to her bottle challenge. She is on Zantac to stop the acid production. There are also other liquid meds that are available to coat the esophagus if it continues to be a concern.

Second, the doctors felt she was retaining too much fluid so Ella took a diuretic for 3 days. This obviously caused her to urinate more frequently and she lost about 3 ounces in water weight. She quickly regained it though and hit the 7-pound mark on Thursday night. We think this also helped with her breathing and oxygen dependency since there was excess fluid around her lungs, which leads me to my next comment.

Ella was moved also to 0.1 liter flow of oxygen and has successfully handled it. This is the last step before removing the oxygen assistance entirely. Truth be told, the nose prongs are barely in her nose anyway since she has learned how to yank them out. I'm feeling optimistic that she'll be off oxygen in a few days.

She continues to be challenged by the bottle, although I'm sure one day it will just click for her. In order to successfully bottle feed, her oxygen levels must stay steady. (Isn't it interesting to see how all of these items are intertwined...every little change affects something else.)

Her blood count levels have stayed steady and her ability to produce new cells is just fine.

Lastly, the lab techs performed a culture on her stools. They found a fancy-named bad bacteria and are treating it with antibiotics. She'll take those for 6 days and is already half way through her dosages.

Here are a couple of cute picture for those that haven't gotten to see her in a while, compliments of the St. John's paparazzi. I absolutely LOVE her fuzzy hair after bath time. Anytime I need a smile, I look at these. She's so cute!

Check out the New Poll!

Who does Ella most closely resemble? You might want to use these pictures to help. Click on them for a closer view.

Little Girl, Big Moves

Today, Ella's crib went for a ride across the hall to her new room! She upgraded to a room with windows since she is now old enough to see daylight without being over stimulated. We absolutely love it too because we can see the outside world while spending most of our weekends there. Should we still call it MotElla? I think so.



Ella also started enjoying her bouncey seat as development time. The nurses roll up towels and washcloths to help support her neck and body since she's still a bit small for it. She loves focusing on objects (well, not so much in this picture since she decided to take a nap instead).



Lastly, Ella made some progress on the bottle feeding. This weekend she was able to aggressively cue for her feeding and she took one bottle on Sat and one today. Today she was able to safely finish all 2 ounces in just 30 minutes!! This is significant progress and we hope it's a sign of things to come.

Therapists

Ella was evaluated by the occupational and speech therapists this week and they believe that Ella's slower swallow development is just a maturity issue at this point. Basically she was able to take a few bottles a couple of weeks ago, however since then her sucking abilities have developed faster than her swallowing. So when she is pulling in more milk from the bottle she then doesn't know what to do with it. It should self correct itself in the next few weeks. In the meantime, she is able to take one bottle per day if/when the therapists are present. Also, the nurses will likely still conduct the video swallow study and upper GI to make sure it's just immaturity, and to see how her reflux is affecting her.

The physical therapist continues to watch Ella's neck and leg muscles to make sure they're strengthening equally on all sides. She believes that Ella is slightly overusing her outer leg & foot muscles more than her inside ones. So Ella has some special tape on her shins and ankles to force her to use certain muscles. This is a very minor issue in my opinion, just an added bonus to having expert care 24/7.


All this talk of the therapists reminds me of Sean Connery on SNL...

Weight: 6 lbs, 13 oz
Length: 18 1/4 inches
Clothing: out with the old, in with the new(borns)

Family Tradition

Ella officially became part of the Panera family today - see her beautiful, new rocking chair!



Mom has been visiting Ella during 2nd shift this week while Dad has been pulling the 3rd shift. The exciting thing is that 3rd shift handles bath time, which is by far Ella's favorite time of day. She is so alert and even stays awake long enough afterwards to enjoy her rattles, mobile and often storytime.

No further updates on the bottle feeding. The occupational and speech therapists worked with her this week so we should know more in the next few days on next steps to moving her along.

Battle with the Bottle

Ella surpassed the 6-pound mark this weekend...6 lbs, 4 oz! Can you believe she's more than tripled in size?

The bottling was temporarily put on hold this weekend until the therapists can further evaluate her swallowing. Due to some gulping sounds and other facial cues Ella was making, the nurses believe she may be aspirating. It's hard to tell for sure at this point so it's better to be safe and get the therapists involved. Depending on how her evaluation goes this week, they may try different bottles, thicken her milk (so she can't drink it as fast), or do a swallow study where they hook a camera up to her and watch her mouth and throat on a video screen while she's drinking. Mom got a little upset hearing about the set back. Although in reality it's likely easy to correct or simply figure out, it was still difficult to hear since she's been progressing so well for the past 11 weeks. We know she'll be fine. We're just anxious to get her home.

Ella sported her Cowboys jersey today in hopes of bringing home a playoff victory, but unfortunately it didn't help. Oh well, she got her revenge by generating a loud blowout in her diaper when the Vikings scored their first touchdown.

Here's to moving forward.

Girls' day out

Ella and Mom enjoyed girl time on Saturday. The day involved shopping for Ella's new shoes and enjoying manicures. Ella's all set to hit the town!

Update

Mom and Dad have moved their days with Ella to evenings and nights. While tiring on us, it is interesting to see how Ella reacts differntly at night compared to day. She seems more awake and for longer periods in the evening hours. Night owl? It also allows us more opportunities to give her baths!

While we and Ella have enjoyed all the visitors, we are going to resepctively ask for no visitors (family included) for the next 7 days. Ella slid a little backwards on her O2 and we want to give her a chance to catch up. She also has not quite grasped the whole bottle thing, so we want to give her the best opportunity to be well rested when she goes for the bottle. And she needs to be rested, because she is taking 55 CC in each feeding...that's a lot of food for her to digest! This is a long way from the 2 we started with. On the stats side, she is sitting at 5 lbs and 14.5 ounces - I think we're going to hit 6 lbs this weekend!

Field Trip

Ella went on a field trip today to another floor in the hospital to get a hip exam. The nurses loaded her up in an isolette and she apparently enjoyed the ride, staying wide awake the entire time. This is a common exam for infants, and is a requirement for premature babies to go home (another sign that she's getting closer to discharge). The doctors just make sure that her joints weren't injured during the stressful delivery. All checked out fine.

Ella still has room for growing in the area of bottle feeding. Although she is doing fine on the bottles she does take, she only gets bottle opportunities when she is alert and giving us cues. This means that she is only taking about 2 bottles a day. In order for her to be alert, we're realizing that uninterrupted sleep is very important at this point. As such, we'd like to ask that visitors are limited to Tues, Thurs, Sat and Sun. This will give her days of peaceful sleep so she can be more awake for bottles.

Mom and Dad are surviving through work. The days are long and dinner is often at 9pm or later, but it's totally worth the time with Ella. She makes us smile everyday with her new discoveries like pursed lips, noises, and her interest in her butterfly mobile and rattles.

Weight: 5 lbs 11 oz
Length: 18 1/4 in
Hair: Slightly curly when wet. Fuzzy spike when dry.
Finger nails: Sharp as daggers. Soon to be painted red.

Tummy Time Nap

These boots are made for walking

Ella shows off that she is ready to go home - just fit her with some snow boots!

Tonight, the physical therapist was in and showed us ways that we can make sure her neck stays loose (as she tends to turn to the right - because that is where all the action is next to her crib)! She also showed us how to make sure her feet and leg muscles are developing properly. Since they took the oxygenation monitor off to do so, we got the first pictures of both feet since her birth footprints!

Dad gets a double surprise

Tonight Dad got the double diaper surprise as Ella continued to finish her business while Dad was trying to put on a clean diaper. Makes Mom laugh.

As many of you know, Mom returned to work on Monday and Dad is back from the holiday break with busy season looming. This means that our hospital schedule is mainly evening hours. It makes for some long days (already) but totally worth every minute when we're there. Ella seems to be so much more alert. Last night she was awake exploring her environment for an hour! We're not sure if she is a night owl or maturing in her development where that is a more frequent occurence. Either way, we're enjoying it.

Overall, progress is happening. We're starting to see her have more interest in her bottles and takes more milk per bottle. She has a bit of swelling in her legs and around her eyes due to water retention, essentially. The doctors may prescriber her a diaretic to flush out some of the excess fluid, but this is a non-issue at this point.

Here's my new favorite pic.

Splish Splash, Ella was taking a bath

Ella had fun in the bath last night. Mom and Dad made a second visit to the hospital to participate in Ella's bath time and weighing. It was so cute seeing her roll around on the scale and actually tolerate the bath. We thought for sure she'd cry the whole time, but no tears (Johnson & Johnson was right!)

Then and Now

Ella is 2 months old today! We really can't believe how quickly it's gone by and how much Ella has progressed. She has come so far in many areas - feeding, weight gain, breathing, and blood cell count, just to name a few.

Then...
Weight: 1 lb 15 oz
Length: 13 3/4 in
Breathing: CPAP and 30% oxygen at 5 liters air flow nose cannula
Feeding: 2 ml by feeding tube
Bed: heat regulated bed



Now...
Weight: 5 lbs 0.2 oz
Length: 16 1/2 in
Breathing: 100% oxygen at 0.2 liters air flow nose cannula
Feeding: 45 ml by bottle and feeding tube
Bed: open crib

Tiger wants to go for a ride with Ella!

Vaccinations

Ella received her 2-month vaccines over a 2-day span. She got stuck with a needle several times in her thighs for a total of 7 vaccinations. Poor girl. She took it like a champ though and the band-aids made it all feel better.

Developing those lungs