Copy work

Bragging time - Elsa has been asking to do her "school" work again and we finally sat down together to start doing some copy work.  I was rather impressed with both of them!

Caffeine free!

Oliver's doctors said he no longer needs caffeine!  Alleluia!

We've been downloading the information from his apnea monitor every two weeks and finally the data from the monitor showed no apnea events (when he would forget to breathe or breathe irregularly for too long).  He's been on caffeine since he was a week or so old for apnea due to his prematurity, and his doctors have been eager to get him off of it as soon as possible because the caffeine may be exacerbating his hypertension. 

I'm especially excited because that means he won't need the monitor for too much longer!  The home apnea monitor is a foam/velcro strap that goes around his chest with two electrodes stuck on either side.  The electrodes detect when he takes a breath and when his heart beats, and if he waits too long to take a breath or if his heart rate drops too low it sounds off a crazy loud alarm.  It also sounds the alarm is the wiring is loose, if the power cable is faulty, or if you've left it plugged in next to a baby monitor for two long (in our experience, 95% of these kind of alarms happen between the hours of 11pm and 5am).  Also, the electrodes have been chafing terribly on his soft baby skin, so I am very eager to get rid of the monitor.  Usually they want to keep a baby on the monitor for a month after stopping caffeine, but I may push to see if we can stop a bit sooner.

Oliver continues to gain weight well, though I think it is mostly in his cheeks.  He's nursing much better now - today he nursed for about 30 min. for three of his meals!  We have a developmental assessment on Thursday when the occupational therapist will evaluate his progress again.  He's still a sleepy baby, but he tries hard to lift his head and do normal baby things when he's awake and alert.  I'm proud of him - it's hard to lift your head when half your weight is in your cheeks!  (and when your mama keeps flashing the camera in your eyes when you're finally looking up!)

Self-portraits with a camera rarely turn out good for me, but here's a few decent ones from when I was holding Oliver tonight (it was the only way to get a plesant face; he would fuss as soon as I put him down).

rainy, chilly June

Aside from a loud thunderstorm (which frightened Elsa terribly but caused Nora to walk around the house saying "baboom, baboom!"), we've generally been enjoying the cool and wet weather we've been having lately.  We wore our sweaters today to get our milk at the farm and made sure to jump in all the puddles. 

The flowers have enjoyed the rain as well.

I haven't gotten a good photo of Nora lately - she just moves too fast!  Her new favorite word is "mess!" - as in, "look what I just made!"

Good lab results!

Yea!  Oliver's sodium concentration rose back up to 131 mmol/L according to his lab work today!  He had been at 126, (with 125 and lower being extreme hyponatremia), and the normal range is 135-143 mmol/L.  We're so glad that his body responded to the increased dosage of sodium citrate and that we do not have to rush up to Portland! 

We'll continue to watch his weekly lab work closely.  Hopefully his sodium levels will continue to improve.

Thank you all for your prayers - we are so thankful that his lab results were so good.  (Though getting the lab done was quite an ordeal requiring two trips to the hospital, four nurses, five pokes, and finally help from his favorite NICU doctor!  The boy doesn't like to bleed!)

Hyponatremia - pass the salt, please!

After Oliver was discharged I quickly learned that if "Unavailable" appeared on my cell phone, I'd better drop everything and answer because it means that one of his doctors or nurses was calling.  During the week I get an average of 2-3 calls a day from "Unavailable" - today is was one from the pediatrician's office to schedule an appointment in Portland with a specialist, one was a follow-up call from the lactation consultant at the hospital, and the third was Oliver's pediatrician himself with the results from yesterday's labs. 

Oliver's weekly labs showed that his blood or serum sodium (salt) concentration has continued to drop even after trying two different sodium supplements.  Hyponatremia (low blood sodium) can be caused by a number of different root problems, and usually is the result of the body holding too much fluid and thus diluting the sodium concentration.  Having the right sodium concentration is important in maintaining the right electrolyte balance in the blood, and an imbalance can cause cells to swell and have other problems. 

So, we're increasing Oliver's sodium med for the next few days and we'll go in for lab work again on Monday so see if his sodium levels have improved.  If they get worse he'll be in the "extreme hyonatremia" range and we'll probably be sent to be admitted to OHSU in Portland for him to be under the direct care of the Pediatric Nephrology doctors who have have been monitoring his underdeveloped kidney (which is probably at least part of the cause of his hyponatremia and also his hypertension).

So please be in prayer with us that the increased dosage of sodium will address this issue and even help his body to resolve it. 

On a very positive note, after a discouraging week of being sick and only a few good times of bottle feeding/nursing, Oliver did absolutely fabulous at nursing when we saw the lactation nurse yesterday.  I was so encouraged - we estimated that he got at least a whole ounce before he got tired!  And no choking or heavy breathing!  I think that he knew he was being watched and has already learned to perform for an audience. 

You know your family's been sick for too long when...

... your toddler comes to you pretending to take her own temperature, saying a high pitched "beep beep, beep beep" to imitate the fever warning on the thermometer:

Nora is finally almost back to being herself after being sick (fevers, cough, severe congestion) for a full week.  Elsa got the bug next, and it lead to an ear infection Sunday night.  I got sick Saturday.  In an effort to keep Oliver from getting sick we've barely taken him out of the bedroom, we've turned off the air circulation in the house, the girls are not allowed in, and we sanitize our hands, change our clothes, and wear a mask when we go in to him.  Even with all that, he has started coughing, but thankfully the pediatrician thinks he just has a simple cold and not the full-blown yucky bug that we got.  Thankfully Joel has stayed well and has done a great job taking care of us all. 

Here's Nora from earlier in the week, poor kid. 

We've watched all the appropriate kid movies that we own several times over.  I think we're finally on the mend, and, if not, at least Nora knows how to take her own temperature now.

Chubby boy

Oliver's made it to 9 pounds now, and he's got the cheeks and rolls to prove it!

There's not much new medical info to share; we're still doing weekly check-ups and lab work, and getting appointments scheduled at OHSU in Portland for July.  His eating is still improving (he's doing pretty good with a new bottle we've been using), but he'll still need the help of a tube for a while yet.  This last week we've just been trying to keep him from getting sick!