Thursday, January 20, 2011

Today is better

The title of this post says it all: today is a better day for Judith.  She doesn't have that really "sick" look to her eyes anymore, her complexion is very pink thanks to the blood transfusion, she's responding to the antibiotics, she's finally getting to eat, and she's a crankopottamus.

I can tell that she's feeling a bit better today, but I can also tell that she still doesn't feel good in general.  She's angry about having the IV's in (and will probably be angrier once they get the PICC line in), but is happier with the CPAP off.  Judith was on CPAP for a little over 24 hours and was able to come off of it at 9:00 last night.  She's been fine without any respiratory support, and was actually on 21% with a pressure of 3 by yesterday afternoon (21% oxygen is room air).  So basically by that point it really wasn't doing anything for her except ticking her off.  She kept trying to pull it out herself - reminds me of when she was on it the first couple weeks after she was born.  She was always pulling it out.

They are going to repeat the lumbar puncture tomorrow to get another meningitis culture.  One of the doctors was a bit annoyed with the whole situation (not because of Judith, but I'm not really sure why - all I know is that he was not happy, and it could have been an annoyance with the lab or something).  He examined her, and wrote the orders to switch her antibiotics to a full course of penicillin, which will be given for 14 days starting today.  They're still treating her like she has meningitis along with the Group B strep, and if the culture comes back negative we can stick with the 2 week penicillin treatment.  If it comes back positive, we'll be looking at a longer course of antibiotics.  I'm hoping it comes back negative, and from the way it sounded during her exam this morning, a lot of the inflammation has gone down (her soft spot didn't feel as full as it did when she first became sick).

I'm sure Judith is a bit happier, because she is finally allowed to eat!  They had her NPO for almost 36 hours, and she was able to have her first meal at noon today - I gave her 10mL of milk, and she sucked it right down.  She was pretty mad at me because she wasn't allowed to have more.  She took her bottle again at 3 and did the same thing.  The doctors do have her on lipids and TPN again to help compensate, but I'm hoping that these can be stopped soon since she's allowed to take my milk again.  What's nice about this is that, unlike when we were working on getting her to tolerate her feeds, she is allowed to do cue-based feeds, meaning she can take a bottle whenever she wants.  The NG tube will probably have to go in for a little bit (her nurse didn't want to put it in yet at noon because she wanted to see how she does with the bottles first) - because she's sick and is trying to fight off the infection, she may tire out with the bottle feeds like she was doing Tuesday, so they will have to gavage her feeds if this happens.  Once she's feeling better and the antibiotics have a chance to work, she should be able to build herself back up to taking all her feeds from the bottle.

It's kind of funny, because the one doctor this morning commented that she'll probably be more than ready to go home soon, but the antibiotic treatments will hold her back.  She should be ready to come home once this is all over - she will be 38 weeks 2 days gestation by the time she's done with the treatment.

There's a real bright spot in all of this: they were going to do her follow-up ROP exam tomorrow, but decided to do it today (not sure why, but I think it might be because they're doing the lumbar puncture tomorrow).  She is at a Grade 2, which means her eyes are fully developed!  The nurse was very surprised, and honestly I was too.  I wasn't expecting her eyes to be fully developed until closer to, if not after, her original due date.  She gets to wait 6 months before having another follow-up.

It started to snow here.  Poor doggies - they are so fed up with all of this!  Buster still won't go much farther than the step onto the patio.  And John even shoveled a spot of grass for them.  Lady doesn't care - if she has to go, she charges out there, does her thing, then runs back into the house.  They're about as sick of this as we are!

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