28.1 or 2.3

Today was a good day!  It was mostly uneventful and most of the updates are positive.

They are discussing moving Grayson to a CPAP.  Of course, because you can never trust a preemie, he started relying on the vent a lot more.  This morning they had to give him a little more pressure, but if he extubates himself they will probably try the CPAP.  Otherwise, we will just hope he keeps doing well enough that they can plan the transition.  We think one of the biggest issues for him is that his tube is not quite large enough, so there is space around it they call a "leak."  It sounds like he is snoring and we don't know how much of the pressure and oxygen is really making it into his lungs.  But the next size up may be too big for him and could possibly damage his vocal cords, but if he goes on the CPAP, there is no tube into his lungs.

They are running the culture on his spinal fluid but it looked clean at first glance!

The doctor confirmed his head ultrasounds were not changed.

Grayson is moving to complete breast milk with fortifications and is finishing his final IV of "Total Parental Nutrition" (TPN).  Because our babies spent the first 2-ish weeks eating 2 mls of breast milk, they weren't getting most of their nutrition from their food. They analyzed their blood and gave them all the nutrients they needed through an IV.

He will also finish his antibiotics at 4 am, so unless something changes, he should have his PICC line taken out on Thursday.  PICC lines are similar to IVs but thread through the vein to the heart.  They are more durable then IVs so they last much longer.

Scarlett's PICC situation is trickier.  They took hers out when her blood tested positive for E coli because bacteria can stick to the plastic.  They had the team come in to put a new one in yesterday, then 30 minutes later found out her 11/14 blood culture was growing E coli still.  Because a normal IV line goes bad so quickly, they are hoping to leave it in, but if the 11/17 culture also tests positive they will need to take it out.  Based on the other cultures, we should know on Wednesday.  To complicate things, her PICC wasn't positioned where they wanted it.  They tried to make a few minor adjustments, but it takes a specially trained person to really move it.  Based on the blood culture they will either remove it or fix it tomorrow.  Ideally she would have a PICC through her antibiotic treatment, which would finish 14 days from when the blood was drawn from a negative culture (Dec 1st if the 11/17 blood culture remains negative).

The doctor did tell us her PDA has grown.  This condition is pretty typical in preemies and they won't do anything with it right now.  If it doesn't fix itself though, she will require surgery.

Scarlett was slightly ahead of Grayson on the diet plan, so she was already off TPN today.  However her milk wasn't fortified until late today.  Being on less fluids could help the PDA close.

Grayson doing Kangaroo Care with me:

Scarlett with a big yawn: