Friday Night Lights

Grayson holding Trish's hand:

Scarlett sunbathing:

Tomorrow the twins will be a week old.  I don't know if there has ever been a week that has gone so fast or so slow.  Today's updates are mostly around our favorite diva, Scarlett.  She received her PICC line today.  She was given her first blood transfusion and seemed to take it well.  She started Phototherapy again.

She also seems to be digesting her food better than Grayson.  They measure this by hooking an empty syringe up to the feeding tube and opening it up, vacuuming the stomach contents out into the syringe.  Then they measure/record their findings and decide whether they want to "feed on top" of it.  For instance, at one of Grayson's feedings today, they pulled out 5 mls.  They only feed 1, so this shows evidence that he is breaking the food down in his belly, but isn't really digesting it.  With a "residual" that high, they might decide to give it back to him but not give him more.  With a smaller residual, they might give that back then give a new 1 ml feeding on top of it.

In rounds today, the doctor laid out a plan to get them off the oscillator.  This would be huge because we have a better chance of being allowed to hold them when they aren't using a tube for breathing.    If they can tolerate a 9 Mean Area Pressure they will be able to move to another device.  I will have to ask at rounds what that device is called because right now, my "daddy brain" is kicking in.  Can I use that or are women the only ones allowed to have "mommy brains?"

I did grab the respiratory therapist and was given a crash course on the Oscillator this evening.  One of the reasons this machine works so well on micro-preemies is because it uses negative pressure.  In our bodies, the reason we inhale is our diaphragm lowers and creates a negative pressure, so air rushes in to fill that area.  Then the diaphragm raises and forces the air out.  Most breathing machines only have positive pressure, sending the air in but not helping it escape.  The oscillator has a piston inside of it that forces air in then pulls it out.  The frequency can be adjusted.  Both kids are currently on 10 Hz.  They get 6 breaths/minute per Hz, so currently they are getting 600 breaths/minute.  They can also change the flow rate but I'm not sure what that does yet.  But the setting we are working on right now is Mean Area Pressure (MAP).  The RT couldn't explain how it works but printed off some documentation that I haven't had a chance to look at yet.  But the machine we need to move them to seems to have a MAP of 9, so if we can get them to 9 and they do well, we should be able to transition them.  It feels good to have a goal, even if there is nothing we can do to help except pray.

Grayson doing leg presses:

Grayson hanging out under the lights.  She has a big belly but all she needs is a bowel movement!