Little Steps

Well, today has been another pretty good day.
Feeding: Karsie has only had two very small spit-ups today and has been tolerating the feeding well. She is still getting 2 hours of continuous and 1 hour off. She is getting a total of 64mL in the 2 hours. That will be increased to 66mL over 2 hours now. Today she is going up on calories again. Last time this was attempted with the formula Pregestimil (and she threw up lots that day). Today she will be going from 22cal/oz with rice cereal and breastmilk to 24cal/oz with rice cereal, breastmilk and the formula Elecare. This is the most digested and hypo-allergenic formula used in the NICU so hopefully she will tolerate this well! If she tolerates this, the plan for tomorrow is to condense her 66mL to 1.5 hours on and 1.5 hours off. Karsie is also being given oral feeding attempts 4 times a day. She can breastfeed 3 times and will be offered a bottle in the night. This is all trying to move towards having her take all her feeds orally. She is still doing a good job breast feeding, but the scale is giving mixed results, so we are not sure exactly how much milk she is taking by breast. She is also having less spit-up lately (which is good for her healing and good for our emotions).

Breathing: She is still off the nasal cannula and doing very well!!! She has been breathing at a good rate and her O2 saturation has been 98-100 the whole time! YAY!

Growing: Last night when Karsie was weighed, she went from 3.195 down to 3.17. However, she was weighed for the first time without the nasal cannula. This probably accounts for the loss... but it also means she is not really gaining. Therefore it is even more important that she tolerate the increase in calories... she really needs to grow! The dietitian, Laura, feels that she will tolerate everything better as she gets bigger... but she has to tolerate everything to get bigger. So she is kind of stuck in this neutral area until she tolerates an increase in calories and grows.

Meetings Tomorrow: We are having two meetings tomorrow and they are both important. We are meeting with the plastic surgeon tomorrow to talk about the tissue expanders and how that surgery will work, when it will happen, and what we hope to get out of that. We will also be able to ask some questions about the long-term cosmetic effects of all this (aka will Karsie ever have a belly button and what will her scar look like). We will also be having a family conference with one of the neonatologists, a nurse practitioner and possibly Dr. Saenz, our surgeon. We will be discussing the next steps in treating Karsie and maybe starting to discuss her discharge! We will also be spending some time talking about both compression wrapping as well as the car seat situation. We have done some serious research on both of these topics and hope the doctors will listen to our concerns and take into account the experience of other families in this situation.

Kevin is coming down tonight to attend these meetings (which we thought were going to be today when he got down but ended up getting pushed back), and spend the weekend with his girls! So, you can expect more pictures over the weekend as he is the one who is technically savvy! :)