Monday, August 24, 2009

And We Have Skin!

Tonight was an especially nice visit.
After the spit-ups from last night, we expected to see Karsie on 5.5mL of milk, but the nurse practitioner went ahead and bumped her up to 6mL. She will continue at her regular rate of increase (0.5mL a day) as tolerated. So if all goes well tonight, she will go to 6.5mL tomorrow. And though you might be getting tired of hearing it... she is still pooping which is fantastic news to us!
She was also increased to 8 hours on the nasal cannula tonight. So as long as she tolerates it, she will have 8 hours on and 4 hours on CPAP each shift. This is also great news!
The best news came during her dressing change. Our fantastic nurse, Amy, let Michelle help with the dressing change. While everything was exposed, Amy pointed out that the area where the patch was originally stitched was now skin!!!!! There are some places where it looks like as much as 1/2 an inch of skin has grown up!!! The patch is kind of moving up off the mound of organs. We are not entirely sure of the mechanics of all this, as the patch is/was sewn to her skin. But none-the-less, the skin is growing. There is still granulation skin at the very edge of the patch, but there is clearly new skin growing too! This is super great news because we anticipated this process taking much longer to progress. Granted, she still has a very large mound of organs for the skin to grow over, we are still pleased to see that the process is underway! We will try to get a picture of this soon.
Karsie is continuing to do very well considering all she has been through, and goes through each day. She gets messed with quite a bit... but she is a little trooper!
We are continually amazed by the power of prayer and the amazing support we are recieving. We still have a very long road ahead of us, but God is good and we are thankful for your faithfulness.

Pre-Delivery Pic

This is the scary hall that Kevin had to wait in while Michelle was getting anesthesia just before Karsie was born.  Note to any father waiting in the room:  Don't believe the doctor or nurse when they give you an estimated time to wait.  What was supposed to take 15 min. actually took 45-50.  It was not a fun wait.  

More Spit-Up

Well, after Michelle and her mom left last night, there was apparently more spit-up. Probably another 7mL. This put Karsie back to 5mL an hour on her milk feeds and back up to 9mL an hour on her TPN. She is still pooping, so the nurse practitioner said she would still go up today (by 0.5mL) to 5.5mL. This allows a little break for Karsie's stomach. She tolerated 5.5 well, so they went down and will slowly try to work their way back up again. There has been no spit-up today so hopefully this will just be a little set back and Karsie will do better this time around.
Otherwise, she is continuing to improve in the other areas. She is on nasal cannula 6 hours each shift and today she was holding steady with 27% O2. The nurse was going to check and see if that would be increased to maybe 8 hours. Her labs came back today and the TPN is still causing her biliruben level to be elevated, but the level is not increasing.
She is starting to turn nocturnal... so she was asleep most of the visit today. Hopefully she will get her schedule straightened out soon! This will not work when she gets to come home ;)
She also has her primary nurses back for the next few days! This is great because they know her and know how to handle her best! This makes both Michelle and Kevin feel much better.
Karsie looking at a picture of daddy! This way she doesn't miss him as much while he is gone!

Karsie got to wear her first sock today. Her foot was getting cold... so Michelle put a little sock on to keep her warm. The other food stays warm from the dressing on the picc line and the O2 lead.