growing and growing

Both David and Mary Louise put on weight today! Mary Louise gained an overly modest 8 grams which doesn't yet get her over the 2 pound 8 ounce hump, but it's a gain all the same. David is now 2 pounds 5 ounces and gained somewhere around 28 to 30 grams (I can't remember that exact number.) So, he did very well with weight gain today.

Mary Louise is down to 1 liter on O2 at 21% most of the time - they increase the percentage during holding time and bath time but otherwise she tolerates the 21% well. (21% is considered room air). Technically, she could tolerate a regular nasal cannula now rather than the vapotherm but the nurse said that sometimes they leave them on very low vapotherm settings until they can tolerate no oxygen supplementation altogether as the vapotherm oxygen is warmed and humidified and dries the sinuses less. The physical therapy group will start to see her tomorrow for range of motion exercise to ensure proper muscle and joint development.

David is not quite ready for physical therapy. He continues to desat some with too much contact - though he is much much better than last week and is continuing to improve each day. He is tolerating the low vent settings beautifully and hopefully will grow enough over the weekend to give extubation another go sometime next week. We'll see though - we're just so very excited about all of the progress he's made.

I spoke with the nurse for awhile today about long term care. I know I'm early but my mind does much better if I can process things and ask tons of questions and research everything before having to go through it. (I've been called "obnoxiously inquisitive"- I just always have to know why - about everything.) Anyhow, we will most likely have a minimum of home health visiting 2 or possibly 3 times a week - sometimes they come just to check the weight of the babies. They will also come to give the monthly Synergist vaccinations during RSV season so that we don't have to bring the babies to the doctor for that and expose them to more germs and illnesses. We will have to attend monthly appointments at the perinatologist's office as well and see physical and occupational therapists there to help the babies develop and catch up in developmental skills that are appropriate for their age. The nurses also started to talk to me about ways we can prevent RSV and other illnesses in the babies once home as their immune systems are and will be underdeveloped and their lungs already damaged from all of the ventilation and supplemental oxygen needed now. In short - we must keep them inside - only allow healthy adults to visit, and practice constant and meticulous hand hygiene. Makes sense.

Anyhow, it was nice to have a "so when they are at home, what do I do" conversation - even though the nurse kept reminding me how far we have to go and that anything can happen at any time.

Another happy day.

Love, Heather

P.S. Mary Louise got to wear her sass!y new hat from Ma Mere today - looked fantastic on her and kept her very warm while I held her. Sweet baby girl.