Saturday, January 01, 2005

When dad arrived, Elizabeth was awake and was trying to figure out how to stuff her right arm in her mouth. Dad gave her the soother. The nurse said she looked and acted much better than earlier in the morning when her blood pressure had dropped and the respirtory therapist (RT) increased the rate of her breathing to 50 from yesterday's 40. Elizabeth was still breathing room air. Her nurse attributed this behaviour to a "preemie moment".
At 10:40 the RT dropped her breathing rate to 45. The plan is to gradually lower this number, otherwise the O2 concentration will likely stay above 94 (desired rate is 84 to 94). A hi O2 concentration is dangerous for her eyes, as she may develop a condition called ROP.
Overall her condition is currently stable. The dramatic changes in her stats (heart rate, blood pressure, O2 and CO2 concentration, etc.) is called "swinginq" and is very common for preemies, especially during post-OP. The trick is (what seems to be an impossible task) to find a combination of settings on the ventilator that will maintain her stats within the desired levels.
Elizabeth is still getting Morphine to keep her comfortable (at a rate of 6 micrograms per kg per hour). The usual rate is 20 microg/kg/hr for most babies, and 30 is also common. This rate will gradually be lowered to 0 by the end of the day as long as she can tolerate it. A good sign is that she is peeing, which means that her kidneys seem to be O.K. Hopefully Elizabeth will get some of mom's milk by Monday. This will give her the much needed nutrition to grow and for her organs to mature.
The ups and downs of her slow recovery will continue (to worry mom and dad) for several weeks. Aparently that's what preemies do.