1 Week, 4 Days (GA: 29 Weeks)

Nanette continues to do better and better each day.  Last night, for the first time, she did not take any pain medicine in the middle of the night.  She just got a new breast pump and it sucks, as it should.  Nanette is a pumping maniac---every three hours all day and night long.  The clear highlight of the day (probably the highlight of the whole experience so far):  Nanette had some skin-to-skin time with Zeke today.  It’s pretty cool snuggling with a 2 lb human being.

First Contact:  Zeke and Mom.

Gabe was put back on CPAP today because he was working a little too hard to breath and his lungs were not fully inflating.  His breathing is better with that little added help (never undervalue a little positive pressure!).  Dr. Chan gave us the results of Gabe’s follow-up cranial ultrasound.  Gabe's lateral ventricles are enlarged (ventriculomegaly) and he has been diagnosed with mild hydrocephalus ("water on the brain").  This can cause further brain damage and will be monitored each week with head ultrasounds.  It is likely that the enlarged ventricles are due to a slight blockage in the cerebrospinal fluid (CSF) absorption due to Gabe's previous brain bleeding (posthemorrhagic hydrocephalus).  Oftentimes, this will resolve spontaneously as the old blood (causing the blockage) breaks down.  The enlarged ventricles could be caused by other things as well.  If his hydrocephalus worsens, a shunt can be added to drain excess CSF when Gabe is older (at least 2kg).

Zeke is still a champ.  He had a 1 day trial of a formula that has partially broken down proteins that are soft on his stomach.  He had been irritable and the doctor wanted to see if his irritability was due to his bowels having trouble with breast milk.  They also gave him Versed to calm him down.  We told Zeke’s care providers that we have had several babies with colic but we never resorted to formula or sedatives.  As far as we could tell, this information seemed irrelevant to those experts.  He is back on breast milk again today and doing great.  He loved it when his mother held him.  His oxygen saturation shot right up and we had to turn his FIO2 down.

Kids know how to get to the heart of the matter.  Yesterday the 11-year old son of our good neighbors summed up the situation perfectly when he said, "It's great that both of your twins are still living."