Ho Ho Ho. Merry Christmas.
Chloe and Owen are both doing well. They are recoverring well from pneumonia, I suppose. They are having no trouble breathing, and they have been taking their antibiotics well. I guess the doctors will let us know when they're completely over the pneumonia, although it doesn't seem to be a big concern to anyone. Business as usual.
Both kids are growing. Chloe weighs 2 lbs 3 oz now, and Owen weighs 3 lbs 2 oz. Owen's feedings are up to 28 CC's every 3 hours, and Chloe's feedings are finally starting to increase. As far as I know (as of this time yesterday anyhow), Chloe's feedings are up to 4 CC's every 3 hours.
On Christmas Eve, Julie and I hung out at the hospital for 4 or 5 hours. We did skin-to-skin holding (where we hold them right against the skin of our chests) with both of them. I held Owen and Julie held Chloe. She slept like a baby. Owen was a little more rambunctious, wiggling and twitching the whole time. Both Julie and I fell asleep holding them. It was nice.
The volunteers from the Parent-to-Parent support group brought little tiny Santa Claus hats for the kids. We took pictures with them wearing their hats (to be posted shortly).
Owen is starting a fortifier study within the next day or two. The purpose of this 28 day study is to determine whether a new breastmilk fortifier out on the market helps premie kids to grow faster (and to tolerate their feedings better). Although the kids need the antibodies that they get from breastmilk, it just doesn't have enough calories to get them gaining weight quickly. So, they fortify breastmilk with a powder fortifier made by the fine folks that make Similac or Enfamil formulas (formulae?). The new fortifier being studied (made by Mead Johnson, makers of Enfamil) is supposed to have more nutrients than these, and it's supposed to be easier to digest. Owen may or may not get the new fortifier. He might get randomized into the control group and just get the same old stuff. At any rate, the very fact that he's enrolled into this study is a good sign. They will only enroll babies who are doing well breathing and who are in good overall health. The study nurse who I talked to said that very few babies actually finish the 28 day study. When I asked why, she said 'Most of them go home within 28 days.' Wow.
Chloe had another head ultrasound on Monday. It seems as though her ventricles are still expanding. Her head circumference has been growing as well, but not at too agressive a rate. The doctor who we talked to said that he talked to a neurologist at Primary Children's Medical Center (in Salt Lake), and he said that Chloe's head growth is concerning, but that he wouldn't reccommend taking any action yet.
The reason her head is growing, and the ventricles expanding, is because the brain makes cerebrospinal fluid in the ventricals. Normally, it drains down into the spinal cord and then flows over the surface of the brain. If blood leaks into the ventricles, as it clots, it blocks this flow of drainage and the ventricles expand. As they expand, this puts pressure on the brain (luckily, infants have soft, unfused skulls, so the pressure is much much less than it would be for an adult).
To relieve the pressure, they can put in an 'Omiah Reservoir.' Essentially, this is a little plastic container inserted under the scalp (but outside of the skull). There is a tiny plastic tube connected to this container, which goes through the brain tissue and into the ventricle. Excess cerebrospinal fluid flows from the ventricle into the reservoir, where it can be drained once a day by medical staff.
Now that you know about the Omiah Reservoir, you should know that Chloe isn't a candidate for one. She is still too small, and her head is so little. Putting a reservoir under the skin of her scalp would have a high risk of rupturing the skin and getting infected. Plus, because she's so small, her immune system isn't as strong as it should be to handle foreign objects (like the reservoir) in her system.
If the circumstances with her ventricular expansion were more severe, they would consider doing a reservoir, but they don't think that it's severe enough yet to warrant the risk of infection. So, we're just hanging in there for a few more weeks to see what happens.
Also, in her head ultrasound, the doctor said that they are continuing to see some indication of periventricular leukomalacia, shown by a haziness in the areas around the ventricles in her brain. I talked about PVL in my last update, so I won't say anthing more about it, except to say that in this ultrasound they still haven't seen any cysts. And that's good.
So, the short update for Chloe is that the bleeding in her brain has stopped. But as an aftereffect of the bleeding, she's building up pressure that may or may not need to be relieved using a drain of some sort. Within the next few weeks, she may break down the blood clots and re-absorb all of her excess cerebrospinal fluid without any medical interventions. Or she may grow to the point that it makes sense to put in a drain. We'll just have to see.
Thanks for chcking the updates and for caring about our kids. Keep praying for them.