9/9: Emily went in for a checkup after having concerns about decreased fetal movement. It was decided almost right away that it was time for the little one to make their debut. Ted and Emily had anticipated that their baby was going to be a girl but had decided to keep it a surprise. Sweet Evelyn Luella just could not wait to enter the world and to prove it, she arrived at 23 weeks and 5 days, quite a bit earlier than expected. She came into this world with a big squawk but as quite a little human-8 ounces to be exact. Right away she was taken to be cared for in the Neonatal Intensive Care Unit, the best spot for the world’s littlest fighters. At this point, her blood pressures were on the lower side so she received a little bit of blood and a little bit of platelets and was started on a medication, Epinephrine, to support her hemodynamically during this time. She was requiring a good chunk of oxygen on the ventilator, which they were able to wean later on in the night. Everyone was happy with how she was doing but were weary of the “honeymoon stage” that all premies (premature babies) can go through
9/10: Evelyn has been wrapped up with foil around her and saran wrap over the top to help to keep her warm during this time but to allow the medical team to have quick access to her, she is a little casserole at the moment. Today was not a day of too much news but they were able to turn the Epinephrine off this morning, aka little Ev is supporting her blood pressure herself! Her lactic was 12.2 this morning, on the higher side, potentially from a reperfusion injury.
9/11: All of the grandparents have officially gotten to meet baby Evelyn and she is loved beyond measure by so many. She is quite the celebrity at UIHC, who says size doesn’t matter ;) There is talk that she might even be a redhead, fingers crossed, her hair is coming through a little bit strawberry blonde! Throughout her first few days, she has received lots of visitors and has had so much love and excitement on her arrival! They did find today that there is a hole in Evelyn’s heart. It is something that all babies have while in the womb but it normally closes after birth. At this point, the hole in her heart is large but they can use Tylenol to try to close this. They gave her her first dose of this today and will give it for 3 days and then reassess; they can continue to repeat these doses and hopefully that will be enough to close it, if not, surgery could be in the future, but we are hopeful!
9/12: Evelyn had a great day today. For the first two days, she was working with only one lung operating. While she was doing great with that, it was determined that the left lung needed to be open so that her right lung would not develop issues from carrying all of the weight of ventilation. They did a good washout and suction of her lungs and everyone was happy with how that went. They gave her a medicine called Curosurf, which is artificial surfactant, to help to open the lung. With this medication, they turn her back and forth to distribute it, they call this “surfing”, she is a beach babe already. Her chest xray after surfing was quite poor and she was up to 100% oxygen support on the ventilator, her labs were not looking good either. However, the little trooper turned things around and she got air in both lungs! A big win!
Evelyn’s kidneys were not happy at first either-initially urinating not enough, then a little bit too much, but now she is going just enough. They did a kidney ultrasound and took samples of her urine, since it was quite dark in color, but everything is looking good from the renal standpoint! Little hungry girl was lucky enough to get some milk today! Emily has been able to produce enough milk so that she didn’t need donor milk at this time (GO MAMMA). She got a big ol’ 1mL of milk today through her tube and was loving the breast milk swabs they gave her to suck on! Until nutrition is on board more regularly, her electrolytes will be a little bit wonky but this is something they will keep a close eye on. One of the bigger concerns with premature babies is their fragile vessels, especially those of the brain. There are grades of bleeds-1 is the most minor with hardly any risk of long term issues and grade 4 is the most severe. They are getting regular ultrasounds on Evelyn’s head to assess for this and yesterday she did show a grade 1 bleed. They will rescan her head again continuously but we are just hoping and praying that this does not continue to progress. In the NICU world, one big milestone is the 3 day mark, and today Evelyn reached that point! By getting to this point, her survival rate is better but her next goal is to make it to day 7.
9/13: Unfortunately, with the highs come some lows. Evelyn did not have a great day today. Her blood counts were very low today, resulting in the super difficult decision to limit visitation to protect her. On her brain scan today, her previous bleed is still showing as a grade 1 (praise Jesus), however, they did see a very small spot in a different area of the bleed as well as a small subdural, which was most likely from birth trauma. While they can’t tell how involved either of these are at this time, they will continue to monitor these. After Tuesday’s “surf session” Evelyn’s lungs decided to not participate and on the next chest xray her lungs were whited out (showing very minimal airflow), the doctor was very worried. Usually Evelyn is able to bounce back from low desaturations with a little bit more of an oxygen boost but at this time, she wasn’t budging and her oxygen saturation came down to 62%. While knowing it was a risky decision to make, they decided it was worth it to try to surf again today, immediately her oxygen needs decreased and she looked better which was such a relief. The first xray after was not great but her post four hour xray was looking a lot better and there was once again aeration in the left lung! It is possible that the left lung can continue to collapse but today’s surf session was a winner. As previously stated, Evelyn started to be fed, feeding slowly, at almost snail’s pace, is important in these little ones, as their guts are extra fragile. Today, she had a little gas bubble so they did a little enema and while the gal is little, the poops are large! While it seems silly to be happy about poop, it is a great sign and they will continue to do daily enemas. One of her umbilical lines, a way for Evelyn to get fluids and medications, unfortunately clotted today so she got a PICC line. This procedure went very well.
Ev and I made it through our first year of CRNA school!! She’s been with me since day 1 listening to lectures and studying with me. My classmates call her our little frat baby and thinks she deserves a degree at the end too. 1 down, 2 to go evie girl, hang on tight because it’s going to be a wild ride!
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