Day 61: A rocky start

Adalyn and Emma had a rocky start to their day today. A little background first. Adalyn took a full bottle (36 mL) at 9pm on Sunday and 3am Monday for her nurse Erin. She took the bottles in 15 minutes or less, with no alarms, spit ups, and burped like a champ. Then this morning at her 9am care time she spit up a fair amount and her belly measurement was up 2 cm. So this started the usual process of put the feeds on hold, call the doctors, and wait. Well the docs were not worried. They felt it was pretty appropriate given that she was for the first time in a long time taking a large volume all at once. So they resumed her feeds. At noon she took a full bottle again. Later that afternoon the docs decided to increase her feeding volume to 39 mL every 3 hours. They did not increase how often she is allowed to take a feeding by mouth. So her orders are still that she can take a feeding by mouth 3 times a day and she gets 15 minutes to take as much as she can. What she does not take in 15 minutes gets compressed over 1 1/2 hours. Her other feedings she gets 39mL compressed over 2 hours. So after a rocky start she ended up having a fine day. She did good with her alarms. At 9pm Dave got to give her a bottle. This was her first bottle of the new volume. She still did great, but was only able to get 30 mL in in 15 minutes. So they had to compress 9mL over 1 1/2 hours...seems a little silly :) But Adalyn was pooped and ready to cuddle with Dad anyway. Her weight last night was 4lbs 9oz (2070 grams)...what a little piggy :)

Emma's rough start yesterday lasted a bit longer than Adalyn's. In the morning Emma spit up some dark brown coffee ground looking emesis (which means it is old blood). She has done this before if you will recall. So the nurse called the doctors and they put Emma's feedings on hold and did an abdominal x-ray. The x-ray looked fine so they restarted her feedings at 11mL an hour just like they were before. In the afternoon Emma spit up fresh blood. So her nurse aspirated her OG tube and got some more fresh blood from there. So she called Dr. S who put Emma's feedings on hold again and ordered another abdominal x-ray and some blood work. In the meantime they put an IV in Emma's foot to give her IV fluid so that she would not get dehydrated. They also started her on Zantac and Maalox. The blood work looked fine. The x-ray showed that her OG tube was in too far which is what Dr. S thinks caused the bleed (irritation from the OG tube rubbing on her stomach). So they resumed her feedings at 10mL an hour and left her IV running at 1mL an hour. She is still getting the Zantac which I think is good because it will help her not to feel so uncomfortable from her reflux. The whole rest of the day she did not get any blood out of her stomach via her OG or through spit up...yay! She had another eye exam yesterday which showed that the ROP in her right eye is the same, Stage 1 and that she also has stage 1 in her left eye. I am happy to report that through all of what Emma went through yesterday she hardly had any alarms! Her nurse said that Emma had not had the bleeding in her stomach they probably would have trialed her off the high flow nasal cannula. Oh well, another day. I am just so proud of Emma for being such a big girl through all of that! Also, with a rough day where her feedings were on hold twice she still gained some weight! Emma's weight last night was 4 lbs (1815 grams).

Oh wait, I don't think I ever gave you Sunday's measurements. Adalyn was 4 lbs 7oz (2000 grams) and 17 1/4 inches long. Emma was 4 lbs (1800 grams) and 17 1/4 inches long.

Please pray that God continues to help Adalyn progress well with her feedings. Pray that this is the last time Emma has to have bleeding in her belly. Join us in praising God that the bleeding stopped and there were no signs of NEC. Pray that God heal Emma's reflux so that she can make progress with her feedings. Praise God for both of the girls having few alarms yesterday! Pray that God heal Emma's eyes and prevent any further progression of the ROP. Pray that He protect Adalyn's eyes from developing ROP. Please continue to pray that God help the twinners grow and develop well and that He protect them from infection.