Adam has his good days and bad days, which is typical and expected with preemies like Adam. Adam has Apnea spells (where he stops breathing and when this happens, the nurse on duty just has to tap on his back to help remind him to breathe. After the nurse taps him, if he still does not start breathing - the nurse has to see how long it takes him to bring his heart rate and pulse back up. So far, Adam has only had a few spells where the timing was worrisome, but they are so few at this time there is no concern that he may need to be taken off of oxygen and be put back on the ventilator.
Adam has handled the transition from ventilator to oxygen very well. Adam was on 3 liters of vapor-therm, this is used to expand his chest to make it easier on his little body to breath. This specialist lowered Adam down to 2 liters. Thursday Adam had about 12 spells in 2 1/2 hours. The Doctor then increased Adam to 4 liters. He stayed on 3 liters for about two days, and put him back down to 3 liters of vapor-therm. Right now Adams little body is comfortable on 3 liters. Eventually, they will try to take Adam back down because the goal is to wean him off.
Adams quantity of food has been lowered but the calories have been increased. Also, his feedings are being put into a machine which pulls the milk through his feeding tube down to his stomach over an hour period rather then letting gravity take the food down to his stomach in about 10 minutes. The doctor made the decision to do this with his feeding because Adam had a few days when he was getting so sick after every feeding and was not gaining the weight he should. This does seem to help because Adam is getting less sick after feedings; however, just last night he got sick right after his night nurse gave him his feeding.
The morning nurse took Adam off of the machine and fed him as usual, where the food goes into a sarance holder and the gravity takes the food down to his stomach through his feeding tube. The nurses are alternating his feedings between the machine letting gravity take it down to see how Adam could handle it (and he did do well today). By the time Mourad and Suzanne arrived at the hospital last night, Adam had already gotten sick so the night nurse said that his next feeding will be put into the machine. As long as Adam's stats are stable, he can be held for about 20 to 30 minutes a day. Mourad has never been able to see Adam outside the incubator, but last night - they were going to try and let Mourad hold him. But, since Adam was having some feeding problems the nurses thought it would be a good idea to not let anyone hold him, Mourad agreed. They are going to try again tonight. :)
Adam had an echo done on his heart and according to the doctor, Adam still has a little opening - but this is not a huge concern and the opening should close on its own in the future. No brain scan was ordered this week because the doctors do not suspect any changes. According to the scan results from last week, Adam shows a grade 4 bleed on his left brain and a grade 3 bleed on his right (which was what he has had). He is not bleeding now, the last scan showed no swelling or hemorrhage, thanks God.
There is a chance that as Adam grows, some of the blood in his head from the previous bleeds can be absorbed into his body. However, if not - there are specialists at Vanderbilt who can perform surgery and remove the blood from his brain when Adam gets older. Adam grabbed onto his ear today. He does not have any cartilage in his ear yet, so he stretched it out as far as he could with out it hurting. He pulled so hard; he started crying because he hurt himself. Suzie said it was so sad, but cute at the same time. :)
Little Adam is very particular and he has no problems letting you know if he's mad at you or not (haha) He got mad at a nurse last week because she was bothering him to much. He kicked his feet on his bed and used it as leverage and almost caused himself to roll on his right side (which is really amazing considering most newborns cannot do this - let alone a preemie).
