Day 19, Afternoon

We just visited Hannah and she's still going strong. Her ventilator rate has been lowered a bit, so she's processing more oxygen with fewer breaths. The nurse says a preemie her age will typically require two or three more weeks on the ventilator, but of course the word "typical" is not one you can hang your hat on in the NICU. Her oxygen level is down around 25%, which is getting pretty close to normal room level, which is 21%. Compared to the 70-100% she required a week ago, this is good level to be at.

Assuming everything else remains stable, they'll try sending some nutrition through her digestive tract early next week. Right now, she's getting all her nutrition directly into her bloodstream via IV. They'll do a "test run" of some liquid nutrient fed to her stomach through a tube, then see if that passes all the way through as expected. If so, the next goal would be small amounts of milk, and over time transitioning from IV nutrition to ingested milk.

Day 18, Late Evening

Hannah has woken from her surgery sedation and appears to not be in any pain (based on heart rate, movement, gestures, etc.) so they have not put her back under sedation. All her vital signs look good and the incision site is holding up fine. All in all, a firm step forward to better heart/lung function and recovery.

A note about the staff at Medical Center of Plano: Of the couple dozen doctors and nurses that have helped Carla, Hannah and Steven over the past 20 days, I would have expected to meet at least a couple that we didn't like or that didn't seem entirely competent. But there don't seem to be any below-average professionals at this hospital. These are all exceptionally smart and compassionate people, truly committed to their patients' health and happiness. They saved Carla and Hannah's lives, did everything possible for Steven, and have kept us reasonably sane throughout. I don't have the slightest reservation about leaving Hannah in their care, which impresses the hell out of me every time I think about it.

Day 18, Afternoon

Hannah's PDA surgery went smoothly, and she'll be resting under sedation for the rest of the day. The nurse, surgeon, and anesthesiologist all remarked on how well it went and how well Hannah tolerated it. It may be a couple days before we see improvement from the PDA closure, but her oxygen and CO2 levels have already been pretty good for several days.

Before the surgery, Hannah opened her eyes and looked around a bit. This is the first time I've seen both eyes open.

In the elevator on the way to the NICU, I rode with a couple wearing "Team Hannah" T-shirts, which I had to interpret as a good omen. They were grandparents of another newborn Hannah in the hospital. I welcomed them to the team, of course.

Day 17, Evening

We had another good afternoon with Hannah. Carla got to hold her again for about an hour. They call this treatment "kangaroo care". Hannah's ventilator settings have been reduced a bit more to let her do more of the breathing work. Her PDA surgery (see previous post) will be tomorrow at noon, and her lung function should improve even more after that (better blood flow). But she won't be able to be held tomorrow or the next day, to give her incision time to heal.

Day 17, Morning

Hannah had a good night. The doctors are hearing a heart murmur, though, and it is usually caused by the PDA (the "on" switch for the lungs) not being completely sealed. This is pretty common in preemies, and is treated first with some medicines that sometimes cause it to seal. Hannah has had two courses of the medicine, and it appeared a couple days ago that the PDA was sealed, but it seems to have partially opened again. They'll try to confirm this with an echo cardiogram, and will then close it surgically if needed. This is a relatively low-risk surgical procedure where a tiny metal clamp is placed over the shunt that was supposed to clamp shut on its own (picture clamping a clothespin on a drinking straw). The sides of the vessel will eventually heal together, but the clamp will stay in as a life-long souvenir of the NICU.

The surgery will probably be done later tonight or tomorrow.

Holding Hannah

I'll let the pictures speak for themselves.

Hannah, Day 16, Morning

One of the milestones we've set for ourselves was the day that Carla could actually hold Hannah in her arms. Hannah's been connected to a respirator, a chest tube, an IV, two catheters, two electrodes, and a temperature sensor, more or less since she was born. That pretty much precludes taking her out of the isolette.

This morning, when I called to check, the nurse said Hannah had a very good night, with oxygen supplement down to 25% and the respirator rate backed off to 46 breaths per minute. Her chest tube (draining the lung leak) was removed last night, and one of the catheters was removed a couple days ago.

The nurse said she's ready today to be held in Mom's arms. We're excited, of course, and very encouraged.