4 Weeks Old and 4 lbs!

Today marks Calvin's 4th week and he celebrated by making it to 4 lbs. He's filling out and we are loving his chubby cheeks. He is also more active and when we arrived at the hospital tonight, he had squirmed his way over to the incubator door. We think he is implementing the escape plan that Grandpa Rick laid out for him.

Cal is now on the CPAP for 5 hours and off for 7 hours so progress is being made on the breathing front. He is also showing signs that he will do well with breastfeeding. Tomorrow he gets an eye exam to check for retinopathy of prematurity (ROP) and we're hoping for the best.

All in all, Cal seems to be doing better and better every day. It makes his parents very happy.

He's got more grams than a gram convention

Calvin weighed in at 1795 grams this morning. As most of you have probably immediately calculated in your head, that's just shy of 4 pounds. That's a lot in proportion to his original weight of 3 pounds, and we all thought that he looked bigger today than even yesterday. He's getting to look a little more like what you think of when you think 'baby'. This is a little weird- after getting used to seeing nothing but preterm babies, full term ones look like ungainly giants, and it's been interesting watching him fill out. He's moved on to feeding every three hours instead of hourly, too.

From the nurse's perspective he was kind of misbehaving today, pulling out his feeding tube several times. This meant that he was free of tubes when Sam held him, which was nice to see:
Those pictures are very calm looking compared to what he was actually like today. Anyway, today was pretty fun on the Calvin front. To celebrate, here's a Weekend Fun Edition of Calvin, by the numbers!

425: net weight gain in grams.
33: mL of milk every three hours to sustain that growth.
4.7: average number of times per day I rifle through his nursing chart, looking for more data. Must have data.
2: Tablespoons of extra virgin olive oil that's been rubbed into his skin so far.
1.8: average hours per day spent outside the incubator (estimated).
1: number of times the word 'explosive' has been written in his nursing chart.

The Cardiologist's Assessment

Nick and I patiently waited most of the day for the visiting cardiologist to stop by and take a look at Calvin and he finally made it near the end of the day. He did an echocardiogram (or ECHO) of Cal's heart and found that Calvin does have an open duct. However, he said that it is not a big opening and that this is what he would expect to see in a preterm baby. Cal's doctors told us that this indicates we should give him time to work on his breathing and hopefully the duct will close on it's own in the next 2 weeks. If he is still having trouble in a couple of weeks, then we may be hearing from the doctors about the other options (medicine or surgery). We'll keep you posted.

In the meantime, Calvin has put on more weight (3 lb 12 oz total!) and he is making a name for himself in the nappy changing for the nurses. As one nurse put it the other day, "he pooed for Britain." Wait to go Cal.

I'll leave you with an adorable pose Cal struck while I held him today.

Some pictures from Mother's Day

Sunday was Mother's Day in the UK, and Calvin came out for a two hour cuddle.

Blip on the radar

So, Calvin is starting to ease into the 'long time' tail of the distribution for getting off the CPAP. It sounds like it will take another week or two of him still relying on it before people start to think this is a real problem, but at the moment his breathing sticks out as one area where he's not really sprinting out of the blocks. I was never much of a sprinter, so I blame myself.

What they now suspect he has, and might be contributing to his slow move towards breathing on his own, is a patent ductus areteriosus (PDA). You can google it for details if you're into that sort of thing, but basically the ductus areteriosus is a structure involved in letting blood bypass the lungs while a baby is still in the womb (and hence not doing much breathing). It's supposed to close up shortly after birth, but in preterm babies it can sometimes remain open (patent), sending too much blood to the lungs and overburdening the heart.

Calvin isn't totally symptomatic of this, but they hear a heart murmur and are going to have a cardiologist take a look on Wednesday to get a better idea of what's going on. If he does have one but it's small and probably not the cause of his breathing issues, they're not exactly eager to rush in and aggressively treat this. The plan is still to give him more time to grow and mature with the CPAP support, and see what happens. After asking two doctors variations of the same question as many times as I felt that I could, our understanding is that this isn't yet a pressing concern, but something to be aware of. We'll know more on Wednesday, I suppose.

We heard about this last night, and night is a bad time it turns out to find out not-so-sunny news. After more reading, pestering the doctors, and in the light of day, this seems ok for now though, so I hope this post isn't alarming.

I'd like to post a picture to lighten the mood, but all the pictures from today are on Rick and Rose's camera. Imagine Calvin chomping and slurping away at a miniature pacifier- that's how we left him tonight, and that's cute.

PS- magic of the internets, Rick just emailed me a picture. No imagination required!

Another sunny day in the NICU

We've been having some really sunny days here in Dundee which makes our visits to the NICU a little cheerier. Sometimes Calvin gets hit directly by the sun and the nurses have to put a blanket over his incubator so he doesn't overheat. After all, he isn't supposed to be experiencing the sun yet.

Calvin is still doing well today. There isn't much to report except that he is gaining more weight (3 lb 6 oz total) and they continue to cycle his CPAP on for 8 hours and off for 4 hours. I (this is Sam writing this blog by the way) got to cuddle with him twice today, which always makes me happy.

In case you wanted to visualize where we're spending all of our time, here is a picture of me in Calvin's corner. See the monitor by the incubator? Imagine trying to ignore all the flashing lights and alarms that emit from there. I think I'm getting used to it now. Rose suggested we make a recording of all the alarms since Cal seems to be able to sleep through them and maybe he'll need them later in order to fall asleep. I sincerely hope not.

A glimpse of a routine

I tried out my 'go see Calvin, then go to work' schedule today for the first time. My plan is to do this three days a week, and work from home the other two. They kick us out of the NICU from 9 to 11 so that the doctors can freely talk about the babies, so if I can get to the hospital at 8 or so then I can do his morning cleaning, feed him and then get on the bus to work by 9. Then Sam can head in after 11 and spend the early afternoon with him. Sounds good in theory, anyway.

He's continuing to gain weight, cycle on and off the CPAP, and devise new ways to make changing him an adventure. Here's a picture of Grandma Rose holding him for a few minutes. This prompted the nurse to say that 'Granny was over the moon'. Kind of funny, the word 'granny' applied to Rose.