Sunday, December 31, 2006
Pain is all Emily sees
Well Emily got transferred to the Si-Pap machine that they were waiting to get in. She hasn't done that well on it though. She figured out rather quickly how to turn the machine off by holding her breath and is often doing that. Therefore defeating the purpose of the machine. Her stats on the machine are not that great also so they are often switching her back and forth between the C-pap and the SiPap.
We think that Emily has a Kidney stone. She is prone to them because of the diarill that she is on to make it so she can live (fluid build up in her lungs is common with her condition). She was screaming uncontrollably for most of the afternoon evening yesterday. They were trying to keep her sedated last night but from what I hear her stats started drifting down and would hang there for long periods of time. While short times of this are not bad (they are not good either) hanging there is really bad!
They are running a series of tests on her today (unfortunately no ultrasounds because of the holiday, this would tell if she has kidney stones) and hopefully we will have some answers soon. We are going to the hospital early today to be with her.
This is about all the news we have for now. Sorry for no pictures but who wants to look at a baby in pain?
Jennifer
Friday, December 29, 2006
Go Emily Go!
Sorry for no pictures. We did take video of her yesterday but that was it. I forgot to mention that Emily rolled over 2-3 times front to back on Wednesday. She clearly knows what she wants and is not going to wait for people to do it for her! Also Emily scooted across her crib yesterday. She was on her belly and made it about 5 inches. This was even in the P.J.'s that are a bit big for her and made it so her legs were well within the body of the outfit. She was funny doing it too. She would complain and kind of commando crawl then get tired sleep for a minute or two and then do it again. Very funny!
I realize that I should explain the photo of Emily in jail. I was talking to my father the other day and he was walking to work. He told me that he has pictures of Emily on his person. I asked him if he had made a button of Emily like he made of my sister before they brought her over from China. He said he hadn't. I said he should and I would take a picture of her "behind bars" so he put "Free Emily" on the button. Therefore the picture. I am going to try to see if I can get a better one of her "behind bars," but she has to be doing a bit well for that since she needs to cooperate with me.
The only other new thing is Emily is now on 27 calories per oz. This is equivalent to Emily drinking Ensure everyday. She is actually getting the same calories.
That is all that I have for now!
Jennifer
Thursday, December 28, 2006
Emily and her Christmas
"Free Emily!!"
Sorry we haven't been able to post till now. The Internet was down for 2 days at the time that I normally post. Then when it finally got back up I had a backlog of things to do and so posting got pushed back.
Emily has been doing okay on the c-pap. She has been at 100% (though the machine says 94%) for about 3 days now. Yesterday they even increased her c-pap to 8. She has occasional desats that I think are more or less mechanical then anything else. Normally they don't go below the high 80's. She was able to eat from a bottle/breast and was put on the high flow cannula to do so. However the last few days it has been clear that she needed the C-pap so I haven't even asked if I could do it.
We put her in her Christmas dress on Christmas and she promptly decided to throw up on it within 30 minutes of getting in it. So unfortunately we were unable to get a family picture. We are planning on trying again but I don't know when that will be.
She had some hum dinger of poo's recently. Grandpa Billings you smell like roses compared to her. She actually makes your eyes water and one nurse said she felt like she was going to throw up just testing it (they test the poo for blood). In other words, when she stinks, run for the hills!!
What else can I say about her... Well the doctor talked to me yesterday and said that he is going to try one more c-pap machine that they are trying to bring into the hospital. This c-pap can give inspitory pressure (or pressure when she breaths in, I still don't quite understand how it is different then C-pap but it is) which they tried to do on one of the other c-pap machines that they currently have and couldn't get it to work. He says that if this doesn't work then we should plan on going to the children's hospital by mid January for the trache. We are nervous, scared, and I think I am a bit excited for that day. Excited because then we will have a set plan and road to head down and hopefully this would lead to her going home sooner rather then later. Also I want her to be able to take from the bottle and we can't really do that now. I know that no procedure is not with out it's risks but I hope that Emily will be able to come out of this relatively well.
That is about all the news I have for now. Talk to you all later!
Jennifer
Sunday, December 24, 2006
Emily becomes an Elephant
Thursday, December 21, 2006
A Rough Day
We got some bad news about Emily yesterday. The flow rate on her cannula was increased to 6 liters / minute, and they haven't been able to wean her off of 100 % oxygen. The doctors have said that if she gets to the point where she would require a CPAP, they are going to send her to CHOP (the children's hospital) and have a trache put in and put her on a ventilator. If this doesn't happen, the best we can hope for is that she stays in the intensive care nursery at Pennsylvania Hospital for many more months until they can wean her flow rate down to 1 liter/minute or less. In any event, she will likely be on oxygen for several years after she is released.
Tony
Tuesday, December 19, 2006
Emily's Weekend
Sorry it has been a while since we posted. Emily is doing well. She had a really good day on Saturday and was awake for most of the time that we were there. On Sunday she had a bad day though and was desating a lot. She looked pale to me and they ran a blood test and she was anemic. So she got blood and a diarill. She looked better afterwords (yesterday) but she is still desating. Not bad (into the high 80's low 90's) but still desating. She stopped her inhaled steroid, because we didn't think it was doing anything for her and now we are all wondering if it really was doing something for her.
The occupational therapist saw her on Saturday and was shocked by her. She started showing off all of her tricks. She said that Emily is developmentally around 2 months of age. That was good news to hear!!
I started the ball rolling (or maybe I gave it a good hard push) on getting a high flow cannula at home for her. There used to be a one type but the FDA recalled it. Now Emily is on a second type but it is new and not very many home care companies have it or can deal with the high flow systems. The respiratory people were looking into it with no avail so I e-mailed the company directly (that makes the heater for the cannula) and told respiratory I did so. I guess now the rep for the company that they are leasing this system from (just for Emily) was there yesterday and she is looking into it for us. I just don't want to be in a situation where she is ready to go home except she is on a high flow rate that we can't accommodate, because we haven't done the research. I guess it pays to be the squeaky wheel sometimes!
That is about all that is going on now. Emily is going to be supplemented with Formula soon (maybe even today) but I am now not worried about my milk supply. I know that pumps are only marginally effective and Emily can draw more from me then a pump can. I think I am just going to do my best and hopefully when she comes home then Emily can get what she needs from me. I may have to rent a scale though just to be sure though.
Talk to you all later!
Jennifer
Friday, December 15, 2006
Blue Jean baby's milk
Emily has had some good days recently. She had her milk scan on Wednesday which I was there for. I was actually able to be there for the whole test. The test was simple enough, lay Emily on an imaging table and feed her a bottle with radioactive (slightly) material in it with her milk. Then feed her the rest of her bottle. Then lay her flat on this imaging table and leave her there for 1 hour. We, the nurse and I, were able to watch her radioactive milk go into her belly via monitor and then watch the whole time she was on the table. It started to go in to her intestine while we were there. The whole point of this test was to see if she had any acid reflux and to see if this went into her lungs. In my opinion, she has no reflux at no time did we see it go back into her lungs, or even come back up for that matter. The downside to this test is she was radioactive for 24 hours after the test and so they had to take extra precautions with her. Keep her diapers in a different spot and not wash her bottle for 24 hours and such.
I am pleased to say though that she is not radioactive anymore. In fact I can say with some certainty that she doesn't even have it in her system anymore. This is because she had not one but 2 blow out diapers yesterday and this is with the size 1 diapers and not the newborn diapers!! The first one happened around 3 pm yesterday and it was EVERYWHERE! I decided to give her a bath right then and there. Then I put her in her swing and scrubbed her whole crib, and the counter behind her crib (not that it got all over all of that but that area did need a good cleaning!!).
Oh one more thing about the Milk Scan. She is on a high flow cannula which is giving her a flow rate of 4 liters per minute and it is well humidified. In order to be transported down to where the test was going to be performed she needed to get on a regular cannula. This means no humidity and no 4 liter flow. So she was on 2 liter flow during that time (about 2 hours). They had her hooked up to a portable pulse ox machine (to measure her oxygen in her blood) and most of the time she was sating 98 and above. It was really nice to see with her.
Emily also has been taking her bottle well. Last night she took her whole bottle at 8pm, 12am, and 4am. The night before she took the whole thing at 12am and 4pm. It will be interesting to see if this pattern continues. I did ask if she could be on a trial "ad lib" or eat when she wants, and the doctors are not ready for her to do that yet.
Many of you have wrote to me about Domperidone and the wonderful results you have received from it in regard to milk production. I have looked into it, and even went to a compounding pharmacy who said that they don't carry it anymore. So after a bit of research I found out why the FDA doesn't allow it in this country anymore. Here is the link http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01292.html Emily already has heart problems so I will not be using this drug even if it were allowed in the country. I just wanted to share with you in case you are using it what effects it may have on your child.
Talk to you all later!
Jennifer
Tuesday, December 12, 2006
Emily and the bunny with a heart
Monday, December 11, 2006
Don't we all wish we could lose our water weight?
Friday, December 08, 2006
Emily's New Dress
Well Emily is able to eat from a bottle or breast. She is completely in control of the situation because of her heart. However there are a few ground rules. She can only have breast or bottle and if she chooses breast she can only be there for 20 minutes tops. As you can see this can cause all sorts of problems. She prefers to go to breast but when she doesn't get all of her feed she wants the bottle. So they have resorted to giving her a pacifier dipped in a sugar solution to try to calm her down. It works... sort of.
Other then that Emily is doing well. To look at her you wouldn't think that she is as sick as she is. She sleeps a lot but all babies do that. She is normally only awake when it is time to eat. She also knows which people she can demand attention from and which ones she can't. I have noticed that around shift change she demands attention from me even though I have been there all day and she hasn't wanted that much! Silly Emily!
I am told by talking to different people that people are not looking at the sidebar on this site. I have included various things and links on it recently. Including Emily's registry, an appendix to this blog with more detailed information of stuff on this blog, a way you can get prints of our pictures and see more pictures then we have on this blog (if you want earlier photos let me know), and just today I posted my friend Sonia's blog. Those who don't know Sonia and I met about a year ago when we were both battling infertility. She got pregnant with twins last November and ended up having many of the same problems in her pregnancy as I did in mine. She delivered at 23 weeks on April 4, 2006. She sadly lost her daughter but her son Isaac is doing very well. He came home after a 6 month hospital stay. Having known her has made me feel like I am not the only one that has went through all of this and I believe has made me even more thankful to the time I have with Emily.
Wednesday, December 06, 2006
My pretty little girl



Hello,
Well Emily had a good day yesterday. They were able to wean her oxygen down to about 60% and she was doing well at her feeds taking at least some of the bottle if not all of it.
However after her noon feeding the cardiologist came by and talked to me. I guess Emily's Echocardogram showed that her heart is enlarged on the right side, the side that pumps to the lungs. This is because her lungs are stiff and it is harder to pump blood through that side. They have many treatments for this we are told. The first one they are trying is a blood vessel dilator. This is a oral medication. They actually have to grind it down and put it in a suspension just for her as it is typically given to adults and not children and therefore it is only available in a pill. This condition will not go away tomorrow or even next month. This condition will last as long as her lungs are in the state they are in. So 2 years seems to be the consensus from all that we have heard. That is not to say that she will be in the hospital for 2 years though. The doctors all believe that we have months not years though until we can finally take her home.
In the meanwhile Emily has to treated very well. Whatever she wants she gets. If she is stressed at all it puts added pressure on her lungs and therefore her heart. Also they have stopped feeding her by bottle till they get recommendations from the children's hospital on how to feed her. I hope it is soon since Emily really likes eating for herself! This is because any choke that she may have can cause extreme damage to her. Same is true if she were to become ill. Emily has very little to no "reserve" to breathe with and so she needs to be well at all times. Most babies don't get the RSV shot in the hospital (hospital is suppose to be a controlled environment) but Emily will because she is that ill.
The doctors seem happy that they finally have a diagnosis for her. Before they were trying anything to help her not having the ability to do things scientifically. Now that she has this diagnosis they can treat her more effectively.
While this is a hard pill to take, we believe that Emily will continue to fight as she has her whole life. She is truly a miracle. All of the doctors say that.
Yesterday I thought I would try to let daddy have more of a role in her so I let her change her diaper (a good start I thought). Well Emily got daddy. Just as he lifted her legs she went all over getting daddy in the process. Amazingly she got the only section of her bumper that is covered in plastic! Good aim Emily!! Needless to say he will not be changing any more of her diapers for a while!
In other news my father and his wife, who already have a 5 year old adopted from China, has sent in the application to adopt a "waiting child" from China. These are often children, to my understanding, that may have slight medical problems. They also can be older children. They are almost always girls and I believe that they requested a girl this time. They hope to get their doctuments (including a picture of little Miss Emily, as last time there was a picture of me) to China by this spring, with a hopeful going to China and a homecoming of next summer. This is much faster then the 2 years that they waited the first go around. My sister came over when she was 10 months old for those who don't know. Hopefully they will (hint, hint) create a blog of their own so everyone can follow their progress. I will let you know more information as it is available to me.
Jennifer
Tuesday, December 05, 2006
Emily's new device
Well Emily did rather well yesterday. She couldn't get her oxygen lowered over night and didn't take any bottles but by the time I saw her she really wanted to be held. So I did that. She breast fed well from me taking about 15 to 46(!) cc's or 1/2 oz. to 1.5 oz from me. Her stats also improved with me there. They decided to try her on a different nasal canula. They can give her more humidity and more flow with this canula. The hope is to eliminate the oxihood. So far it has worked well. She is on a flow rate of 4 liters per minute and an oxygen rate of 70% last I heard. Hopefully they will be able to lower her flow soon. The only bad thing about this canula system is has a tube that is only about 4 feet long so she is really tied down as far as how far she can be from the source. In other words her already small world got smaller! However this new canula is helping her and last I heard she took 1/2 of her 12 midnight and her 4 am feedings by bottle!
That is about all the news I have for now. Sorry for no pictures I didn't have the camera with me when I sat at the computer and I am multitasking as it is. I will tell Tony to post some pictures tonight.
Jennifer
Sunday, December 03, 2006
Thirteen Days Old, Corrected





Emily is still packing on the weight- she now weighs 2600 grams, or 5 pounds, 11 ounces.
She had a pretty good day yesterday and did well through the night. She was very congested yesterday and had to be suctioned, but she had a good session with occupational therapy and slept a lot. She has also started taking her feeds from her bottle again. The pictures today show Emily in her brand-new hat that her Mom made for her yesterday. (All of the nurses seemed quite impressed.) Jennifer held Emily on her knee while doing some knitting, and she seemed to enjoy that. Emily has also been getting much more expressive with her eyes and face. It's hard to describe, but she's furrowing her brow and moving her eyes in more suble ways. She's also starting to look to her left more while she's in the crib because people have started to approach her from that direction and she's starting to get some stimulation there.
Although it looks like we'll be spending Christmas with Emily in the hospital, I think that she would like it. To put it another way:
Brand-new pacifier - $2.00
Yarn for cute little hat - $5.00
Brand-new pulse-ox - $15.00
Cute little preemie outfit - $30.00
Christmas dress to have my picture taken with Santa - $40.00
Dr. Brown's bottle with preemie nipples - $60.00
2007 Honda Odyssey- $29,400.00
5+ month stay in the NICU - $???,???.??
Spending the holidays with Mommy and Daddy - Priceless
While Emily was breast feeding yesterday, she got tired and grabbed Mom with both hands (a double-fisted drinker!), turned her head, put Mom's nipple in her ear and fell asleep. Mom thought that this didn't look too comfortable and tried to move her. This led to some of Emily's loudest screams yet, accompanied by some oxygen desaturation alarms before she finally won the argument, put Mom's nipple back in her ear and went to sleep. I'm not sure that this was the kind of drinking problem that the doctor was referring to when she said that Emily still needed to work on feeding before she could go home.
Tony
Friday, December 01, 2006
Emily's Lungs

This is what a normal lung would look like if she had been born as most babies are.

Just thought it would help people understand what we are up against.
Jennifer
Our family meeting





The picture below was taken before she got her blood. You can see how pale she is.

Hello,
Well Emily is doing slightly better yesterday. She is stating well most of the time. However she is on 100% oxygen through the canula and through the oxihood. They have increased her inhaled steroids and if they work, they expect to see it happen by early next week.
Now the family meeting. We were told again that her lungs are barely functional. She has very little "reserve" and so minor things seem like big things in her. The doctor even said that she is the kind of baby that you see a few times in your career, rather then a couple of times a year. She is hoping the inhaled steroids will work with her since she can be released with those. However if they don't they may have to give her a oral steroid again. To me this means that she is going to be in the hospital for even longer since she will do well for a while and then she may rebound from it. They may also try her on one other drug that the pulmanologist recommended. Her renal ultrasound looked good but they are seeing the effects of the lasix (a diarill) on her kidneys. They are getting calcification I think.
They have moved the "milk scan" back to next week if they do it at all. She said that there is reason to think that she doesn't have any reflux (or very minor) and that what they are seeing is just that her lungs are in bad shape. She is also getting an EKG to check her heart to make sure it is growing correctly since sometimes they see the heart grow wrong in babies with bad lung disease. (The heart has to work harder to get blood through the lungs so that side gets bigger then the other side that just pushes it through the body.)
As far as when she will go home it is really not looking good for Christmas. She said that if she were to guess it would be months not weeks that we are looking at for going home. There is even a possibility of being transferred to a rehab center. I think that they will make that decision towards the end of the month though. The good news is they are talking about an end game. She is going to go home as oppose to the last family meeting when even that was questionable. Her requirements for going home are she has to be taking every feed by bottle, she has to not desat as much as she does (and we have got used to), her flow on the canula needs to be less then 1 liter per minute (currently at 2), and she has to show signs of having some reserve as far as lung function. These are a lot for her to overcome in a short period of time.
Tony and I at this point are thinking about postponing our Christmas this year. We can't imagine a Christmas without Emily and regardless of how hard we really try we are not going to be able to spend that much time with her on Christmas. Our new goal for her coming home is Tony's birthday of February 25. Ironically this is the one year date of the IUI that helped create her. We have decided that we would take the 25th of whatever month she comes home and call that Christmas. I just hope it isn't in Lent. I am going to let her have a picture taken with Santa though. The hospital offers that. I am hoping they will even let her be in her Christmas dress that I got her. I am also thinking of taking a "family portrait" while she is in the hospital. I figure this would be simple enough when she is having a "good day". After all we have 3 cameras that we bring everyday. Surely we would be able to get a good one with that. I might have to do it a day that she has a lot of people she knows working though since she may not want to look at the camera otherwise.
The thing I am most sad about is her not seeing snow when it snows this winter. Not that I want her playing around in it or even going out in it. The windows in the ICN are really far back behind all of the counter and electrical stuff. So even if we can see it snow she wouldn't be able to see that far. I have asked one of the nurses and they told me that they do have portable oxygen tanks that I can take her to another window in the ICN that she could see the snow. Though this would only be if she were having a good day since she would be off her monitors for a minute. On that note also I am planning on packing a small bag for the car should it unexpectedly snow more then is safe for us to get home in. I don't want to be stuck at home during a Nor'easter (a really large snow storm, like the one when I got married for those of you that were there. That was a Nor'easter in the truest sense of the word). I would rather be at the hospital in that case.
My goal for the remainder of the time that Emily is in the hospital is make it feel as much like home as possible, for her and for us. I don't know what more I can do but if I think of something I will do it.
That is all I have for now.
Jennifer