Day 140 - Discharge today

Baby Hao, you did well and finally graduated from Malaya University Hospital today.

It was a long journey. 140 days period, near to 5 months long.

You fought well for the past 140 days. You grew from 640g to 3000g today.

It was a tough journey. You have went through it and become a tough guy.

In another 30 days, you will need to go through a hernia repair procedure.

We hope the journey ahead will be smoother and you will catch up all the development in a few months time.

Welcome home boy!

God's bless!

Day 135 - Breathing by yourself

Boy, it was a big surprise when papa visited you in the evening. You are off from the oxygen air blender.

The professor of respiration system has decided to take off your nasal cap as you are able to breathe at 21% oxygen. We thought the flow setting at 4.0 is high, actually it is set based on your weight. Based on your current weight, setting below 6.0 will not be able to assist you. This professor believe that you will be able to breathe by yourself and yes, you are doing fine.

The standby doctor visited you few rounds today to monitor your situation. Your lung is not that bad, commented by the evening standby doctor. The good sign is your are very active. Yes, you are active and demanding, it causes your mom restless nights and both your sisters and papa have to stay late every night to assist your mom.

Your mom care and love is the main factor that help you to recover fast. Your sisters supports is also serve as important element.

Your mom sleep less than 3 hours per day for straights 9 days and she is not able to catch her sleep for more than 2 hours per episode as she need to feed you every 3 hours. It is definitely very tiring and she is able to sustain because of her unconditional love to you.

Your sisters are exhausted also. They have been travelling to hospitals every night without fails and stay up until late nights for continuous 130 days plus. Most of the time they are sleeping in the car during the journey back home. They are 10-year-old and 8-year-old now. Both are adorable kids.

By the time you read this post, your mom may be at her 50s, and your sisters shall be at 20s. Please love them and listen to them if you are a teenager.

If you are already an adult, please take care of them. Especially your mom. The unconditional love from her is the greatest remedy to you.

Being healthy is so important.

If you are a teenager now, please spend time in your academic, sports and hobbies. This is the golden chance to acquire knowledge and explore your strengths. Do not spend time in video games and try to be an adult.

If you are an adult now, do not pursue material stuffs like getting fancy car, worse still pursuing those car accessories. Focus at your day time career and spend time with your mom and sisters. Last but not least, exercise.

To get you to breathe without oxygen needed 135 days. Don't you agree being healthy is vital?

Stay strong boy!

God's bless!

Day 134 - 2925g, infections free, quarantine

Boy, until today, your mom has stayed in to take care of you for 8 days. While you are gaining some weight in the measurement of hundred of grams, your mom lost 2kg.

You are weighted at 2925g by your mom today morning. You are still on oxygen air blender with high flow setting at 4.0 while oxygen is set to 21%.

As per the professor that take care of your respiration system, he said that you have been infected by various lung diseases since July until the recent virus infection.

Papa really hope that with the quarantine you will be shielded with all the infections and gain strength on your lung.

You look more relax and happy. I believe your mom definitely able to give you more attention and care. 

Please be considerate and listen to her. She is definitely very tired in taking care of you and for sure she is not able to catch enough sleep during this period of time.

Stay strong and be good.

God's bless!

Day 126 - 2680g, RSV Virus Infection, Quarantine

Boy, you have been quarantined at general ward due to your lung infection. 

From the sample, you are identified to be infected with Respiratory syncytial virus (RSV). 

RSV virus is be spreader through air, hence in view of the safety of other infants at NICU, you were sent to a quarantine room in the general ward.

Your mom have to stay in with you as you need dedicated attention and there is no such service in normal ward.

You are still on oxygen air blender. Air flow at 5.0 and oxygen at 30%. 

Because you were sent to general ward yesterday, today morning is the first time you see your sisters with both your eyes widely open. They visited you yesterday evening, but you were closing your eyes whole night long.

Let's recover from the lung infection and discharge by October month.

Stay strong!

Day 119 - 2565g, CPAP, Pneumonia

Hao, you have weight drop today. It is 95g decreased in 2 days time. We were very worry.

You have a lot of secretion which we believe is due to the pneumonia. The good sign is your oxygen setting is lowering down as we believe you are recovering.

You will encounter apnea during suction procedure. And this phenomenon occurs very often since you caught in pneumonia. 

You were staring at your mom while she was soothing you. Your big eyes are shinning and dark. You utter voices like talking to her.  

You are strong fighter. You inspired me. You make me stronger and a better person.

The colorful world is waiting for you out there. Get well soon and go see the world.

God's bless.

Day 117 - 2640g, CPAP, Blood transfusion

Boy, you are sick now.

You have several apnea incidents yesterday and in the midnight you were put up with CPAP.

Your left lung were detected with milk that cause by reflux on 21-sep. It is recovered as per today X-ray. But now your right lung is detected with milk.

You are also having blood transfusion. This is because of the drop of your hemoglobin in your blood.

The doctor has also change the antibiotic that covers wider range of infections. I guess they have no clue on what makes your situation deteriorate yet.

Stay strong boy and we will pray for God's mercy on your recovery.

Day 115 - 2580g, pneumonia, reflux

Boy, you are suffering from pneumonia. It is due to the back flow of the milk from your stomach to your throat, and then the milk was sucked into your air way. 

We believe this is due to the carelessness of the NICU. Your mom spent 9 hours at hospital yesterday. I can see she is very worry about you.

You are on antibiotic and the setting of oxygen air blender is high. Flow at 3.0 and oxygen at 40%.

Doctor has reduced your milk feeding to 50ml maximum per serving. Boy, drink slow. Drinking too fast will cause air captured in stomach and back flow of the milk from stomach to throat.

Please pray that you will get over the pneumonia soonest and get healthy.

God's bless!

Day 114 - Apnea, resumed oxygen air blender

Boy, you were suffering from Apnea this morning. You were resumed with oxygen air blender aid and is on antibiotic now.

According to the nurse, put you on antibiotic is kind of standard procedure.

Most of the apnea for preterm babies will resolve at 44 weeks of postconceptional age. 

Today, you are 44 weeks and 2 days of postconceptional age. Understand you are extreme low birth weight 28 weeker, I really hope your apnea will resolve soon.

Papa really hope to can get well by October. We want to bring you home.

Stay strong boy. Papa love you.

Day 112 - 2530g, off from oxygen air blender

Boy, you have good weight gain. The curve of your weight over days is steep. Good progress boy.

The doctor has taken away the oxygen air blender this morning. This is a trial. If you do well, you will no longer need the oxygen air blender, and very soon you will be scheduled for hernia repair surgery.

Boy, papa believe you will make it. And you will be doing well without oxygen aid.

You were with intubation ventilator for too long. That's why the dependency of oxygen flow become your behavior.  

You need to learn on steady breathing and with consistent rythm.

Try your best son. You can!

God's bless!

Day 108 - 2360g, stop breathing

Boy, you are gaining weight persistently. It is indeed a good progress.

Doctor Choo visited you in the morning. He told your mom that you are doing well, just a matter of time.

You are now on demand feeding. Understand that the nurses are feeding you in between 80-100ml.

You drink too fast. This is the general comment from all the nurses. And after you drink, you may get tired, resulted desaturation sometimes.

You were not breathing yesterday midnight. It was after you taken the 100ml milk. 

Drink slow boy. Remember to breathe.

Get well soon.

Day 106 - 2285g, ROP eye exam, on demand feeding

Boy, you gained quite a bit of weight. Hope the weight gain is directly contributed to your new lung cells where it will resolve your chronic lung disease.

You are still on oxygen air blender. The setting of the air flow is at 1 now. 

The nurse said you often forget to breathe when you drink milk. And you drink really fast. You are also tend to forget that you need to breathe when you shit. She said you only started to resume your breathing when you are done.

You are on on-demand feeding now. It means on top of your 60ml every 2 hours schedule feeding, as and when you cry for milk, the nurse will feed you.

On the eye exam, you are basically confirmed free from ROP as of now. A follow up exam will be carried out in another 6 months time.

Boy, remember to breathe. And breathe steadily.

God's bless!

Day 102- 2140g, stopped Ursodeoxycholic acid

Baby Hao, you gained 100g in the last 3 days. You are suffering with chronic lung disease, the only way to recover is to grow your lung, where the new cells of the lung is more capable in exchanging oxygen. 

To do that, the weight does critical matter. You need to continue to gain weight at faster pace. 

Your mom received a phone call from NICU, the doctor told her that you were suffering from desaturation and it was do bad that until the doctor decided to put you back in CPAP. It was happened on last Sunday evening, and you were on oxygen air blender on the Monday morning.

It was caused by stomach upset/ bloating , I guess. The the abdomen is pushing up, it create pressure to the lung. It resulted difficulties in expansion, hence directly affecting the oxygen saturation. However, it is just my guess.

What lead to bloating? It is because you drink too fast. I can't expect you to comprehend what I said to you now, but I hope that when you read my post now, you listen to my advise that you need to chew your foods thoroughly before you swallow. It will be great for your digestion system and many other benefits.

I need you to get well soon and get home in October. Both your sisters accompany us in every of our visitation. And till now, they are yet to have a chance up see you. They are very supportive, and I really hope they will have enough sleep after you get home. And, I believe you will like them very much. 

Doctor has put up order to stop your Ursodeoxycholic acid medication. It is indeed a good news.

Boy, be a man. Fight like a warrior and get well soonest.

Love you boy.

God's bless!

我的爸爸

           我的爸爸是一名修理机器的技术人员。他从早做到晚，连晚餐都没有吃就带我们去医院探望弟弟。每天晚上，我都带饼干给爸爸吃，爸爸因为驾车不能吃饼干。所以每天妈妈都喂爸爸吃饼干。我的爸爸很严厉，因为每天晚上在车上，爸爸都问我：“璇，你今天在学校学会了什么？”如果答不出，爸爸就会很生气的说：“你在学校睡觉阿，如果你在你再这样的话，明天你就不用去学校。”除此之外我爸爸也很善良，一次在路上看到有人欺负小动物，他就会上前阻止。

            爸爸的爱好是与我们一起打羽毛球。他最喜欢吃沙爹和喝酒。有一次，出席宴会，所以他的同事购买了几瓶酒，妈妈就说：“老公，你最多只可以喝两杯。”因为喝太多酒伤身。

             我和爸爸做过印像深课的事是，我们一家人一起去云顶玩。我们也带了杯面去那边吃。我们在那边逗留了两天一夜。那时我还三年级。我们玩了好多游戏。我希望改次能再次到云顶玩，可以和爸爸在一起玩乐。

Day 99 - 2040g, no more feeding line

Boy, you gained 40g over the last 2 days. You are at 1240g now.

You are now only attached with the oxygen air blender tube that is close to your nose.

The line feeding tube has been taken off from your mouth. You are good in sucking the feeding bottle now, but you drink a bit too fast.

With the removal of the line feeding tube, you shall be more comfortable now. 

You will be able to go back home after your lung & liver are matured and after the hernia repair procedure.

Rest well and stay strong boy.

Day 97 - 2000g, 45ml milk, Oxygen Air Blender

Boy, you achieved 2000g today. A remarkable achievement and it is worth celebrating.

I believe the strong weight gain for the past few days is due to the strategy that the NICU apply on you, where you are continued to be assisted with air oxygen blender with air flow at 2-3 as well as adjusting the oxygen to 22-23% as and when you are tired. This is to ensure that most of your energy is utilizes to gain weight.

The nurses also tight you to prevent you from making too much motion. You know, you are known to be very active and strong at NICU since long long time ago.

Your mom also contribute in calming you down by breast feeding and kangaroo care. You sleep well after every session of  skin to skin contact with her.

Hao, continue to do well and stay strong.

God's bless!

Day 92 - 1795g, out of incubator

Boy, you are at 1795g today. The doctor wanted you to gain weight faster, supposingly you will be on new fornula milk that is for better weight gain, but due to your high protein level, your diet is maintain with alternate preterm formula and breast milk plus Carborie.

I am writing this post beside your bed. We can see each other. You have a lot of aggressive motions despite you are wrapped by the blanket. The nurses told me because of your hyperactive, it utilizes too much energy that cause you have poor weight gain.

Your mom is pumping her breast milk at the nursing room at NICU. She loves you so much. Mother's love is unconditional, I need you to remember that, and take care of her by doing good as well as staying healthy and strong.

You are a fighter, I like you to maintain this attitude and fighting spirit in your entire life. 

You are calm when your mother holding you and having skin to skin connection.

Stay strong my little man.

God's bless.

Day 88 - 1775g, 40ml feeding

Boy, you gained 65g in the last 3 days. I would say it is a good weight gain. I hope  such weight gain can be persistent.

Your feeding volume has increased to 40ml every 3 hours. Hope you digest well.

The air flow setting of the oxygen air blender has gone down to 1.5 since yesterday, really hope that you will breathe well without it in no time.

The air pollution is terrible out there. Papa hope while you discharge, the situation has become better. 

Not sure how old are you when you read this post, Malaysia currency has hit rock bottom as compared to past 17 years, RM4.25 to USD1.00 and RM3.00 to SGD1.00.

Papa is a bit skeptical of the future of you and your 2 sisters in living in Malaysia. 

Malaysia is a nice country to live. Freedom and affordable.

But, for next generation like you and your 2 sisters shall expose yourself to live in other countries during your schooling life or early working life. Then, you will be able to make a choice that suite you.

Last but not least, like your mom saying, healthy and safety are the most important blessing that we could have, and should not take it for granted.

God bless!

Day 86 - Vomiting

Oh boy, your feeding volume is still at 38ml every 3 hours. 8ml via mouth feeding and 30ml via line feeding.

Because you are still aided with oxygen air blender, line feeding is still necessary. And because you are staying in the incubator, it is also very challenging for the nurse to feed you via mouth. Your posture in the incubator is definitely not appropriate for mouth feeding, I guess.

You vomitted in the evening. Your mom carry you and soothed you. I can see your face that you value her very much. Mother's love is uncondition. You calm down very soon, you smile and fall sleep in a while.

Boy, you need to learn to breathe without the oxygen air blender, and I strongly believe you will recover faster after the nasal mask is removed.

God's bless.

Day 85 - 1710g, Oxygen Air Blender

Baby Hao, your weight gain is not consistent. For the last 2 days, you gained only 10g. Maybe it is time to increase the milk feeding volume.

The air flow of oxygen air blender has set to 2.0 now. Yesterday evening, the nurse feed you 8ml of milk via mouth suction and the rest of 30ml via line feeding. You seems to be struggle in drinking the milk. Practise makes perfect, I believe you will be good in another few days.

You are fairer now, before that your skin color is very dark. Your skin pigment has developed. Another good sign of maturity.

Stay strong boy.

Day 84 - ROP Eye Exam

Boy, you had your ROP follow up eye exam today. 

The exam was postponed from morning to afternoon. Professor Doctor Choo performed the exam. 

She told me your left eye ROP stage 1 has regressed. No visible ROP during this round exam. Right eye is alright since day  one.

However you will be diagnosed in another 3 weeks time.

As per doctor, for preterm birth weight less than 1000g,  chances of getting ROP is 90%.

Because you are still aided with oxygen, continual follow up exam is necessary.

Stay strong boy.

God's bless!

Day 83 - 1700g, Incubator

Boy, you hit another milestone today. Your weight is at 1700g.

Your sister discharged from NICU 8 years ago when she reached 1700g. But you still need oxygen air blender, and still living in the incubator.

Your mom said you did much better in drinking milk via suction as compared to your sister. But you get tired very soon.

It is alright because you are extreme premature baby with extreme low birth weight.

You actually did very well in view of your starting point. 

You are less aggressive these days. You are cute and gentle. 

Day 82 - 1655g

Boy, you have good weight gain. You gained 55g in 3 days time. You are now at 1655g. 

Over the 80 days journey in the NICU, you gained 1010g against your birth weight at 645g.

Your feeding volume has increased to 38ml every 3 hours. I believe when your digestion system getting mature, the feeding could be increased further.

The nurse said you did well in milk suction even thought you are still on oxygen air blender. 

Your mom did try breast feeding yesterday, she said you did very well. But you are greedy, you cried for 2 hours upon she put you back to incubator.

Mom's milk is sweater than honey. I believe you want more than milk, you felt the love and caring from her.

I hope the mother & son bonding is eternal.

Stay strong, grow well.

God's bless!

Day 79 - 1600g

Boy, you are weighted at 1600g yesterday. You have crossed another milestone. Well done!

Your milk feeding is still maintain at 35ml every 3 hours. I believe it shall be increased further when the primary doctor exam you on next Monday.

You are still on oxygen air blender. The setting of the air flow has reduced to 2.5 from 3.0. I trust you will be doing well. Eventually while you cope well with lower air flow setting, you are one step nearer to breathe without any aid.

Papa is currently in Singapore, on business trip while updating last 2 days status of your medical condition.

Love you! Stay strong!

Day 77 - Oxygen Air Blender, 35ml feeding

Baby Hao, you are on oxygen air blender for 3 days in a row. You looks abit tired, however I trust you will be able to overcome it.

If you continue to do well, you will not be put back to CPAP.

From your weight lost yesterday, I believe you must have try very hard, consumed a lot of energy. Hopefully the increased of feeding volume to 35ml every 3 hours will put your weight gain back on track.

Gain strength and move on.

God's bless!

Day 76 - 1570g, fluticasone propionate nasal spray

Boy, you have weight reduction at 10g over the last 2 days. I believe it does not matter as your total feeding were reduced in past 3 days due to changing of feeding frequency from 2 hourly to 3 hourly.

Doctor prescripted you with fluticasone propionate nasal spray to prevent you from lung infection as well as to strengthen your lung because you have prolonged depending on ventilator and nasal mask.

In medical term, you have developed chronic lung disease because you still need ventilator or oxygen air blender upon 36 weeks adjusted age.

You are now at 38weeks plus. I hope you can breathe by yourself before 40weeks adjusted age.

Stay strong boy.

Day 75 - Oxygen Air Blender, 35ml Milk Feeding

Boy, you are on oxygen air blender today since morning. Because you are doing well, the nurses do not switch you to CPAP alternately.

I managed to speak to Doctor Choo and Doctor Yip today. They are positive with your progress. They will arrange you for the hernia repair surgery when your weight cross 1700g. Your PDA is confirmed resolved by itself as well. 

Your feeding has increased to 35ml every 3 hours. Please continue to do well as I believe you need higher volume feeding for better growth.

Your mom has resumed to work since last week. She is pumping breast milk at the office and at home while need to handle tremendous office tasks and spend time visiting you at NICU.

Your good progress will definitely help in relieving your mom from being worry or emotional. She cares of you very much.

Good night & God's bless!

Day 74 - 1580g, 30ml milk feeding, CPAP

Son, you are at 1580g today. Your milk feeding has increased from yesterday 25ml every 3 hours to 30ml every 3 hours.

As compared to previous record, your total milk feeding per day is still 24ml lesser. However I believe your milk feeding volume shall be increased in another day or two if your digestion system is alright.

The CPAP settings are still the same with PEEP at 4cmH2O and oxygen at 31%. The good news is your oxygen saturation has improved.

You have pulled out 2 feeding lines in the morning. To calm you down, the nurse has decided to tight you with the blanket.

Hao, I believe you are progressing well. Stay strong.

God's bless!

Day 73 - 1560g, CPAP, PEEP 4cmH2O, Oxygen 21%

Boy, you are not switched to oxygen air blender & CPAP in every alternately. After the last week eye exam, you are on CPAP mode.

I guess is doctor wanted to improve your weight gain as during the last Saturday, 8-August 2015, your weight gain is only 10g in 2 days time.

Your peep setting has lowered down to 4cmH2O and oxygen has reduced to 21%, which is equivalent to room air oxygen level.

Everytime when the CPAP mask was pulled off, your oxygen saturation reading actually did better. I believe you have no problem in breathing without the ventilator or oxygen air blender. Your challenge is your stamina. You get tired after awhile if you breathe without aid.

Your feeding has changed to 25ml every 3 hours. This means that you will be fed 64ml lesser milk per day as compared to the old diet. The nurse said if you are doing well, your feeding shall be increased further.

You look great today. 

Sleep well, gain strength and get stronger.

God's bless!

Day 70 - Eye exam

Baby boy, you have gone thru eye exam today on your ROP. The result is as per last week examination, your left eye developed ROP stage 1 and right eye is alright.

It is indeed a good news. I hope your ROP will be recovered by itself.

I did not manage to visit you yesterday. I was having a whole day event near the hospital. And I will be travelling tomorrow.    Since I am attending an event near the hospital, I excused myself for a while after lunch to visit you.

You were sleeping and on CPAP when I entered the NICU. The prong mask was disconnected, I immediately get a nurse to fix it for you. 

You are sweet and look alike your sisters.   

Papa miss you.

Stay strong!

Day 69 - 1535g, Kangaroo care

Boy, papa did not manage to visit you today due to my tight schedule. However your mom visited you twice, in the morning and evening.

You gained 35g over the last 2 days. You are weighted at 1535g today.

Your mom did kangaroo care for you. I believe you enjoyed it very much. 

You are still on 22ml feeding. I am not sure if you are already on full feeding. I do hope that the feeding volume can increase further. 

Good night son, I miss you.

Day 68 - CPAP & Oxygen-air blender

Hi boy, your mom is unable to do kangaroo care for you today. It is because you are tired. 

The nurse just switched you from oxygen-air blender to CPAP. Your oxygen saturation is fluctuating from 83-100. It is indeed a big fluctuation.

I guess you are alright with your respiration system. The stamina could be your challenge now. I believe it has something to do with the weight as well.

You still have a lot of secretion. The blockage of your air way is definitely another reason that prolong your dependency on ventilator.

Stay strong boy.

God's bless!

Day 67 - 1500g, CPAP & Oxygen Air Blender

Boy, your mom visited you this morning. You encountered several bradycardia episodes in the morning. 

The primary doctor then increased your PEEP setting to 6, initially was 5. This incident made your mom very worry.

The doctor also shares with your mom that during the last Friday eye exam for ROP, you experienced an episode of apnea where you did not breathe and your body turn purple.

Boy, papa understand you have gone through tough time, you did well, what I need you to do is to be tougher than the circumstances and do better. That is the destiny of a man. We survive at all circumstances and get stronger.

In the evening, you are on oxygen air blender and all the setting is lower than before. The oxygen setting is 21% (previously 30%), pressure at 2.5 (previously 3.0), and your clinical indicators are all great!

You also achieved the weight milestone which is 1500g. So, your next milestone will be 2000g. It will be great if you can achieve it in 10-14 days time.

Let's challenge all the new milestones and be tough boy.

God's bless!

Day 66 - Kangaroo care, Inguinal Hernia & ROP update

My dear little boy, papa met the consultant today, she said you have poor weight gain as you are only weight at 1475g at 37 weeks adjusted age. She said you shall be at 2kg. The consultant has suggested to start kangaroo care for you.

So, when we visited you in the evening, your mom was doing the very first time kangaroo care with you on her chest.

You are so adorable. First time we see you out of the incubator. Your mom hold you with both hands and put you skin to skin with her chest. You were so calm, and you sleep tight.

I know you must be very happy. Listening to the familiar heart beats, the aroma of your mom body smell, the body warm that went thru your body via the skin to skin connection.

You are on alternate CPAP and oxygen air blender. You respiration system is still weak.

Doctor Yip said that you will need to go through the hernia repair surgery before you discharge.

As for your ROP, one of your eye has developed ROP stage 1. I hope it will be resolved by itself in 2-3 weeks time.

You started to have good weight gain last week. Hope to see you crossing 1500g mark this week.

God bless!

Day 65 - Oxygen-air blender, 22ml feeding

Son, you are on oxygen-air blender today. The setting is Oxygen 30%, Pressure 3.

Your feeding has increased to 22ml every 2 hours. It is a new milestone for you. Your feeding has been hovering between 16-20ml for many weeks.

You like to cry a lot. Your mom said it is ok as you are still a baby. She sing songs to calm you down. You hold her finger tight.

We believe you cry because you are hungry. Maybe the feeding is still lesser than what you really need. To overcome that, you need to digest the milk well, so that doctor will increase the volume gradually.

You are still medicated with ursodeoxycholic acid, I believe your digestion system is still not mature yet.

You are very aggressive. I hope you will be having such aggressiveness in pursuing your dreams while you are growing up.

Get well soon.

God bless!

 

Day 64 - 1475g, ROP Stage 1, CPAP Oxygen 23%

Boy, papa was not around for the last 2 days. Papa received your progress update from your mom.

You were detected with ROP stage 1 on last 2 day, day 62. A follow up eye exam will be carried out on day 69. 

If your ROP is not going to worse off, high chances it will be resolved by itself. Let's pray that you will be alright.

You have good weight gain recently. Your weight today is 1475g, another 25g to cross the 1500g milestone. 

Your milk feeding has also increased to 20ml every 2 hours. Hope that you will digest well and eventually can increase the feeding further.

You sleep well in the evening when we visited you. Oxygen saturation is good, calm breathing and steady heart rate.

Stay strong boy.

God bless!

Day 61 - Inguinal Hernia, CPAP Peep 5, Oxygen 25%, rapid breathing

My baby Hao, you are still on CPAP today. 

When we visit you in the evening, the CPAP prongs mask has disconnected from your nose. Your oxygen saturation is alright, but you breathe too rapid, up to 120 times per minute. Your nose were bleeding as well.

Your mom get a nurse to fix up the mask for you. You still have rapid breathing even thought the mask is well fitted to your nose.

I was very at that moment. But I still try to calm down myself so that I can calm down your mom. I told her do not panic, but monitor. I get her to start talking to you so that we will receive her energy.

Your respiration rate eventually has coming down to 30-40 times per minutes after a while. You must be distressed for hours where no one notice your mask has disconnected from your nose. 

You are detected to have Inguinal hernia today on both side of your groins. I believe you will need to go through a surgery to repair your hernia. Probably when your weight reached 2400g. 

Good boy, let's catch some rest and get stronger tomorrow. 

God bless!

Day 60 - 1415g, 10th blood transfusion 28ml, CPAP Oxygen 25%

Baby boy, you started to have good weigh gain. You are at 1415g today, another 85g to cross the important milestone.

You have a lot of secretion, thick one, and mostly in the nose. The nurse told us that you looked tired in the morning. Even after suction, you are still struggling to breathe. Hence, you are returned to CPAP ventilation with PEEP 5, Oxygen 25%. A blood sample is taken due to this as well.

From the blood test, your red blood count is below 8. Hence, a blood transfusion is warranted. This is your tenth blood transfusion since you are born. And it is 12 days gap from your last blood transfusion.

I hope your low red blood count is purely due to the immaturity of your bone marrow only.

I hope over days, your bone marrow, lung, liver and gut are growing stronger and stronger.

Son, you look tired today. Have a good rest and get well soon.

God bless!

Day 59 - Oxygen Air Blender

Boy, the new device that replaced the ventilator is Oxygen Air Blender.

The milk feeding has increased to 18ml every 2 hours in the afternoon.

Be it invasive ventilation, CPAP or oxygen air blender, you are always trying to pull of all the tube that supply you oxygen.

You did it again on the oxygen air blender mask. Yes, you can breethe without the mask, put it will consume much of your energy which suppose to nurture your organs and improve your weight gain.

Due to your hyper active behavior, you have poor weight gain. Besides, you have prolong the period of oxygen dependency. 

This directly extended your stay at NICU.

Be calm boy. You have gone so far, very soon you will be able to breethe without any oxygen aid.

God bless!

Day 58 - Off from ventilator

Baby, you cross another milestone today. You are off from the ventilator, and now aided with oxygen & air mixer. You shall be very comfortable now without the CPAP prong mask.

Your progress well today. I believe very soon you will be able to breathe by yourself.

The nurse has decreased your milk feeding to 14ml in the early morning in view of your bloated tummy. Your feeding has resumed and maintained at 16ml in the afternoon till evening.

In the afternoon, the nurse gave you a try to suck the milk by yourself. As expected, you forget to breathe while you were sucking the milk. But, it was a good try. 

Sucking milk while breathing may be the first multi-tasking skill that you need to learn.

Boy, papa is proud of you. I can see the strong fighting spirit in you. 

Staying strong and be stronger.

God bless!

Day 57 - 1330g, CPAP Oxygen 25%

Baby Hao, you gained 50g in these 2 days time. You are now at 1330g. Another 170g to cross the 1500g milestone.

Crossing 1500g is a significant milestone for all the preemies. As per doctor Choo, most of the complications of the preemies will be recovered after passing 1500g. 

In the morning, your oxygen setting was at 21%. But in the evening, the setting has been increased back to 25%. It is ok baby, you have tried your best, let's rest for a while and strive again.

You continue to sleep well after the increased of milk feeding volume.

As per the nurse, your secretion at the nose is thick and a lot. This shall be the main cause that hold you down.

I am so sorry that you inherited the sinus nose from me. Your grandfather has similar problem.

I like to see your chubby face. You are adorable. 

Rest well tonight and challenge the next milestone tomorrow. 

God bless!

Day 56 - 20ml milk feeding, CPAP Oxygen 25%

Boy, doctor has finally increased your milk feeding volume from 18ml to 20ml every 2 hours after so many days.

You are less desperate for food after the increase of the milk volume. You sleep better.

It is because the intention of the doctor is to set you 1 milestone at a time. You are coping well with CPAP, which means you are ready for another milestone challenge, in this case is your feeding intake volume.

You are still on ursodeoxychohe Achod medication as your gut and liver are still not mature enough. Which both organs have signifant impact on your digestion system.

You also changed bed location and sleep in another incubator today. 

Rest well and get ready to cross another milestone.

God bless!

Day 55 - 1280g, CPAP Oxygen 25%, IVH recovery

Baby boy, you have weight lost of 10g against the last measurement.

I believe it is because of the change of ventilation mode from nIPPV to CPAP. You need more energy to breethe. A part from that, you always pull off the mask resulted you need to breethe with any aid until the oxygen desaturation alarm trigger the attention of the nurse.

Doctor put you back to CPAP today morning with oxygen at 25%. You were put at prone sleeping position in the morning and evening.

We noticed that you were very uncomfortable with the prone position in during our visitation in the evening. You try to move your body.

You started to pull your leg over, slowly you stretch your body to turn around. Yes. After a few minutes, you managed to turn yourself from prone position to side position.

We are happy to see that. It tells us that you have strong muscles, strong will power and good motor skill.

The nurse in-charge told your mom that you have recovered from IVH stage 1.

You did well and keep doing better.

Proud of you.

God bless!

Day 54 - CPAP trial

Boy, when your mom visited you in the morning, you were under CPAP mode at pressure 6cmH2O.

Moving from nIPPV mode to CPAP mode is a big milestone. I received this good news from your mom and was very delighted.

In the evening, when we were visiting you, the alarm of your medical monitoring system keep beeping due to desaturation of oxygen. 

The nurse then carried out suction procedure and put you back to nIPPV mode with oxygen at 30%. As expected, you bleed everytime when suction is performed. We can see your blood in the vacuum filter.

It was extremely heart pain to me. I can see your mom was panic, but she tried to keep herself calm. From her eyes, I see sadness, endless pain and miserable.

After the suction, the situation improved. But even under nIPPV mode, your oxygen saturation is still not as good as past 2-3 days.

Your mom is very disappointed. I told her that it is common for preemie to take

A few step back after some good progress.

I believe that you are progressing every day. You have strong muscles, and it is alright for you to take some rest after more than 12 hours of CPAP trial.

I believe you can. Have some good rest and strive when you are ready.

God bless!

Day 53 - 1290g, nIPPV Oxygen 23% at 15bpm

Boy, you have great improvement on your weight gain. You are now at 1290g, another 210g to cross the 1500g mark.

I believe the new CPAP prong mask has significantly contributed to your breathing ability and lung function. You are able to rest well as the mask is always intact despite how aggressive your motion is.

You are still on 18ml milk feeding every 2 hours and your digestion system is able to cope well.

We can now hear you crying even thought you are inside the enclosed incubator. It means your lung is getting stronger that enable you to cry out loud.

You are still suffering from the secretion that cause your nose blockage. I know it is very painful for you to go through the suction every 4 hours, and it causes you bleeding. Bear with it eventually you will recover and be alright.

God bless!

Day 52 - Trial on new CPAP prong mask, nIPPV Oxygen 30%

Baby Hao, you must be very comfortable today. Professor Doctor Choo has put you on trial on a new CPAP prong mask. The intention of the NICU is to replace the existing mask which is loosen easily with a new type.

You are chosen to be the first trial before they confirm the order because you are the most active baby at NICU. It is normal for you to take out the mask by yourself, multiple times in a day.

The new mask fit you well. No matter how you fight and try to pull it off, it is still intact. I believe your breathing can improve faster with this new toy. It cost the hospital MYR1000 per piece. At this moment the USD vs MYR exchange rate is USD1.00 for MYR3.80.

Doctor Yip also mentioned that the incubator that you are staying in cost the NICU MYR180,000. This amount of money can buy us a full specification Toyota Camry or Mazda6 in 2015. It is definitely more expensive than the car your papa is driving.

You are unable to pull off the new mask. But you did pull out the feeding line.

Physically you look strong and tough. You have strong muscles especially at your chest. You will be looking great if you can breethe well.

I am happy that you are contributing to NICU on the trial of the CPAP prong mask. 

I hope you will read all my post at different age of your life. And I can really see how deep your mom love you. Your bonding with your mom is so strong.

During your stay at NICU, your eldest sister persistently insisted to accompany your mom in every visit. And your elder sister has also been with us in most of the visit.

Only parents are allowed to enter NICU. Thus, your 2 little sisters are staying outside and waiting for us.

Can you see the chain of bonding?

You are the youngest man in the family. You need to grow stronger than me and take good care of all the ladies, especially your mom.

Stay strong, my man.

God bless!

Day 51 - nIPPV Oxygen 25%, 18ml milk feeding

Boy, I believe you are inherited with my sensitive nose. You have severe nose block that require frequent suction.

You were struggling in the morning. We can see that you were using a lot of energy to breathe, because your nose is block. Your chest and abdomen muscles were seen aggressively expanding and retracting.

Your mom is very worry on your situation. I told her worse case you will use more energy and resulted slower weight gain. 

You continue to digest well with 18ml milk feeding every 2 hours. Hopefully the primary doctor will increase your milk feeding tomorrow based on your weight.

In the evening, after the suction, you sleep well. You are so sweat, just like your sisters.

Stay strong and get stronger everyday.

Papa, mama, sisters and your grandparents love you.

God bless!

Day 50 - 1220g, nIPPV Oxygen 25%

Baby Hao, you have good weight gain. You have crossed the 1200g milestone. Now, we shall aim for 1500g.

The doctor has prescripted to add in 0.6g Carborie into the breast milk. Carborie is glucose polymer module that will give you more energy. 

You are still on alternate feeding between preterm infant formula and breast milk. 

The ventilator oxygen supply has been weaned down to 25% in the morning. I believe you will continue to do well and achieve Oxygen 21% in another 2-3 days.

Everytime when you are hungry, your mouth is sucking the feeding line. The nurses said you shall be able to get out from feeding line very soon. But before you can do that, you need to get off from the ventilator

So now, you need to continue to strengthen your lung, chest muscles, abdomen muscle and improve your stamina.

A part from that will be gaining weight. Size does matter for you. Crossing 1500g is key.

Stay strong boy.

God bless!

Day 49 - 9th blood transfusion, nIPPV Oxygen 30%

Today is Muslim festive season, Aidilfitri. 

We went to hospital in the morning to visit you. Doctor James Liew told me that you are stable now when I met him at the entrance of NICU.

However when I met you at your incubator, you looked struggling to breathe, and oxygen saturation is hovering at 75% to 85%. 

Doctor James Liew came in. He ordered a suction for you and took your blood sample to test your blood gas.

You were better after the suction. You still have a lot of secretion, and some of them turned into solid.

The blood gas result was similar to the last few days reading, red blood count at 8.8. Doctor James Liew ordered a blood transfusion for you.

Your mom become very emotional. The worse off when the doctor unable to put in the line after trying on both of your hands and your right leg.

Boy, you need to recover faster for your good self as well as to reduce the pain of your mom. 

I believe you are. 

Stay strong and grow stronger.

God bless!

Day 48 - 1190g, nIPPV Oxygen 25%

Little boy, you at weighted at 1190g today. Since your extubation, your weight gain pace is at 5g per day. It is slower than what we expected. Maybe it is due to the reason that you have been aided with invasive ventilation for more than 40 days.

Your feeding has increased to 18ml every 2 hours. Your tummy has no longer bloated. Effective in the evening, you will be feeding with preterm formula milk and breast milk at alternate basis.

Boy, you have gone thru a lot. You need to stay strong, gain more strength and weight in order to detach from the ventilator.

The beautiful world is waiting for you outside NICU.

God bless!

Day 47 - nIPPV Oxygen 23%

Baby Hao, you are doing great today.

Doctor has weaned down your oxygen setting from 30% to 25% in the morning and subsequently to 23% in the afternoon. The oxygen at room is at 21%,    you are now very close to be able to breathe without the ventilator.

A part from lung function, you need to strengthen your muscle especially at your chest and abdomen so that you will have the stamina to breathe.

Doctor Yip commented that you have gone through a lot of up and down. She said that you are now stable and on steady growth.

Do you know that you are consider senior citizen at NICU?

There is a serious infection going on at the NICU. Many of the infants are infected. Hopefully it is now curb from spreading.

Let's pray that all the babies are on their path of recovery and get healthy soon.

Stay strong.

God bless!

Day 46 - 1180g, Eye exam, nIPPV Oxygen 30%

Oh boy, you have poor weight gain. You only gained 10g in these 2 days.

You have eye exam today for ROP. The result is alright, but you still need to inspect your eyes for another few round to really ensure you are free from ROP.

Your feeding is at 17ml every 2 hours. Your stomach is less bloated now.

There is a massive infection at the NICU, the nurses are busy with reshuffling of the infected infants into the other room.

You are strong boy. You really active. You cried because you are hungry, and you are sort of fighting to protest. 

You need to save your energy to gain weight. Too aggressive is no good. Your hear beat and respiration went sky rocket when you were fighting.

There are also several occasion that you took out the ventilation cap. You have no problem breathing without aid but it will cause you to deplete your energy very fast which may cause problem in gaining weight.

Doctor Yip said your blood platelet count has normalized which is a great achievement. But your red blood count is slightly lower at 8.8.

Rest well and recover soon.

God bless!

Day 45 - nIPPV Oxygen 30%

Oh boy, when we arrived at NICU, the oxygen cap was out from your nose. Yes, you pulled it out again.

Even thought you are not aided, but your oxygen saturation is greater than 90%. But we can see you use more energy to breathe. I would say it is a good sign. I m confident you will be able to permanently take off the ventilation in days or another 1-2 weeks times.

3 of your neighbors were sent to quarantine today due to infection. I hope you are not infected. Mean while I hope the babies to recover as soon as possible.

Your abdomen looks much better now. Maybe your digestion system has improved. You are still on preterm formula milk, not sure when will doctor resume you with breast milk.

Boy, listen to your mom words. She spent hour talking to you everytime she visits you. 

She loves you so much and what you need to do is progress well and let her carry you at her arm.

Let her bring you home soon.

God bless!

Day 44 - nIPPV Oxygen 30%

Hao, today is your fourth day after extubation. You are coping with it well. Keep it up.

Papa and mama met Doctor James Liew this morning. He said your lung is still weak, and they will continue to monitor your oxygen requirement. These 2 weeks will be very determining to see if your lung can cope with room oxygen 21%.

Doctor James Liew said it is key milestone for you to be able to breathe by yourself without any aid before your adjusted age at 36 weeks.

You digest well with the preterm formula milk and you are on full feeding now. I believe you are be able to make it and free from the cpap by 36 weeks adjusted age.

You are now only on feeding line that go through your throat. Both your hands and your legs are free from any lines. I believe you have never as comfortable as of now. You sleep well everyone we visit you.

Hopefully the good sleep will also expedite your recovery.

While I am writing this post, your mom is talking to you. She also hold your hand while she is praying to the God

Mama's boy, stay strong.

God bless!

Day 43 - 1170g, full feeding, nIPPV Oxygen 30%

Baby Hao, you are doing well on your third day of non-invasive venlitation. Doctor has weaned down your ventilation setting in the morning, lowered the bpm and oxygen % to 21%.

It is a bit tough for you. Nurse has increased your oxygen to 25% and subsequently 30% while maintaining the low bpm parameter.

You closed your eyes tight since extubation. I believe you are focusing yourself very much in breathing.

Practise makes perfect. Keep doing it and you will master the skill. Keep practicing it and your lung will gets stronger.

You are weighted at 1170g. Another 30g to cross 1200g milestone. After that we shall target 1500g and 1800g. 

You are on full feeding today. 15ml every 2 hours. Your abdomen is still bloated. You are free from hypoglycemia now and I hope you can digest well and I do not want to see another blood transfusion on you.

I believe you hear your mom talking to you everyday. She is the woman whom gives you life, be strong, recover soonest and stop letting her worry.

My little boy, be brave and strong like a man. I know you are.

God bless!

Day 42 - nIPPV Oxygen 25%, 12ml feeding

Today is your second day of extubation. You did well, thus the oxygen supply has reduced from 30% to 25%.

Your waist line increased by 1.5mm. It is bloated but soft. Hence your feeding has increased to 12ml every 2 hours.

Your mom is still very worry about you despite you are less ill now. To make her relax, I try to crack some jokes. One of them is saying that you are like supermodel, measuring your waist line every day. Hopefully she can has some peace of mind.

I think you are doing well and believe you are on the right track of recovery.

Boy, you need to practise breathing seriously and exercise your lung.

Stay strong and God bless!

Day 41 - 1145g, Extubation NIPPV Oxygen 30%

My little boy, you are on second trial on extubation today at 9:00am. The initial oxygen setting was at 35%, and it has been weaned down to 30% in the afternoon.

You have less movement today. Maybe because you are concentrating to breathe with your nose.

Your are weighted at 1145g. Another 55g to go to achieved 1200g. You shall gained weight faster after extubation, and really hope to see you gaining 20-30g every day.

Doctor Yip said your IVH is remained the same. And papa also hope you will do well with the eye exam next week.

You are on 8ml preterm formula milk feeding today. As per the nurse, your abdomen is still bloated but has improvement on your waist measurement (smaller size).

You are a true fighter. Stay strong and grow stronger everyday.

Have faith in God and pray for God's mercy.

Day 40 - 8th blood transfusion, Abdomen bloated, SIPPV Oxygen 35%

IMy boy, your stomach is still bloated. Due to that, your feeding is still maintained at 5ml. And you have your 8th blood transfusion today.

Doctor has switched your diet from breast milk to preterm formula milk in the afternoon. 

Doctor suspect you are feeding intolerance due to your digestion system is not able to handle the bacteria in your mom's breast milk.

Papa hopes the preterm formula will work well with you as you shall be feeding at 12-13ml every 2 hours. 

You must be very hungry. I see you sucking the ventilation tube with one of your hand holding on it. 

The good news today is the nurse said your secretion has turned to white color from yellow color. It means the secretion is not as thick as before.

Stay strong and God bless!

Day 39 - 1120g, 5ml feeding, SIPPV Oxygen 30%

Hao, you have achieved another milestone on your weight, you have crossed the 1100g line. Your weight is at 1120g.

Your stomach is still very bloated. Doctor tried to increase your milk feeding to 8ml but it is reduced to 5ml in the evening. 

The doctor has reduced the ventilation maximum pressure setting to 12mmHg from 17mmHg. But the oxygen supply has increased to 30%. You need to continue to improve your breathing effort as papa would like you to be extubated.

You look slightly pale today. It must be frequent blood sampling due to your hypoglycemia. I hope your bone marrow is more mature now to supply you red blood cells so that the doctor will not order you another blood transfusion.

Brave boy, be strong and recover soon.

God bless!

Day 38 - 5ml feeding, Nystatin Oral Suspension & Ursodeoxychohe Achod

Today is an eventful day. Your mom went to visit you in the morning and found out that you are fasting and need to take X-ray for your chest & abdomen.

The nurse told her that you are only able to digest half of the feeding of 10ml every 2 hours.

At that moment, your oxygen setting was at 35%. Increased from 25% yesterday.

Your mom texted me the above and that made me very worry. I can feel the pain she has, and definitely can imagine it is at least 10 times more painful than me.

I thought you will need to on several days of fasting and then I quickly call your mom to sign consent form for insertion of the long CBL line for TPN supply, because that procedure require contrast media that warranted for a consent.

She off her hand phone after texted me. I am unable to get hold of her, I leave her with some text messages and quickly call your grandfather-in-law who accompanied your mom to ensure the consent form is signed.

I would not want you to delay any seconds in getting nutritions. 

Your mom returned my call saying that doctor requesting her to purchase Ursodeoxychohe Achod for your treatment.

The pharmacy of the hospital is located at the main tower, and the hospital compound is designed like a maze. I can sense she wanted to get you the medicine as soon as she can, meanwhile I also doubt if she is able to locate the pharmacy. I did not stop her, I let her try. 

I went to hospital in the afternoon to check out the results of your X-rays and also to buy you the medicine. 

Your abdomen X-ray looks fine. Just bloated. Ursodeoxychohe Achod is to improve your bowel movement and digestion. I hope the medicine help. Your feeding has been resumed, 5ml every 2 hours.

Your chest X-ray shows that your lung is still weak. But while I were leaving the NICU in the afternoon, the oxygen supply has reduced to 25%, and your oxygen saturation is near 100%.

You are also precripted with Nystatin Oral Suspension. I believe it shall be due to the mouth thrust, even though it is not visible as per papa and mom observation.

Again, you were crying today. You must be hungry due to fasting or feel unwell due to stomach bloated.

Stay strong and we love you.

God bless!

Day 37 - Hypoglycemia, 10ml feeding, SIPPV Oxygen 25%

My boy, today when I asked Doctor James about your condition, he have me a thumb up before commenting. You must be doing great.

Doctor James said you are actually ready for extubation last week, but due to your hypoglycemia, the extubation trial will be postponed to this week.

Doctor James also seconded Doctor Yip that your tummy is bloated, and it is common for you and some of the premmies. 

Your mom has already hear from Doctor Choo that you will be extubated this week, she keep praying for you and give your lots of encouragement to ensure you will do well.

Today you opened both your eyes wide and starring at your mom. You don't do that to papa, you will just look at me for seconds and then close your eyes. You must be mommy's boy.

As per the nurses, your digestion is alright. But there are some residue of 0.5-1.0ml of the previous feeding when the nurses performed suction. Even thought it seems to be alright as per doctors and nurses, but it still keep us worry.

Papa strongly believe you will be doing well with the coming extubation and will eventually gain weight and grow healthily.

Both your sisters were with us during the morning and evening visits. They were waiting outside NICU because only parents are allowed to enter.

Boy, when you are extubated, just keep breathing and consciously improve your breathing. Breathe in deep and steadily.

Proud to be your dad.

God bless!

Day 36 - 1060g, Hypoglycemia, SIPPV Oxygen 25%

My boy, your left leg is swollen due to the line. The doctor has remove it and put a new line at your right hand.

A part from hungry, it could be a reason that make you cry yesterday.

You have gained 5mg today. You are at 1060g.

Your feeding is maintained at 10ml breast milk every 2 hours because of the glucose supplement to treat your hypoglycemia.

If everything goes well, you will be extubated next week.

Finger cross and God bless!

Day 35 - 1055g, SIPPV Oxygen 23%

Baby boy, you will not be weighted everyday because you are off from total parenteral nutrition (TPN).

You gained some weight, you are at 1055g today. The weight gain is a bit slow as compared to doctor expectation of 20-30g per day.

Doctor has also discussed with your mom about her diet. They suspect your glucose deficiency may be due to the quality of breast milk. Which could be also resulted from her diet.

The Caeserian section operation for your delivery has caused your mom's red blood cell count dropped drastically. She received blood transfusion 1 day after you were born. 

She was so weak and she looked pale for weeks after discharged from the hospital. She has just recovered 1-2 weeks ago.

Maybe it is a good idea to mix some formula milk for preterm baby when you reach 1200g or above.

It is painful for papa and mama that you need to go thru so much at the beginning of life. On positive thinking side, I believe this NICU journey will make you a very strong man in the future.

You were crying when I visited you. Because you are intubated, we could not hear your voice. 

You were fighting, with your 2 hands and 2 legs. You keep crying. We thought you were feeling unwell. 

The nurse was very helpful. She come and soothed you, but you still cry and fight after a very short while.

She then changed your positions. You finally calm done after she put you on prone position. You were sucking the ventilation tube. Your mama noticed it. You cry because you are hungry.

 

Boy, continue to improve your lung and breathing, we want to hear your voice.

Develop your will power and pray to God for blessing and mercy.

Day 34 - SIPPV Oxygen 25%, Glucose deficiency

My boy, you continue to do well with breathing. Event thought your tummy is bloated, your digestion system is doing fine.

Your glucose level is low. Doctor will prescript you with feeding glucose, at the same time restart the antibiotic as it can be an infection that cause the blood glucose level to come down.

Meanwhile your blood is sent to lab for culture. Hopefully it is not due to any infection. 

Boy, you have gone thru so much at NICU. Really hope that you will be able to  extubate next week.

Continue to stay strong. You have gone thru the most challenging first 30 days of your life, you shall be able to get thru the rest of the days 

God bless!

Day 33 - 7th blood transfusion, SIPPV Oxygen 25%

Baby boy, your mom visited you today morning. Because papa was not around, your mom has to discuss and understand your progress with doctors.

Doctor Yip stopped the Bromhexine Hydrochloride as she found it is not effective on you. I also think that this medicine may be the root cause for your bloated tummy. 

I hope your respiration system will continue to improve even without Bromhexine Hydrochloride.

You have the 7th blood transfusion today. I really hope this is the last blood transfusion for you.

You no longer needed TPN today. The long feeding tube, CBL line has been taken out from your right arm. You must be feeling better today.

Doctor has also reduced the oxygen supply from 30% to 25%, stay strong and continue to do well.

God bless!

Day 32 - 1045g, 11ml milk feeding, SIPPV Oxygen 30%

My little boy, you gained some weight after 2 days of weight lost. Your weight lost is due to reduction of supply from the TPN where TPN will cause water excessive water in the body.

You have eye exam today on retinopathy of prematurity (ROP). Due to your eyes are still immature, nothing is detected. Another scan will be done in 2 weeks time.

You must have suffered a lot during the eye exam. We see you opened your eyes and looks very weak. We see that you look vulnerable and scared.

Your mom was calming you down, talking to you. You are active, but less responsive. Papa know, you gone thru a tough day.

Your tummy is bloated. Doctor Yip said some preterm babies are like that, bloated tummy. I hope you fall into the "bloated tummy" group.

You passed motion 4 times today, and you are on full feeding now, at 11ml every 2 hours.

Hao, get stronger and breathe on your own.

Love you.

God bless!

Day 31 - 1015g, 9ml milk per feeding, SIPPV Oxygen 30%

Oh boy, you have weight lost today. 

You are lighter by 50g as compared to yesterday. Hopefully it is because of the transition between TPN and breast milk feeding.

Your milk feeding has increased to 9ml every 2 hours. Based on your current weight, your full feeding volume shall be 10-12ml. If everything go smoothly, you shall be on full feeding in another 1 or 2 days time.

You continue to improve on your respiration system. You are still on SIPPV mode but the oxygen supply has reduced to 30% from 35% yesterday.

The nurse has put you on prone position to prevent you from pulling off the ventilation tube. Papa know it is not comfortable, but pulling it off is very dangerous. The only way to release from intubation will be get stronger and breathe without ventilator.

Because you are on prone position, you are facing down and unable to see your mom. When she touches you, I can see you wanted to turn around and see her. You are very strong, I can see your hands and legs are trying very hard to turn your body. I know you want to see your mom.

If you are studying in primary school while you read this post, please go back and hug your mom.

If you are studying in secondary school while you read this post, please tell your mom that you will choose your friend carefully and will always behave yourself, give her a hug as well.

If you are studying at college while you read this post, visit her often and date her for lunch, hi teas or dinner. Hug her always.

If you are working, be it still bachelor or married, visit her often, update her that you are healthy and happy. Spend times with her together with your sisters. Give her some hugs.

I can see the bonding between you and her. Both of you love each other so much. 

May this power of love help you to recover soonest and may the power of love nurture your mother's health.

God bless!

Day 30 - 1060g, 7ml per feeding, SIPPV Oxygen 35%

Baby Hao, you are full moon today. Today is your 30th day in this world.

The doctor has lowered the oxygen supply % to you from 45% to 35%.

You breathing continue to be more stable. 

Papa and mama believe that several factors has contributed to your improvement. 

We believe Bromhexine Hydrochloride has significantly reduced your secretion. Even though as per the nurses your secretion is still thick. 

Another factor could be your weight. You have crossed 1000g, you are now more energetic than when you were at 700-900g.

You are off from antibiotics and resumed with breast milk feeding. The doctor has further increased your feeding volume from 5ml every 2 hours to 7ml every 2 hours. 

You have some weight lost. It is normal as you are cutting down a lot from the total parenteral nutrition (TPN). When you are on full feeding, TPN will not be needed and the CBL long line will be taken out from your right hand. It will definitely make you more comfortable.

Papa, mama, and your 2 sisters went to temple after visiting you in the morning. We pray for your good health and your grandfather speedy recovery from his arm injury. 

Get well soon son, everyone at home is waiting to welcome you home. We miss you.

Be a tough boy, and be faithful to God.

God bless!

Day 29 - 1075g, 5ml feeding, SIPPV Oxygen 45%

Today is Saturday. Visiting you has become our family event during weekend. 

Because papa is not working on Saturday and Sunday, I can bring your mama, sisters visiting you twice in a day.

You gained 15g today, weighted at 1075g. The breast milk feeding has increased from 3ml to 5ml every 2 hours.

With increased milk intake, I hope you shall be able to gain more weight. 30g per day will be good thought.

You look pinkish today. This is very important as everytime when your skin turned fair (doctors said it is pale while previously I thought it was your skin pigment getting matured), you will have blood transfusion in a day or two.

Papa hopes that your bone marrow is functioning well now so that you will not need any blood transfusion.

Your breathing looks steadier as compared to last few days. Oxygen saturation gets better but still swing up and down sometimes. 

Your stomach looks bloated. But again the nurse said it is ok and you are digesting well.

The line at your left hand has been taken out because it cause your left hand swollen. You are also not given any antibiotics today. Finger crossed and I really hope your mom's breast milk is able to supply you sufficient antibodies.

Everytime your mom touches you, you smile. She said you are a happy little boy.

Stay strong boy, and get stronger everyday.

Have faith in God, pray for God's grace and mercy.

Day 28 - 1060g, SIPPV Oxygen 45%

Hao, the little man, you are now 4 weeks old. You are 32 weeks old now and doing great!

You continue to gain weight, you are at 1060g today and is very near to reach the 1100g milestone.

Doctor Yip said you are tolerate well with the milk feeding, the volume has increased from 2ml to 3ml every 2 hours today. But your stomach seems to be bloated a little bit.

You have a lot of secretion today. Mama said it could be the effect of Bromhexine Hydrochloride that diluted those thick secretion that stuck in your respiration system and enable the thinner secretion flow out from your lung.

The ventilation oxygen % has slightly wined down from 50% to 45% today. We believe you will be able to improve day by day.

You are considered suffering from Bronchopulmonary Dysplasi (BPD) because you are still unable to breethe by yourself without the help of ventilator after 28 days since born.

What you need to do know is strengthen your lung, breathe steadily, and digest well your mom breast milk.

Stay strong boy.

God bless!

Day 27 - 1035g, prescribed Bromhexine Hydrochloride

Oh boy, your ventilation setting is still high, oxygen supply at 50%.

Your secretion is very thick, nurses have difficulties in doing suction for you, and your oxygen saturation will drop tremendously when you are disturbed.

There was a visiting consultant in the morning. She precripted you with Bromhexine Hydrochloride. It is a syrup that will make your secretion thinner. The nurses will be dosing you at 0.3ml of Bromhexine Hydrochloride every 8 hours.

Papa & mama hope that the medicine will really help you to clear your lung and eventually improve your respiration.

Your are feeding with 2ml of breast milk every 2 hours. Hopefully your digestion system is coping well now and will be able to move up the feeding volume and achieve full feeding in no time.

Since you received a blood transfusion yesterday, doctor Yip scanned your brain today. Your IVH remain at stage 1 for both side of thebrain. What a relief.

The nurse covered you tight with a blanket, and you sleep very well when we visiting you yesterday evening.

We have some worries because you were normally very active in the incubator. The nurse on the evening shift is preventing you to pull out the tube by yourself.

Papa also think that you should rest more  to recover faster.

Rest well son and get stronger everyday.

Day 26 - 1045g, 6th blood transfusion

You are a naughty boy.

I noticed your ventilator tube has been changed. As per doctor, your tube came out from your mouth when you cough. And as per the nurse, it was pulled out by your itchy hand.

Boy, you are very active. It is a good sign. But can you please do not pull any tubes and wires around your body? Especially the ventilation tube, you still need it to breathe. 

If you think it is not comfortable, exercise your lung as you have only one single task, which is to grow healthily. You need to exercise your lung, breathe properly and rest well. As soon as you can breath without ventilator, the doctor is more than happy to take it off from you.

A part from that, please be cooperative with doctors and nurses when they are performing procedures on you.

You had your sixth blood transfusion today. It could be due to your bone marrow is still immature. It will normally overcome on 37th week of gestation. It means you need another 6 weeks to overcome this. But I do believe you shall be able to make it in less than 4 weeks time.

Because of your itchy hand, you are sort of reintubated. Your ventilation settings are going back to high parameters. Boy, can you stop doing that?

You are a little man. Extreme preterm but with fighting spirit. I shall be confident in you and start to catch up stuffs that I left over for 3 months since your mother pregnancy complication started.

Buddy, be strong, and do not pull the tubes.

God blessing!

Day 25 - I know you miss mom

Hao, our little boy. 

I know you miss your mom very much.

Today the nurse put you at the position that you are facing the ventilator.

Your mama touches you from the other side but you are not able to see her. Like any other days, she talked to you a lot. She give you encouragement and wanted you to grow stronger everyday.

When she walked over to the ventilator side to see you from front, you opened up your eyes, and your raised your right hand wanting to touch her.

Your mama wanted to hold your little hand, but the ventilator is blocking her way. 

I am not sure how old you are when you read this post. Just go hug your mom and hold her hand. She is the closest person to you in this world. No one love you like your mom does. 

I can see your ribs, chest and abdomen are less contracting when you breathe. You are recovering from lung compliance, I guess. This is the good sign as you should get away from intubation as soon as you can.

There is no change on the ventilation parameters as well as oxygen %. I hope it will wean down gradually tomorrow.

You are still on trial breast milk diet. 1ml every 3 hours.

Doctor Choo said your bowel X-Ray looks good. Thus, I believe you will be on full breast milk feeding in days to come.

Son, your mom, both your elder sisters, your grandmom, our friends are praying for your good health.

Have faith in God, and together pray for God mercy for your good health and recovery.

Day 24 - 1030g, resume feeding, IVH Stage 1

Son, we must say a big thank you to Doctor Khoo and her mentor, Doctor See. Doctor Khoo has changed the intubation tube to a bigger size at 5:30am in view of your thick secretion and your physical weight. 

Your breathing has improved a lot. Your ventilation oxygen % has reduced from 55% to 35%, and your oxygen saturation has improved tremendous. I believe within this week it will be able to reduce further to 21%.

Doctor Choo and Doctor Yip has proceed with scanning of your brain. They confirmed both your brains are developed with IVH stage 1. What a relief to papa and mama.

Doctor Choo has also resume you with breast milk feeding. Started with 1ml every 3 hours. I hope you will do well this round and will be able to achieve full feeding in days to come.

You have increased your weight to 1030g, Doctor Choo said you have slight water retention, hence your nutrien infusion will be adjusted accordinfly. Overall, your weight gain is remarkable.

Son, you are doing well. Papa and mama want you to continue with the strong spirit. 

Stay strong!

Thanks God for assisting my son along the NICU journey. God bless!