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!