Bella definitely gave Mommy a run for her money today. The morning started out well. I was able to make rounds and hear what the game plan was for the next week. They started advancing her feeds today. That means she is getting an increase in food every 9 hours and getting fed every 3 hours. She appears to be tolerating her food very well and having nice bowel sounds and movement. Bella's IV fluids were decreased as they begin to wean her from them. They stopped her hydrocortizone this morning. which was the medicine mainly used to help with blood pressure. Carol was able to remove Bella's ART and PAL lines...just has the PICC line to go. They held her fentanyl drip at .5 instead of decreasing it anymore; her pain scores (tolerance) were showing some withdraws. Overall everything they had to say was good. I left her feeling good about how she was progressing.
HOWEVER, when I returned for my afternoon visit with the princess, she decided to make Mommy's heart go into her throat. On several ocassions her heart rate dipped to the low 100s and her oxygen saturation (desat) went to the 50-60s. She tends to do this in any position other than her stomach. Therefore, she remained on the biphasic CPAP today and will probably stick with that for at least a couple more days. She did have one instance of bradycardia that just made me beyond nervous. Carol seems to think Bella may have a floppy airway; if so, that will heal with growth and development. As soon as I got to the apartment I cracked the Preemie book to see what it could tell me. As with most things, it talked about how apnea and bradycardia are very typical with preemies (this is considered As and Bs). This only made me feel somewhat better. Chris and I talked about how Bella tends to do well when she is first transitioned to something new (her honeymoon period) and then takes a step back. I am guessing it is all part of the long roller coaster ride. Our deduction is that she was able to keep up with the CPAP at first because it was new. Now she appears to be tired and truly having to learn how to breath on her own.
Below are pictures of me dressing Bella and her getting comfy in her new digs. (Many thanks to Lauren and Abby for letting us borrow these precious outfits!)