February 11, 2008 – Fourteen days

Fourteen days.  For some, fourteen days is the period between our last and next paycheck.  For others, fourteen days sounds more like an ideal amount of time for a much-needed vacation.  For Jenn-Jen and me, the past fourteen days has been a marathon of emotions, sporadic sleep and countless trips to and from Sutter Memorial Hospital.  Most important, for Katelynn and Daria, fourteen days signifies another milestone reached.  They are now two weeks old and have fought through many battles that may have easily taken their fragile lives.

During my drives back from the hospital, I can’t help but notice the large billboard on Interstate 5 near the Richards Boulevard exit.  If you haven’t seen it for yourself, it’s a sign that’s hard to miss.  Essentially, the sign is put up by the California Lottery and is split in half with two large digital displays showing where the Mega Millions and Super Lotto jackpots currently stand.  Tonight, they show $150 million and $69 million, respectively.  

You may wonder why the lottery is significant to me.  I look at the sign, as many of my fellow drivers in the adjoining traffic are doing the same, and assume a few of us are sharing that mutual feeling of hope.  The main difference is that my hope is not that I pick the winning numbers to help secure a future of financial freedom, but rather, I place my hope that God will continue to work a miracle and allow Katelynn and Daria to beat the odds.  As you may recall, each of my daughters had roughly a fifty percent chance of just surviving birth at twenty-five weeks gestation.  While things can still change in a heartbeat, each additional  passing day has meant another day of life for our girls.  Our neonatologist tells us that the first fourteen days are the most critical, so I will take a few deep breaths of relief and wish a very happy birthday to my precious Katelynn and Daria.  I am in no particular rush for them to grow up too fast, but I have warm-hearted visions of my family celebrating the day our beautiful daughters turn fourteen months and even fourteen years old.  That is the hope that I hold onto and ask God each day to turn it into reality.

As for today’s update, there are two different reports to share.  First, with Daria we are seeing her in a more comfortable state as compared to what we experienced during yesterday’s heart-wrenching visits.  She was much calmer through the day and evening, but still experiencing a number of oxygen desaturation episodes.  When I came back to the hospital at night, I noticed her blood pressure was quite elevated.  The nurse quickly explained that this is the result of a combination of several things.  Daria was still on her Dobutamine drip, as it keeps her blood pressure up, but the doctor instructed the nurse to discontinue the medication.  She is still receiving cortisol (http://en.wikipedia.org/wiki/Cortisol), or hydrocortisone, every twelve hours to help with hypotension, or decreased blood pressure, so the last dose administered may still have a lasting effect.  Additionally, Daria was receiving a transfusion as her blood count showed her to be a bit anemic.  It was encouraging to see her blood pressure starting to come down after the nurse turned off the Dobutamine pump and clamped the tubing with her hemostat. 

In an effort to keep Daria’s infection at bay, our neonatologist ordered a third antibiotic, Vancomycin (http://www.drugs.com/pro/vancomycin.html), to provide a broad-spectrum treatment.  She is still receiving Ampicillin and Gentamicin, but this new drug differs, as it targets gram-positive bacteria.  The thinking behind behind using this tactic is to use blanket antibiotic treatment while the laboratory cultures are growing to identify the specific microbe that is afflicting poor Daria.

I am relieved to report that Katelynn is still doing very well.  Her breast milk feedings have now increased to three milliliters per hour and the doctor is soon expecting to remove her total parenteral nutrition (http://en.wikipedia.org/wiki/Total_parenteral_nutrition), or TPN, feedings, as well as the lipids she is receiving through her IV.   Once Katelynn is able to handle four to five milliliters per hour, she will be taking a full feeding for her age.  This is very positive news in her continuing development.

During my evening visit, I also noticed that Katelynn was a bit more alert.  She had her eyes open for longer periods of time and I could see that she was trying to look around.  Katelynn also moved her hands and feet more than I have noticed in many days.  Our concern remains that her grade 4 IVH may have caused damage to areas of her brain that affect her motor skills, but our neonatologist reassured us not to be concerned.  The nurses have explained that the sedation from Katelynn’s PDA ligation and Broviac line placement often take a while to clear out of her system, so that may be the reason while she has appeared somewhat sluggish.  I’m just glad to see physical evidence that my daughter remains feisty.

The head ultrasounds for both girls still have not been performed yet, but I am told that tonight is the night.  We are eagerly awaiting the results, yet we know that there is absolutely nothing we can do no matter the outcome.  It’s a torturous position to be in, but we still feel better knowing the facts as soon as they are available. 

So fourteen days have passed since Katelynn and Daria made their grand, but unexpected entrance to the world.  I have been away from work for fourteen days and may be out for another fourteen.  Nonetheless, I wouldn’t want to fool myself into thinking that we are anywhere near a midpoint in our journey through the NICU.  We are in a marathon and maybe, just maybe, past the first mile marker.  If you are joining us recently, I ask you to read my posts back on February 1st and 3rd, and watch the videos of Team Hoyt.  I watch them myself from time to time to remind me that God gives strength to what we may see as weak.  Now, it is time for rest before the training continues tomorrow.