A new perspective (66 days)

Yesterday, we were excited about the possibility of Bryce moving to a crib. Late this afternoon, we learned that Bryce will be moving to a new home, but it won't be a crib. In fact, it won't even be in this hospital. Early tomorrow morning, Bryce will be transferred to Children's Hospital in Minneapolis.

It all started this morning when the opthamologist stopped by for Bryce's routine eye checkup. Based on her exam, she diagnosed him with stage 3 retinopathy of prematurity (ROP). ROP, which occurs in 80% of preemies born before 26 weeks, is an abnormality in the growth of blood vessels within the eye. In severe cases, it can lead to detachment of the retina, which usually causes blindness.

Late Friday afternoon, one of the doctors who specializes in disorders of the retina (a retinologist) dropped by to examine Bryce. His findings were heartbreaking: Bryce's ROP is very serious, and without immediate surgery, he will almost certainly go blind. The retinologist who examined Bryce did not feel comfortable performing this delicate operation, so our teensy tot is going to be transferred a few miles down the road, where he'll be placed in the care of one of the world's finest retinologists.

Obviously, this abrupt change has rocked our little 'home' in the NICU. Although we've heard very good things about Children's, and we want him to receive the best possible care for his eyes, we're very anxious about leaving behind the familiar people and places at UMMC. We're not all that eager to embark on yet another new adventure, and I get the sense that many of the staff here will miss us too.

Things are still very uncertain right now, but it sounds like Bryce's surgery will happen early tomorrow afternoon. I'll try to post updates over the weekend when I have more information; if you happen to read this before then, please keep Bryce in your thoughts and prayers on Saturday!

Sleeping in style (65 days)

One of the first things that Logan said upon meeting his baby brother was "funny bed, has roof." Bryce must have inherited some of his father's sensitivity, because ever since then, he's been determined to show the nurses that he's ready to move up to the open-air model. This morning, the temperature on Bryce's isolette was set at a balmy 28 degrees Celsius; if he can maintain a healthy body temperature at this setting for the next three days, they'll try moving him to a crib. If all goes well, the incubator we've been huddling around for the past two months (see pic) may be relegated to the pages of Bryce's scrapbook.

As far as the NICU is concerned, Bryce has been a superstar all week. His weight this morning was 1670g (3lb, 11oz), and his weekly labs were all right on target. He's still scaring Mommy and Daddy half to death with the occasional heart rate drop or oxygen desaturation, and we were dismayed to learn that our poor little guy has a hernia, but the medical team assures us that this is business as usual for a baby whose corrected age is negative seven weeks. In my heart, I believe that Bryce is going to come home, and my head says "it'll be fine, just cherish each day with him", but I'm still fairly certain that those two gray hairs on the left side weren't there earlier this year.

Cause for celebration (63 days)

Bryce's long-term followers may recall that about a week after birth, Bryce was diagnosed with a moderate (grade 2) intraventricular hemorrhage (IVH) on the left side of his brain. Christie and I were extremely concerned, because we knew that this condition had the potential to damage Bryce's brain in several different ways. Fortunately, subsequent examinations at week two and three showed that Bryce's hemorrhage was not getting any worse, and actually seemed to be resolving. So, the doctor told us that they would follow-up at some later date to check for potential complications caused by IVH.

As it turns out, that later date was yesterday, and we could not have asked for a better outcome. The examination showed no trace of the prior hemorrhage nor any evidence of the scary conditions commonly associated with IVH: hydrocephalus (i.e., enlargement of the ventricles) and periventricular leukomalacia . Better yet, the examiner found no signs of any congenital brain malformation, so Bryce is still on track for his Ivy League education. The word "thankful" seems insufficient to describe how Mommy and Daddy felt about this very welcome news.

Where's my cake? (2 months!)

Poor Bryce will have to be pardoned for the dubious looks (see pic) he gave Mom and Dad after learning that the NICU would be celebrating his two-month birthday with a "gift" of three vaccine shots. Christie and I were equally nervous; he still seems awfully little, but we relented after the nurse, nurse practitioner and neonatologist each assured us that this is a good thing. As the doctor put it, "you don't want your preemie catching pertussis."

He's back on track after Friday's drama, and his weight gain over the weekend has been modest, which means he's probably clearing out that extra fluid and replacing it with some healthy baby chub. At 3.5 pounds, Bryce is almost certainly the smallest two-month old baby we'll ever meet, but he makes up for his lack of stature with a hero's spirit and verve. Bryce was especially energetic after his transfusion, and his weekend antics provided Mom and Dad with some greatly appreciated comic relief.

Three of Bryce's roommates graduated to the "west wing", where stable babies room-in with their parents for several days before moving home. Though we're thrilled for their parents, it's somewhat disheartening to watch other families come and go; it's quite possible that Bryce is now the oldest baby in the NICU. On the bright side, one of the babies who moved out was a fellow 24-weeker born 3 weeks before Bryce. Though each preemie's journey is different, and we're painfully aware that life can change in an instant, we're starting to feel like maybe there's a hint of light at the end of this tunnel.

Still a preemie (59 days)

It seems that perfection is fleeting. When I walked into the NICU early Friday morning, Bryce's nurse told me that he'd gained more than two ounces overnight. My first thought was "uh oh, that can't be all good weight; he must be retaining fluid." About an hour later, my fears were confirmed when Bryce reminded us that he is still a preemie by suffering one of his worst spells to date. Shortly after we removed him from his isolette, his breathing became labored, and his oxygen saturation plummeted to 30-50%. It required significant intervention from Bryce's nurse to get him back into a healthy range, and the anxious onlookers (Mom, Dad, Great Grandma and Great Grandpa) were all feeling pretty strung out by the time the rosy pink flush returned to his cheeks.

The nurse practitioner stopped by for a quick exam a few minutes later, and no one was surprised to hear that Bryce's lungs sounded "wet." When preemies retain fluid, it has a tendency to collect in their lungs, which makes it more difficult to breathe. Thankfully, Bryce isn't exhibiting any symptoms of infection; however, watching your child turn blue and gasp for air for several minutes will ruin any parent's day. I won't bore you with all the medical details, but they decided to increase his caffeine dose (yes, he's already an addict) to encourage regular breathing and to give him a blood transfusion, which will indirectly dry out his lungs by helping his kidneys to expel more fluid.

Later in the afternoon, he was doing much better, so the caffeine-spiked blood must have done the trick. I'm pretty sure my son is not a half-vampire, but given Christie's insatiable appetite for those Twilight books, perhaps I should be concerned...

A happy place (58 days)

The past few days have been blessedly quiet. Bryce's feedings have been steadily increasing (up to 30 ml tri-hourly), and he's responded by sprouting like a weed. Our brawny little boy gained 30-50 grams per day during the past six days, and he weighs just over 1500 grams (3.3 pounds) this morning. If he stays healthy, it's entirely possible that Bryce could hit six pounds in only six short weeks. Go, twinkie!

On Monday, Christie was pleasantly surprised when the medical team asked if she'd like to try nursing Bryce! No one was expecting him to actually feed by mouth yet, but they decided that he's ready to practice putting his oral fixation to good use. Bryce's reaction was par for the course: he eventually got a mouthful of milk, choked on it, stopped breathing, and they called it a day. :) Nevertheless, Christie was ecstatic, and they'll continue to practice over the coming weeks.

Medically, Bryce has never been better. In fact, during rounds this morning, the doctors reviewed all of Bryce's vital signs (as they do every day), and for the first time ever, their plan is to do nothing. No tweaks, no adjustments, no weaning -- nothing. He's perfect just the way that he is. ;)

Three pounds! (54 days)

TSIA (Title Says It All)

Seriously, the days are starting to blend together. Bryce's routine goes something like this: (1) eat (2) sleep (3) stop breathing (4) wake up (5) poop (6) back to step 1. It's almost like he's a real baby! Now we just need him to get a little bigger so we can eliminate step 3. :)