A Little Better

2 PM Update: No bad news is good news. James' blood pressure remains good, his heart rate has returned to his more normal rate, his belly's size and firmness hasn't changed -- these indicate the absence of deterioration, which is all you can really observe in these early days of NEC. The next round of x-ray and lab results won't be available until after 7:00 PM. James and his parents are comforted by the fact that one of James' favorite nurses is watching over him today. She is his first line of defense right now, watching for the first small signs of changes in color, belly, temperature, and other signs of distress.
--------------------------------------------------------------------------------

James's morning's X-ray showed a little improvement, and they have gotten his blood chemistry more stable. Last night, he had higher levels of carbon dioxide and glucose than they like to see, and they had to keep going up on the ventilator settings to get things back in line. He's still on the ventilator and probably will be until at least tomorrow. (That way he can use his energy for healing instead of getting tired breathing.) They're going to do X-rays every 12 hours (rather than every 6) unless something changes (that is, if his clinical picture -- the visible signs and symptoms that he's showing -- gets worse, they'll do an X-ray sooner). So, we are still on edge, but at the moment this is a little more hopeful than last night.

We are very glad that both of the boys' primary nurses are on today; last night both of them had new people, and while James's nurse especially seemed excellent, we are more comfortable with people who have had them before, because we think that they will be able to recognize changes from the boys' normal patterns or behavior more quickly than someone new. (For instance, a couple days ago, one of the nurses who hadn't had the boys before said, "Oh, James is the more active one!" We just laughed, because it's exactly the opposite! Of course, since Matthew is swaddled, he looks a lot less active from an outside perspective.)

Matthew seems to be doing fine. His heart rate was elevated last night, which had us worried (but which the nurses didn't seem concerned about -- but again, they hadn't had him before and so didn't necessarily know that it was different for him). Mike mentioned it to them and to the doctor, and the doctors discussed it at rounds this morning. Although being sick could cause that, they don't think he's sick because he's not showing other signs. The other more benign options are that 1) he could have been a little hot (which we think is probably what it is -- his temp was on the high side of normal), 2) it could be the caffeine (they raised his dose recently to adjust for his higher weight), or 3) it could be because he's anemic (which he is, but since another test showed that he's making red blood cells, they decided that he didn't need a transfusion). In any case, it seems to be back closer to normal this morning, so we're not too concerned.