March 17, 2008

We had Racheal back with us today. So, Shelley went to see the babies this morning, while Randall stayed with Racheal; and then Randall went to see the babies this evening, while Shelley stayed with Racheal.

Rylie continues to do well. With his bottle feeding this morning, he took the whole bottle. He has gained weight. His weight tonight was 1500 grams, which is 3 pounds 5 ounces. Both Shelley and Randall got to hold Rylie today. He continues to do well breathing room air.

Ryan is doing well most of the time. He still starts dropping his oxygen saturation while he is getting feedings. He does okay the rest of the time. Randall got to hold Ryan today, for a little while, while he was getting a feeding; but he started having a reduced oxygen saturation, and we had to put him back into his warmer.

Reese had a rough day today. She continues to need an IV, but the nurses and doctors were unable to get a regular IV started. They got consent from Shelley for a PICC line; but they had problems getting the PICC line started. They ended up doing a cut-down in order to get an IV started. She was sedated for the whole thing, and still is quite sedated this evening. Her echocardiogram still shows a PDA, but, after the Indocin, it appears to be smaller.

A cut-down IV is a simple procedure. Instead of trying to insert the needle and catheter through the skin, the skin is cut open in order to expose the underlying tissue. An appropriate vein is found, and cut; the catheter is then threaded through the opening. Until ultrasound, cut-down procedures were done more often. With ultrasound, it is often possible to see the veins clearly, and it allows a person to guide a needle and catheter into a vein more easily; since ultrasound guided IV cannulation has become available, the need for cut-down procedures have decrease, and so fewer cut-down procedures are done these days. However, it is still a vital means of getting an IV started, when other options fail.

We will be going back to Comanche tomorrow. We will visit the babies one last time before we leave.