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Thursday, March 31, 2011

Day 3 new update 11:59 pm March 31st 2011

We have a little bit of bad news mixed with positive results. Henry was not able to get rid of the right amount of CO2 and unfortunately he had to get on the different type of ventilator-the oscillator as pictured earlier. The great news is that it seems to be working very well after they tweaked it several times this evening. In fact they have stabilized the CO2 levels and oxygen saturation and will be bringing down the levels of oxygen ever so slightly every two hours throughout the night. He now has a little bit of a wiggle in his breath and the machine is doing 95% of the breathing for him. Earlier he was sedated with a neuro muscular blocker which made him breathe less on his own and now he is letting the oscillator take over.
Video of Henry on the oscillator.

He is still getting more different types of fluids and drugs than I have fingers and I thought I would share the what the magic potions look like.

Left to right, this machine gives Sugar water, Morphine, heparin, and versed (a sedative) This is a photo of the machine which administers the dopamine and dobutamine. An identical machine will give plasma and red blood cells. His Xrays continue to improve and look less hazy which means the air pockets are starting to open up and spread out.

This is a picture of the portable xray machine.

Here is a photo of the latest xray. His right lung is the one in distress (collapsed) and the doctors say it is starting to look better.

We have been comforted a bit as we talked to a nurse who works in NICU and 5 years ago she had a child in NICU for 11 days with similar symptoms. He fully recovered and never had a single side effect.

Also one of the Doctors on rotation this evening is the son of one of my A&M professors Dr. Harry Jones. Like his father, he was also an Aggie and it was comforting to be helped by a fellow Aggie.

Memorial Hermann has a fantastic program operated off of donations called the Ronald McDonald House. It provides limited housing of about 10 rooms at Memorial Hermann 7th floor to the parents of those most in need to be close to their newborns per night. Tonight we are lucky as we are going to be just down the hall from Henry. We are actually spending the night closer to Henry tonight than last night.

This evening Grammy and Poppy brought Charlie up to eat some donated "Papa" (Charlie's way of saying Papa Johns Pizza) by the Ronald McDonald House in the Kitchen Lounge. Thanks for all the inspiration of prayer and words. They really mean alot. I like to remember that after a storm comes the rainbow.

Day 3: - Thursday, March 31st *Update-12pm

Henry is holding a bit steadier. They thought they would have to put him on the High Frequency Ventilator called an Occilator but the current Servo-i ventilator running full blast of 100% oxygen seems to be working ok for the moment.  

Henry's current ventilator machine- Servo I

They have this newer, stronger ventilator ready- an occilator- in case they decide he needs it. 

New additions since 10am:
1) Calcium Supplement - to help his heart and blood pressure work more effectively.
2) Two additional seditives in addition to the Morphine. (Versed and Ativan)
3) Nitric Oxide - His GAS (Blood Test) results show oxygen levels lower than they wanted so the Nitric Oxide will help dilate the vessles in the in the lungs so they can absorb more oxygen.
4) Dobutamine - 2nd drug to try to elevate blood pressure
5) Antibiotics

 He has been responding well to the extra fluids and they temporaily help the situation, they just want to make sure he doesn't get too much so he doesn't swell. They are also planning on giving him some red blood cells.
They encourage us to touch him and talk to him because he's familiar with our voices.

Day 3 Thursday March 31st

6am update

We have good news. The PICC line IV went in successfully last night and is now a better way to administer the IV.

Last night they gave him a third dose of surfactant and his body is accepting it and it will hopefully continue to help heal his lungs.

They did a GAS (blood test) test and the seven levels including co2, oxygen, and other elements of the blood look to be holding steady.

Just in case the doctor ordered a heart echo and great news is that everything came back normal.

*UPDATE- 9am*

The 6am update was too optimistic. The new shift doctor, Dr. Lopez came in at 8am and called our room asking us to come up to the NICU. She spent about an hour explaining what I am going to try and summarize in a couple of paragraphs.
His 3rd dose of surfactant wasn't as effective as they'd hoped. He is now requiring 100% oxygen from his current ventilator. She explained that babies deficient in surfactant usually start producing it on their own around 48 hours of life. They aren't going to administer more doses because it could have an adverse effect.

Henry has developed PHTN-Pulmonary Hypertension which is abnormally high blood pressure in the arteries of the lungs. We want his blood pressure to be higher in his body than the lungs so his blood will flow into the lungs, giving him more oxygen.

In hopes of improving his condition, they are going to switch his current ventilator to a larger heavy duty machine called an oscillator.

They will monitor the new ventilator for a couple of hours and will likely start the following.

1) Give him more fluids to try to raise his blood pressure in the body.
2) Start Antibiotics as a precautionary measure. They are taking blood from his UAC line in his umbilical cord to test for infection.
3) Continue Dopamine to help force the blood pressure up and encourage blood flow into the lungs.
4) More morphine to make him as comfortable as possible. They are stressing that he needs to be in a very calm and quiet environment.
5) Possibly administer Nitric Oxide which will dilate the vessels in lungs and will relax the muscles in the lungs.

Goals for today
-Get his oxygen as high as possible in his body

Good news
Dr. Lopez has secured us a room provided by the Ronald McDonald house in the hospital, which is a hotel just across the hall. There are twin beds there and friends and family can visit during the day... including Charlie! This is an amazing service that will allow us to be close by Henry and as comfortable as possible, while still letting visitors come in.

Dr. Lopez also says that Pulmonary Hypertension is an illness of recovery.

She said to expect 4 to 5 rough days leading into the recovery. While he is in critical condition, this is a common course for Respiratory Distress Syndrome and unfortunately will probably get worse before he can get better. It was nice to hear facts and good to be told straight forward that he will be critical for the next ~5 days, but hopefully after that his body will start to take over and improve.

Keep the prayers coming! We'll update more as we hear the news. Things change very rapidly.

I learned a new word last night… pneumothorax. (Day 2)

Late last night the nurse came by and informed us that unfortunately things had gotten worse.
In the middle of the night Henry developed an air pocket- a pneumothorax, beside his left lung. This air pocket exerted pressure on the lung, created a small hole in the lung, and collapsed it. They quickly relieved it by putting him on a ventilator and inserting a chest tube to equalize the pressure.

He is now breathing better with the ventilator and they have administered a surfactant to help heal the hole in the lung.

They said he was in a little bit of pain from the tube going into his chest, so they administered morphine to help with the pain through his IV in his tiny hand. He is getting a little bit of nutrition as well through a sugar drop in this IV.

This afternoon, they informed us that they want to replace the IV in the hand with a UAV/UVC through his umbilical cord. This would allow them a permanent place for an IV as well as a line to draw his blood from so they won't have to heel prick him so often.  It is slightly risky due to potential infection and does mean that they expect him to be here at least 72 hours longer.  They said with any luck he will be able to get some of Mommy’s milk tomorrow through a TPN and encouraged us to bring any blankets to make him know how much his mommy, daddy, brother, and family love him!

They were successful at placing the UAV line into his umbilical cord to allow them to draw blood quickly.  However, they were unable to get the UVC line in place so they had to stick to peripheral veins and moved his IV from his little hand to his forehead.  This is not as ideal because these peripheral veins don't last as long and they'll have to keep looking for new places on his tiny body for IV.  It also looks terrible to see this IV in his head. 


Henry is seeing effects from the morphine and now has a catheter to help him pee. The good news is that he has plenty of fluids.
Since Kerem and I visited at about 5:00pm, his oxygen levels in his blood have decreased so they have decided to administer a 2nd dose of surfactant. 
They are also putting him on Dopamine through his IV to try to raise his blood pressure a little bit which would hopefully increase the blood flow to his lungs.  They are administering a very small dose to prevent complications with his kidneys or heart. 

Update:  (wed Night)

They have been really testing the ventilator to try and get the right oxygen saturation and it has been tricky to say the least.  After giving him the surfactant they were able to keep his oxygen input at around 40%, but at around 10pm he was needing up to 80% from the machine.  His blood level has too much C02 in it so they are also concerned about that.  They are now talking about possibly switching ventilator machines. 

They just decided that the peripheral IVs aren't working as well as they need them to, so they are going to try to insert a PICC line in his arm to provide a more permanent access to his veins.  This is where they informed us his NICU stay looks like it'll be a week at minimum. 
To be honest we are scared and we are looking at a 7 days stay forward at best. I know this is terribly written, but please try to understand the circumstances and we will do our best to update it when we understand and process everything.

Henry's 1st Day- Not what we expected

We noticed when we were holding him for the first time that he was making little grunting noises.  We just thought they were cute, new baby noises so didn't think anything about them.  The nurses were a little concerned saying that if he's grunting with every breath that may mean he's struggling breathing. 
They took him away to the nursery for cleaning and routine testing and that is when they got a little worried about the development of lungs and possibly the level of oxygen in his blood.

Around 10:30 am they brought him to our room in an enclosed carrier and informed us that he will need to be admited to the NICU to get help with his breathing.  This was heartbreaking- we were so excited to get him back & to hold him some more.  They told us after the dr's assessed him and they took some xrays of his lungs, we could go visit him but he would not be staying in our room with us. 

First, they put an oxygen rich hood or cap over his head and things started to get a little better, but his oxygen blood levels were still a little low.

Second, they decided that the best thing to do would be to start CPAP (Continuous positive airway pressure).  It is administered through the nose simiar to oxygen you see with older people.  This goes into is nostrils and stays in place with the face mask.  It was hard to see him like this with so many tubes and this over his face. 

 We wanted so desperately to hold him again, and luckily they let us. 

This seemed to work great throughout the day and Becki, her brother, and my sister saw great progress Tuesday night as his oxygen percentage was near natural percentage of about 23% down from 50% oxygen earlier in the day.

Becki, having been up for at least 48 hours headed to bed with me right behind her hopeful to see Henry first thing in the morning.

Henry Lee Moore - March 29th, 2011


Here is his birth story, written by Trey.

Becki's last maternity picture- 37 weeks, 5 days.
At about 10:00 pm on Monday, March 28th Becki started having strong contractions only a few minutes apart. We took a walk, she took a bath, and laid down but nothing helped. So we quickly called Becki's mom, Teresa to come stay with Charlie while we headed to Memorial Herrman Hospital in the Texas Medical Center.
We went to Triage and were quickly admitted, because of Becki’s progression to a room to prepare for Henry’s arrival.  It was about 1:30 am by the time we started to relax in our room and Becki was able to get an epidural.
Teresa was taking care of Charlie at home but we were wanting her to be there for the delivery so she woke up early and dropped Charlie off at school when they opened at 6:30 am.  Labor was progressing quickly at this point so we were trying to hold on for her to make it.  Teresa arrived at the hospital about 7:20 am and I went down to get her from the garage. When I got back the Doctor on call- Dr. Beard had just broken Becki's water and it was time to push.  Becki progressed quickly and beautiful Henry arrived at 7:58 am on Tuesday March 29th weighing 6 pounds 6 oz and about 19 and ½ inches.

Henry was wide awake and had his eyes locked on both his Mommy and Daddy. He is truly a beautiful boy, alert and awe inspiring.  He looks so much like Charlie, except he has a different nose and a lot more hair!

Charlie has this exact expression!

 We enjoyed a wonderful 1st hour with him taking pictures, holding him and memorizing his perfect features before they took him to the nursery.

Wednesday, March 30, 2011

Welcome back to our Blog!

Hello family and friends! 

Please forgive us for being lazy with our blogging.. 2011 has proven to be a busy year so far! We've been working, playing, and preparing for our newest baby to join us. 
We are ready to start this thing back up again, so please follow us as we journal our family life!

What better way to start up again than to introduce our newest little blessing into our lives- Henry, who arrived Tuesday, March 29, 2011.

Get ready to fall in love with one amazing, tiny little boy. 

Trey, Becki, Charlie & Henry