Wednesday, December 2, 2009

Olive and the teddy graham

Sorry for the delay in updates on Olive... This little teddy graham has kept me pretty knocked out lately.

Here are updates on Olive from Lynette over the last few days:

No more infection!
Thursday, November 26, 2009 at 10:50am
Olive had another lumbar puncture today and the results were very good. No more bacteria found in the sample, and the white blood cell count, protein, and sugar were all back to normal. She has been much more active and breathing on room air again without the help of any machines, so we are feeling very encouraged about this.

Rusty spent the morning holding her, and at lunch we swapped and I spent the afternoon holding her. Tonight after I put her back in her isolette she was crying, irritated and flinging her limbs in all directions. I took her back out and thought maybe she needed to be burped, but that didn't seem to help all too much. She probably cried for a good 15 minutes without calming down. Then I noticed her trying to shove her hand in her mouth, so I stuck my finger in her mouth and she started sucking away. We gave her a pacifier and she was suddenly comforted and fell asleep. This is the first day she has had a strong sucking reflex, so we are excited. We may be able to start trying to breast feed later in the week if she continues to stay strong and breath well on her own.

CT Scan
Saturday, November 28, 2009 at 7:23am

Today Olive's neurosurgeon came to look at her recent CT Scan (done yesterday) and explain the results to us. Her brain tissue continues to expand (!!!), and the clot from the previous hemorrhage continues to liquify. We are excited for every good news we get about her brain tissue continuing to expand, even if it is little by little. Olive also still has communicating hydrocephalus which means they can continue doing lumbar punctures every few days to relieve the pressure in her head.

As far as the results of her lumbar puncture, the CSF fluid contains no more bacteria or organisms so that is good news. The glucose level in her CSF fluid is also back to baseline. However, her protein and WBC count are still not back at the normal level. He said that this increase in protein causes her CSF fluid to be more viscous, which is why we need to wait to put in the VP shunt. If we did it now, the increased protein level could cause the shunt to clot and not work properly.

SOOOOO...the neurosurgeon is saying that we will wait on the WBC count to level out as well as the protein. Once those two lab values are in place we will consider putting in the VP shunt...maybe in another two weeks or so. And hoping that her weight is closer to 2 kg (4.4 lbs) by then.

If an opportunity to return to the States would arise before the surgery we would jump on it. Otherwise we will plan on being here for the surgery and recovery.

Last night I tried breast-feeding Olive with the help of the nurses and she was starting to get the hang of it. However, this morning when the neonatologist found out he wasn't too impressed. He says that it is very important for us to know her intake and output at this point, and he would like to wait on that. there was no more of that.

Today I was looking at photos of Olive in her first days of life and couldn't believe how much she has changed in two months. She has been through so much in her short little life, especially to think that my due date isn't even until December 15th. We are so grateful for each day we've had with her and for the days ahead.

Olive - 2 days old

Olive - 2 months old

Livin it up in Bangkok
Mon at 9:05am

Olive had another lumbar puncture done today, and only 6 ml was removed because she was being squirmy and the resident couldn't keep the needle in. She only had 6 ml removed a few days ago too. From what I hear from the States, normally you release around 15 ml or above at a time, so I'm hoping they know what they are doing by releasing such a small amount.


Her protein level and WBC count in her CSF decreased more today (this is good news). Tonight she is getting a blood transfusion of packed red blood cells cause she was a little anemic. She was sucking away on her little pacifier when I left her tonight.

Rusty left for Chiang Rai this morning and will be there until Wednesday night taking care of some business with the sponsorship program and visiting friends.

So, I figure now that I'm all alone in Bangkok its time to live it up!

"Living it up" will most likely consist of visiting Olive at the hospital everyday, going out for a cappuccino with whip cream, and if I'm feeling real wild and crazy I might even start writing thank-you notes.

the word on the street.
Tuesday at 10:13am

I spent the day at the hospital with Olive today. Today she was pretty drowsy and not acting much like herself. This evening her oxygen saturation was on the low side of being o.k. so the residents decided to do another lumbar puncture. I was feeling anxious about having another resident do the procedure since the last two times they didn't do the best job and only removed 6 ml of CSF fluid.

I'm trying to find the balance of protecting Olive from being a resident's case to practice on, and being a patient's mother who isn't super annoying. I realize I am at a teaching hospital, but I am not a fan of Olive being someone's case to practice on...(insert nervous sigh here).

Olive cried through the whole thing. They removed 15 cc of fluid this time. After the procedure she seemed more like herself and spent a good 20 minutes alert and flinging her little limbs around. I held her for another hour before walking back to the apartment.

Tomorrow the neurosurgeons are planning on placing another temporary ventricular drain to remove more fluid.

The head neonatologist said it would be o.k. for me to begin trying to breast-feed Olive tomorrow, so I'm hoping things go o.k.

Rusty was able to be home for the rice harvesting at the AYDC in Chiang Rai today. All the parents of the kids came to participate so he was able to connect with a lot of them and share in eating some dog for lunch. : >)

The weather in the north is much colder than here in Bangkok. He is sleeping in a sleeping bag and comforter in Chiang Rai, and I am sweating down here in Bangkok as I listen to Christmas music.

Still no word on another flight being available to go back to the States anytime soon.



P.S. We have five breast pumps donated for the NICU in Chiang Rai, so we are set!

The little champ.
Today at 10:56am

Had a really good day with Olive today. This morning the opthamologist came and looked at her again and said he is still very pleased with the results and doesn't think she will be needing any further treatment. They will keep doing weekly checks to make sure things continue to stay on track with her vision.

This afternoon we started breast-feeding. Olive latched on like a little champ, and once she was on her eyes got huge and she looked really excited and unsure what to do about the milk coming out into her mouth. I was laughing at her little expression and trying not to scare her with my shaking. Her vitals stayed good, and she had no issues with her oxygen level dropping so the neonatologist gave us the go ahead to continue trying a little each day.

Today I also met with both the neurologist and neurosurgeon. Starting tomorrow morning they will do daily tapping to remove fluid from her head. From what I understand they just use a syringe and will remove between 10-30 ml of fluid each time.

Rusty will return tonight from Chiang Rai. He had a really good time connecting with friends there.



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