Monday night and Tuesday morning

In short:
Olivia has hit that elusive plateau (or so it seems) since she has not gotten any worse in 24 hours. She is responding to the treatments.

Stats on 5/21 @ 9:00 AM:
Oxygen saturation 98% pre-heart, 99% post-heart
Respirator 86% oxygen, .2 parts per million NO2 (down from .3 yesterday, 15 ppm NO, Forced Pressure is 28 (down from 29 yesterday), Forced Breaths per minute is 32.
Temp 36.7 degrees C
Blood Pressure 65/39 with a mean of 50 (right where they want it)
Drugs:
Fentanol .7 ml/hr
Midanol .79 ml/hr
Dopamine 1.44 ml/hr (dosage 11 mcg/kg/min)
Heparin 1 ml/hr
Neotrace 12 ml/hr
Course of Action:
Blood Pressure meds were decreased slightly overnight. Respirator pressure and NO2 were decreased slightly overnight. Olivia's diagnostics dropped slightly from the change, but recovered on their own.
No big changes should be made today in order to get some consistency in the diagnostic #'s the doctors are seeing.
Olivia is less sensitive to movement and stimulation this morning, so she is able to maintain he oxygen levels and blood pressure better.
They will try to insert her new IV through her arm and to her heart now that she may be able to handle the stress involved.
They will begin to give her fats through IV and increase her sugars.

At length:
We are so relieved to have a day when she has not gotten worse. It is too early for us to take this as a sign that she will start to recover, but it is a great milestone. We left her alone for the afternoon and didn't visit her until 9:00 last night to try to leave her less stimulated. It was hard for us, but it seems to have been a good call. We made a list of the tests they were going to take and just called the nurse after each one was scheduled to see how it went. After the test at midnight, we felt assured enough to be able to fall asleep.
At the rounds this morning, we had the same doctor as yesterday. She had ordered that no changes be made at all yesterday and seemed a little snippy that the evening doctor "took a chance last night" by lowering her respirator levels. But it did no harm, so we are happy. We asked why they keep lowering her support whenever she stabilizes for a few hours then take more blood tests just to see her crash and have to start it back up again. The answer was that it provides them with more data to see where she is at. They know she is getting better when Olivia can tolerate a decrease. Yuck. The doctor this morning said that at she wants that stopped for at least a day because she fears that all this pushing may cause her to take 2 steps backwards. We will see what the other doctors end up doing.

I have been asked a couple times how common this situation is. Our primary issues are Meconium Aspiration Syndrome and Aspiration Pneumonia. I asked a doctor and they said that meconium in the amniotic fluid happens in about 5-10% of births. Of those only around 10% of the fetuses breath it in (aspiration). Of those it is rarley serious or with complications like Olivia's. If she wasn't so stong and vigerous (good Apgar score for high altitude), and if it wasn't treated immediately at birth (actually Olivia was suctioned before being fully born), then there would have been a danger of brain damage. As it is, Olivia's oxygen saturation has always been kept artificially high, so she should still be super smart.

Petra was able to change Olivia's diaper and take her temp again today. I also learned that the hospital's pediatric unit on the floor above us has a play area that Juuli is able to go to. We went up there together while Petra was with Olivia and it is an amazing place. First of all, it is huge and is part inside and part outside on this enormous enclosed deck (on the 6th floor). Toys, books, videos, fish, games, puzzles, cars and trikes and stuff, a garden, a kinda planetarium thing, lots of pretend furniture and appliances, ... It also has "ChildLife" counselors that help siblings cope with sickness, and they give advice to parents on how to keep the family rolling. We talked to them briefly today and will continue to go there often. It will at least get Juuli excited about going to the hospital.

Speaking of Juuli, we also took her out for a special dinner last night. We talked it up all day and took her out to Chuck E. Cheese. It was different than I remember as a kid, but she still loved it. We let her pretty much be the boss there (besides insisting she eat before giving her the tokens). She was able to drink soda, run around without us right next to her (there weren't a lot of people inside), ride on all sorts of things, dance with the mechanical mouse, and play things to win tickets. We kept her up late (visiting Olivia after), but it was well worth it and she is still talking about it.

Also, the Ramsey's stopped by after one of Gerry's appointments yesterday. Juuli was very excited to play with Marilyn, especially since my mom and sister had gone back to LA for a day. We bought her some cooler clothes (it is burning up here) at Walmart, so she is very excited about that. My mom will be back tonight and is bringing a pool to play in, so that will also be fun.

We are trying to come up with a new daily routine for our family to help us. We think we will call the new nurse each morning when we wake up, then get to the hospital around 9:30 and drop off Juuli at the play area, Petra and I will meet the nurse and go to rounds. We will then go play with Juuli for a little bit and talk to ChildLife if we need to, then go to lunch (turns out the hospital has a great cafeteria) around 11:15, Petra will help with Olivia's Noon "maintenance", then we will be back at Grandma's by 1:00 for naptime. At 3:30 either Petra or I can go to the hospital for Olivia's 4:00 diaper and tests if it works out that we can, then we will both go together at night to meet the evening nurse. It is a busy schedule (especially when you add in the breast pumping every 3 hours), but it will help to have a routine.