Homecoming in sight

Xavi has been making great progress. He's up to 5 1/2 pounds, so he's gaining weight well, and he's been keeping his body temperature stable for some time now. Those are two of the major requirements for being able to come home.

The other challenges--taking all of his feedings by mouth and oxygen level--we'll be seeing about in the next couple of weeks. He's doing great both bottle feeding and breast feeding, but he's not yet able to take a feeding by mouth at every feeding (which come every 3 hours). He's steadily building up his endurance to do that, though, so I'm sure we'll see good progress on that front this week.

The other main question is what his oxygen requirements will be. It looks very likely that he'll still require oxygen support when he comes home. They will be trying out some new things this week to see how he will do on a low-flow cannula with 100% oxygen (currently he's on a high-flow cannula with a much lower concentration of oxygen).

We're just about 3 weeks from his due date, and it looks like he'll be home by April 9 if not before.The end is in sight!

Eva and Xavi

Each Wednesday one of the girls comes to the hospital by herself to have special time with Xavi and me. We have lunch together (they love the "hospital restaurant," where lunch usually consists of a mini-box of Fruit Loops or Apple Jacks and Sun Chips), and then we go up to spend some time together with Xavi. Last week, Eva got to help Amy to take Xavi's temperature, change his diaper, and then got to hold him for the first time. They both loved it! Xavi kept opening his eyes to look at her and gave her a little smile, and then conked out and slept peacefully while she held him.

Keeping an eye on what's going on

First family photos

The girls love having Xavi out in an open crib. They can see him and reach him and relate to him much more easily. These are the first photos of our whole family together!

Sweet sleeper

Making progress

All the news is good news! Xavi is making great progress these days:

• He's been out of the private room for almost two weeks. There are only 2 private rooms in the NICU and he was in one of them for about 7 weeks, so getting out into the ward with the rest of the kids is a good sign that he's not critical anymore. He scooped the most coveted spot in the NICU: the bedside right next to a big window.
• He's in a crib!!! We came in this past Saturday morning to find his nurse completing the changeover from isolette to open crib. This is a great sign of progress, meaning that he's able to keep his body temperature stable without the help of the enclosed isolette, and that he's not having to work too hard and burn too many calories to do it (which would impede his gaining weight). He's now much more accessible and easier to hold. The girls love being able to get so close to him too.
• He weighs 4# 4 oz, just gaining 6 oz in the last 4 days.

And the most wonderful sign of progress is that he is now off of CPAP entirely and just on the nasal cannula. He's been on the cannula for gradually increasing periods of time for the past week. He was doing well and is also getting old enough to be really tired of the CPAP, so yesterday morning they decided to see how he would do on cannula all the time. So far he's doing very well. Being just on the cannula is a great step forward for him, indicating that his lungs are getting stronger and he is becoming overall stronger and more able to handle the work of breathing on his own. 

In addition, being on the cannula full time means that feeding by mouth is in sight. We started "social breastfeeding" about a week ago, giving him time to get the idea without needing to actually get any nourishment from it. The nurses moved his feeding tube to his nose on Sunday, so for the first time in his life, his mouth is free of tubes and he is beginning to make positive associations with his mouth.

Especially now that he's off of CPAP, he is very awake and alert for longer periods of time each day. He seems like a very sociable little guy, really liking to look at people with long, thoughtful gazes. He also loves the music-playing mobile on his crib and will focus on the animals circling around for a long time.

Naked no more

Hurray! Wearing clothes is actually a sign of progress, and Xavi has been making all kinds of small strides in the past week or so: 

• He is becoming overall more stable, so that the main things going on are eating, breathing, and growing without other major interventions or crises anticipated.
• He is gaining weight--some days 1 oz per day--and is up to 3 lb. 6 oz.
• He is more able to maintain his body temperature. They removed the probe which constantly monitored his temperature (the isolette then regulated its temperature moment to moment based on whether he needed to be warmer or cooler), and now he is just in the heated isolette. They are weaning the temperature inside the box, preparing him for the eventual launch to an open crib. He now needs those clothes to help him stay nice and warm.
• His head ultrasounds have shown stable ventricles for the last several weeks. Since there has been no sign of his hemorrhage worsening up until this point, there is a good chance that it won't get any worse.

(Those bright blue spots are part of the CPAP mask, not his eyes :) Not a great picture, but had to show the clothes.