January 4th, 2010

Thanks Kenny for setting this up! We are technologically incompetent (well, at least I am; Deitre on the other hand, surprises me at times...).

Kierson is now at 28 weeks and still fightin' (her nurses all comment on what a little fighter she is). Born at 25 weeks, weighing in at 1lb 11oz, she is now a full 2 lbs!

She initially did quite well in the NICU for the first 3-4 days life on the ventilator but then developed pneumonia. This infection proved to be resistant to the first 2 broad-spectrum antibiotics and a third broad-spectrum antibiotic was added (initially ampicillin and gentimicin, then changed to ampicillin and zosyn and now vancomycin added).

Unfortunately, simultaneously with the pneumonia, Kierson developed PIE (persistant interstitial emphysema) which is often seen in extreme pre-emies as their lungs get damaged by the pressures of the ventilator (called barotrauma, there's more to the story on that but trying to keep it short). Essentially, because of the PIE, there is very poor exchange of carbon dioxide for oxygen. This results in an otherwise perfect little neonate that ends up retaining lots of CO2 and gets little O2 into her bloodstream because of immature and now damaged little lungs.

The neonatologists have tried 3 different types of ventilators trying to correct this life-threatening imbalance. With each change in type of ventilator, there appeared to be improvement but this was only of short duration. On December 26th, Kierson's doc came to us and told us she didn't think Kierson was going to make it as her blood gasses were steadily worsening. Never have we ever felt so helpless. Some tears were shed and some close friends called.

The following day, Kierson amazingly began to show a reversal in her abnormal blood gasses, they were small changes but changes in the right direction. Over the next 3-4 days, her twice a day chest xrays also showed signs of resolving PIE and pneumonia. On Dec 31st, however, the PIE looked much worse on chest xray and Kierson was changed to a different ventilator in anticipation of her condition deteriorating. Now that the pneumonia appeared resolved, she was also started on steroids to help simmer down inflammation in her lungs and promote the production of surfactant. She was given some surfactant (naturally made by certain lung cells, this is a necessity for proper lung function) down her endotracheal tube (her breathing tube) which did show immediate benefit.

As far as her blood gasses go, there has been marked improvement since Dec 31st. However, a new problem has discovered. Kierson has developed intermittant episodes of bradycardia (slowing of the heart). She will go from cruising along in the 150s and suddenly drop down to the 50-60s. She hangs out here for what seems an eternity and then rebounds back to the 160s. Sometimes, however, she requires the nurse to stimulate her to do so. Other times, she rebounds on her own. Because of this, her doctor has put her on one-to-one nursing care so that these episodes don't get missed, preventing Kierson going into cardiac failure.

Thank you for your continued prayers for Kierson, her nurses and doctors, as well as for us. This has been a very difficult time for us in light of having a 6 month old (older) sister at home that is doing lots of "firsts" and needs us to be around to "oooh" and "ahhh".

Paul