The Sattler Scoop: Due Date

It is hard to believe that today actually would have been my due date. While I am so thankful that Casey has come so far in the past three months, I can't honestly say that I wouldn't have wished she had an easier start. There is definitely some sadness when I think of what this day could have been, but at the same time it is hard to imagine we should have had to wait another 3 months to meet our sweet girl. Yesterday we celebrated Casey's three month birthday with an official weight of 6 lbs 6.5 oz, and today marks the day that Casey actually turns zero. Preemies are given two birthdays, the day they were delivered and their adjusted birthday, which is their actual due date. Their adjusted age is the age that is used to see how they compare on height and weight charts as well as how they compare developmentally to other babies their age.

Today was also our goal date the hospital has given us all along for when we could hope to take her home. Unfortunately, we aren't going to make our goal of having her home by her due date, and realistically it could be a few more weeks. Overall, this week has been pretty frustrating as far as progress toward her homecoming goes. After my last post, Brian and I became increasingly concerned that Casey was having more and more heart rate drops while she was feeding. The nurses didn't seem too worried, and when we brought it up with the doctor she indicated that she would only be concerned if the bradys were happening at almost every feed. We then learned that the nurses were also experiencing quite a few dips in her heart rate when she ate, but they were often able to catch them and stimulate her before they registered on the monitor as a brady. This was leading the doctor to believe that these episodes were still infrequent. Our frustration level only increased when we arrived Thursday evening and discovered the alarms on her monitor had all been cleared, leaving us with no idea of what had happened for the last few feeds. We decided it was time to have some pretty serious conversations with the doctor. We both expressed to her that we were no longer satisfied with the "wait and see" approach, and we wanted every effort to be made to see if there was something more going on that was hindering her feeding progress. After hearing our concerns, the doctor ordered that she be changed back to the slow flow nipple, that the head of her bead once again be elevated, and that she be held in an upright position for 30 minutes after feedings as preventative measures for reflux (an extremely common condition for preemies). The doctor also ordered a swallow study and upper GI test yesterday to see if Casey is aspirating when she swallows. Thankfully, the results showed she was not aspirating, which would have meant thickening her feeds and switching her from breast milk to formula (pH imbalance between rice cereal to thicken and human breast milk). The test did show she has some minor reflux issues, but not enough to medicate. The good news: she is not suffering from severe reflux. The bad news: she is not suffering from severe reflux - which means there is no quick fix right now except continuing to wait for her endurance to build. Since the changes the doctor made, we have been encouraged that the heart rate drops have significantly decreased, so we are at least hopeful we are moving back in the right direction.

Our prayer needs this week are for her feeding stamina to improve without an increase in heart rate drops, for her eye exam next Monday to show improvement, continued prayers for healing of the bleeding in her brain, and for our strength as we get through this last stretch.

Enjoy the latest pictures of the Doodlebug: