Jacob's Page - January, 1998


Jacob Paul Steblein, born 12/24/97 - 4lbs 9ozs, at 5 weeks old!

Jacob Update as of 1/31/98 - Jacob is 5 weeks old! He weighs in at a whopping 5lbs 5oz's now! Overall, he looks good, but the common preemie expression 1 step forward and 2 steps back is accurate. Jacob has not been doing as well the last couple days. Mom was on the phone with the Pediatrician and Hospital NICU staff late yesterday afternoon. Jacob is struggling a little more with the medications and feedings. For some reason, he has been refluxing or regurgitating much of his just consumed milk. This is of particular concern when he spits up his medications! They say it is fairly common in preemies because the valve that typically would hold down the food is not closing or developed propertly. They are not sure why it seemingly has gotten a little worse. I have just put a call out to all the Preemie list server parents asking for any input. The list server is such a good resource (thanks to you all)! In the meantime, we are following the doctors/nurses advice and have added rice cereal to b'milk, split his medication dose in half, and keep him propped up most of the time -- so the food does not come back up! This seems to be helping some. We are hoping it does not continue as bad as these last 2 days. It's pretty scary when he starts convulsing, starts turning gray and lethargic, and the monitor is going off! The last 12 hours has been a little better. We think it would be easier to cope if we were getting more sleep. Paul and I are trading off on the sleeping, so we can at least get a few hours each! Paul took over last nights feedings via b'milk in a bottle. I got up at 4:00am to take over and then Paul went to bed until 11:00am. Gee! These details were not in the Parenting 101 or the previous experience books we read!! Hmmm....Good thing this isn't our first kiddie or I think it would be our last (smile)! Hugs 'til next time.

Jacob Update as of 1/24/98 - Jacob is 1 month old today! He is doing about the same since he came home. He sleeps 20-22 hrs. a day. He continues to gain weight -- up to 5lbs 1oz as of tonight. We know this because the hospital neonatologist just reviewed his monitor readings for the last week. They noticed more heartrate episodes than they expect and like to see. So, off to the Dr.'s we went at 8:00pm this evening. The diagnosis is 'Reflux', which was suspected from the number of times and quantity which he spits up after a feeding. Not uncommon to preemie's, this can be treated with medication called 'cissapride' (sp?). The medication will cause him to pass the feedings through his stomach faster, thus reducing the number of reflux episodes. Hopefully this will help his little tummy. They expect he will be on this medication for a few months. Other than that, he continues to grow bigger and better -- much to Savannah's chagrin (that's another story -- see her homepage for more details).

Jacob Update as of 1/16/98 - Jacob came home last night, monitor and all! We are so happy to have our baby home where he belongs. We had our first (of many to come) night of awakenings for nighttime feedings! He fed at 11:00am, 1:30am, 4:30am, and 7:00am. Not too bad. The monitor hardly went off due to false alarms -- at least compared to what I had expected. This was usually due to positioning while we were holding him or changing his itty, bitty, diaper. Jacob is now wearing newborn diapers, since he weighs in at 4lbs 12oz now!

Now that we are all at home as a family, you can expect that we will be exceptionally busy since Savannah is home sick with us today, and we have a 3 day weekend coming up! If you don't hear from us, we hope you will understand. That's why we established this web page. This way, updates can be made after a 2:00am feeding while the rest of the world sleeps! Take Care!

Jacob Update as of 1/15/98 - 2:00am - The neonatologists decided to run another pneumogram from 4:00pm yesterday afternoon to 4:00am today. This test will monitor more than the last one to include heartrate, respiratory rate, stomach ph (to check for reflux) etc. Let's go Jacob! We expect to have preliminary results sometime by noon. We anticipate Jacob will come home sometime later today or tomorrow, based on normal results -- and, no other surprises

Jacob Update as of 1/14/98 - 6:00am - Still looks like the end of the week or the weekend before Jacob comes home.

He continues to suffer heartrate declines and forgets to breathe while taking a bottle. We are learning a bottle feeding technique to minimize the impacts. The downside was the other day they had to use free flowing oxygen to revitalize him after one of these episodes and it was severe enough that he even had some discoloration, i.e. blueness, but it only took 10-15 seconds of the oxygen to get him back to normal.

Then, yesterday as I was finishing giving him a bottle with some medicines he started gasping and choking. Same type of scenario, his oxygen and heartrate dropped way down. However, I saw it, checked the monitors, tilted the bottle away and called for the nurse. She too had seen it, but watched to see how I dealt with it. Boy, was I shaking! He came through ok.

Then, to make things more exciting Jacob had 2 tachycardia (overly high heartrate - 190's) episodes while I was holding him. At that point, I put him back in the crib to rest and he was fine, and his heartrate went back to 140's-160's. Just when I thought we were coping well he seems to do something new!

Overall, everything else is pretty much the same. His basket is ready and waiting for him to come home!!

Jacob Update as of 1/11/98 - 6:00pm - Jacob will be coming home in the next 3-5 days. This is even a little later than we thought just this morning! The doctor's were disturbed by the 'abnormal' results of the neumogram, that's why he is not yet home. Jacob showed more bradycardia (dropped heartrate) episodes during the wee hours of the morning. They have started him on caffeine to help control the bradycardia's.

He will definitely come home on medication - caffeine, and a monitor. The monitor is LOUD, heavy, and awkward, especially for one person to carry, along with diaper bags, car seats, etc.

Mom was able to go see Jacob again on Friday - finally! One quick breastfeeding session, and tons of snuggling, then mom went back home to continue recovering from bronchitis.

Saturday mom spent about 8 hours with him. Dad came and spent 1/2 the day too. Fortunately, Paul's parents were here to help watch Savannah! Interestingly enough, Jacob has not had any bradycardia episodes while breastfeeding. Seems to happen with bottle feeding. However, his respiratory rate, or breathing, becomes really shallow at times. But, we think that is still pretty normal for his age and situation. I guess that's it. We'll keep you posted.

Jacob Update as of 1/9/98 - Jacob has a history of A's and B's (apnea and bradycardia). Apnea is when he stops breathing. Bradycardia is when the heart rate drops. Funny, I had never made the correlation that he had A's and B's from all the other information they gave us. But, I guess it's because they evaded those terms with us in the Neonatal Intensive Care Unit (NICU). Until one week ago, Jacob had been on, Aminophylline, to control the A's and B's. So, he had no recurrences of A's and B's during that time frame.

Jacob is running on the strip test, pneumogram, now. It ran from 4:00pm yesterday to 4:00am this morning. As of 1:00am, Jacob had no apnea, but did have one bardycardia, where his heart rate dropped to 80. This is not horrible, but not really good either. I think they were a little surprised. The nurse attributed this to a possible over exertion, due to vigorous sucking, during the 9:00pm feeding. She tried a different nipple, that was not as soft, and that appeared to help. He still has a wet burp. Ugh, messy, but at least he is tolerating his feeds better. He is up to 50cc's and is eating every 4 hours now. He is still at 4lbs 7.8 oz and gaining steadily.

We go for CPR any day now. And, Jacob will probably come home this weekend. However, he will come home with monitors attached. I guess that means you don't go anywhere? Ugh! I'll have to find out details on that one. If any of my cyber Preemie mom's can tell us what it's like to be home with a baby on a monitor that would be great. Can you send an email or post to the Preemie-L list server?!

Jacob Update as of 1/8/98 - It's 3:00am and just talked to the Neonatal Nurses at the hospital. Jacob graduated from an incubator to a crib earlier and is doing well so far! He is also tolerating his feeds pretty well too. Officially his weight is up to 4lbs 8 1/2ozs, which is almost to his birth weight of 4lbs 9ozs.

Paul came home at 4:00pm with an update -- it looks like they are estimating it could be this weekend that our baby gets to come HOME!! He needs to pass a 12 hour strip test to measure respiratory rate/heart/blood pressure/oxygen levels/sleeping etc. However, based on Jacobs Mom's current bout of bronchitis it is likely he could stay there a little longer to minimize risk of infection. Preemies are so vulnerable! Each day is such a blessing! We continue to take them one day at a time!

Jacob Update as of 1/6/98 - Jacob is now being fed through both a gavage (a tube from mouth to tummy) and also being bottle-fed breastmilk fairly well now. He is still about 4lbs 8oz which is up from a low of 4lbs 2oz. The best part is that he graduated to the intermediate nursery, called "step-down"! This is where babies go when they are getting better! This is a major milestone!

History -- We had a new addition to our family Christmas Eve. Jacob Paul, our son, was born 12/24/97. This is 8 weeks earlier than expected. So, yes we have a preemie! Jacob was born weighing 4lb 9oz and 17" long. He is now doing even better than before. He started out being intubated with oxygen, given a surfactant to keep his lungs from collapsing, and experiencing an irregular heartbeat, respiration, and blood pressure. Since then, he has gone off the oxygen tent, back to a nasal CPAP (continuous positive air pathways) to keep oxygen constant and flowing, and down to breathing on his own. He has also experienced a bout with Jaundice (now better), as well as requiring additional supplementation of sodium and calcium.

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