Beckett's Top Five and Go Home Criteria

Beckett's Top Ten...over the past couple days

FYI...
Days in the NICU: 76 days (Ellie was only in NICU 71 days, and came home a week before her due date)
Weeks Gestation: B man will be 36 weeks gestation on Friday! Almost "full-term."

1. TODAY he has been off Oxygen since 10 am (that would be 6 hours and 20 minutes so far! Yes, I just called the NICU again, after I finished this post, and edited this part...I just had to know if he was still off) AND he tolerated being off the nasal cannula even during two feedings! The nurse actually said his oxygen saturation was higher during the feedings...which I expected the opposite! The nurse is letting him cheat slightly though as he has spent some time on his tummy. He desats less, but he will have to learn eventually to get rid of that! We can't put him on his tummy at home...It's "BACK TO SLEEP" at home with no monitors.

2. The DRG (also known as Dr.Grubbs) finally came back to see Beckett yesterday after a couple other hospitals in the area had been hogging his time. ;) It was good to discuss the Ho Ho Home plan. He is pleased with his progress for a 25 weeker, and is thinking we could likely go home before Christmas. The plan is to get him off of oxygen completely before we go home. Ben and I would just LOVE to take a preemie home with no tubes or wires! Please pray for Oxygen No No for HO HO HOme. It's looking like we will do a combo of breastfeeding and bottle feedings with fortifier (for calcium, phosphorus and calories!), and will still stick pretty religiously to the 3 hour feedings (No "never wake a sleeping baby" rule of thumb for us preemie parents).

3. Weight last night: drum roll please. 6 lbs. 2.4 oz. Yes, that's right. He has now gained approximately 4 pounds since birth. Rock star! Wahoo for normal birth weight sized kid :) He does have a pretty awesome double chin, and some cute chubby cheeks.

4. Dairy Foods: Yes please! The DRG gave mom the go ahead to try a regular diet again with Dairy! So excited, although he said I couldn't go eat a whole tub of ice cream after we talked yesterday. :( When I left the NICU, I may or may not have stopped at McDonalds and had ONE fruit and yogurt parfait. It was just as good as I remembered. And I did stock up ONE for breakfast this morning, and I had a chocolate milk with breakfast this morning. Yummo. Dr.Grubbs said we could try and transition while he was still in the hospital, so we can see how he tolerates it. He has had some "looser" stools lately, but we aren't sure if this is related to the dairy yet. We are still transitioning to the Enfacare, so that could be it too. Dunno.

5. Lungs: Well, Beckett had a Chest X-Ray this morning to see what his lungs looked like now that he is more mature. You know when I was talking about 34 weeks being the week they determine the Chronic Lung Diagnosis...well, I was wrong. It's really 36 weeks. So Friday...dum, dum, dum....is the day. Basically, if he is still on oxygen = He gets diagnosed with Chronic Lung. If he's off on Friday = no Chronic Lung diagnosis. Most likely, he will have some respiratory issues, that could turn into asthma issues, or be the lovely "I have a harder time with respiratory infections when I get a cold, croup, etc." So far today haven't officially heard how his X-Ray came out.

So what will Beckett need to do before we can go HO HO HOme?
A. Be episode (As and Bs) free for 5 consecutive days (He has done this, as his last caffiene dose was November 26, and his last episode was I believe November 22). The DRG believes he has outgrown the Apnea of Prematurity episodes! Hurdle #1, check!
B. Be more consistent with his feedings, and adequately, consistently gain weight for at least 2-3 days. He currently can eat "ad lib" (as much as he wants) with a minimum of 55 mls at 22 calorie fortified breastmilk (with the Enfacare by Enfamil - special formula for preemies that he will go home on...and that we can buy in the store). He still has the feeding tube in if he needs it. He has been going strong now not needing gavage for I think two days (and this is great) but we now need him to prove he can take all his feeds for 2-3 days with out oxygen. We need to make sure he is really letting go and not waffling, and this isn't going to interfere with his feeding/weight gain.
C. He needs to be able to maintain his own temperature. Since this past weekend, his temp has been on the low end of normal, which isn't bad, but it isn't great. So half way, check. This has amounted to a ton of layers both clothes and blankets, hats and being swaddled. They tried him on the "tuck in the side of the bed" anti-swaddle method that is required for home (Yeah, apparently new SIDS recommendations are anti-swaddling)...although I think sleep sacks are still ok (I need to follow up with the Occupational Therapist on this) but he was a little cold with that. So hmm...we shall see. I tried to give him a bath today, but his temp was low, so he couldn't get it. Maybe tonight when both Ben and I are there! (We are spending our date night at the NICU with Beckett, taking the infant CPR class that is required before we come home).
D. Car seat test for 90 minutes where they monitor desats; no episodes.
E. The DRG also said that Beckett will need to draw pictures for his doctor, and some advanced calculus. But then he said he might let that slide.
F. B man will also get the Synagis shot to help prevent RSV (which is a swear word to NICU preemie parents, especially when they go home during lovely cold and flu season). This won't totally prevent the virus, but will help boost his immune system, since his is so compromised from prematurity.
 G. Beckett will need to be ok with his mom and dad going on at least a couple more dates while in the hospital so they can mentally prepare for the no visitor/ quarantine that will occur with the outside world after he comes home. Especially during cold and flu season.

****Ok, so again, special favor to ask all you Fort Worthian Parents with pediatricians. I'm pediatrician shopping, and need some good recommendations. I need to have this figured out before Beckett goes home, and of course, the FB post that I asked before, I can't find it! Ugh! So can you all e-mail me this time (God bless Gmail search function) at mandysue@gmail.com with your info! Thanks! *****

We are so blessed. So thankful to God for being with us through this journey, and for letting us experience joy during the homestretch. We can't wait for our family to be complete, and at home. We will continue to wait patiently until B man tells us he's ready. Please pray for us, as I know I will be freaking out when he first comes home, kinda like the first few weeks after he was born. We can do this. I know we can do this. I've got a great team. An awesome husband, and a big sister Ellie who just can't WAIT to hold her baby brother.

Praise God with us thanking Him for Beckett's health and progress. He deserves the praise.