Stats and PICC lines

More consent forms. I find it amazing that due to malpractice lawsuits, etc., Jana and I have to sign for every procedure that is going to help our babies live. Doctors evaluate all of the information that is given to them and make a decision based on those facts. If anything goes wrong then they could be sued for that decision. Jana and I make sure that we know exactly what the procedure is and why they are doing what they are doing, but we did not go to med school. We don't have 30 years experience in NICU. If it will help our little girls then by all means, do it.

So we signed consent forms for PICC lines yesterday. A PICC line is a Peripherally Inserted Central Catheter. It is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart. However, unlike other central lines, its point of entry is from the periphery of the body and typically the upper arm is the area of choice.

A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm, and usually in the upper arm using ultrasound. Also, PICCs differ from peripheral IV access but similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. PICC insertions are less invasive, have decreased complication risk associated with them, and remain for a much longer duration than other central or periphery access devices. (http://picclinenursing.com/picc_why.html)

The PICC line is big step for Emma because of the decreased complication risk compared to the line they were running in her umbilical cord. A PICC line is much easier to keep sanitary versus the umbilical line and you can deliver a higher dose of sugar to Emma so that she has the strength to fight off all of the things plaguing her. The doctors had to wait to do a PICC line because her skin was so fragile at birth, but it has now thickened up enough to work. They put it in her left arm.

Emma's platelets dropped from 110,000 to 28,000 yesterday and they were concerned that it was due to clotting on the umbilical tube. Hopefully the PICC line will help with that. This morning her platelet count was down a little to 70,000 so they had to put an IV like line in her other arm to giver her blood, since they took out her umbilical line. I know that the poking and prodding is far from over, but I hope that it will lessen somewhat. They did an ultrasound on Emma's brain yesterday as well and it looks the same, which is good.

Abigail is flying high and has tripled her feed intake. She went from 1 ml every 3 hours to now 3 ml every three hours. She has also gained 20 grams and is now over the 1 lb threshold again at 460 grams. We now need to pray for poop. We want her bowels to wake up and start working. If they don't, they'll give her a little glycerin bolus to help move things along. The nurse said that it's not uncommon for preemies to take 2 weeks for their first bowel movement.

I keep thinking that Abigail is going to open her eyes at any second, but both Emma and Abigail's, bilirubin is still a little high so they have their blinders on to protect their eyes from the LED light shining down on them.

I found out that preemies digest food better if they are laying on their stomach. Abigail was in that position yesterday, which may be why she is consuming so much right now.

7 days old today and counting...........