Josh had a pretty good night last night.  When Mom arrived this morning, she found Josh taking a nap in his isolet.  The day nurse told us what a good night Josh had, with only on episode of apnea.  It seemed that today was going to be a good day.  Then Mom saw that Josh was on 25% oxygen and wanted to know why - after looking back, it appeared that Josh had been on that since yesterday afternoon  Mom asked the nurse to please wean him back to 21% oxygen (room air) since he did not usually require so much oxygen.  The nurse did this and Josh's oxygen saturation dropped to 79% and would not come up.  The nurse worked with Josh to try and get him settled, suctioning him and repositioning him.  He had two episodes of apnea with bradicardia while we were trying to get him sorted out and finally she had to go back up on his oxygen to 24%.  This is a low amount of oxygen and it is possible that with the increased physical activity Josh has been doing, that he is requiring a bit more oxygen to make his breathing easier.  So we will wait and see if he can be weaned off the oxygen in the next few days

Then the nurse practitioner came by and did her physcial exam on Josh noting that had a heart murmur, which is not something he had before.  Mom was even more displeased by this. The new nurse practitioner and attending did not seem concerned by these findings. After talking to Josh's nurse and another nurse practitioner and listening to Josh's heart herself, Mom felt a better.  Josh does have a slight heart murmur which had not been heard before, but this can be caused by several things.  It is possible, but less likely, that the hole in his heart had not fully closed yet - although Josh is not current displaying any other symptoms of this.  It is also possible, and slightly more likely, that the murmur is caused by anemia resulting from blood drawn for labs and an inability of his little boy to keep up with his needs because of immaturity.  The team doesn't want to do anything yet because his murmur is so small that they would not treat it right now regardless of the cause and it puts unnecessary stress on Josh to try and figure out what is causing it.  So the plan right now is to just watch if over the next few days and see if it required interventions.

On a good note, Josh's feeding are up to 15ml every 3 hours.  At this rate he will be at full feedings by Wednesday!  That means they can stop his IV fluids and he will just be waiting and growing.  Josh continues to tolerate his feeding well with no residuals after each feeding.  He continues to be very active and spent several hours today trying to do push ups and lifting his head off of the bed.  It was very impressive to watch him move himself around the bed.  He can even turn from his belly onto his side!  We had no idea preemies were so advanced in their movements. Dad got to do some Kanagroo time with Josh after work today, which was great for Josh and Dad.  Josh was one happy baby napping on Dad's chest.

Prayer Request:

• Josh's heart murmur would not develop any further, but would resolve over the next few days.
• Josh's brain would continue to develop so that he is able to get his breathing tube out.
• Josh would be able to be weaned off of the little oxygen he is on.
  
• Josh would continue to tolerate his feedings well and would gain a little weight each day.
• Josh would not develop any infections while he is in the NICU, especially while he is on the ventilator.
• Mom would have some success at increasing her milk supply using some of the new methods the lactation consultant gave her.

Praises:

• Josh is tolerating his increased feedings without any problems.
• Josh is becoming more active each day, which is a good sign.
• Josh is off of his IV nutrition and only receiving IV fluids.
• Dad got to do Kangaroo Care today after work.
  
• Mom is starting to get acquainted with some of the other families in the NICU.
• Mom and Dad are thankful for their family and friends who are providing such good support.  We greatly appreciate your prayers, comments and support!

(Josh during some of his awake time this morning)

 

(Josh taking a nap after a lot of awake time this morning - his back is healed up)

 

(Josh picking his head up from the bed)

 

(Josh rolling on his side - such a big boy!)

 

 (Josh's nurse came up with a creative way of keeping his hands busy after her tried to pull his ET tube out when Mommy went to the bathroom)

(Josh enjoying his Kangaroo time with Daddy)

(Daddy helping Josh with his feeding during Kangaroo time)