November 4th

Things continue to improve for Missy and Noah.

Missy has been able to visit Noah quite a bit over the last 24 hours. She was able to hold him for about an hour and a half last night after Anna and I left. She is feeling much stronger and is getting around a bit better. Her hemoglobin level continues to be stable, though she is having some minor drainage from the surgical site. Miss is still on antibiotics but has had nothing grow from cultures. Her fever may simply be the result of a non-specific inflammatory reaction.

Missy's spirits continue to improve. Her doctor told her today that he was quite happy with her progress and he suspects that she will be able to come home on Tuesday. Obviously we were excited at that prospect.

Noah is looking great. He remains under the phototherapy lights for his jaundice. They put up a special filter that blocks out the blue light so that we could see what he looks like. It turns out that he has blonde hair, at least for now.

Noah's respiratory status has been good. He was taken off of CPAP last night and placed on oxygen through a nasal cannula. He continues to have some working with his breathing, but I think this may be related to what is called a patent ductus arteriosus (PDA). The ductus arteriosus is a vessel that is normal during fetal growth that allows blood to bypass the lungs, which you don't need while a fetus, and go to the body. When babies are born prematurely, the ductus arteriosus may not close at or near the time of birth like it does normally. If the PDA is large enough, the blood from the body will go into the vessels in the lungs and lead to respiratory problems. A PDA can also make the heart work harder to do its job. Today, I took the liberty of examining Noah and determined that he still has a PDA. At this point, they will probably just watch it since it isn't causing significant problems and can still close within the first week. However, if it continues and/or he develops worsening of his respiratory status, they will give him IV ibuprofen to close the PDA. This is an effective therapy in about 80% of PDAs. If the ibuprofen doesn't work, he would have to have surgery to ligate the PDA. We'll wait and see what happens. It is my hope that at worst he will receive ibuprofen.

He is tolerating mommy's milk well and is up to 7 mL per feed. I am not sure what sort of goal they are aiming for as far as volumes, etc. Missy told me that his feed volume is being increased 2 mL per feed as long as he tolerates it. They will likely fortify the milk once he gets to full feeds so that he can get more calories to increase his growth and get a bit of fat on that skinny little frame. Noah's weight was down to 3 lbs 1 oz (1400 grams) last night. When they get his feeds up, they will be able to get his IV out of his belly button and decrease his risk of infection.

Noah is off of antibiotics and looking good from that perspective. He continues to make urine and is moving a lot more now that the anesthesia is out of his system.

Anna and I had a great time at church this morning. It was wonderful to get to give God the credit for all of this during the worship service this morning. We have been so blessed with such a wonderful church family. We can't thank everyone enough for their love and support. Anna and I were especially thankful today for the opportunity to spend some time with our friends, the Fernandez family. We got to try out the Lucky Dragon Chinese restaurant for lunch.

Please pray for the following:
Noah's neonatologist for the next two weeks, Dr. Guida
Missy's OB/GYNs, Drs. Laveren and Heinzel
Strength for our family during the days and weeks ahead
Opportunities to be salt and light to others

Thanks for checking on Noah and Missy today.

I plan to post at least one verse of scripture at the end of every post. So far, the verses are ones that have been included by friends in emails of encouragement to us. I pray they are an encouragement to everyone that reads Noah's blog.

"And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Romans 8:28.