Staphing issues in the NICU....

...because there's quite a bit below, we thought we'd include the pictures first this time around!

OK - wow. Where to begin. The last week has been filled with an incredible amount of activity. We'll start with what might seem the scariest (but we assure you it's not really as bad as it first seems) and then move onto the....well....less scary.

Over the weekend, one of Thomas's buddies became a bit ill as a result of an infection. As his cultures came back, it became apparent that he was infected with MSRA - Methicillin resistant Staphylococcus aureus http://en.wikipedia.org/wiki/MRSA. (although to be fair, there's no proof that the MSRA caused the illness - it could have been caused by any bacteria) MSRA poses a particular risk for those with under-developed or damaged immune systems (including premature babies) - so once one baby tested positive, all babies had to be tested. A number of babies tested positive for "colonization" of MSRA - which means that the bacteria was found in their mucosa http://en.wikipedia.org/wiki/Mucous_membrane. As Thomas is one of the babies who tested positive - fortunately "colonization" does not mean infection or illness. It simply means that Thomas has one more type of bacteria living on his skin (we all have some form of Staph infection living on us) than he did a week or so back. All babies testing positive for colonization need to be separated from the rest of the NICU babies to prevent further spread, and the possible creation of a "super germ" which could become resistant to more forms of antibiotics. But as Thomas has been in isolation (which means simply that we need to wear a sterile gown and gloves when in Thomas's room) since Monday - his clinical status has not changed to reflect any infection. In fact, as explained by his doctors, he is no more at risk for infection than he was two weeks ago. So while TJC mom and dad were a bit worried to begin with - once educated, we can chalk this up to one more piece of our total hospital experience. But while infections are a constant risk in long term hospital patients (and today was Day 79 for TJC), Thomas's vitals are being watched even more closely than normal, so if any sign of infection does pop up, it can be treated at a very early stage to minimize any potential illness.

Since that was a mouthful, I'll share the next bit of news quickly. On Sunday Thomas bypassed the FOUR POUND mark, and is today weighing in just under 4 pounds, 3 oz. We've also begin bottle feeding Thomas again - 2x a day - as much of his feeding as he'll take. He's got the hang of it, but the coordination of suck, swallow and breath is exhausting to the little guy - so we spread out his two bottle feedings 12 hours a part from one another- and he continues to take the rest of his feedings by tube.

Last Wednesday, Thomas was able to try out a new piece of equipment - a high flow cannula. If you can remember, up until this point Thomas had been back on his CPAP - waiting for the go ahead to begin cycling onto the cannula again. The largest benefit of the high flow cannula, is that it eliminates the need for cycling. It has the comfort benefits of the cannula, with a higher flow of oxygen (the flow is the force of the O2 into Thomas's breathing passage) which results in a CPAP (continuous positive airway pressure) which keeps Thomas's alveoli http://oac.med.jhmi.edu/res_phys/Encyclopedia/Alveoli/Alveoli.HTML from collapsing with each breath. (As Thomas's lungs are improving, he no longer needs the higher rates of pressure (CPAP) and is albe to rely on the flow and a lower pressure.) Thomas has been doing very well on his new piece of equipment - and his oxygen requirements have been dropping steadily over the past week. The goal is to get to 21% of O2 (the concentation we breathe) with one liter of flow. Right now Thomas is on 21 - 35% of O2 and 3 1/5 liters of flow. It will take him several weeks (and possibly months) to be completely weened and onto room air, but he has certainly been moving in the right direction.

Lately the name of the game has been cheering for team TJC in light of taking pictures, so we only have a few this week. As you can see, most of the pics are taken from either TJC mom and dad's arms....as we're spending all time at the hospital now holding Thomas. It's making leaving him at night harder and harder b/c he's been loving being held (note his several cuddle positions - including burrowing into TJC dad's arm). Such a treat to be able to experience such a "normal" baby thing as our son wanting to be held in our arms more....

As always, we are extraordinarily proud of our little guy !

Thanks for sharing - we'll be back soon.

-TJC mom and dad