1 Month

Lincoln is one month old today. So much has happened in one month I can hardly believe it! The nurse weighed Lincoln tonight before Dan and I left to go home and Lincoln is now 7lbs 7oz! He really is growing up. He is now wearing size 1 diapers, too. He still isn't able to wear clothes, but I suspect his newborn clothes would be getting tight. I don't know that his feet have grown any though, but it is hard to tell since I see him everyday. Dan and I were able to hold him again today. It is still just was wonderful as the past two days!

As far as a medical update:
Lincoln is taking 5 mL of breast milk every 3 hours through his feeding tube, and he still has his TPN through IV for nutrition.

His sedation has been turned down a little. They will wean his narcotics very slowly so as not to trigger withdrawal symptoms. He has been on them for nearly his entire life, and has grown dependent on them.

His ventilator was set to 30% oxygen at a rate of 22 breaths per minute when Dan and I left. His wean of the nitric oxide was a complete success and was turned off completely at 7pm! The doctors want to give him some time to be sure he is stable so they will watch him over night. His rate on the ventilator will be turned down to 20 breaths per minute around 11pm. At that point all the settings are in place for Lincoln to be extubated tomorrow morning! I absolutely cannot wait to hear him for the first time! The milestones just keep coming! The plan is to switch out Lincoln's endotracheal (ET) tube for a high-flow nasal cannula system for supplemental oxygen. His oral feeds will have to stop for a few days to be sure he is doing well on the high flow oxygen.

Assuming his extubation happens according to plan and he does well with the high flow, the main requirement for discharge is to get Lincoln to take food orally (not through a feeding tube as he is now) and to have him eat 120 cal per kilo of weight every three hours. The amount of time he has left in the NICU just depends on how quickly he can increase his feeds and gain the proper weight the doctors are looking for. Learning to feed is what takes the longest as far as CDH recovery. Lincoln will start speech therapy soon to aid in his oral feeding (in addition to the physical therapy he now gets due to him being sedated and having limited movement.) Getting his first pacifier was a start in getting him interested in sucking, which he is doing great so far!

Lincoln has been through so much already and beaten so many odds. 1/2500 babies are born with CDH, of which only 50% survive. Of those 1/2500, only 10% are born with Right CDH. Being a male with right CDH is even more rare. Only 50% survive beiSng put on ECMO. Lincoln is truly a miracle. He continues to amaze me every day. Even though he is still very touchy and fragile, I feel like he is in the home stretch now!