Jacob & Jordan Update 2-24-10

Friends, Family, Prayer Warriors:

Today has been an eventful day for our little ones. As indicated yesterday, both kids were switched to nasal cannula in the second attempt to progress them to breathing on their own completely unassisted. While they both were off the CPAP for longer this time, at least 24 hours from yesterday, both are showing in their own unique way that they just are not ready to be off the CPAP completely quite yet. As I previously mentioned in posts past, this is a common happenstance for preemies, and as hard as it is, Sheri and I have to be patient and let the kids develop at their own pace.

Jordan indicated that she needed to go back on CPAP by having 5 brady episodes during the day and 1 brady episode during the late afternoon/early evening. Jacob's situation was a little more intense...I'll get to that in just a moment. For the official report for Jordan, she had 8 wet diapers for the entire day, 1 dirty diaper for the entire day, was between 21% Room Air and 24% FIO2, had 1 desat for the day, maintaining her daily 6.8 mg. of caffeine for her heart, 24 CC's of milk, weighed 2 lbs. 10 oz. for the day, and was 2 lbs. 12 oz. for the evening. With the exception of taking her off the nasal cannula and putting her back on the CPAP, that was about all the excitement Jordan had for the day.

Jacob however, is another story. His way of indicating he wasn't ready to be on nasal cannula yet was much more serious. In addition to having 6 brady episodes in the morning, during the afternoon Jacob began to show signs of irregular breathing by taking fast breaths and then holding them, and one of his afternoon stools showed a smear of blood. This was an indication to the nurse staff and doctors that there were signs of a building infection; Jacob was immediately pulled off of his feeding tube, switched back to IV supplements, ordered to get 8 hour doses of vancomycin and 24 hour doses of tobramycin, had one x-ray taken at 4 pm and then again at 6 pm, and had a blood and urine culture taken. The initial prognosis: Colitis, or worst case scenario, NEC (Necrotizing Enteriocolitis. NEC is the premature version of adult colitis (inflammation of the rectum and/or large intestine) and is very serious. Had Jacob just displayed the irregular breathing and the brady episodes, the doctors and nurses would have had chalked up the situation to being tired out from being off the CPAP and not ordered more x-rays and the antibiotics. The blood in the stool is what caught the doctor's eye. The x-rays, which are taken usually once a day to monitor bodily activity per the doctors orders (each incubator bed is equipped with one), also showed an abnormality. When an x-ray from two weeks past which Jacob was on full feeds and showing no signs of distress and the x-ray taken from today were held up together, Sheri and I could see a lot of white areas on today's x-ray. Dark spherical areas of different sizes and shape were explained to us to be healthy bowel movements. A lot of white on the x-ray translates into oxygen, and while the bowels need oxygen to maintain good functionality and you want to have some in there, too much is a concern and usually indicative of infection. These three symptoms (brady's, irregular breathing, and blood in the stool) and the x-ray taken at 3:30 pm made the call for the doctors to stop the feeds, bring in antibiotics and give Jacob bowel rest. The blood cultures and urine cultures were taken to assess how severe things had progressed to and were to be analyzed in the lab for three full days. After those three days, and if tests continued to show negative for infection, Jacob was doing better and he had a history of good stools, then the feedings would resume at the low end and eventually be brought back up to where he left off on the full feeds.

This thought and reaction process is what Hermann Hospital is known for; start off with the worse-case scenario and work your way out, eliminating the bad things first with the assessments and status, and has saved a lot of lives. For now, we are praying, and as we have been updated, you are praying for too for those we could contact through the chaos, that the results after the three days will be either nothing at all, or colitis. Colitis wouldn't be ideal but the alternative of NEC is something Sheri and I do not want to wrestle with at this point.

Jacob's detailed report record for the whole day is: 5 mg. caffeine, 20 cc's of milk before incident occurred, 6 dirty diapers, 8 wet diapers, 2 lbs. 5 oz during the day, and 2 lbs. 4 oz. during the evening.

Please continue to pray with us for the well being of our little miracles.

Kind regards,


The Cordova Family (Andy, Sheri, Jacob & Jordan)
cell - 281-300-6212
email - maverick2601@hotmail.com

P.S. The answer to the trivia question from yesterday: Johnny Carson, The Tonight Show

P.P.S. the photos discussed in the 2-23-10 update have now been loaded into the slideshow. These are the ones that were taken with Sheri's camera while the photographers from The American Medical Journal were taking their photos for the April 2010 issue which will feature an expose' of Jordan and premature infants and care. Enjoy!