Short and sweet.

Max had a great day. He was at room air most of the time and rang his little oxygen saturation alarm very little. They've made it so that the alarm goes off at 87% instead of 84%. This is so that they make sure his oxygen levels are as close to optimal for as long as possible. With these restricted parameters, he was still doing well.  Also, they've increased his feeds by 4ml (to 47ml) in order to compensate for the missing fortifier from his breast milk. This makes him more full - and therefore makes him struggle a bit right after his feeds - but he's dealing really well with it overall and is just a cute, little, adorable guy.  Theres not much else to report.  Except that he's a bit of a tiny fella.  He's at 48.5cm in length, which puts him at just under 19", which puts him at "kind of short".  Which is no surprise seeing as his mum and dad (but especially his mum) are kind of short too.

A lot of boring news.

There isn't much to say about Maximilian today.  Mum had some good cuddles with him today.  We were going to try for some more kangaroo care/breast suckling, but Maximilian simply wasn't in the mood for it. He was a bit cranky due to his eye exams, and this seemed to have tuckered him out pretty well as he fell asleep almost immediately once he was on mum's chest. Overall he was having a great day though.  He had his eyes open for a while, was fairly interactive and managed to be cuter than ever just by existing.  They're back to full feeds, and they've re-introduced his vitamins and iron to the feeds. They're still holding off on re-adding the fortifying formula to the milk for a bit longer; they want to give his tummy time to readjust to normal feeds so that he doesn't have issues with them.  This is all because of the holding pattern they had him in for the past few days on account of the blood found in his stool.  Because of that holding pattern, he also gained very little weight. He's at 2523g (5lbs 9oz) now, which is an increase of a whole 15g.  We're expecting the next weigh-in to be a bit more robust.  So, yes. Today was just another regular day with Max.

Good form.

Today we got in two nice, long Max visits. He's doing exceptionally well today, and he's very happy to no longer have the IV contraption on his arm. He continues to do well with his oxygen set at room air, and they've recently had to stop his oxygen alarms from sounding "happy alarms" because they can't turn his oxygen any lower than it is. In fact, today they gave Max a trial without his nasal prongs, and he went 3 hours breathing all on his own before he needed to go back on for a boost of oxygen. We're quite impressed!

At our first visit today, mum and Max had some kangaroo cuddles (where we snapped another photo for the 'growing Max' series.) This is the time that Max gets his food, so his brain was telling him to root around and find something to eat, despite his food being delivered via tube. So, we figured we'd try him at the breast again and see how he'd do. Max has a really great latch, and is certainly capable of a strong suck, although he tires quickly and is content to suck and snooze while his food takes a more direct route to his stomach. Once he begins taking food orally we'll make a more concerted effort at nursing, but for now, the bonding for mum and son is quite lovely.

At our second visit, dad and Max had a snuggle. The little guy was wide awake and quite interested in his immediate surroundings - mostly his daddy smiling at him and his mummy nibbling his chubby little arms. He fought sleep off the whole cuddle despite his blinks getting longer and longer, he just didn't want to miss anything. Once we got him snuggled back in his bed he finally drifted off to sleep.

And he lifted up his arm, and instead of a hand... he had a cup?

The biggest thing to note today is that Max has been at room air for the better part of 24 hours. This is amazing in the context of him having little food in his tummy; being poked and prodded more often that usual; and having a weird contraption made of an IV line, a popsicle stick, tape, gauze and a pill cup on his one arm.  Despite having no idea what to do with that one arm, Max has been doing wonderfully well.  They've started re-introducing his feeds, and by early morning tomorrow, they will remove the IV feed and have him back up to his full feed amount. An infection of his bowels has been officially ruled out, and all of his tests have come back looking good.  The blood in his stool - although still not something to ignore - is now officially most likely due to the hernia he has and he will have to wait for surgery to have that resolved. He still has plenty of energy and is as active as he can be right now.
Both mum and dad had a cuddle today, and Max dozed very peacefully in both cases.  He seems to be starting to understand who his parents are and it's nice to see him so calm when being handled by them.  Also, he seems to really enjoy having his head stroked softly quite a bit. He smiles and makes such adorable little faces when Rafael does it.

Lots of tests, lots of nothing.

Max was a bit cranky today. When we visited him, he had been without any food in his tummy for 24 hours.  Despite being obviously cranky, he was breathing really, really well. He has been at room air for the last 2 days, except for those moments where he's at his crankiest while being poked and prodded.  His requirements then are still far lower than the 30-40 they used to need to give him, so he's doing quite well.  Today, he has had x-rays and an ultrasound to find that nothing is really wrong with his innards.  They're still giving him antibiotics and waiting for other test results to see if anything is officially "wrong" or if the blood in his stool is simply a result of his hernia or a benign-ish tear in his rectum.  Whether or not this affects his surgery date, we don't know. At any rate, it's important to note that Max is not at all acting sick. Just before they started with all these tests and his fasting, he was at his most interactive, most exciting and most cute.  This gives the medical staff (and his parents) the confidence that he's most likely fine and that the issues are as minor as they can be.

In the next little bit, Max may actually get to go for a trip to have an MRI done at Health Sciences Centre to give him a once over.  Before they do that, however, they want his MRSA issue to be in check. They have started treating him for it with some goop they put in his nose (he does not love that), so hopefully he'll start testing negative for it soon.

He was cute and gorgeous today, in case anyone was wondering.

Double Cuddle

Max had a lot of energy today. They haven't given him his sedative in a while, so he has been far more alert and interactive than he used to be. This is also, in part, due to his gestational age; he's pretty much a "newborn" now so he's acting like a newborn. He looks around a lot, startles himself when he sneezes, makes little faces and indicates when he's hungry.  He's so wonderfully full of curiosity and attentiveness, and it's wonderful to see. Mom and dad both got to hold him today and he responded really well to both of his parents and was doing great with his breathing and everything. And, Mum and Dad both had sore arms afterward as they were cuddling with a gargantuan baby weighing in at 2508g (5 lbs. 8.5oz).
The down side of the day was that his hernia may require earlier attention through surgical means.  Initially, we were given a tentative surgery date of September 17th.  They may make this earlier as it may be causing some blood to appear in his stool. This means that they will want to treat that earlier rather than later. So, they've given him some antibiotics on a prophylactic basis and that they've temporarily stopped his feeds so that they can properly gage the cause and severity of the issue. The one major rule of thumb with babies that's making us more "ok" with this than some people may expect is that he has so much energy and is doing well in all other regards.  He doesn't seem ill, and his hernia is SO obvious, that it would be a big surprise if there was something else going on down there.  Most likely, he'll just have to get his surgery earlier.  After a few tests, we'll have a better idea of what's going on.  
Max is otherwise doing very well and is still as cute as possible. He was a bit crankier tonight, but he'd been poked and prodded enough where we're surprised he wasn't angrier.

Shining Star.

Today Max must have known that he was the absent guest of honour at his baby shower. He was on his very best behaviour today for the occasion. Max got two visits today - the earlier visit with mum and a later visit with mum and dad. Each time we were greeted to the little man with his oxygen set at room air. He managed fairly well through the fussing of his changing and only needed a little extra oxygen during his feed once his belly was getting full - a full belly makes it harder to breath. He's very calm and alert now that he's off of CPAP - so much so that they haven't given him his sedation medication all day. We're very impressed with his progress; he's our little star. If he can keep this up he'll be eating food like a big boy in no time, and I'm sure no one is more excited than him.