Still not moved

Well we are still in the North :( (no offence Northerners!) as our local hospital still does not have any cots in the appropriate unit for Jacob and Lilian, we have been told that the unit coordinators here will try every day to get them moved and that if the wait gets too long (we have no definition of what 'too long' actually means for them!) the coordinators at this hospital will ask the Consultants here to make a referral to the Consultants in our local hospital, as this usually results in a move fairly quickly.

In the meantime, Jacob has gone back onto Flat CPAP as he was going into a little too much oxygen on High Flow and seemed to be a bit tired. He can still transfer hospitals on Flat CPAP so that is not a problem, and he is keeping his oxygen requirement very low which is very encouraging. It's not unexpected that he would return to CPAP as he seemed to progress to High Flow a little too quickly in our opinion - he likes to get used to one change at a time!

Jacob's weight is increasing nicely and his feeds are being increased in line with his new weight. At the moment he still has his TPN to ensure he continues to gain weight but they are keeping the level he receives of that the same (so it works out as being effectively reduced due to his weight gain). His Stoma losses seem to be under control finally so there are no worries about having to reverse his Surgery before he is really suitable for it.

Lilian is very much enjoying her second go at High Flow, She is staying in around the same amount of oxygen she was using on Flat CPAP which is excellent considering she is now having to do more work herself. Her feeds have been moved to 3-hourly with a view to moving her to breast / bottle feeding in the not too distant future (no more pesky gastric tubes for her to pull out 4 times a day! - the Nurses will be pleased!).

Lilian still has a little way to go but the plan would be to get her onto Low Flow next - this provides very little breathing support, and if the Doctors think it necessary, either of the babies could be discharged while they are still on this, so this is not a barrier to them coming home at all. With the progress Lilian is making it is anticipated that she may even be promoted to Special Care before she is transferred home (this could make finding an available cot easier than trying to get 2 HDU cots), however this is still a good couple of weeks off.