NICU Day #42 - Excellence in Kangarooing!

Tuesday, June 1, 2010

Yet another huge thanks going out to Amber and her girls.  You are such a wonderful and amazing friend to drive across town on so many occasions to give me the chance to spend more time with Timmy.

I did make it to the NICU this morning in time for rounds.  I walked into Timmy's room, met Henry for the first time (the man is hilarious!) and he had only just started giving me the rundown on Timmy's morning when his phone went off and he asked if I wanted to go with him to rounds.  Absolutely!

I will readily admit that I don't remember everything.  I was pretty dilirious this morning and didn't have my notebook with me to write things down but, overall, everything is looking really good right now.

Dr. Tsai (pronounced just like "tie") was in charge this morning.  I really like her.  Every time I've been in rounds with her, she stops pretty frequently to talk to me, explain things in more detail or ask my opinion, thoughts, concerns...  Timmy is now up to 7mls on his feedings and tolerating them extremely well.  When Henry drew back the syringe to check residuals at his 11:00 feeding, the tube was empty.  Hooray!  We may just be getting somewhere this time, but I'm not going to get too overly excited just yet.  Maybe when we hit 15mls I'll throw a party!  (Graham crackers and chocolate in our room!  =)  )

They have completely discontinued the morphine altogether.  He has been off the drip for about two weeks and was taken off the PRN ("as needed") today, as he hasn't needed it for almost the full two weeks and has done well with the Atavan when needed.  He is still on Pulmicort, a nebulizer he has been receiving and I have forgotten to mention for at least a week now.  It is supposed to help with breaking things up in his lungs.  The surgeons have prescribed a neonatal version of Immodium called Ioperamide, "an antiperistaltic used as the hydrochloride salt as an antidiarrheal and to reduce the volume of discharge from ileostomies."  Since most fluid is absorbed in the large intestine and Timmy has had a large portion of his removed and what remains isn't currently connected to his digestive tract, he has a fair amount of fluid coming out of his ileostomy.

The big issues for Timmy are feeding and respiration at this point.  Feedings seem to be going well, but Timmy is having trouble coming off the ventilator.  Dr. Tsai did talk with Melissa this morning and it was nice to have her talk directly to me as well, she said she was planning on coming to talk to me anyway, whether I came to rounds or not, to explain what the plan is for getting Timmy off the ventilator.  Yesterday, his flow was weaned very rapidly, from 18-14, and he did handle that extremely well.  She explained that the reason that was done was because his blood gases came back "too good", meaning his CO2 level was too low for his existing rates, so they dropped them and attempted to subsequently drop his pressure, which he did not handle.  There also appears to be some discrepancy between labs as well.  Not exactly sure where each is and why samples would get sent different places - seems like the same test for the same baby should always get sent to the same place. Dr. Tsai is testing this out today with four babies (Timmy being one) who have blood drawn every 12 hours.  Their nurses will send a sample to each lab for comparison.  She thinks this may be why Timmy's blood gases suddenly appeared to be too good and admitted that they may have, therefore, rushed the second attempt at extubating.

More excellent news (hope these little tidbits don't offend anyone) - there is a new pump in the lactation room, the Medela Symphony, and I got more than an ounce today.  Hooray!  Things have very much improved in that department this weekend.  I'm thinking it may have been being able to get in a pumping session every two hours during the day for three days straight.  Possibly drinking more, possibly just obsessing about Timmy in my mind while I was separated from him...  Who knows?  In any case, just soooo glad that we're going in the right direction there as well.

I did get to hold Timmy today.  At first, he was very squirmy and definitely agitated.  Henry suctioned and I tried adjusting his position a few times.  Tried holding him a little tighter, holding fingers, holding feet...  I then asked Henry if I could move him so his head was on my chest and he helped me get the vent tubes oriented correctly.  Still wasn't working...but not for long!  Just as I was thinking, "He loves this position at night.  I don't know what else to do." Henry said, "Would you look at that."  Meaning the monitor.  Timmy was satting 95!  Totally relaxed.  I think he likes to hear my heartbeat.  I don't think he's a huge fan of just reclining in the crook of my arm.  Wonder if that was his problem two weeks ago when I tried to hold him after surgery for the first time...

Timmy was also slated for his ophthalmic (eye) check today.  It's just a routine check they do on all preemies to check for ROP (retinopathy of prematurity).  I was glad I had read that in the Preemies book so I knew it was coming because they check all the babies, not because they had seen anything concerning.

I got the call from Henry at 2:00 saying that he passed and his eyes look normal.  Insert sigh of relief here!  I will admit that I couldn't help but think, "Oh, please.  Please let us miss this one!"  I know there are plenty of other babies dealing with at least as many, if not more, issues than Timmy.  It just seems like our roller coaster is finally on a little incline and I'm beyond ready for that at this point.

So appreciative of all the friends and family who continue to love and support us in everything they do.  I love these days when I don't even have to wait 12 hours before getting to see my baby boy!  Thank you, thank you, thank you!!!