A Happy Sunday

Yesterday (5/27) was a good day. Henry was in his new spot at the end of the pod near the window. While it isn’t perfectly quiet, it is much better than being at the other end of the pod. Janice was Henry’s day nurse and reported that he weighed 810 grams. He wasn’t doing as much sat surfing, which is great. Jeff and I helped with cares (taking his temperature, changing his diaper, and helping with his feeding) at 2PM. Jeff managed to flip Henry from his side to his back (usually the nurse does this) to prepare him for cares. I was impressed because this has to be done delicately and one has to deal with a lot of wires and tube. After cares and feeding, I placed my hands on Henry. I had my right hand on the top of his head, and he held my left index finger in his hand for a long while and became very relaxed. I touched his forehead a couple of times when I thought he was getting a little too relaxed (respiration slipping into the teens) because I didn’t want him to have an apnea episode or brady.

We talked with Dr. McLain. Nothing new to report. We’re just hoping that he’ll continue to take the breast milk and continue to grow. I asked Dr. McLain how much of a back slide going from the cannula back to the CPAP was. She didn’t think that it was really a back slide because they tried the cannula without any expectation that it was going to work.

When we came in the evening, the staff was taking chest x-rays of Henry. The nurse practitioner (Mary Ann Roberts) said that she just wanted to take the x-rays to have a baseline, since they hadn’t taken x-rays of his chest in awhile. Also, the CPAP tends to be a bit noisy, so it is sometimes difficult to hear exactly what is going on in the lungs. Mary Ann said that for his age and size, she was impressed that he has been on the CPAP instead of the ventilator. She did not think that they should push him on moving to the cannula because she said that he does not yet have the muscle in the diaphragm to support the lungs quite yet. Once he gets a little bigger, his body will be more prepared to handle providing the pressure instead of needing the CPAP. She also explained that whereas adults and full-term babies have a solid skeletal frame to support the lungs, at Henry’s stage of development, the skeletal frame is still a bit soft (the density of the bones is more like cartilage than hard bone). Jeff and I took a look at the x-rays. The lungs are still underdeveloped, but at least the lung area on the x-rays were not completely white, like they were during week two. We could see a slight grayness on some of the areas of the x-ray, suggesting that there is some lung there.

Melissa was Henry’s evening nurse. He weighed 840 grams. His head circumference was little bigger since the previous week, but Melissa thought that it was probably because nurses may measure from slightly different areas of the head. The increase was small. So no hydrocephalus worries. Jeff and I again handled cares at 11PM. Jeff turned Henry from his stomach to his back. I was again impressed with Jeff’s ability to turn Henry over.

After cares, Jeff did some kangaroo care (skin-to-skin contact) with Henry. Melissa gave us the choice of doing the CPAP or a “blow by” for his oxygen. She said that he’d done well with his blow by on his previous cares. A “blow by” is used when they are changing his CPAP masks from face mask to nose prongs or the reverse. Basically, it is a bag that blows oxygen past the face (100% oxygen), but it doesn’t provide the pressure. They also do the blows for short periods of time just to give the baby’s face some rest. They often massage the face a little bit (since having a mask or prongs can be a bit irritating) during the blow by. We decided to do the blow by. Henry was placed on Jeff’s chest, positioned so that he could hear Jeff’s heart beat, and he looked really, really happy. His facial expressions were very positive. His eye brows were up, and he occasionally would open his eyes to stare at his daddy. After a half an hour, Melissa came back to put on Henry’s CPAP. Henry’s saturation levels were excellent, but Mary Ann told Melissa that she did not want Henry to do the blow by for long periods of time (based on the same logic as explained above regarding the cannula). Henry was quite mad when Melissa put the CPAP back on him in the isolette. He turned purple to show his anger. When we left, his stats (heart rate, respiration, and saturation levels) were good. So all in all, yesterday was a good day.