"Henry's the Man"

Tonight, Jeff and I received a surprise as we entered the NICU around 8:30PM. Henry was moved off of the CPAP onto a nasal cannula. The CPAP provides some pressure when deliverying the oxygen, whereas the nasal cannula provides the oxygen without pressure. The CPAP requires a tight seal around the face mask or nose mask (they switch back and forth between face mask and nose mask). The nasal cannula simply uses nose prongs without a seal. Basically, the advantages and disadvantages of the devices are as follows:

CPAP
Advantage: Requires less energy to breathe
Disadvantage: The device is rather cumbersome and requires a hat to secure the tubing of the device; the masks are uncomfortable (Henry frequently tries to remove the device from his face)

Nasal cannula
Advantage: No hat required; more comfortable around face
Disadvantage: Requires more energy to breathe, since the baby has to take in the oxygen, which was previously provided with some pressure from the CPAP

Belen was Henry's night nurse again. She said that they decided to move him onto the nasal cannula right around shift change (between 6:45 and 7:45). His weight remained at 720 grams.

One of Henry's former nurses, Melissa, walked by and was surprised to see Henry on the nasal cannula. I don't think that they normally put babies as small as Henry on the nasal cannula but he was doing so well on the CPAP that they thought he was ready. Melissa said, "Wow. Henry's the Man!"

Henry looked a lot more comfortable on the nasal cannula. It was nice to see his handsome face, which the CPAP tends to obscure. They did leave the CPAP near his isolette...just in case he needed it again

Henry did have a few bradys while we were there. Brady is short for bradycardia, which means that a baby's heart beat has dipped below 100 beats per minute. Bradys and apnea (where the baby stops breathing) often happen in preemies because their bodies sometimes forget that they are no longer in the womb and their mothers are no longer doing the breathing for them. So up until around 34 weeks gestation, bradys and apnea are quite common. The baby's heart beat will slow down or he'll stop breathing, the alarms will go off on his machine, and the nurse has to come over and revive the baby through stimulation (e.g., stroking his back or feet). Henry has had the occasional brady in the past, but most of the time, he brings himself out of it.

I called the NICU around 1:45AM. Belen said that they decide to put Henry back on the CPAP. He'd had a few more spells, and his oxygen saturation levels went down into the 70s (they try to keep them in the 88% to 92% range). But she thinks that they are going to try to alternate between the CPAP and nasal cannula (4 hours of one and then 4 hours of the other).

In other news, Belen said that he's digesting the breast milk so far. No residuals yet, which is very good news.