All Nighter

Yesterday was a long day. He did fairly well through the day. However, after Kate held him in the evening we were not able to get him calmed down. He would lay passively with his eyes open for several minutes and then erupt into a crying, flailing fit. His heart rate was also elevated, running at around 170-180 when normal is 143. We tried moving positions, giving him a binky to suck on, changing his diaper, turning off the lights and closing the flaps on his isolette but nothing could make him happy. Typically he is a pretty calm and content baby.

He kept this up for several hours. Eventually his heart rate started to slow and he seemed less agitated. However, he still would not close his eyes. Typically we see his eyes open very infrequently. It seems that the last few days he is more frequently alert with eyes wide open looking around.

Kate and I both feel uncomfortable leaving him when he is not resting comfortably. So we were there with him until 4am. We called the nicu after we got home and his heart rate was in the 150's and his eyes were closed, finally.

We developed several theories as to why he was so on edge last night. Nadine thought he might be trying to force a bowel movement or might have gas. She pulled the contents of his stomach up a couple times and found a significant amount of air in it. However, that didn't seem to relieve him at all. To reinforce her theory he had a big bowel movement at 5am.

She also thought he could be over tired. She has seen babies that get over stimulated and then just can't shut themselves down. They fight sleep for a while before finally crashing.

My theory is that he does not like the potassium they are giving him. I had been holding him in the early afternoon. He and I were both asleep when I awoke to find the nurse Henry standing over the top of us because he needed to give Henry his potassium.

After that baby Henry was much more agitated. At one point he had a screaming fit and set off his heart rate and respiration alarms which is something he very rarely does. That was at 1pm. It eventually led me to put him back in his isolette. I don't recall if his heart rate was elevated but I do recall he was wide eyed even until I left around 3pm.

The fun in the evening started sometime around when Nadine gave him his potassium, 1am. I'm not sure of the timing but I think things coincided pretty closely. So it will be interesting to see if this theory plays out. If it does I don't know what the options are. He needs the potassium because the lasix drains it out of him. He needs the lasix because he doesn't urinate enough on his own yet.

The potassium theory is also bolstered by Kate's own experience with potassium supplements. At some point in grad school she found that taking potassium and magnesium supplements caused her to stay awake. I'm not sure how she discovered this but she did. A quick Google search on potassium and sleep turns up a lot of results. A quick perusal seems to suggest that potassium and sleep are related but generally seems to say that potassium helps sleep, not hinders it.

In other news, yesterday was a lasix day and it showed. He had a new personal best on his diaper, 69 grams. He lost weight, going back to 1010 grams (2lbs 3.5 oz). Henry was his nurse during the day and Nadine was his nurse at night. He is up to 6ml's per hour on his milk intake which is considered his goal at this point. He seems to be digesting it well. Hopefully he continues to do so. This is his third time to reach full feeds of milk and we don't want to see him taken off it again. He needs the calcium to help his bones grow, he is still rather under sized.

I ran into a family that had a nicu graduate with them yesterday. Their baby had been 25 weeks when he was born and weighted 750 grams. I believe his mom said he is now 4 months old. He was in the nicu for 11 weeks and went home without any monitors or oxygen. He looked great and the mom said he was free of any health issues. I'm certain Henry is not going to be going home at 11 weeks, he will be eight weeks tomorrow and still has yet to really take off growth wise. However, it was nice to see a living and breathing example of a nicu success story.

I will add some pictures later. Right now I need to head down to see what happens at his next dosage of potassium.