Henry's New Party Hat

When I arrived this morning, Joyce asked me if I had seen Henry's new party hat. I peaked into his isolette to find that he had a cup on top of his head with tape holding it in place. It was his new IV. The PIC line (peripherally inserted central catheter) that had been in his left leg went bad. Apparently, Nadine noticed something wrong with the leg last night. It was getting swollen. By the time Joyce arrived on the morning shift, the staff decided that it needed to be pulled out. So Joyce had the fun task of putting an IV in his scalp. As you enter the NICU, there is a board on scalp IVs that says they look scary but are no different than regular IVs, except for the location of course. It does look scary, but it doesn't go into his brain. It resides in a vein between the skin and the skull.

His leg continued to look swollen throughout the day. And it was red around his inner thigh. The bad PIC line might explain why Henry wasn't releasing urine like he should have been yesterday. So, his Lasix doses have now been reduced to every other day. He had no problems peeing today. I changed two 25 gram diapers, which is pretty good for his size.

My parents stopped by right before Henry and I did our kangaroo care. They brought him a cute Snoopy suitcase filled with blankets.

Henry and I spent around two hours doing skin-to-skin. His sats were good. He did cry a few times. Joyce said that he was probably hungry and could smell the milk on me. Even though his bowels are looking good (yesterday was his last planned intestinal x-ray), they won't start feeds for another few days.

Dr. Jeminah Van Handel, the resident handling Henry's case for June, reported that his head ultrasound was clear, which is good news.

After skin-to-skin, Joyce helped me put Henry back in the isolette. My mom came back to the NICU right after skin-to-skin. Henry was quite alert during his afternoon cares. My mom keeps saying that Henry can recognize me. I haven't always been sure that she's right. But today, I think that he was focusing on me and looked pretty happy.

Then, Mary Ann came by to put in the new PIC line. The scalp IV is a standard peripheral line. Unfortunately, there are some nutrients (e.g., calcium) that shouldn't or can't be put in the peripheral line. So a new PIC line was necessary. Mary Ann asked me if I wanted to help hold him down while she did the procedure. She also asked me if I was able to tolerate the sight of blood and Henry being poked as she didn't want me to faint in the middle of it. I'm not squimish, and I watched Carrie do the last PIC line without problems. So, I helped out.

Mary Ann gets a kick out of Henry since he's so feisty. She was the nurse practitioner on duty the night that Henry pulled out his entire PIC line from his right arm. Henry is rather memorable. Today's PIC line is PIC line number 5. However, he hasn't yet broken the record, which is 8. I'm hoping that this is one record that he doesn't try to break. Nevertheless, Mary Ann says that he has made the infamous list of NICU babies and PIC lines.

Joyce gave Henry some sucrose before the procedure. Sucrose acts as a pain inhibitor in babies. The PIC line was placed in his right arm. It took Mary Ann a few tries to find a vein that would allow her to thread the tubing up to his heart. Basically, the procedure involves inserting tubing through a needle that looks much like a regular IV needle. Once inserted, the tubing has to be slowly pushed into the vein where it travels up close to the heart. This takes a while because sometimes the tubing doesn't go with the flow. It has to be pulled out if it hits the wrong spots. Henry was calm throughout the entire procedure. Then, an x-ray was taken to make sure that the PIC line was in place. Mary Ann said it was nearly perfect but decided to pull the line back 1 cm just to make sure that it wasn't too close to the heart. This involved removing the dressing and getting the sterile equipment back out. Henry started to get a little fussy at this point, but all in all, he handled the event incredibly well.