No PICs on Purpose

Henry had a good day yesterday. Joyce and Holly were back from vacation. Holly had in-service training in the morning, so she stopped by to see Henry and then we saw her again at 11PM when her shift began.

Joyce said that she was a little worried when she first came to work and didn't see his name on the board initially. There are 33 slot numbers on the board that correspond the various stalls. 31 of them are for the slots in the pods, and 2 of them are the isolation rooms. The board is white. For some reason, slot 33 is thinner than the other slots on the board and it is green. In addition, Henry's status is green, so the green pen on the green slot doesn't show up well. Anyway, she was much relieved when she found his name.

Henry had a treat for Joyce. He pulled out his feeding tube for the third time in the past week. At least Emily, who was on the night shift Wednesday night, had changed his isolette cover so that it was a half cover rather than the full cover. The advantage of the full cover is that it keeps the isolette dark, which is a good thing. But, if he's on continuous feeds and pulls the feeding tube out and it isn't spotted right away (there are no alarms to signal that a feeding tube has been removed), then it can create quite a mess.

During the day, Henry was restful. He and I spent about 4 hours kangarooing in the afternoon. I've noticed that he gets a little restless if kept in the same position for more than an hour, so I ended up craddling him at one point, rather than the straight tummy on chest position. It was the first time that I had moved him from tummy to back, and then back to tummy by myself. He's getting a little bigger, so it is much easier to find places to put your hands without disrupting his tubes and leads.

While we were doing skin-to-skin, Dr. Van Handel stopped by. Henry had four nights of weight gain in a row, so they gave the order to have the PIC line removed. Currently, there's no hyperalimentation (also known as TPN) running through the line. It is being kept open with a saline solution at 1 ml per hour. Dr. Van Handel's thought was to remove the PIC line and increase his feeds (gradually) by 1 ml per hour, so that Henry gets the extra nutrition and calories.

I asked Dr. Van Handel about Henry's IUGR (intrauterine growth restriction) because when born, Henry fell the the bottom 10th percentile on weight for his gestational age. There are some developmental complications that can arise from it (not that they necessarily appear, but risks increase significantly with IUGR). She was going to look into it for me, but I suspect that we won't have a lot of answers until he's four or five years old.

Kathy came on duty at 3PM. She took out his PIC line. PIC number 7 is out of his system...at least, it is elective this time. Another advantage of removing the PIC line is that it removes a potential site of infection.

Currently, he only has seven wires and tubes attached to his body! So progress has been made. He has three leads attached by wires, the cannula tubes, the pulsox, the temperature probe, and the feeding tube. The leads are used to measure his heart and respiration rates. The cannula tubes are used to give him oxygen. The pulsox is used to measure the oxygen saturation levels of the blood. The temperature probe is used to measure his temperature in the isolette (it's actually plugged into it); if Henry's temperature is high, the isolette is supposed to turn itself down, and if his temperature is low, it should increase the temperature inside the isolette. And the feeding tube is for the breast milk and for his medications and vitamins.

Jeff picked me up at the hospital during shift change, and we went to dinner. When we returned, Kathy asked us if we wanted her help in getting set up for the kangaroo care or if we were ready to do it ourselves. We decided to give it a whirl. So, we did his cares and then Jeff got ready in the chair. I managed to get Henry from the isolette to Jeff's chest without removing any tubes and wires. It's much nicer without having the PIC line to worry about.

Holly came on duty at 11PM. She helped us put Henry back into his isolette. We did his cares and then she weighed him. He had a weight gain of 40 grams. He now weighs 1190 grams.

I recently called Joyce to get the morning update. Henry was doing fine. He had one dip during the night, but other than that, it was an uneventful evening.