Surfing and a Blood Transfusion

On Saturday night (6/9), Melissa J. was his nurse. She was excited to be assigned to Henry. She signed up as one of his primary nurses but hasn't had him in a couple weeks. Henry's weight was down to 810 grams. When Melissa checked his stomach, the residuals looked slightly green, but not enough to discontinue the feeds. I did skin-to-skin with Henry, and it went well. It was quite relaxing; I even drifted off to sleep for a bit. Jeff said that Henry's sats and heart rate looked good during it. At one point, Henry had a small desat when the nurses' chit-chatting got a little loud. He recovered quickly, but he's clearly still noise sensitive.

On Sunday (6/10), Mary was his day nurse. I wanted to do skin-to-skin, but the recliner was being used. The nurses often offer to get a rocking chair when the recliner isn't available, but holding Henry in an upright position isn't that good for him (according to some people). One nurse had told me that the upright position puts some strain on his lungs. Seems rather odd that they only have one recliner in the entire NICU; apparently, they have others "on order," but they have been "on order" for months.

While I was there, Henry had an apnea/bradycardia that lasted about a minute. As near as Mary could tell, he had been bearing down to produce a stool, and he must have held his breath during it, which resulted in the episode.

Mary checked Henry's stomach for residuals. She found just a little bit. It didn't look green. Mary said that they have started adding calories to the breast milk to help Henry gain weight. And, they gave him some vitamins. One problem with the vitamins is that it can turn stomach contents green, which makes it difficult to analyze the stomach contents. You don't know if the stomach residuals are green from bile traveling in the wrong direction or from the vitamins.

In the evening, Marcie was Henry's nurse. Jeff and I hadn't met her before. Henry weighed 820 grams. Jeff did skin-to-skin with him, and it went well for a while. Then, Henry had several desat episodes that required Marcie to bring out the oxygen mask used during blow-bys. Marcie suctioned out Henry's mouth and got some goop out, but that didn't prevent further desats. At one point, it seemed like something wasn't quite right with the fit of the cannula; we heard something that sounded like a leak. So we decided to put Henry back in his isolette. Marcie tried to rearrange his cannula tube and feeding tube. Henry had a rather big desat in his isolette where his saturation levels at one point went down to 45%; even though it only lasted a second, it was still disconcerting.

Because Henry was already agitated (more agitated than we'd seen him in a long time), Marcie decided to do his cares and take his blood tests for the evening. While Marcie was doing the blood work, Jeff and I went downstairs for a snack (around 11:20PM). When we came back about 20 minutes later, we found Michelle helping Marcie put in an IV into Henry. Jeff asked what was going on. Marcie said that Henry's crit levels were 26.5. His crit levels had been low for a while, so I can't say that I'm surprised. They started up a blood transfusion. Mary Ann, the nurse practitioner, talked with us. They are hoping that with the added red blood cells, Henry's body should have an easier time carrying the oxygen. When we left around 12:45AM, he looked OK. He is going to be closely monitored this evening. We very much hope that they won't have to put him back on the CPAP.