Henry's Preemie Primer

I know that Jeff and I often use medical vocabulary in our writing that we've picked up during our 89 days (and counting crash) course in neonatalogy. So I just thought I'd write up a short vocabulary list with definitions of things that are currently on our minds.

NICU: neonatal intensive care unit

Brady: short for bradycardia; refers to the heart rate dropping low; it is a concern when the heart rate drops below 100 for 20 seconds or more

Apnea: when the baby stops breathing

As & Bs: apnea and bradys

ROP: retinopathy of prematurity; eye damage caused by prematurity; happens when the blood vessels build up at the back of the retina, potentially causing the retina to detach

IUGR: intrauterine growth restriction or intrauterine growth retardation

SGA: small for gestational age

Desat: desaturation; when the oxygen concentration in the blood drops below a certain level; in Henry's case, the alarms go off when it drops below 85%; oxygen concentration is measured with an instrument called a "pulsocs"

NG tube: nasograstric tube, which is a feeding tube that goes through the nose

Anemia: low numbers of red blood cells in the blood; this is problematic because red blood cells carry oxygen to the body

Hematocrit: measure of the number of red blood cells in the blood

Mottled: discoloration of the skin suggesting circulatory distress; mottled skin looks blotchy and uneven

Gastroesophageal reflux (also called GER or reflux): stomach contents washing up the esophagus

Henry certainly has reflux problems, which I believe trigger a good number of his bradys. The stomach contents coming up the esophagus hit his vagal nerve, which slows down the heart. Reflux can be treated with medication as it is with adults. However, a quick google search reveals three possible side effects of such medications with preemies: (1) the medications tend to inhibit digestion by toning down the stomach acid; this is particularly problematic for preemies who are often malnourished, (2) the medications may predispose babies to fungal infections, and (3) there is some suggestion that reflux medications contribute to NEC (necrotizing enterocolitis), an intestinal infection potentially resulting in the death of sections of the intestines.

Jeff pointed out to me the other day that some of the reflux may be caused by the fact that Henry has an NG tube going down to his stomach, blocking the muscle at the top of the stomach from closing all the way. The muscle is called the lower esophageal sphincter. I'm hoping that if we can get Henry to take more feeds via breast, then we can add bottles into the mix and get the NG tube removed.