Last night, I took a nap while my mom and Jeff looked after Henry. My dad switched off with my mom and brought us Mexican food. Jeff and I switched shifts around midnight. Henry is feeding every two hours, and he's a slow eater. I was able to get the occasional 20 minute nap in here and there. I wanted Jeff to get some sleep, because I thought Jeff was more sleep deprived this week than I was. I believe that Jeff got a whole 5 hours of sleep. The alarm on Henry's apnea monitor went off because of a loose connection around 5:15AM. Jeff got up when it went off. I had actually intended Jeff to sleep a little longer. I got some shut eye an hour or so later.
During my nap, my dad arrived to watch over Henry for a few hours. Dr. Moussa called while I was asleep. She told Jeff that she hadn't yet figured out the supplementation issue (mind you, she took Henry off supplementation on Monday, and it was now Friday, and he was born a micro-preemie, just about all of whom require supplementation as a necessity). Jeff told her that we had decided to switch to Dr. Bianchi. Probably best that Jeff took the call. He is fundamentally a more diplomatic person than I am. When I was on the speech & debate team in college my freshmen year, I received an award for being "The Most Diplomatic" person on the team at the end of the year banquet. Those days are long gone, I'm afraid.
My dad spent the morning with Henry, and my mom took the afternoon shift, because I had a faculty meeting to attend at noon. Henry's home nurse, Michael Jones, visited around 10AM. Henry weighed 5 lbs 4 ozs. His oxygenation was tested with a pulsocs; it was 97%. Henry was fascinated by Michael's pulsocs cord. He watched Michael intently as he pulled the cord from his bag. Each day, Henry's focus seems to grow a little bit more. We mentioned the supplementation issues to Michael, who suggested that ProSoBee might be a potential solution; my mom's friend Michelle had also mentioned this formula, which she used on one of her children who had a dairy intolerance.
Before I left for my meeting, Dr. Bianchi called. He talked with Dr. Wispe late yesterday afternoon. Dr. Wispe said that Henry absolutely has to have supplementation. He said that if he couldn't tolerate the Enfacare, then we should supplement the breast milk with Isomil (a soy-based formula). I strongly suspected that this would be the case. After all, as I told Dr. Moussa on Monday and reiterated on the telephone on Tuesday, Dr. Wispe had said that Henry needed the extra calcium because of his metabolic bone disease. His bones are fragile and need the extra calcium that he failed to get during the third trimester. What little he had was sucked out of him by the Lasix. When I talked with Dr. Moussa on Tuesday, she said that she was concerned about it too. But if she was so concerned, why did it take her until Friday to call us back and still not have an answer? Although it is true that on Monday she called the GI doctor who said it was probably a milk allergy and agreed with her about taking him off the formula supplement, the GI doctor doesn't know Henry's file from Adam and wouldn't have the knowledge of Henry's other problems, like the doctors in the NICU have. The GI doctor only knows about Henry's reflux. And, frankly, he didn't spend much time with Henry (maybe 5 minutes while we were in the NICU). Moreover, the medical literature on children with chronic lung disease is pretty darn clear that supplementation is necessary for preemies because they tend to extend more energy while breathing than do those babies without chronic lung disease. Without supplementation, Henry won't gain weight.
My intuition to switch pediatricians as soon as possible has been validated. Henry Bianchi came highly recommended by the NICU's lactation consultant (Rene) and the discharge nurse (Laura). Plus, one of the nurses (Annie) had taken her children to Dr. Bianchi. Finding a pediatrician with background in extremely low birth weight (ELBW) infants isn't easy. There are a lot of pediatricians with good backgrounds in kids in general, but ELBW infants aren't the same as other preemies. There are a whole host of issues that come along with them.
Hopefully, Henry won't have a soy allergy too. That would be very problematic. As for now, we won't worry about it. We'll cross that bridge later if it becomes necessary. I'm hoping that Henry's milk allergy is relatively brief. Jen (cousin) told me that one of their children had a temporary milk allergy. I'm hoping that is the case with Henry. After all, he'd been taking a milk-based formula while in the NICU for several weeks without any bleeding to our knowledge. It also be that I just overdid it in drinking too much milk last week, which then just pushed Henry over the edge on the amount that his system was willing to tolerate.
The meeting at my department was longer than usual (over two hours and 45 minutes). As far as meetings go, it was a good one. My department tends to be meeting-adverse, despite the fact that everyone has a good personality and enjoys each other's company. It's a small group of eight faculty members. I was surprisingly focused during the meeting. As soon as I left the meeting, however, I called to make sure Henry was OK. He was fine. My mother had switched with my dad at this point.
I stopped by Babies R Us to get the Isomil. And, I ended up buying some dietary supplements for me. I've been taking Expecta as an Omega-3 fatty acid supplement since the beginning of second trimester. Because I'm no longer eating dairy, I decided that I needed an animal source as well. So I selected a supplement that has some fish oil in it. This is a big deal for me because I haven't purposefully consumed meat, chicken, or fish since I was in third grade (when I became a vegetarian).
Jeff and I still haven't figured out how we are going to handle our work schedules. My hours are more flexible than Jeff's are, but I still need solid blocks of time to get my work done. Guess that will be one of tomorrow's tasks.
Henry apparently had slept a good deal of the day. By the time my mom left, however, he was very alert. He had a feeding marathon that lasted two hours. He again had some flecks of blood in one of his stools tonight. It wasn't much. Just a few flecks, each about the size of a felt tip pen dot. Considering that it could still be residuals from cow's milk in my breast milk (it hasn't been 10 days since I've stopped eating dairy), we've decided to hold off on calling the doctor quite yet.
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