Bath Night

On Tuesday, Debbie was Henry's day nurse. Henry's feeds were condensed to a two hour period (feed over two hours, no food for one hour). Debbie tested his blood sugar before his feed (after it had been off for an hour). It was 52, which is OK but kind of on the low side of OK.

Henry had an eye exam. Although the staff don't like it when the parents watch because it is a Clockwork Orange looking exam, I stayed and watched from a couple feet away. He has developed ROP (retinopathy of prematurity). Basically, ROP is when the blood vessels at the back of the eye build up. If too much build up occurs, then they can cause the retina to detach. Blindness is a potential side effect of ROP. Considering that Henry was so very premature and small for his gestational age, he was bound to get it...it was just a matter of when. The potential solution is laser surgery to zap some of the vessels and hence prevent detachment. But we aren't at that stage yet. Henry has a mild case (stage 1 in zones II and III of the eyes). And, hopefully, things will correct themselves. He has a follow-up exam next week.

At one point in the day, there was a power outage. All of the monitors in the pod went black. Luckily, the oxygen was set up on a backup generator of some sort. The backup can last 20 minutes. The outage messed up Henry's isolette, which kept going off, even though I could tell that the temperature was at the goal temp inside the box. After everything came back on, the monitors went out a second time. It was rather disturbing. Basically, as far as Henry's safety goes, the only thing he had to have was the oxygen. If his monitors are down for a while, it isn't great but he's been relatively stable for a few days (with the exceptions of some desats which he recovers from on his own). But, there are a lot of babies in the other pods who are attached to ventilators and such. Therefore, loss of power isn't an option.

Kathy was Henry's evening nurse on Tuesday. She does one 12-hour shift each week. She helped Jeff and I give Henry a bath. We changed and weighed him before the bath. Henry weighed 1650 grams. At first, the scale said 1680, but we decided that a 100 gram increase was highly unlikely, so we weighed him two more times (1650 was it).

Jeff took the lead on bathing Henry. Kathy guided us through the process. She took off all of his leads and pulsocs. So other than the feeding and cannula tubes, Henry was a free man. We wrapped Henry in some warm blankets. Jeff began with his hair. Henry loved having his hair washed. Then, we dried his head. Jeff placed Henry in the tub with the blankets around him. We slowly unwrapped him from the blankets in the water, and I washed him while Jeff held him upright. He loved it. However, when it came time to get Henry out of the tub, he was not a happy camper. He was really angry about being removed from the warm water. We wrapped him in a dry, warm blanket when he came out of the tub. As I held him, he decided to show his displeasure by voiding and stooling in the blankets and a little on me. The nurses in the pod were highly amused.

Word from the docs is that Henry only needs his blood sugar taken once a day. But Kathy, knowing my anxiety, asked me if I wanted her to take it again. She was afraid that I wouldn't be able to sleep. Very perceptive of her. She took it, and it was 60.

On Wednesday, Linda was Henry's day nurse. The word from the doctors was that Henry's feeds were to be given over 90 minutes rather than two hours. I held Henry for a couple hours as usual. The pod was really, really loud. The baby pterodactyl's family were incredibly loud. Like child, like parent, I suppose. Luckily, she finally went home at the end of the day. In addition, the mother of the baby next to Henry was on her cell phone all day (except when she was on the pod phone). There was one point where she was holding her baby and shouting to her baby's nurse what to tell her kids who were on the pod phone. I said something to Linda but she said, "Well, there's really nothing we can do but put Henry in the isolation room but he wouldn't be there long if someone needed it, like parents rooming in." Of course, there is another solution: People could STFU. Nurses should keep their voices low rather than using pod three as gossip central, and if guests are getting loud, nurses should tell the families that they need to keep their voices down. I told her that the staff is the problem. But she didn't know how to respond. As one can probably guess, I've had it. I'm planning to take it up with management today.

Jenny was Henry's nurse last night. It has been a long time since Henry had had Jenny as his nurse. She is a sweet, soft-spoken woman. She said that she had given him a thorough going over and thought he looked wonderful. She weighed him at 1690 grams. I don't know if it was her or Linda who did the test, but Henry's reported blood sugar for the day was 71, which is good.

The pod was quiet last night (busy but quiet). It was really nice (a different world since the Jurassic age). There were actually quite a few people in the pod, but everyone was keeping their voices low. The lights were dimmed. Henry's sats were excellent (hanging around 97-98% while Jeff was holding him). It was a really good night.

Compressed Feeds Begin

Joyce, Kathy, and Holly were on duty yesterday. Joyce had Henry down to .3 liters of flow on his oxygen. Dr. Tsai decided not to do the transfusion. There is some confusion as to whether or not his crit levels really improved. The 23.5 hematocrit levels were based blood work sent down to the lab, but when Holly had done it up in the NICU, the results were 25 last week. They recorded last week's as 23.5. This week, they didn't send it down to the lab and got 25.

I held Henry for a good part of the afternoon. Pod three is full. It is incredibly noisy with background conversations. Joyce had hoped to move him to a crib, but decided against it because of the noise factor. His body temperature has been fine.

Joyce started the compressed feeds at 1PM. This means that his continuous feeds were turned off at 12:30PM. Then, at 1PM, she gave him 30 mls to be given over a 2.5 hour period. She took his blood sugar at 1PM before starting up the feeds, and it remained relatively high (I think it was 67).

We tried breast feeding at 1PM (hoping that the stop on the feeds would make him hungry). He feed a little bit (just a few sucks). We'll keep trying.

Hans stopped by to talk about his liver. Some test results showed that Henry doesn't have enough calcium and phosphate. So they are switching his fortifier from the Enfamil to the Similac (which should meet or exceed his needs). Hans said that Henry will have fragile bones.

Jeff picked me up at the NICU during shift change. We went out to dinner and then came back around 7:45PM. The noise level was high (too many families in pod three chit chatting). The baby next to Henry has alarms going off all the time, so the nurses are desensitized to it and take FOREVER to turn the damn things off. Again, further sleep disruption for Henry. Henry was crying in his isolette when we got there. We changed Henry's diaper before Kathy weighed him. The diaper was huge. Henry was weighed at 1580 grams (so no change since yesterday). Tried nursing again, and he nursed for about a minute. I held him for a while. Then, Jeff held him for a while.

In some good news, the baby girl who makes the screeching pterodactyl noises all the time is going home soon. They really should have put that girl in the isolation room so she wouldn't ruin the atmosphere for everyone else. Her screaming fits wake everyone else up. And sleep is necessary for brain development. The father of the pterodactyl has told the nurses that he doesn't care if she screams as long as she is OK. Easy for him to say that. Meanwhile, she hurting everyone else's quality of life. I asked one of the nurses if she was in pain. They didn't think so; she's just an irritable kid. Again, seems to me that sticking such a child in an isolated area would have been to everyone's benefit.

I called the NICU this morning. Holly said that Henry was doing OK. His oxygen is at .4 liters of flow at 35%. He is still doing some surfing.

Sharp Shooter

Yesterday (Saturday), Joyce, Kathy, and Holly were on duty. Joyce thought that Henry looked good. We didn't really see a lot of our trio as their other patients were at the end of the pod, including one of the screamers, who requires a lot of attention because of gastrointestinal issues (born with her intestines outside her body, I think, which were put back with surgery).

I tried nursing Henry in the afternoon but he wasn't that interested. Joyce thinks that Henry's just about ready to go in a crib. But she's not convinced that I'm ready to have him go in a crib (which is an accurate observation). Henry is doing well with his temperature. Although he is tolerating noise better, I like the security that the isolette has to offer.

In the evening, Henry made another fountain while Jeff was changing him, so we had to get him new blankets. It's a bit challenging shielding the area from Henry's path, with him being in the isolette. We're hoping that the changing process gets easier when we have more room to maneuver when he's out of the isolette. Jeff held Henry in the evening. Holly weighed him when we put him back. He was 1560 grams. His skin looks quite pale; it is clear that he's still anemic.

Karen was Henry's Sunday day nurse. My mother held him for two hours in the morning. I held him in the afternoon. Before holding him, Henry made another fountain, which ended up soaking the blankets and hitting his pulsocs chords. Karen got a new pulsocs for him and changed out his blankets while I held him. I tried doing skin-to-skin with Henry, but I think he smelled the milk on me and cried until we tried nursing. He flailed around trying to latch for a while. He was clearly interested but not quite coordinated to do it. I ended up getting the pacifier and cradling him, which he liked.

Karen asked me what we had decided to do about his immunizations. I told her that Jeff was still looking into it. He has concerns about the shot protecting against diphtheria. Most nurses and doctors want the immunizations done. A few others, including Karen and his resident Hans, are quite understanding about our concerns and recommend researching our options. Karen has four children and had one child have a reaction to that shot (caused her discomfort for a few days after it). That child only got the first of the diphtheria sequence because of her reaction. The problem, of course, of not completing the sequence was that Karen was incredibly anxious because there were a few outbreaks of it in the community. Hans told me the other day that he and his wife decided to wait on their 32-weeker's immunizations until the baby was 2 months (age corrected) rather than 2 months (birth). Neither Karen nor Hans were saying that's what they'd recommend for Henry. They were just understanding about possibly waiting on the shots.

Holly was scheduled for a 12-hour shift tonight. Jeff went down by himself for some male bonding alone time. Holly weighed Henry at 1580 grams. His head circumference increased by 1.75 cm, so he's now at least on the growth curve when it comes to that. He increased his length by 1 cm. Holly tested his hematocrit levels, which were 25. So, we'll have to see if they decide to transfuse him tomorrow.

Jeff reported that the pod has gained a few new acquisitions. I'm hoping that they are quiet ones.

Joyce, Kathy, and Holly are on duty tomorrow.

Holding Henry

Jen was Henry's day nurse again yesterday. The pod was incredibly noisy yesterday. When I arrived, my mom was holding Henry because he'd been fussy inside the isolette. There was a lot going on in the pod. There are two babies on the opposite wall from Henry's isolette who are big and loud. On top of that, Karly, a baby on Henry's wall, had a few procedures done that made her upset. She's 2 months old and cries loudly too. She was being discharged yesterday, so there was a lot of commotion.

I held Henry was a while, but he was getting "disorganized" which is not good for his brain development. I think that the noise was getting to him. Jen had turned his oxygen flow up to .6 liters before I got there. I ended up putting him back in the isolette until things settled down. Henry got agitated inside the isolette, so I pulled him out again, and he settled in my arms for a couple hours. He did a little nuzzling.

We get different reports from different people about the levels of interaction that we can have with him. And it would be easy to choose the opinion that suits what the parents and family want to do (e.g., have a lot of interaction with the baby). Based on what I have read, I'm of the opinion that the noise should be kept to a minimum, since his brain is still laying down gray matter. Although he looks like a "normal" baby (just a lot smaller), every time he gets more stimulation than he needs, that's just mental resources getting diverted to the stimuli rather than to him laying down his neutral foundation. Basically, the research says that they continue to lay down gray matter (which is the stuff that connects areas of the brain to each other) for a month after they are born. Consequently, some development experts say that you really shouldn't overstimulate (e.g., sing, throw a lot of words at) babies even when they full-term. You should wait a month before singing to them (by then, most of the gray matter has been laid down). It would also be easy for people to misread the saturations levels and assume that if Henry's sats are OK, then he can be stimulated. But this is also a mistake. Just because he is tolerating interactions doesn't mean that he doesn't need rest and quiet time. The nurses often tell parents that they shouldn't use the monitors as a guide to their babies. And yet, I think that this is often what some nurses do (e.g., the babies' alarms in the pod aren't going off, so let's have a gossip session right next to the sleeping babies). By some nurses, I am by no means including Joyce, Kathy, and Holly in that group. I'm looking forward to the return of our trio (the Fab Three) later in the week.

Jeff came in the afternoon. We'd been planning to give Henry a bath. Penny was going to show us how to do it (there are ways to minimize stress when giving the little ones baths). But Henry was sleeping soundly with high sats, so we decided to wait. We put Henry back into his isolette around 6:15PM. Changed his diaper. They have stopped weighing the diapers on day shift. So we changed his diaper, but gone are the days when we get to predict how much it weighs. To make a long and gross story short, Henry made a huge mess while Jeff did the changing. It involved me having to wipe down the side of the isolette. Changing Henry will be so much faster and easier when we don't have the restricted movement that comes from changing a baby through port holes.

We returned around 9:30PM. Ashley was his evening nurse. After we changed his diaper, Ashley weighed him at 1550 grams. Henry was pretty darn fussy during the diaper change and weighing. He stopped crying when I took him out of the isolette and handed him to Jeff. But he was wired. He was hyper-alert, looking around. He almost looked paranoid. We gave him his pacifier, which did its job relaxing him. And he stared at Jeff for several minutes before drifting to sleep. Jeff was dozing off as well. So around 11PM, I suggested to Jeff that we call it a night. Henry was relaxed when we put him back in his isolette.

Surfing Again

On Wednesday afternoon, Jeff arrived about an hour after I left. My mom was there. Jeff held him until shift change.

Holly was Henry's nurse on Wednesday night. She weighed him at 1480 grams. Jeff held him for a while again. Henry had a good night.

Yesterday, Jen was Henry's day nurse again. Henry had been doing a little surfing. I held Henry for a couple hours. He didn't seem as crazy about the skin-to-skin. He was a little fussy. I ended up cradling him. After I left in the afternoon, my mom came and held him for a few hours.

Before I left, I ran into Hans, Henry's resident. Hans spent about half an hour with me talking about Henry's progress. We looked through some of Henry's old x-rays. We went through the ultrasound reports. It's unclear whether Henry really had a brain bleed back in May or whether that it was a measurement artifact. If it was a bleed, it was really small (6mm by 5mm on 5/8 and 4mm by 3mm on 5/15) in the cerebellum. Hans showed me Henry's most recent chest x-ray. You can actually see some tissue there. And finally, we looked at his abdominal x-rays because I wanted to see what the NEC looked like. I was curious because when we talked with Dr. Wispe on 6/18, he wasn't convinced that Henry had had NEC. Based on what I saw, there are some bubble like things on the x-ray but it doesn't look like it was in the lining. And it disappeared by the following x-ray. Hans said that Dr. Tsai said that such a pattern could be stool in the bowels, which people sometimes confuse as pneumatosis (bubbles). This is of course frustrating to find out now because the whole NEC incident put Henry two weeks back on nutrition. He was given TPN during that time, but one doesn't really gain weight on TPN. It's hard to grow with it. Looking back on 6/11, Henry showed no signs of distress other than a few As and Bs and a CRP test, which suggested infection, but the other tests didn't. Several doctors don't believe in the CRP test.

Jeff and I went to Babies R Us last night...just to get a sense of what's out there. Then, we headed to the NICU around 9PM. Ashley was Henry's evening nurse. She has taken care of him before...several weeks ago. She had weighed Henry at 1510 grams.

Jeff tried doing skin-to-skin with him, but Henry was pretty fussy. Jeff tried cradling him. Again, Henry was fussy. Then, I tried holding him. We ended up putting him back because he was doing some major surfing. His oxygen was at .5 liters of flow at 30%.

Henry did much better when he was put back in his isolette. I don't know if his surfing is brought on by too much stimulation today or not having his caffeine anymore.

I called the NICU this morning. Jen reported that Henry had done a lot of surfing through the night, so Ashley wasn't able to wean down his flow of oxygen.

Our plan for the day is to do less holding because Penny wanted to show us how to give him a bath this afternoon. We suspect that the bath will wipe out his energy reserves. We'll have to see how he's doing this afternoon.

Quiet Day

Henry was asleep for a good part of today. Jen was his day nurse. Although we had been told that they were going to test Henry's hematocrit levels today, they didn't do it. They decided not to transfuse based on the tests done on 7/6 (hematocrit at 23.5 and retic count at 4). It is a bit frustrating when we are told that they are going to do something and then they make decisions based on old information. I thought that Henry looked rather pale today, and he seemed more tired than usual. But I guess that they are waiting for him to have some bradys before they decide to transfuse. They decided in rounds to pull his IV (which Holly had already pulled out a few nights ago because it had gone bad). According to Jen, they don't want to transfuse because that would set back his red blood cell production 6 weeks. They also decided today to stop his caffeine prescription. He had been getting caffeine every day to help stimulate his heart rate and breathing.

I did skin-to-skin with him today. It had been a few days since we'd done skin-to-skin because he's been wearing outfits. Tried nursing, but he wasn't interested. I suspect that until he's slowly weaned off the continuous feeds, he isn't going to get excited about nursing. When Jen aspirated his stomach, he had 8 mls of breast milk in there. That's OK because preemies are allowed to have up to their hourly dose of milk in their stomachs when on continuous feeds. He's currently getting 9 mls of breast milk over the course of an hour. And the breast milk is still being fortified to 24 calories per ounce.

One of the frustrating things about the NICU (and I suppose medicine in general) is that we often get different instructions from different people. I was upset yesterday because in the discharge packet, they said that freshly expressed breast milk could only be refrigerated for 24 hours. But when we first arrived in the NICU, we were told that it could last a week. We had quite a few vials of breast milk in our fridge for 6 days, which were then moved to the freezer when it was clear that Henry wasn't going to use them right away (this was early on in our adventure). Henry has since consumed those vials of milk when we took the frozen vials into the NICU. I became concerned that they have been putting spoiled milk in his stomach. I asked Lisa G. yesterday, and she said that she wouldn't keep it for more than 24 hours. Then today, Jen thought it was a week, but she asked another nurse who said 48 hours. I ended up talking to the lactation consultant, Rene, who clarified that it was good for 1 week in the fridge at home (only 24 hours in the NICU because the NICU fridge is opened and closed 300 times a day).

My mom arrived at the NICU while I was holding Henry. I left around 2:30PM. She stayed with Henry. Then, Jeff stayed with Henry from 3:30PM until shift change.

I'm continuing to have problems with the insurance company (Schaller Anderson). University Physicians Healthcare sent me a bill for $170 that they said Schaller Anderson wouldn't pay. Basically, the anesthesiologist's bill for my c-section was $1020 for his time (64 minutes) and $170 for 2 units of emergency anesthesia. I called Schaller Anderson yesterday and they called back to say that I needed to call UPH to have them resubmit the bill as one item rather than two separate line times. My insurance is supposed to cover emergencies in total. Considering that the UPH bill is simply for the same event but broken down by detailed expenses, I don't understand what Schaller Anderson's problem is. The brain trust in the claims department categorized the emergency anesthesia line item as a "misc physical service." Under their codebook, that's usually reserved for cosmetic surgery (which they don't cover). I don't think that I would have been able to handle the c-section without the anesthesia (hence, it didn't seem cosmetic to me). I have a high pain threshold, but I suspect that the emergency c-section without the 2 units would have been beyond my pain tolerance capacity. I called UPH and asked them to resubmit the bill. According to them, the "misc physical service" category was done by Schaller Anderson's claim department. The UPH side clearly labeled the anesthesia as "emergency anesthesia 2 units." I considered calling my case worker Rhoda about this but her helpful advice is often to call the phone number at the back of my insurance card, which is of course what I did.

Henry's Fountain

Lisa G. was on duty yesterday. Henry slept a good part of the day. I came around 12:45PM. My mom was holding him. He was supposed to have an eye exam, but that was rescheduled for today. I held him for a while. He wasn't that interested in nursing. I put him back into his isolette around 3PM, so that I could get some lunch. When I came back up, he was still sleepy, so I left him in his bed.

Jeff and I came back to visit him in the evening. We ran into my sister Carolyn in the washroom. Aunt Carolyn changed his diaper. Henry put on a show for her by having a brady and then, in the middle of the change, making a fountain. His diaper was 32 grams. Kathy was Henry's evening nurse. She weighed him at 1450 grams. Jeff and I were a little disappointed because although we do not expect him to gain weight everyday, we don't like to see it go backward.

After the diaper change, Aunt Carolyn held him. We were lucky that the nurses decided to ignore the no visitors after 9PM rule. The pod was quiet, and there were no other families there, so it was easy for them to ignore it, which we appreciated. After Carolyn held him, I tried to get him to nurse, but he just wanted to sleep.

I suspect that his super sleepiness yesterday was brought on by one of two things: (1) he's going through a growth spurt, or (2) his anemia is getting to him. He was supposed to have a crit and retic test today. They usually do those blood draws in the early morning. When I called, Jen was his nurse this morning and she said no blood draws had been ordered or made, which is odd. So, I'm headed down there soon to see what they've decided to do.

Sponge Bath

Joyce, Kathy, and Holly were on duty yesterday. Henry spent the morning with Grandpa and Grandma Kenski. My mom reported that Henry had slept most of the morning. Joyce thought he looked great. He was put in one of the new outfits that my mom got him.

Joyce said that Jeff and I should start getting his nursery ready and find a pediatrician. So I plan to start looking today. Unfortunately, the NICU staff can't give out recommendations.

I tried nursing him around 1PM, but he ended up sleeping in my arms. I was glad that he was able to sleep through the pod ruckus. Two of the babies were being poked and prodded, and therefore were unhappy campers, letting everyone else know about it.

Joyce had an assignment for me and Jeff...go out and celebrate Henry doing well. So Jeff and I went to see "Transformers" in the evening. Afterward, we went to the hospital. Kathy had weighed Henry at 1480 grams. After changing Henry's diaper four times (consequently, I doubt that he was still 1480 grams), we took him out of his isolette. I held him first, and he did some nursing for a little while. Then, Jeff did some holding. After we put him in the isolette, Holly helped us give him a sponge bath, which Henry didn't mind too much. He seemed exhausted after it and went to sleep. It looked like he was going to have a nice deep sleep. When we left, the lights were dim and the pod was quiet (a rare thing).

Jurassic Pod

On Saturday night, Marcie was Henry's evening nurse. She had already weighed Henry by the time we got there. He was down 40 grams to 1410 grams. Jeff kangarooed Henry for a while. Marcie turned off all of the lights, so it was really dark in the pod (except for the light of the baby monitors).

I call Marcie before we went to bed. She said that Henry was quiet for about a half an hour after we left but then started to get fussy, so she held him for a while.

Around 8AM on Sunday, Jeff and I received a call from one of the pediatric residents in the NICU. She called to report that Henry had pulled out his feeding tube in the middle of the night. They think that it was out for about 20 minutes. For some reason, they ended up doing a blood test and found that his sugar levels had dropped to 34 and that such drops could indicate a sign of infection. They put an IV in Henry's foot, so that he could receive some dextrose. I told the resident that Henry has had infections where nothing was picked up on the CBC, but the CRP had picked it up. The resident said she would mention it during rounds to the attending doctor.

So, Jeff and I headed right down to the NICU. Joyce was surprised to see us because my dad had told her that my mom was coming in the morning (that was the original plan). I explained that we had been called by the resident about the blood sugar levels and possible infection. Joyce didn't think that there was as much cause for alarm because Henry, other than looking pale, hadn't shown any signs of problems. After rounds, Joyce had Dr. Edde to talk with us. Dr. Edde doesn't place much faith in the CRP test. The problems with running the CRP is that it takes 4 times as much blood as the CBC. So, we'll hold off on that testing until Henry shows signs of infection. The most plausible explanation for Henry's sugar drop may be that the stopping of the continuous feed while his feeding tube was out. Therefore, they will have to monitor him closely whenever they decide to condense the feedings rather than have them run continuously. Dr. Edde was concerned about the low sugar levels as the 50s is the preferred minimum on the sugar levels. At last check, Henry's crit level was back to 23.5 and his sugar levels were 56.

The census in the NICU was down to 19, so Karin had to shut down pod four. Joyce gave us some options on where Henry was moved. We could move to the isolation room. That's a nice space because it is a small, single room. The disadvantages are: (1) it opens up onto the hallway, which has a lot of traffic, and (2) if a baby needed isolation, then Henry would have to be moved again. The second option was pod three, or what Jeff and I have dubbed "Jurassic Pod," in a corner space. We cringed at Jurassic Pod because it has a few screamers in it. We call it Jurassic Pod because there is one baby in the pod that sounds like what we can only imagine a baby pterodactyl must have sounded like (which we could hear from pod four). I asked Joyce about pods one and two. But Joyce pointed out that although pod three has the screamers, pods one and two have the beeping machines. So, we decided to take the corner spot in Jurassic Pod.

The other big news of the day was that Joyce had me nurse Henry for the first time. Henry had been rooting. He did nursed for a couple minutes and then got tired. But it was a good sign.

Kathy came on duty at 3PM. Jeff and I left around 4:30PM. After we left, Kathy moved Henry into Jurassic Pod.

Jeff and I came back in the evening. Kathy had taken his head circumference, which read at 28.25 cm. That's a 1.25 cm increase over last week. He's almost on the growth curve now! He also grew 2 cm in length over the week.

I tried nursing Henry again. But he was too tired. Then, Jeff kangarooed with him. Holly came on duty at 11PM. We were going to give him a bath but decided to wait until the doctors decided about the blood transfusion. Kathy had prepared a new isolette for Henry before she left. Holly got everything in the isolette switched over. Once in his new isolette, she weighed him four times (1390, 1410, 1430, and 1430 grams). She was assuming that the 1430 grams was the right number. Jeff and I suspect it was a little lower because he has the IV in his foot. Holly mentioned that one of the reasons that they look at week trends rather than day-to-day fluctuations is measurement error with the equipment.

When we left, Henry was doing fine in his new bed.

Adventures with the Temp Probe

Last night was a good night. Kathy was his evening nurse. She and Jeff changed a diaper weighing 42 grams...rather impressive considering that he hasn't been on Lasix in a couple days. Jeff did some kangarooing with Henry. I called to check in on them and talked with Kathy. She received the lab results and his reticulation count was high (retic count of 4), meaning that his body has begun to produce red blood cells on his own. Consequently, he won't be getting the blood transfusion. But they will continue to monitor his hematocrit levels...just to make sure that his hematocrit levels don't get too much lower. The big news of the evening was that Henry gained another 50 grams (post-42 gram diaper). He weighed 1450 grams (3 lbs 3 oz).

Today, his primary Lisa G. was on duty. She'll be leaving soon to take another job in administration, so he'll get a new primary(ies). I am hoping that they are Joyce, Kathy, and Holly (who are currently associates, meaning that they won't get Henry if one of his primaries is on duty).

According to Lisa, Henry had a quiet morning. She checked his hematocrit levels, and they were 29 and 30, which is much better than 23.5. I changed Henry's diaper and did skin-to-skin with him for a couple hours around noon. He was pretty relaxed during the kangaroo session, which was good because it was rather noisy in the room. The mother of the baby next to Henry only speaks Spanish. So the lactation consultant had to translate a lengthy conversation between her and Lisa. I don't know why translators have to speak at a loud conversational level. There are signs around the NICU that say that babies can't sleep well when exposed to more than 55 decibels of sound. The average conversation is 60 decibels. Hence, you need to speak in a quiet voice when in the NICU. This is the third translator who has been loud, loud, loud in the past week. I finally asked Lisa to ask them to speak quietly. I had been holding a fleece blanket over Henry's ear for most of the conversation and was getting a bit tired of trying to balance (with one hand) holding the blanket over his ear, getting him to nuzzle, and holding the cannula tubes in his nose (the tape was coming undone on the tubes). The other hand was supporting Henry's body.

Henry didn't like being put back in his isolette. He kicked up a fuss and kept desating. To make a long story short, he went through three diapers in 10 minutes. It looks like he is digesting food well. Lisa suspects that he will not have put on weight when he is weighed tonight, given his output.

My mom came around 3PM. Henry's isolette was really warm. The temp probes were screwed up again. So we spent the better part of 2 hours trying to make sure that he didn't get too hot. The temp probe is a wire that hooks into the isolette on one end and attaches to the baby under a little duck sticker at the other end. This morning, Lisa reported that the temp probe temperature matched the hand held thermometer that is used under his arm. When I took his temperature before skin-to-skin, it was 0.7 degrees Celsius off. He was fine with the hand held thermometer, so things were OK. When we put him back into the isolette, the temp probe was about 1 degree off, which was frustrating. The isolette adjusts the temperature inside the isolette based on what the temp probe says. So when the temp probe doesn't work correctly, it really screws things up. Today, it made his isolette feel like a sauna.

Henry was fine when I left around 5PM. My mom stayed to watch over the temperature situation.