Our days are starting to fall into a routine. I work in the morning, either from the office or at Amanda’s and then I head over to see Jack around 2:30. I’ll usually stay until his 6pm feeding and then Arch meets me and we spend some family time together.
To minimize interuptions to Jack’s rest, and because Preemies are so sensitive to stimulation, the nurses cluster: feeding, suctioning, respiratory therapy, temperature check and diaper change into “care groups.” These care groups happen once every three hours and coincide with the times when he is most likely to be awake. So, if I time it just right, I am there for two feedings and sometimes (like today) I get to hold him.
I also get to change his diapers, which was not a particularly pleasant task this afternoon. I’ll just say this, we had to air out the isolette.
In a nutshell, Jack had a very good day. Yesterday was a bit iffy as he was still having a ton of Desatts even on the vent. But today, today he was like a different baby. He is up to 15ccs of milk and was remarkably calm during his 3pm feeding. While we were chilling (and waiting for the isolette to air out) Dr. Paley, one of the chiefs, came over and talked me through the next steps in Jack’s care:
1) The team would like to wean him from the vent directly to a Nasal Cannula, skipping the CPAP step altogether. What this means is that they would like him to not rely on pressurized air to keep his lungs open. We are weaning him off the vent by lowering the air pressure every day. Today they lowered him to an air pressure of 15, from 20 (room air pressure is 10). If he can tolerate that level for a couple of days, while remaining stable, he’ll be extubated by early next week.
2) His breast milk feedings account for 1/2 of his daily nourishment. He is also recieving an IV drip, called a TPN, that provides the other half. As we slowly increase the amount of breastmilk he receives they will start adding some human growth fortifyer to get more calcium into him and plump him up. AND as the breastmilk increases they’ll come down on the TPN until he is recieving all of his nutrition from breastmilk. This could happen in the next 2 weeks.
3) He will start getting his Synagis shots this month. Synagis is a monthly shot that Jack will recieve during cold & flu season. it provides some protection for him against RSV. More on RSV will come your way in upcoming posts entitled “hand washing and other necessary evils” AND “why my baby hates your baby”
4) He is scheduled for his first eye exam next week. Jack is at risk for ROP, a vision condition that most Preemies have. Since Jack can’t read an eye chart (YET), the pediatric opthamologist basically dialates his eyes and then checks out the condition of his blood vessels. No word on whether he has to wear those crazy old lady sunglasses afterwards.
In short, the doc was (more…)
