Sunday, March 20, 2016

Brady's and Desats, Oh My! - March 20th, 2016

This morning when I came in to see you, the resident from neurosurgery came to check on your little head. He felt it and said that it grew 1.5 cm over the last three days and said it felt kind of full, but soft. He said that he would leave it up to the NICU team to decide whether they wanted to tap into the reservoir.
Your nurse overnight made you a nice little sign with your name on it and attached it to your isolette so everyone knows who you are. It was so nice of her! Since it was close to your care time, I was going to do your care and then go get some breakfast. As soon as I did your care, the nurse asked me if I wanted to hold you and of course I did! This would be the first time that I would hold you since the 15th! So I missed out on breakfast, but it was well worth it. It is a little different at CHOP than at Virtua. The nurses have to get permission from the doctor for me to hold you, so I waited until the doctor called back. The doctor said she is a little hesitant for me to hold you because she doesn't want your temperature to drop much, but she said if I really wanted to, I could hold you for one hour only. The nurse said she thought that it would be fine, so I held you for an hour. Periodically she would come over to take your temperature to make sure that you were okay. You were a little chilly the first time she took your temperature, so she put another blanket over you. The next time she took your temperature, she said she didn't believe it, so she tried your other arm. She still said she didn't believe the temperature because you felt warm. However, since it was a few minutes over an hour, she said that it would be best to put you back in your little home. I definitely cherished every minute that I got to spend with you this morning!
The doctors did their rounds shortly after, and they said that they were going to tap into your reservoir. They would take out 10 cc's, and if you were not tolerating it well, they would stop. I went to lunch while they did that. When I came back, they said that it went well and they hoped that the brady's and desats would calm down. I also asked the PA why they switched the prongs and the nasal mask and she said that they switch every time they do your care because they try to prevent the breakdown of the skin. If they left one thing on you the whole time, since your skin is so sensitive right now, it would damage your skin. The doctors also said that they would keep advancing your feedings because you were tolerating them well. At midnight you will be up to 10 or 11 ml (I forget which one).
The doctor came back to see how you were doing since taking out the fluid and when he walked in you had brady'd. He was hoping they wouldn't be as frequent. He left, and I decided to take a nap. While I napped for a short while, you had clusters of brady's and desats. Your PA said that she didn't know why the nurses were documenting some of the "episodes" because they weren't true brady's. She said she wasn't worried about them because that is what preemies do.
Mommy, Mom-Mom, and Aunt Jessica went to dinner and when we came back, you were doing the same thing (brady's and desats). The doctor came in and asked if the same thing happened at Virtua when you had an infection. I couldn't remember if you had a lot of episodes when they first caught the infection, but I know they caught the infection early. He said that he didn't think you had an infection because you were moving all around and not acting sick at all. I told him that at Virtua, all of the nurses and doctors said that if they didn't notice the bands in your blood work that they wouldn't have known you were sick either. I told him about how you had E. Coli sepsis, and he said that he would speak with other members of his team to see what the next approach would be.
Another doctor came in and said that she was going to do blood work to see if they can catch anything. She said since you had a UTI and E. Coli Sepsis, that is what they want to check first, then urine, then CSF, if needed. She said they wanted to do the least amount possible to you. They ordered the blood work for 9 pm when they did your care again. I also asked about your newborn screening and the thyroid panel they said they would do, and they said they have to submit another newborn screening this week so we will know soon if it comes back abnormal again.
For your 9 pm care, I was able to bathe you again! I changed your diaper and you peed on the nurse! I took your temp and did mouth care as they were taking your blood. They said that my breast milk has oxytocin in it, so it helps you with pain. I stayed a little longer than expected, and poor daddy didn't get to go eat what he wanted to. I did feel bad, although he didn't think so.
You are hanging in there buddy. Let's pray for no infection and for a great night! We love you!! Stay strong Mason!