As far as episodes go, you had a few last night so they upped your cannula to 2. They did your blood work this morning and your hemoglobin went down (again) to 8.7. Your Retic was 3.6, and they like that number to be at about 4 or 5 (or higher). I was waiting for the doctors to round to let me know their plan for the day. I figured with those numbers, they would give you a blood transfusion.
For your 8:30 am care, we did NNS. You did well this morning. I held you until you were done eating, and then I put you back because I needed a nap. I took a nap (or closed my eyes at least) until the NP came in to speak with me. She said that she wanted to do a chest X-Ray to see if they could take you off of the cannula. She said that your legs were swollen and she thinks it is because you are raised in your bed because of your reflux. She wants to try Zantac for reflux and if it works, then they can lay you flat and get rid of all the swelling. She weight adjusted your caffeine, so maybe that will help you as well. They didn't tell me this - but I noticed your feeds are over 40 minutes now instead of 30. Speech came and said they wanted to start NS, but the doctor said to wait and see what the X-Ray showed. Since the X-Ray still had to be read, I went home quick after you 11:30 care (and after holding you for your feed) to get some lunch.
When I came back from lunch, the nurse told me that they saw fluid in your lungs. She said that they were going to start you on a diuretic for three days to hopefully get rid of the fluid in your lungs and your legs. I started making a list of questions to ask the doctor.
We did your care again at 2:30 pm and I did not hold you after because I wanted to be able to ask all the questions I had. The doctor came in and sat with me as I asked a page of questions. She basically said that you most likely will need a blood transfusion by the end of the week. She said your retic count is lower than they would like it, but they still want to hold off to see how you will do with these new medications. If at the end of the week your hemoglobin is even lower, they will most likely transfuse you. I asked how long they wait to transfuse babies and she said the lowest they let it get is 7 and then you get blood. I asked how long it takes for the reflux meds to work and she said 3-4 days. They will see if the meds are working around that time, and if they are not, they will take you off of the medicine. Your RR is high, making anything with speech difficult. You can't learn to eat when your RR is high because it could cause you to aspirate. We don't need that!
After your 5:30 care, daddy and I left. I just got off the phone with the nurse for tonight and she said you only had one episode today. She said that you now weigh 5 lb., 3 oz. I asked her why you lost weight and she said because of the diuretic. She said your diaper was just 111 grams, which is 3 ounces! You are getting rid of all the fluid, which hopefully will help you feel better.
I will see you in the morning. We hope that you have a great night and you start to feel better. Hopefully by this weekend you feel like a brand new little man! We love you and love how strong you are!