A Very Small Bit Of Actual New Information
As I mentioned below, on Thursday afternoon we were hopeful that an extra couple of days in the hospital boarding room would enable Sarah and Ainsleigh to come home together on Sunday. That, I am sorry to say, turned out not to be the case. It is now Monday afternoon, about a week and two hours (give or take a weird government-mandated time change) since Miss Ainsleigh's birth, and she remains in NICU. The criteria for releasing her from NICU remain the same: she must be completely off of supplemental oxygen, and she must be able to take all of her nutrition from a bottle (ie, she must have no more need for IVs or feeding tubes). Since Thursday, there have been flashes of both good and bad news on both of these fronts.
As to the oxygen, the news is unequivocally good. The trend lines for her oxygen consumption are great. She spent all day Thursday on the oxygen. Friday, she was only able to keep her blood oxygen saturation up in the absence of the oxygen cannula for about half an hour. By Saturday night, this had climbed up to an hour or two. And sometime late Saturday night or early Sunday morning, she started tearing the cannula out on her own and living without it for hours at a time. (The nurses generally let the baby sleep for ~2.5 hours at a stretch, and during that time notice that the cannula has come out if and only if the monitor shows her blood oxygen content falling.) As of today, she's spending much more time without the oxygen than she is with it; even when she was feeding this morning she had no need of the cannula. This, as I say, is pure unadulterated good news.
The feeding picture is a little murkier. As I noted Thursday, the doctor wants her to take ~45mL of formula every three hours. Through most of last week, she was just way too sleepy to come close to this goal. At feeding time, she'd be awak for about the first ten minutes and in that time would take about 15mL of formula. You could then antagonize her just enough to keep her partially awake for a further 20 minutes and get her to take another 15 mL of formula. After that she was out, and the remaining 15mL of formula needed to be pumped into her via the feeding tube. This kind of behavior was the rule all day Wednesday and Thursday. On Friday afternoon, however, she suddenly perked up and took a full 45mL of fluid at three feedings in a row. I was really pleased by this. The NICU staff (both doctors and nurses) have been telling us constantly that there will be a day when her little lightbulb goes on and everything turns around abruptly. With three consecutive successful feedings on Friday, I thought we had reached that day and that the end of the NICU ordeal was in sight.
I was incorrect. Friday's burst of energy became Saturday's lethargic hangover, and we could hardly get her to eat anything. By Saturday evening the staff decided not to even try bottle feeding her at most meals; rather, at two of three meals Saturday and Sunday they let her sleep and administered the entire 45mL of formula through the tube. What's more, those feedings where we did attempt to bottle feed her were unsuccessful; we'd stepped all the way back in time to the feeding performance of last Wednesday.
Then this morning things seemed to be looking up again. As I mentioned, I'm back at work today. I stopped on the way in, though, to do the 8:00 feeding. The nurse let me bottle feed Ainsleigh, and she did extremely well --- much better, even, than she'd done on Friday afternoon. She took the first two thirds of the bottle in about seven minutes and the whole thing in about twenty. What's more, she seemed more alert and stronger than I've seen her before. Though the nurse told me that Ainsleigh'd "had a rough night" and that she had a bit of fever, I didn't get the impression that anyone was hugely worried about this. As I left the hospital, I was feeling better than I did all weekend.
I'm frankly not sure how my elevated mood has held up through the day. So that I might get some work done (and, despite my general exhaustion and my heart being elsewhere, I have gotten some work done), Sarah went to the 11:00 and 2:00 feedings while I stayed in the office. By phone, she informs me that the NICU staff seems much more worried about this fever business than I thought they were. They've already done another chest X-ray to look for fluid on her lungs. They've also drawn blood for another round of lab tests and started a new course of IV antibiotics. What's more, so long as she's sickly they're back to feeding her through the tube. We are, in other words, back to her condition as of Wednesday.
Despite all this, I'm hopeful that the current downturn is both slight and brief, and that come tomorrow or the next day she'll be back on track. We'll see about that, of course, and I'll keep y'all updated on her progress.
As to the oxygen, the news is unequivocally good. The trend lines for her oxygen consumption are great. She spent all day Thursday on the oxygen. Friday, she was only able to keep her blood oxygen saturation up in the absence of the oxygen cannula for about half an hour. By Saturday night, this had climbed up to an hour or two. And sometime late Saturday night or early Sunday morning, she started tearing the cannula out on her own and living without it for hours at a time. (The nurses generally let the baby sleep for ~2.5 hours at a stretch, and during that time notice that the cannula has come out if and only if the monitor shows her blood oxygen content falling.) As of today, she's spending much more time without the oxygen than she is with it; even when she was feeding this morning she had no need of the cannula. This, as I say, is pure unadulterated good news.
The feeding picture is a little murkier. As I noted Thursday, the doctor wants her to take ~45mL of formula every three hours. Through most of last week, she was just way too sleepy to come close to this goal. At feeding time, she'd be awak for about the first ten minutes and in that time would take about 15mL of formula. You could then antagonize her just enough to keep her partially awake for a further 20 minutes and get her to take another 15 mL of formula. After that she was out, and the remaining 15mL of formula needed to be pumped into her via the feeding tube. This kind of behavior was the rule all day Wednesday and Thursday. On Friday afternoon, however, she suddenly perked up and took a full 45mL of fluid at three feedings in a row. I was really pleased by this. The NICU staff (both doctors and nurses) have been telling us constantly that there will be a day when her little lightbulb goes on and everything turns around abruptly. With three consecutive successful feedings on Friday, I thought we had reached that day and that the end of the NICU ordeal was in sight.
I was incorrect. Friday's burst of energy became Saturday's lethargic hangover, and we could hardly get her to eat anything. By Saturday evening the staff decided not to even try bottle feeding her at most meals; rather, at two of three meals Saturday and Sunday they let her sleep and administered the entire 45mL of formula through the tube. What's more, those feedings where we did attempt to bottle feed her were unsuccessful; we'd stepped all the way back in time to the feeding performance of last Wednesday.
Then this morning things seemed to be looking up again. As I mentioned, I'm back at work today. I stopped on the way in, though, to do the 8:00 feeding. The nurse let me bottle feed Ainsleigh, and she did extremely well --- much better, even, than she'd done on Friday afternoon. She took the first two thirds of the bottle in about seven minutes and the whole thing in about twenty. What's more, she seemed more alert and stronger than I've seen her before. Though the nurse told me that Ainsleigh'd "had a rough night" and that she had a bit of fever, I didn't get the impression that anyone was hugely worried about this. As I left the hospital, I was feeling better than I did all weekend.
I'm frankly not sure how my elevated mood has held up through the day. So that I might get some work done (and, despite my general exhaustion and my heart being elsewhere, I have gotten some work done), Sarah went to the 11:00 and 2:00 feedings while I stayed in the office. By phone, she informs me that the NICU staff seems much more worried about this fever business than I thought they were. They've already done another chest X-ray to look for fluid on her lungs. They've also drawn blood for another round of lab tests and started a new course of IV antibiotics. What's more, so long as she's sickly they're back to feeding her through the tube. We are, in other words, back to her condition as of Wednesday.
Despite all this, I'm hopeful that the current downturn is both slight and brief, and that come tomorrow or the next day she'll be back on track. We'll see about that, of course, and I'll keep y'all updated on her progress.
posted by Brian @ 3:19 PM
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