Sunday, September 17, 2006
The only real problem i've noticed with the private room is the lighting, it's either all or nothing. Doesn't make for great pics.
Some good news and some not so good news today.
On the good side:
She's doing much better overall. Her feedings are going well with very little residual (milk still in her tummy when the next feeding is due to start), she's keeping a nice oxygen level in her blood (hereafter referred to as "saturation") when she's on 21% O2 ("room air" if you prefer) and, well, she's just looking good. She had a great nurse today who was nice and caring and knowledgeable and, dangit, just everything you want to have in a nurse, y'know? ENTD looked at her and decided that yes, she can be given a pacifier, big news for us but we'll have to wait and see if she accepts it. Thus far she's had very little positive experience with her mouth so she may reject a pacifier on the grounds that things in her mouth are just plain bad.
The plan now is to get her on something called a high flow cannula, basically the little tube that goes just under the nose and has the two prongs that poke into the nostrils and feed a little extra oxygen but this one will be blowing a little more air. It's like a cross between the regular cannula and the CPAP and the big advantage is that a cannula just gets taped onto the face and sits there, no fancy hat setup with the the rubber bands and the bubbling and the temperature probe. So she'll probably be a lot more comfortable and picking her up to cradle her on one's lap will cease being an Olympic event for teams of three talented professionals. Once she gets on the high flow cannula then perhaps bottle feeding will get explored. Only problem right now is that the hospital does not in fact have said equipment at the moment, they need to get it approved and then Tuesday can receive it.
Tracheostomy talk again. There is no unanimous opinion on the subject. Christine and i, of course, don't want to see our baby daughter receive a semi-permanent tube into her throat for reasons that are probably obvious, but we're not so overwhelmingly heartless that we wouldn't fully support that course of action if it will ensure the continued survival of our child. It may become a necessity if it looks like she's having trouble breathing, although the ENTD insists there is nothing obstructing her airway. Which means that if she's having trouble it must be a neurological thing. A tracheostomy could help with that. We'll just have to wait and see.
The gastrointestinal tube may be coming this week. We've been slowly getting ourselves used to the idea of this. She can get one and still feed normally afterwards, nothing is precluded by its presence. It's just there in case it's needed. One positive thing about it, amongst many to be honest, is that it would make me feel like her coming home is possibly imminent.
On the bad side:
She has been having some strange episodes of arrested breathing. Three times today while i was holding her and on another occasion today before i showed up she just stopped breathing. On one occasion her heart rate increased alarmingly, on the other three it plummeted alarmingly. On all four her saturation dropped. She came out of them all and then went on to be just fine but they're alarming. Their cause at the moment is unknown. They've not happened before today so the question is "what's going on?" The nurse's theory was that it's a bit of reflux, that a small amount of milk is coming back up into the throat which causes irritation which causes the throat to clench which, you guessed it, causes breathing to stop. This would make some sense seeing as how the only thing different today than yesterday or the day before, all days when she was on CPAP, is that she's getting almost full feedings. That leaves very much open the possibility of reflux. If that's not the problem then, well, i'd really like to know what else it could be since she's never done this before, not counting the time she spat up through her nose and mouth and couldn't breath. Although, on second thought, perhaps they're the same thing with differences of severity.
If it seems like a permanent problem with her then most likely they will send us home with a little monitor that we can hook up to her at home. Otherwise i don't know how we'd be able to sleep at night knowing that she could stop breathing and we'd never know.
Some good news and some not so good news today.
On the good side:
She's doing much better overall. Her feedings are going well with very little residual (milk still in her tummy when the next feeding is due to start), she's keeping a nice oxygen level in her blood (hereafter referred to as "saturation") when she's on 21% O2 ("room air" if you prefer) and, well, she's just looking good. She had a great nurse today who was nice and caring and knowledgeable and, dangit, just everything you want to have in a nurse, y'know? ENTD looked at her and decided that yes, she can be given a pacifier, big news for us but we'll have to wait and see if she accepts it. Thus far she's had very little positive experience with her mouth so she may reject a pacifier on the grounds that things in her mouth are just plain bad.
The plan now is to get her on something called a high flow cannula, basically the little tube that goes just under the nose and has the two prongs that poke into the nostrils and feed a little extra oxygen but this one will be blowing a little more air. It's like a cross between the regular cannula and the CPAP and the big advantage is that a cannula just gets taped onto the face and sits there, no fancy hat setup with the the rubber bands and the bubbling and the temperature probe. So she'll probably be a lot more comfortable and picking her up to cradle her on one's lap will cease being an Olympic event for teams of three talented professionals. Once she gets on the high flow cannula then perhaps bottle feeding will get explored. Only problem right now is that the hospital does not in fact have said equipment at the moment, they need to get it approved and then Tuesday can receive it.
Tracheostomy talk again. There is no unanimous opinion on the subject. Christine and i, of course, don't want to see our baby daughter receive a semi-permanent tube into her throat for reasons that are probably obvious, but we're not so overwhelmingly heartless that we wouldn't fully support that course of action if it will ensure the continued survival of our child. It may become a necessity if it looks like she's having trouble breathing, although the ENTD insists there is nothing obstructing her airway. Which means that if she's having trouble it must be a neurological thing. A tracheostomy could help with that. We'll just have to wait and see.
The gastrointestinal tube may be coming this week. We've been slowly getting ourselves used to the idea of this. She can get one and still feed normally afterwards, nothing is precluded by its presence. It's just there in case it's needed. One positive thing about it, amongst many to be honest, is that it would make me feel like her coming home is possibly imminent.
On the bad side:
She has been having some strange episodes of arrested breathing. Three times today while i was holding her and on another occasion today before i showed up she just stopped breathing. On one occasion her heart rate increased alarmingly, on the other three it plummeted alarmingly. On all four her saturation dropped. She came out of them all and then went on to be just fine but they're alarming. Their cause at the moment is unknown. They've not happened before today so the question is "what's going on?" The nurse's theory was that it's a bit of reflux, that a small amount of milk is coming back up into the throat which causes irritation which causes the throat to clench which, you guessed it, causes breathing to stop. This would make some sense seeing as how the only thing different today than yesterday or the day before, all days when she was on CPAP, is that she's getting almost full feedings. That leaves very much open the possibility of reflux. If that's not the problem then, well, i'd really like to know what else it could be since she's never done this before, not counting the time she spat up through her nose and mouth and couldn't breath. Although, on second thought, perhaps they're the same thing with differences of severity.
If it seems like a permanent problem with her then most likely they will send us home with a little monitor that we can hook up to her at home. Otherwise i don't know how we'd be able to sleep at night knowing that she could stop breathing and we'd never know.
posted by jonathan @ 8:30 PM
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