July 25, 2006

Definition of "bradycardia" (or "brady") Ohhh, just remembered a conversation with one of the NICU nurses from several days ago. She was telling us that when Michael does come home, we need to keep in mind that he is still a preemie and we will need to take some extra precautions, especially when it comes to visitors. We should limit the number of visitors at any given time, as preemies can easily become overwhelmed. Additionally we should keep up with a good hand washing routine.

I don't think I have ever gone into the routine we go through each time we enter the NICU. The first step is picking up the phone outside of the locked door and telling the receptionist who we are. Not until we do this can we even enter the NICU. After we get let in, we have to sign in. Then we start the hand washing. You have to remove all jewelry on your hands and arms, rings, watches, bracelets, etc. Then you open up a scrubbie sponge (one side is a sponge, while the other is a bristled scrubber) and get it wet. Then you apply a generous portion of this special antibacterial soap to the sponge. After wetting your hands and arms you begin scrubbing. And scrubbing. And scrubbing. Remember hearing that you should wash you hands for at least 20 seconds? Remember doing that and thinking how long 20 seconds is? Now wash your hands for at least 3 minutes! Up to the elbow! We have gone through several layers of skin on our hands and arms during these past several weeks. Though skin really is overrated. Once you scrub in for these 3 minutes, then you can rinse and dry off. And then you can go into the room to see your child. And these steps apply even to visitors who will not be holding any child. Everyone entering the NICU must follow these steps.

Now granted, she said we didn't need to be quite that diligent when he comes home. But we should adhere to having all visitors, even if they are not going to be holding Michael, wash their hands for at least 30 seconds. This makes sure that they do a good job of getting their hands really clean.

Additionally, she recommended that anyone who even has a hint of a cold or sniffles stay away. Far, far away. Preemies retain their immature lungs for quite a while, so what would be a cold to us could become very severe for him. She also recommended getting a box of masks for visitors who might have been around people who were sick.

On top of all of that, the nurse at the pediatrician’s office recommended not really taking him out to any populated area for at least six months. Even church. Six months would put it at the end of December. Her recommendation was to pretty much keep him in a bubble.

Now, I don't know if we will be going that far. However, I do believe that we will be trying very had to adhere to most of these recommendations. So don't be put off if we tell you to stay away if you are sick, or tell you to do an extremely thorough job of hand washing if you come over for a visit. We are just going to be doing our level best to give Michael the best chance he can to get strong. Sorry if that bothers anyone. That's just the way it goes.

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Wow, what a long missive, and I haven't even gotten to what happened today! Michael tried having a bottle at 9:00a, 12:00p, 3:00p, and again at 6:00p.

At 9:00a, he wasn't really awake, so only had about 15ml of his 55ml feeding. At 12:00p, Gretchen was there and fed him his entire 55ml bottle. And then at 3:00p he had almost the entire bottle. So at 6:00p, when we were both there, Gretchen tried breastfeeding again.

We decided that it might be good to have one of the lactation people come down again to see how things are going. She listened to what was happening with Gretchen's pumping and what Gretchen was doing to help her milk supply. After hearing the whole story, she was extremely positive about what was being tried. That Gretchen was doing everything she can, and she is in the middle of an extremely stressful situation. Also it is still rather early, so Gretchen is doing a great job and couldn't be doing anything more to help.

Also, Michael is still several weeks early to be getting the whole breastfeeding thing. Bottle feeding is a completely different ball of wax. It is a very easy thing for babies to get the hang of because they don't really need to do anything. Where breast feeding takes a lot of coordination and effort. Given that she said that Michael was also doing extremely well, and looked to be ahead of the game. At this try he actually got about 4ml. A pretty good go.

She did recommend giving him chances at breast feeding at non-feeding times, just to get some "play" time, with no expectation of any sort.

After this try at breast feeding we decided to try a bottle for the rest of the feeding. Well, that was pushing just a little too hard for Michael. He seemed to be a fine job. That is until he "bradied". The full term is something like "bradycardia". This is when your heart rate slows down below a stable level. For babies, this is when it falls below 80 beats per minute. Michael's heart rate is normally in the 130 - 150 bpm range. So his fell to 76 bpm at it lowest, and he started to turn blue. The nurses came in and gave him a little oxygen, and said that it is possible that he might have choked a little.

It sounded like he was still breathing, but it was a little more labored than normal. They said it would not be uncommon for him to be tired from his big day of feedings and just forgotten about all of the steps involved with eating. We finished his feeding using the ng tube. No reason to push it. This seemed to be his way of letting us know that he is not ready to try all of his feedings by mouth.