Tuesday May 27, 2008

Based on the number of people in the hall at the hospital, we can tell if it is a weekday, as it sure feels much busier. However, it was a typical day in the NICU.

But on this blog, it's guest blogging day by Joe! Yeah, I've been quiet so far, and we'll see how long it takes me to wear out my welcome. The girls had a good night of boring growing, which is the best kind of night. I got to hold Maggie today, and she's learned to cry, finally. I'll try to get a recording of it to share. She's almost a normal (but tiny) baby today - I have her PIC line after it was removed! This was her main IV that ran from her lower arm almost to her heart. It's a tiny tube of silicon (like 15# fishing line diameter) that was threaded through her vein. I held her for about two hours, she drooled and squirmed and keeps trying to say "Dada", she'll get it right soon. Maggie's also enjoying her fortified latte bongs - a syringe of fortified milk with caffeine and things like synthroid (for her thyroid). You just hold it above her and it glugs into her tummy. And seeing her in her isolette breathing freely on her own (briefly) with no IVs, just taped on servos and probes, is wonderful.

Evie has even bigger news! We went to visit after 5:00, and we actually panicked when checking out her settings (there's lots of numbers to check when you visit) - her vent had a breath rate of ZERO! Carrie launched into appropriate panic when Patti said "She's on CPAP!" Yay! Continuous Positive Air Pressure is no fun for babies, but much gentler on sick lungs than the ventilator breathing for them. And Evie finally handled her breathing well - she hated being at the oxygen saturation she was supposed to be at - 80-89% to get her O2 to breathe, but not too much to burn out things like alveoli and retina - those we need. She always hung out 77% and then would jump to 91% and back to 76%, with her poor nurses constantly manning the oxygen dial. But on her new CPAP, she was doing an even 87% or so. Joy! Patti did a little "I told you so" dance - she thought Evie should have been off the vent on Sunday. Evie's still on the bad tasting TPN and lipid IVs through her PIC line, though, so she's more wired than her sis.

I'm bummed Carrie missed seeing the endotracheal tube removed - it's a kick. They pull the tape off the bar holding it in, and it pops out. Simple as that. Putting them in is way, way trickier. Then a nurse waves a antihistamine around in front of her (which gets the little patient totally wired), and the put on the scuba-style CPAP nose prongs of discomfort. But Evie doesn't seem to mind, and didn't fight with preemie fury like Maggie. Preemie fury isn't too scary, or long lasting, but is impressive on some level.

Other stuff - darn ET breathing tube on Evie gave her an infection - so she's on antibiotics while somebody tries to grow fuzzy stuff from it in the lab. But with the tube gone, she should bounce back quickly, and she's still the chunky one. If you can be chunky at 2 pounds 11 ounces.

Also, transfusions. Evie got 20 CC's of irradiated O- red blood cells yesterday through her PIC line. Thank goodness for the Internet - you can really find out what's up. Turns out red blood cells can handle a TON of radiation - like 3000 RADs don't phase a red blood cell at all, where if you get more than 10RAD yourself in a short time, you'll probably want some iodine and medical attention. But the irradiation kills white blood cells (leukocytes). This is good because leukocytes from a person with a functioning immune system (adult) put in an infant without a functioning immune system will tend to start replicating in the infant's bone marrow and attacking organs. That's called TA-GVHD, catchy, huh? But easier to say than "transfusion associated graft versus host disease". Whatever you call it, it's pretty much fatal once you have it. So we like irradiated blood for our girls.

If you read this far and want more medical jargon, post a comment! If you want crude jokes, or sex ed for preemies as taught by nurse BJ, post a comment, too.