On Friday, I had to deal with some bumps. My visit during the day was fine - A was doing good, the nurse was even happy to tell me that his one IV was coming out, and that they would start giving him his daily caffeine dose through his feeds. (Yes - caffeine! Apparently, it helps preemies remember to breathe, and he went on it when he moved to CPAP. He'll probably stay on this for quite awhile.) That was exciting, since he's always had some sort of IV in during his entire stay in the NICU. The only disappointing thing was that I didn't get to hold him, since his temp was a little lower than the nurse wanted (recall the whole swaddling thing from the day before.) Not a big deal, we would be in later that night and would probably get to hold him then.
J & I went to dinner with some friends, which was a welcome change of pace, and headed back to the NICU for our night visit. A was still doing fine, and so John got to hold him first. We were going to switch off after about 10 or 15 minutes. Well, after only a few minutes it was evident he wasn't tolerating it...desats, o2 requirement went up, BLAH!!! The nurse put him back in the isolette, where he continued to be fussy and have small spells. That's when I lost it.
Was this the beginning of the downslide? Why can't we soothe our own
child? How messed up is it that HOLDING our baby could be contributing to
his troubles? What if he has to go back on the ventilator? What if we never get out of here? Why do I have to sit here an cry in a public where everyone in the whole damn room can see me? Why? Why? Why?
Oh, there was no stopping me. The tears kept coming. Our nurse (confused, I'm sure, at my reaction which was TOTALLY not proportional to the event that just happened) slunk away and left J to deal with me. J, as always, was awesome and let me just cry it out, reassuring me that no, we won't be visiting Andrew in the NICU when he is five years old.
We left shortly after, and wouldn't you know that a good night's sleep helped a ton? Saturday brought a whole new attitude for me, and I felt more prepared to face what the day would bring. Good thing, since Saturday brought some bumps for Andrew.
His day nurse for the weekend was Nurse M, the 30+ year vet. Every time we hear her voice, I think J and I just relax a bit, knowing he is in the best hands possible. Nurse M is a pro at IV's - the go-to person for the whole unit. One Doctor said to us one day "Nurse M...she could put an IV in that wall if you'd give her five minutes." We like Nurse M. We were both happy to hear her voice when we called for the morning update.
Apparently, A had had a bit of a rough night. First, he had pulled out his replogle again (the suction tube that goes into his stomach) so that had to be reinserted. Then, later in the night they noticed some blood in the tube. That could be caused by many things, from a minor irritation from the replogle (minor) to an ulcer (more serious) or who knows what else. Luckily, they think it was just a small irritation, b/c the blood changed to brown from red, then stopped entirely by morning shift. They are going to watch it to make sure it doesn't reoccur.
Because of the bleeding, they pulled his feeding tube while they investigated what was going on and to monitor the situation. Since they pulled the feeds, they had to reinsert an IV to give him fluids during this time. When Nurse M looked at the old IV site (left leg), she noticed a little nodule near the insertion point. Which they are also going to keep an eye on b/c it could be an indication of infection. Andrew has been lucky to avoid infections so far - they can be very serious in little guys and hard to treat. Again, monitoring is in order.
For the last bump of the day, when Nurse M put in the new IV (right leg), she blew a vein, and fluid got in under his skin. (Even the best IV nurse has off days) We found out about this during our afternoon visit. I'm not exactly sure of what happened, but now he has a series of small blisters near the site. Of course, these all need monitoring too, b/c if the blisters pop, that would be a perfect place for infection. Hopefully, they will go down on their own and scab up. Yes, monitoring is in order. Also, the increase in fluid made his little leg swell to about twice it's size! It looked really bad, but the swelling went down over the course of the day.
Wouldn't you know it that the next IV site they chose (right arm) started to leak soon after they put it in, and the night shift had to take it out and put another IV in his left arm. Poor guy - what a pin cushion! We were assured that all these issues were just bumps, which we can handle. Nothing about the day yesterday shook me up, I took it all in stride. I guess my melt-down the previous night helped! Now we just wait and see, and hope that these bumps don't turn into anything serious in the coming days.