Ill try for a Shorterish post. Going to try to catch up on some sleep.

First thing we check is the event log, only 3 events last night and this morning so far.

Nurse today is a primary!

Weight is 2503, loss of 7 grams.

We discuss yesterday’s events what was done,  what we think about it all. 

EPO has been ordered. Injections Mon, Wed, Fri for 2 weeks then recheck.

Dr. comes by to discuss switching feeds to run over 2 hours instead of 30 mins. This may help with reflux, which might be causing some of his events. He also mentions when a baby can’t tolerate a CPAP wean, some present by needing extra oxygen but n others present by eventing more. He won’t go back to CPAP of 6 yet. Need at least a good day and night.

Mom and I decide no binky dips in milk again. He likes his binky enough dry. Don’t need confusion if he does have reflux I want to difinitively identify the milk came out of his stomach if it does make its way out his mouth.

Head respiratory therapist also ordered to maintain as much pressure as possible. So really working on reducing leak and minimizing blow by times. And nasal prongs for as long as possible. She went to a conference where this approach worked for 1 baby… So she wants to try it.

Head respiratory therapist also decides because of the indentation between his eyes from his nasal mask that they will be doing just nasal prongs for a bit. Sometimes rainout is supposed to not be as bad because it won’t pool inside the nose mask then dump all at once if he tilts his head the wrong way.

Rain out is still a problem. Another respiratory therapist works on getting them to shut the vent above the bed. Talked to a manager who is also working on it. Has not been fixed by the time we left tonight. But at least it might be an option to help reduce rainout, maybe tomorrow?

Cares at 1100 as I’m moving in for a closer inspection to make sure he has nothing growing in his groin folds he manages to pee on me and his bedding his self defense mechanism didn’t quite work this time. 2nd diaper, mom and I do a bedding change. Nurse kindly comments on how independent they are. Started 2 hour feed.

Lunch.

Back to NICU. He had 2 events. Corrected with extra oxygen. Not as big of events.

1400 cares. Manages to pee on me and bedding again. Silly boy. Im done and go to wash my hands mom and respiratory therapist start laughing. RT is pooping loudly. That’s my boy. I give him some time then change his diaper again. He pees in the fresh one, so another clean diaper. He is getting frustrated with me, and very wiggly.  When we are finally done mom swaddles him up.  Binky time,  he sucks on his binky for a good 30 minutes.  I help by putting it back in his mouth when he accidentally spit’s it out.  But only when he signals for it by rotating his head around opening and closing his mouth or sticking out his tongue. Big smiles he is a happy boy!

He is really starting to act more like a big baby.

No skin to skin today, mom and I don’t want to add noise into the madness of trying to figure out trends, cause and effect, and how to get less events .

One event before 1700 cares. We were going to let him sleep through the care because he looks sleepy but he thought otherwise. So temp, 36.9 diaper. Binky time.

Dinner

Nurse tonight is a primary! Same as last night!

Hopefully they have a good night like last night.  She says she didn’t do anything differently,  it is all him.

I think that even though she and his other primaries don’t think they are doing anything different it is different for him. He for sure knows his primaries voices,  maybe smells, the way each nurse does cares is slightly different even though the same things get done. They each have a unique routine, babies like routines.

He is sensitive to everything. Primaries matter. For example If I’m stressed out about something and am talking about it to someone even quietly. He picks up on it and desats. That’s why we try and leave everything that we can outside of the NICU, he understands tone and inflection better than most adults I think.
2000 cares,   Respiratory therapist has to respond to a code elsewhere. Hopefully everything is ok.

Temp, diaper, he pees as I open his diaper. Another comes to do his cares this time around.  I manage to close his diaper in time, none got anywhere else. Fresh diaper, closing it up,  he pees again.  Fresh diaper.  Reswaddled.

Long binky time.

He had a much better day today than yesterday.  Wonder what changes helped or if he was just having a better day.

Please, Let the trend continue.