Signs are that Max didn't enjoy the accelerated feeding schedule he was put on. The original plan was to move Max to get 48 ccs over 30 minutes. The first time they tried this, Max had a fairly significant brady with associated desat that was apparently related to reflux. He only spit up a little bit, but Carolyn could see him moving his mouth and saw the peristaltic movements in his throat. The docs have since slowed down his feeding schedule to 45 minutes and he's tolerating it well, with residuals just on the order of 0.5 cc. Max continues to have very brief and mild desats and some episodes of tachypnia. However, Carolyn and I both think that Max seems much more comfortable now than he did even a few days ago, and his statistics also seem better.
Max's head circumference appears to have increased, with the latest reading, 35.0 cm, representing a +0.5 cm increase. Nurse N. hastened to remind us that small increases like this are normal and not viewed with alarm by the phrenology service. We can almost bring ourselves to believe it. Our spies in the NICU report seeing that Max was getting a head ultrasound; this will give us a reading on the change in Max's ventricles relative to his last HUS, taken a week ago Monday 12/1. Obviously we're hoping for little to no further dilation in the ventricles.
We had been dressing Max in a special line of infant clothing designed for preemies. The onesies come with velcro openings that make it easy to attach monitors and run IV/feeding lines into the little astronauts. (I find simply knowing that such fashions exist, much less owning several pairs, to be kind of depressing.) Carolyn reports that Max is starting to outgrow his preemie wear, which is in itself good news.
I'll conclude tonight with a picture of a stuffed elephant knitted by a colleague's spouse. The thought of knitting something like this makes my head hurt, because I couldn't pass differential geometry in college. We've christened the elephant "Mrs. P" to go with Felix's favorite stuffed bear, "Mr. P". (For some reason, Mr. P only wants to talk about the antics of his friends, Freddie and Fannie. Gosh those three are such rapscallions!)
