Tuesday, January 27, 2009

Evening Update (Tuesday 1/27)

An eventful day for Max in the NICU. The first feeding after Carolyn arrived--the 8:30 AM feeding--went smoothly. Max was asleep on his stomach at the time (a perk of the NICU--none of this "back to sleep" nonsense when you're wired up like Neal Armstrong). He got his vitamins--Carolyn's bĂȘte noire and usual explanation for Max's vomiting--in the 11:30 AM feeding. However, nurse N. went the extra mile and cleverly diluted the vitamins in his milk so that Max didn't get the normal concentrated dose of cheap tequila or whatever it is they make those vitamins out of. As a result, he tolerated them well.

Max started showing desats after he woke up during his 11:30 AM feeding. These may have been the result of a misplaced pulse oximeter, or they could have been signalling real respiratory distress. Nurse N. retaped the red light bulb that is used to measure his blood oxygen saturation and the frequency of his measured desats decreased. Real, or artifact of miscalibrated equipment? We'll never know.

However, throughout his 2:30 PM feed Max seemed quite uncomfortable. He was shifting position on Carolyn's lap frequently and complaining (in his baby way). Around 4:00 PM (i.e. at the end of his 90 minute feed) he puked up 20 to 30 ccs, out of the 70 ccs that they had fed him. After this he felt much better. However, he did have what looked a real desat at the same time.

Over the course of the day, Carolyn gave him a pass on his workout routine. (Nurse N.: You can't go to the gym every day. Amen sister.)

The good news--the news that makes up for his vomiting and desats--is that Carolyn and the nurses have been working with Max on his pacifier. He seems to have rediscovered the joys of using a pacifier. This is important for his oral competence and his plan to eventually break out of the NICU.