Monday, March 16, 2009

Carolyn passes the CPR test

Max received his first piece of mail at HSC from an admirer: the case manager came into Max's suite carrying the envelope and announced, "Max got mail!" It was a cute green froggy card that elicited a big toothless grin (from Max).

Many members of the HSC team have told us several times that a characteristic of preemies is their habit of falling asleep when stressed out. Preemies are born into a chaotic environment and they have only shallow reserves of strength. They learn to shut out the world by dropping off to sleep if things get stressful. We've often noticed Max "playing possum"--pretending to sleep while keeping an eyelid cracked to monitor his environment. Max was smiling and playing happily today, and did well in physical therapy today. Afterwards, it was time for the 3 p.m. feeding and he was drifting off to sleep just before it started.

Max took quite a bit of food by bottle today. At the 3:00 PM feed, Carolyn got him to take nearly 40 ccs. Moreoever, he was more or less asleep throughout. (Fun fact: Babies can eat while sleeping, a practice sometimes known as "dream nursing".) We were excited because this amount brings Max back to his pre-HSC maximum level of oral feeding. Interestingly, the speech therapist said that babies with severe reflux often show a sinusoidal pattern in the amount they eat by mouth over time. They'll start off chronically hungry, eat more over time to satisfy themselves, and then experience a bout of severe reflux pain, so they stop eating much for a time. Speech therapists prefer to see babies eat the same amount for an extended period rather than rapid increases.

Carolyn reports that the nursing staff at HSC appear obsessed with helping her meet certain educational goals. They are constantly asking whether Carolyn wants to learn how to give Max a bath, mix medicines, make formula, and, of course, learn CPR. Carolyn was bullied into watching the video over the weekend but didn't want to put Max down for the required hour of practical demonstration. Today Carolyn took the test while Max got his physical therapy. Carolyn and Max both did well.

Physical therapist M. was excited when she noticed the reddened tip of Max's nose. M. said that babies get this when they turn their heads a lot during tummy time. Indeed, this is true: Last Friday I watched Max drag his head from side to side to track a toy I was slowly trolling in front of him. At the time I was a little sad that he wasn't lifting his head to avoid nose-burn (and because head control is so important). But M. told Carolyn that the red tip is a great sign. It shows that a baby is actively moving his head around. What's more, I realized that Max is doing much better than his older brother at tummy time. While our new camera is being delivered, here is an archive picture of Max's older brother showing his deep displeasure at tummy time.

I hate tummy time!