Wednesday, March 11, 2009

Riding the 'J' train

Carolyn reports that all of Max's vomiting has produced a big pile of dirty clothes, which she had to leave at HSC because she went directly from the hospital to the airport. It's my responsibility now to make sure Max isn't wearing hospital clothes by Friday--an event that ranks with having a volunteer soothe your baby among the ways parents judge each other in these places.

Today was the first day of Max's new feeding plan. The HSC team first placed his feeding tube into his duodenum and then, later in the day, advanced it to the jejunum, making it an 'nj' tube. This is actually a tricky procedure, and requires an x-ray to judge distances. Max will ride the 'J' train--that is, get continuous feeds through his nj tube--from 6:00 PM to 6:00 AM. He will then have to rely on bottle feeding for the other 12 hours. I just phoned in to the HSC and nurse E. reports that Max is sleeping soundly and seems to be enjoying his ride on the 'J' train. (To be clear: no-one but me calls the nj tube "the 'J' train".)

Max's three bottle feeds today went pretty well. He took 20 ccs each time, and seemed to keep them down. Both Carolyn and the speech therapist noted that Max tends to be a motivated eater for the first few minutes at a bottle but that, once his initial hunger pangs are satisfied, he becomes less interested in eating. Presumably this is because he's become conditioned to expect a nice easy tube feeding after just a little work at the bottle. In the coming days he will, one hopes, adapt to the new regime where, during the day, he will have to earn every mouthful.

Finally, Carolyn reported that Max had a great physical therapy session today; he was smiling and happy throughout. He showed off his ability to track objects with his eyes both horizontally and vertically. (No word on his success with the tricky diagonal trajectory.) He also centered well, something we're really trying to encourage. It all left him extremely tired and he burrowed into Carolyn's armpit, his preferred sleeping position, for a long nap. Carolyn and I have each noticed that Max really works to get his head under our arms if he wants to sleep. I wonder if this is a reaction to the noise and light of the NICU? The HSC has a much calmer and darker environment during the night, so perhaps he'll get over this habit. We both like it quite a bit though.