On the tilted bed

Carolyn and I split the day at the NICU between us. I went in the morning, and found Max tightly wrapped in a blanket with only arm free (see picture at the bottom of this post). I held him for a couple of hours while he snoozed. (We did some arm exercises with the one unswaddled arm.) Before I left I changed his diaper and took his temperature. It's always a rodeo, made somewhat more difficult by the radical incline the NICU team have Max sleeping on. He woke up in the middle of it, and I took the opportunity to do some leg exercises too.

When Carolyn got there Max was back to sleep, but woke up when she picked him up. She took the opportunity to do more exercises. He fell asleep in the middle of a leg lift.

No medical news to report. His breathing seems a little more comfortable, thanks to the combination of ND tube, Lasix, and, maybe, radically tilted bed.

Lasix works

Nurse T. (a first-timer with Max---we're always surprised to meet someone new after almost three months in the NICU) reports that Max is having a quiet night. He was awake and alert for his 8:30 PM diaper change but is currently snoozing. The Lasix has continued its work all day and Max has had a series of very heavy diapers and lost 45 grams over the past 24 hours. Nurse T. got Max to suck on a pacifier. His sats remain in the high 90s, suggesting that either the Lasix or the ND tube is in fact giving him some respiratory support. However, Max is still prone to sudden but brief drops in his oxygen saturation. We think he's doing a little better on this front too, though.

Even after losing some weight, Max now weighs in at a hefty 3.3 kilos, or 7 lbs 5 ounces. One of the outfits Carolyn is dressing him has paws for feet. Also, Max now has several frog-themed outfits.

Original due date

Today marks both Max's 10 week anniversary in the NICU and Max and Ada's original due date. In one sense, Max is now a full term baby (and at about 7 pounds he certainly weighs as much as many terms babies). In reality, though, as nice as the NICU is, a day in the NICU can't compare with a day in the womb.

Max seems to have his days and nights swapped around, so that last night--when Carolyn and I were at home--he was quite active but today--with Carolyn there all day--he was quite drowsy. Needless to say, we'd prefer Max to be the same wake/sleep schedule as the rest of the world (college students excepted). Because Max is more active at night than during the day, the nurses are getting to know him a little better than we do. They report that he likes to be picked up to be soothed.

In medical news, Max gained more than 100 grams overnight but his diapers were relatively light, suggesting that he's retaining fluids. This can contribute to difficulty breathing, so the NICU team put Max on Lasix.

Carolyn tried exercising Max and getting him to use a pacifier. In both cases he seemed more interested in sleeping than in exercising.

Carolyn did learn an interesting fact about Max's condition and the NICU team's plan for him from physical therapist S. She said that (I'm paraphrasing) when it comes to the suck-swallow motion, Max's form, his technique, is fine. However, his endurance is poor. It takes Max a lot of effort to suck or swallow, so that he quickly becomes exhausted. Why is this? Because Max is devoting a large amount of effort to simply breathing. The plan is to let Max's lung capacity develop by feeding him with an ND tube, which ought to cut down on food aspiration. S. said that all babies learn to suck and swallow; the most urgent job for Max now is to get strong.