Tuesday, June 13, 2006

Last of the pokes

After I posted yesterday's update, Woody was visited by the surgeon who installed his broviac stent on day 22, who removed it. I knew that this step was coming since last Saturday, after I talked to one of the neonatologists, but it wasn't until seeing him yesterday that I realized what a great step this really was: for the first time since his birth, Woody now has no needles, catheters, or other types of lines piercing his skin. The reason the broviac was removed was pretty elementary. Now that the kid's up to full feedings, and is requiring fewer blood tests (because he's healthier), the risks of leaving it in (namely, blood clots and infections) outweighed the benefits. I am hoping that the removal of one more bit of niggling pain will help him be generally more comfortable, considering that his biggest problem on a day to day basis is his tendency to get cranky and fight against the ventilator. On this subject, Maggie adds that she would like to see the term "de-satting" added to the banned word list; this is what the nurses say when his blood oxygen percentage goes into free-fall. During these episodes, Woody also has a very disconcerting habit of turning blue, which doesn't exactly make us feel great. But I must hasten to point out that these episodes are more scary for us than they are harmful to him.

In fact, the growing frequency of de-sat episodes was predicted by Nurse J a week or so ago as a sign of, paradoxically, health. The more Woody gets strong and realizes that he can fight his ventilator by either holding his breath, biting the tube, or otherwise preventing the air from hitting his lungs, the more he can semi-intentionally create de-sat episodes. A similar issue has been posited as a reason for his slower-than-usual weight gain*: Woody is so feisty that he may be burning more calories just by flailing about than the average preemie. Which is why he's getting supplements for his feeding.

My mini-rant at the exceedingly patient Nurse M last night was handled graciously and professionally. It was explained to me that the fact that we see Woody handled as part of a 1:2 nursing ratio is a sign that they are not as worried about him, and that a 1:1 ratio is only used on the very smallest, sickest babies. I knew this on some level, but of course I want the best and most careful attention on my kid, as I'm sure most parents can understand. Woody is just not in a position where he is going to keel over at any second, and I am beginning to enjoy the talk about what happens when he is released, and what the criteria is for deciding when that point is. I certainly am very impressed by his progress. As for the grouping of his cares, I am resigned to having to remind people about this weekly or so. It certainly wasn't Nurse M's fault on that point; she wasn't the nurse there this morning, and she knows what to do implicitly.

We will be making an attempt to wean his vent settings again tomorrow; he has not been pushed since Friday, in an attempt to consolidate gains and because he's proven very sensitive to trying to turn down the pressure. The lungs are the last area where he still is not doing that great, and I'll be happy to see any progress at all.

*Woody's weight gain issue is not a big deal. A blip in his growth chart is more like it; today his weight was again up 30 g (to 860), and the professionals look at weight gain week-to-week far more than day-to-day.

**One other note-- I know I owe many, many people emails. I beg your patience! I do enjoy your comments and notes to me and will write you back. xox


At 5:04 PM, Anonymous aunt jeannie said...

Cheers to Woody for entering the no-poke zone!! What a trooper. As for his feisty attitude, who does he take after? He has good genes running through his body - and a ka-jillion prayers a day.

At 2:00 PM, Blogger Augmented Brain said...

You watch, he'll outlive us all. Even without the 20-50 years headstart we all have on 'im. ;)

- Auntie Val

At 3:47 PM, Anonymous jared said...

True dat Auntie Val - in my view, this boy is already everlasting. Though aren't we all? And in that sense, perhaps 'drow and the rest of us are mired in a dead heat. See, e.g., theory of an ever-expanding universe and the inevitable death of heat. ;)


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