Rolling on a river

Woody is on the pattern that Maggie and I love with the nurses: primary on during the day, primary on at night. What this means in a nutshell is that the nurses that are the most invested and familiar with him are the ones that are taking care of him. Obviously, with 200 or so nurses that work in the NICU, he can't always have one of "his" nurses all the time, but every so often we run into a few days where he has almost all primaries, and we just feel so very comfortable and safe with his care during these times.

Of course, I want to make it absolutely clear that we trust all of his nurses, and I've never said anything to a charge nurse or a doctor to complain about any of his care, but there's an extra bit of peace of mind that goes along with knowing that he's being taken care of by someone that knows him so well. And as we've gone along, more nurses have signed up as primaries or as "friends", which is just a step below primary in terms of the scheduling priority, and that means that his odds of getting a familiar face has gone up.

Tonight I got to hold him after work, which is always nice, but it was especially good because he's been in a bit of a cranky pattern the last few days. The last time I held him he was having the big swings in O₂ saturation, and Maggie was pretty nervous during that time, and it just wasn't that pleasant. Tonight his dips in his sats were much smaller, and I was able to just enjoy the experience and talk to him and sing. Woody especially likes the deep, low tones of songs, which has led me to try to come up with the lowest register songs I can come up with to sing to him. Of these, they fall into two general categories:

• Johnny Cash songs; and


• Songs I learned while singing in the barbershop chorus during high school.

Johnny Cash songs are easy enough, considering that I listen to them in the car.* The old barbershop standards, however, can be really challenging, because I barely even remember the choruses to most of them, much less the verses. Tonight I did my best to sing songs in a thematic arrangement, and that theme was "river". So I started with "Deep River", then went to "Swanee River" and on to "Big River" finally finishing up with "Proud Mary." I think he forgave me the absolute slaughter of both lyrics and music that I perpetrated, as he stayed pretty quiescent throughout.

I am feeling pretty good about his progress, as he continues his rather meteoric weight gains. He's up to 1225 grams today, which is about 2 lbs 11 oz. I'm keeping my eye on the chub, as it's one of three prongs of the extubation criteria. Roughly, when he gets close to 1500 grams, starts improving on his O₂ needs, and continues not needing much pressure support for his breaths, they will try to extubate him and switch him to the CPAP. The only one of those three that he's not showing excellent progress right now is the O₂ needs, and I'm hoping he do better on that too if we can just leave him alone and let him grow some new lung tissue. I'm hoping the extubation date is soon.

*Of course, I can't remember all the lyrics, so I usually go with extemporaneous versions. It always cracks Maggie up when I get to the part about "Woody shot a man in Reno just to watch him die."