February 18, 2009

Cohen slept all day today! I think I only saw his eyes twice…he didn’t even open them during care time where I royally make him mad with changing his diaper and taking his temp. Don’t get me wrong he was still pissed, but he kept his eyes closed when he cried. I think he has just had so many changes over last few days that he is just worn out. One of these changes occurred this morning when his gavage tube was moved from his mouth and into his nose (nasogastric tube or “NG tube”). He is generally much more comfortable now than he was with the mouth tube, but he does not enjoy the NG tube come feeding time. He makes a really awful sound; it kinda sounds like he’s gasping for air, and I can’t say that I enjoy that much. His nurse said that would go away once he gets used to the NG tube.

Speaking of feeds, Cohen did remarkably well with the .6cc increase, that his doctor wrote for a .5cc increase each feeding! The goal for low birth weight babies is to get them to full feeds which is between 140cc/kg and 160 cc/kg. That equals out to 25-30cc/every 3 hours. Once he is taking full feeds, his IV can be taken out. However, those numbers are a huge contrast to Cohen’s reality of 4cc’s every 3 hours. He has a ways to go before he reaches full feeds. I was hopeful that with the newest increase that Cohen would make some progress quickly, but then he decided to not take his feeds at 3pm and 6pm at all, so that may put a damper on the newly ordered increase. Two steps forward, one step back.

Also, this afternoon Cohen decided to turn orange. Seriously, he went from a beautiful pink baby color to jaundice orange in a period of 3 hours, and of course after the doctor had made afternoon rounds! He does not have any lab work ordered, so the nurses are going to watch him and if he gets more orange they will request a check of his levels. It is not that big of a deal if he goes back under the lights, but I would like them to figure that out sooner rather than later! Cohen needs to start pooping so he can get the remaining meconium out of his system which will help with the jaundice.

Overall, the biggest concern with Cohen right now is keeping his IV site infection free and making sure he doesn’t catch any bugs while he is here. IV sites do not last forever and Cohen’s has been in for 5 days. The little veins are not as big as adult veins (shocking, I know) so IV’s fail much quicker in tiny babies than in adults. His nurse is a little concerned that the IV will not last through the night. If that does happen a decision will be made in regards to whether or not another IV will be placed or if a PICC line would be more appropriate. Either way he will have to get poked again, but the IV is less evasive than the PICC line. Both have their pros and cons, so we will just have to go with what the doctors think is best.

As you can see, Cohen is doing great. Like I said before, he has avoided 3 major complications that babies of his gestational age are at risk for. He has one last test before I can say he has avoided all complications, and that is the ROP exam. ROP stands for Retinopathy of Prematurity. It is a potentially blinding eye disorder that affects premature infants weighing less than 3lbs. The smaller the baby, the more likely the baby is to develop ROP. Cohen was in the 90th percentile for a 29 weeker, so I am hoping this will work in his favor for avoiding ROP. I am not sure when he will be tested for this, but I will of course update with any information I receive in regards to his results.

In other news…only 1.5 more days before John comes to visit!! Not that I have been counting the days, hours, and minutes…. (Though I have been counting the seconds with regards to Carter coming home…) I miss my other two boys and I cannot wait for the day the FOUR of us are back to living a normal life!!