Tag Archives: nurse

the eric update – day 78: saying goodbye. and hello. postcards?

since i have absolutely no free time, i’m going to try something new and only put a placeholder entry here. perhaps i’ll get a chance to put a more detailed account here later. or perhaps not. but for now, i’m just going to give the bullet points there are more important things to attend to.

i apologize to everyone who called yesterday who didn’t get a call back. obviously, cell phone time is short and i’m basically in “triage” mode and only returning emergency calls. after a whole bunch of voicemails it became apparent that there was some confusion about eric’s eye surgery. he was being transferred today ( monday ) and will have an assessment on tuesday. if he moves from being “prethreshold” to “threshold” then he’ll need surgery within 72 hours. the quick move was made because the expectation is that he’ll move quickly into threshold land and everyone wants to be prepared for that event. we don’t know exactly when he’ll have the surgery in the event that it’s required and i won’t have that answer until later tommorrow.

day 78: little feat

as eric gets close to transfer, the nurses get the proper paperwork in order. amidst the release forms i discovered an identification form that has his footprints that were inked on his first night in the nicu.

they sure were small. about as small as nickel.

day 78: leaving bed four

eric made great leaps and bounds while staying in “bed 4” in the nicu, which seemed like a perfect number since he’s eric “the fourth” born on the fourth of july.

we would later discover that he would be sitting in bed 4 at the new nicu, which makes us think that “4” just might be his lucky number.

day 78: reading the numbers

according to the rules that one must follow when tranferring a baby from one nicu to another, the nurses must corroborate that he is, in fact, who they think he is and read match the identification number on his nicu ID bracelet with the number on the transfer papers.

i’m foiling their best efforts to match the ID numbers by telling jokes and they’re laughing heartily.

day 78: saying goodbye to nurse nancy.

nurse nancy is superfantastic and she spent much of the day trying, unsuccessfully i might add, not to cry. eventually i was able to capture her with her “happy face” on.

nurse nancy was eric’s nurse for many of his “big steps” including being transferred to the isolette and the open, unheated bed and his first bottle feeding, so she’s very, very attached to eric.

day 78: saying goodbye to he, himself.

this is charles, “charlie” winslow – eric’s neonatologist. he’s the reason why eric is alive and words can’t really describe how highly we think of him.

he’s a nice guy, a great communicator and rides a bike to work.

day 78: nicu transport. I.

after the transport team arrives from the new nicu they quickly put eric in the transport “crash cart”. the whole process only takes a few minutes.

his “saint mary’s” nurses are standing around looking sad and i wish there was more time to say goodbye.

day 78: nicu transport. II.

little odin is resting comfortably in the crash cart, oblivious to the fact that he’s, ever so briefly, about to see the outside world for the first time.

day 78: nicu transport. III.

part of the transport team from the new nicu is talking with kris and nurse cathy b. the man on the left is the ambulance driver. the woman standing next to him is a neonatal nurse practitioner who is chatting with kris and nurse cathy b.

day 78: nicu transport. IV.

more people from the transport team. the man on the left is a respiratory specialist and the woman on the right is a registered nurse.

they’re amiable and do a great job making us feel relaxed. somehow, during the quick process of getting odin prepped for tranfer i find myself talking with the respiratory specialist about digital cameras. go figure.

day 78: nicu transport. V.

and they’re off!

little odin gets wheeled out of the nicu on his way to the elevator and the waiting ambulance.

day 78: at the new nicu. I.

we weren’t able to ride in the ambulance with odin, so we arrived shortly after he was put in his new bed.

he seems to be welcoming us with a hand wave as if to introduce us to his new surrounds.

day 78: at the new nicu. II.

of course it’s not long before he’s resting comfortably on mama’s chest.

day 78: at the new nicu. III.

in one of the many differences between the two nicus, eric gets weighed before and after nursing in an effort to more accurately determine how much milk he’s ingested. in theory, the practice should help us to make sure that he’s received enough nutrition, but the scale claims that eric has lost two grams after breastfeeding. so much for accuracy.

oh. i guess i should note that eric is gaining weight so fast that it’s almost starting to freak me out. he tipped the scales at at 4 pounds 9 ounces or about 2075 grams. that’s right – he gained 2 ounces over the last 24 hours and over 5 ounces in the past 48. while everyone is suitably impressed, it’s not good to put that much weight on that quickly, so my guess is that they might reduce the amount of fortifier in his breastmilk soon.

day 78: at the new nicu. IV.

eric’ new bed is stainless steel and the temperature of nicu is a lot cooler than we’re used to which help to add to a sterile, antiseptic feeling.
the new nicu is quite different from the old in many, many ways. while “saints” was small, at 15 beds, little odin’s new home is enormous, with over 100 beds. it also gets a lot of sick babies that are transferred from many different places so it has a much different feel. it’s odd to be thrust into the new environment, trying to adjust quickly to the new rules, while walking around and seeing so many babies with shaved heads and drainage bags, presumably alleviating pressure after brain surgery. the nicu is cooler, literally and figuratively and is much more antiseptically clinical. in a weird way, it also feels like we’ve transferred from the ‘jewel in the rough’, small, personal liberal arts school to the large, top tier, big 10 school. the veneer looks more impressive, but it also seems like it could be quite easy to get lost in the shuffle. time will tell.

uh. so, it looks like i’m incapable of writing a ‘placeholder’ entry.

day 78: at the new nicu. V.

despite all the changes, eric continues to chug his botttle feedings while continuing to look very relaxed.

because the new nicu is kept at a cooler temperature, it’s more important to keep a knit cap on his head and cover him in blankets.

many people have asked me about where they can send postcards. it seems that little odin’s quick transfer has revealed all the procrastinators in the crowd 🙂 for now, if you’ve sent a card that’s already in the mail, i’m sure the staff at saint mary’s will keep it until i can find time to come and pick it up ( in fact, i think they were happy to hear that i’d be back to pick up postcards which would give them an opportunity to hear about eric’s progress ). i don’t know the new nicu’s policy , so i can’t say whether or not people will be able to send stuff there ( i’ll find out more today or tommorrow ). i’m not ready to post my home address on the internet ( i’m not really sure why, since it’s quite easy to sleuth it on the the internet. ), but i’ll probably come up with a solution sooner rather than later. as always, thanks so much to everyone who has sent us or plans to send us a card ( or more! ).

the endless kindness of strangers ( and friends and family, of course ) never ceases to amaze me.

the eric update – day 77: a baby shower. rop, apparent but not real? a metric milestone. 11 weeks!

day 77: baby shower. I.

today, 77 days or 11 weeks after little odin was born, we had our baby shower. thanks to the hard work of kris’ sister, gina, and her partner, diane, many people came and had lots of good food to eat. we had a great time and received many, many great gifts, but of course, given the circumstances we had a tough time not dwelling in his eric’s impending transfer to the new nicu for eye surgery.

day 77: baby shower. II.

many people came to the baby shower – this is one shot of a few of the friends and family that came to the event hanging out in our living room.

day 77: baby shower. III.

i’m intently reading a card while ruby, our niece, hands us gifts.

day 77: baby shower. IV.

kris unfolds a blanket for odin, while i look on. dig those crazy dark circles under my eyes. i don’t always look like that. honest.

day 77: baby shower. V.

on the left you can see diane, who – despite being very, very pregnant, organized our baby shower and for that we are very, very thankful.

day 77: baby shower. VI.

a shot of kris’ brother, his wife and one of their children – jagger.

day 77: baby shower. VII.

i didn’t take this very cute picture of our nieces, ruby and ella. they like playing together.

day 77: baby shower. VIII.

another shot, not taken by myself, of ruby – looking very cute.

day 77: baby shower. IX.

kris’ brother with his son, our nephew.

day 77: the explanation.

i might have some of the details incorrect because i haven’t had a chance to talk at length with eric’s opthamologist, but my understanding is that eric is “pre-threshold” and “8 hours” into ROP which is technically stage 3+ and primarily developing in zone 2. if you think of the eye as a dartboard, the optic nerve is the bullseye and is zone 1 and there’s a ring around the the optic nerve which is known as zone 2. there are 4 stages of the disease and stages 3+ and 4 can lead to the formation of scar tissue on the retina, vitreous hemorrhage, and retinal detachment. by saying that eric is “8 hours” into stage 3+ disease, his opthamologist is not telling us that he’s been at that stage for a third of a day, but rather if he’s giving us an indication of hos quickly the disease had progressed. if you were divide the retina into 12 hours, he’s telling us that 8 “continuous” hours show signs of being in stage 3+ of the disease. he only needs to show signs of disease in “3 hours” to be considered “prethreshold” in zone 2 ( as the disease progresses, you move from being “prethreshold” to “threshold” which means you need surgery within 72 hours ), so it doesn’t appear that they are making a marginal call and transferring him unecessarily.

day 77: more hair than yesterday.

or does it.

after spending much of the day trying to come to grips with how his disease could have progressed so quickly, eric’s neonatologist paid us a special visit late in the evening ( on his time off, no less ). we’ve come to expect the going to get weird whenever we see him at odd hours ( he’s a great guy, but as you can imagine he’s A Very Busy Man ) and this visit was no expection.

after stating the appropriate amount of caveats , we found ourself listening to him explain that they could never not do what they were doing because they can’t ignore the results of his latest eye exam – but that fact didn’t stop him from holding out hope that eric’s ROP was not nearly as bad as the evidence would lead his opthamologist to believe. sounding much like a zen master he stated plainly, “you see, it’s apparent, but it might not be real.” in medicine in general and neonatology specifically, sometimes a test will show something to be very apparent, but all one’s instincts tell one that it’s really not real, and in this case, his instincts are telling him that eric’s ROP might not be real.

normally, ROP progresses relatively slowly and it’s fairly unusual to have severe disease appear so quickly when they were monitoring it so closely. in fact, it’s so uncommon that he’s only seen it a handful of times in his many years of practicing neonatology. and every single time it’s happened, the diagnosis was preceeded by a recent blood transfusion, which is exactly what eric received just six days ago. but in his experience, micropreemies that present the disease as eric is presenting who have also received a recent blood transfusion often have the disease disappear or at least significantly regress. his theory is that for whatever reason the blood tranfusion engorges the eye’s blood vessels in a way that makes the ROP apparent, but not real. he stated quite frankly that eric’s opthamologist would not agree with his theory and that it didn’t change the fact that they needed to treat eric as if he were going to need surgery soon, so the discussion has an academic flavor to it. but it’s a bit of hope and i guess in a week we’ll have the benefit of hindsight to know whether or not his theory is true or if it’s just a kooky prognostication by a neonatologist who likes to second guess the opthamologists ( i mean that in the best possible way, if he’s reading this 🙂 ).

day 78: saying goodbye to nurse cathy b.

we said teary goodbyes to some of the night nurses, as they won’t see his again after the transfer tommorrow early in the day. unlike some nicus, eric has had many of the same nurses for his 77 day stay at “saints” and they gave up not getting attached to him a long time ago.

when we came back from lunch today we found eric’s nurse, cathy b, cuddling with eric because she knew it was one of the chances she’d get before he got transferred to the nicu. it was a sweet, touching moment. cathy b’s own son is named eric and she never tried very hard to disguise how much she truly enjoyed caring for our eric.

she sat with us for a long time today and shared stories about her life. we’ll miss her very much and she’s a great example of why saint mary’s nicu is unique.

she doesn’t have to cuddle with our son while we’re away for lunch, but she does because she’s a great nurse and a fantastic person.

day 77: saying goodbye to theresa

theresa was his nurse tonight and, ironically, she was also his nurse on his first night.

she’s sad to see him go the the new nicu for surgery and holds him for one of the last times before he gets transferred in the morning. we’re sad too, because we like theresa a lot.

she asks us if we’d like to give him a bath so he’s fresh and clean before the big move and we decide that we’d like her to have the honor. we can tell from the look in her eye that it means a lot to her and, really, it’s the least we can do to repay her for all her hard work at helping to keep him alive.

we won’t soon forget his nurses and i suspect they won’t forget him either.

day 77: a metric milestone

amidst everything else, eric continued to do what he’s been doing so well on his 11 week birthday – eating and gaining weight. he’s still guzzling bottles at breakneck speed and he tipped the scales tonight at exactly 2 kilos or about 4 pounds 6.5 ounces.

the eric update – day 68: getting taken to bottle feeding school.

day 68: it's the long lost fingergrab

well, it’s more of the same today – feeding and sleeping, sleeping and feeding, sleeping, sleeping and feeding. i think we’re going to find him off tube feeding entirely quite soon, as he’s now able to take four or more bottle feeds a day, depending on the nurses discretion as to how tired he’s getting. i think he’s also getting strong enough that soon kris will move from non-nutritive suckling to honest-to-goodness breastfeeding.

day 68: getting taken to bottle feeding school. I.

for his past couple of feedings, eric had started to increasingly behave in a way that i interpreted to mean that he was getting tired of having a bottle – closing his mouth, pursing his lips, blocking the bottle with his toungue etc. usually when this happens, the nurses are quick to “gavage” him ( feed him via a tube ), with the explanation that it’s best to get his feeding done quick so he has enough time to digest his food.

tonight, when i was feeding him and he hadn’t taken a sip in ten minutes, i started to signal to his nurse that maybe it was time gavage him. i had noticed that nurse marlene had been watching me closely while i was feeding; she walked over and gingerly picked up eric but to my surprise, instead of putting in a tube, she started to whisper to him that she had a lot of faith that he knew exactly what he needed to do to eat. and much to my astonishment, in about five seconds, eric was guzzling away.

nurse marlene is the archetypal nurse caregiver. if you close your eyes and imagine the most grandmotherly of grandmotherly nurses and you’ll likely being envisioning nurse marlene. her white, couffed hair, bifocals and ageing hands betray the fact that she’s been nursing for quite some time and all that experience translates into the thousand little things that she’s doing which result in an easy bottlefeeding.

she very sensitively explained to me all the things i was doing wrong. most obviously, she sits him up, while tilting his head back. i often lay him along my forearm, while holding his head with my hand, which tends to tilt his head foreward making it more difficult for the milk to go down.

she also showed me a great technique for getting the bottle nipple past his tongue. he likes to put his tongue on the roof of his mouth and pretend that he’s sucking, but in reality he’s just playing with the bottle. nurse marlene showed me how put the bottle in his mouth so that the nipple touches the inside of his cheek and then she swoops it past his tongue.

as if that weren’t enough, i’m also being far too timid about putting the nipple all the way in his mouth. apparently, my fears of gagging him are vastly overblown.

day 68: getting taken to bottle feeding school. II.

nurse marlene continued here tutelage with a lesson on the proper way to burp. his head must be tilted up, not down as i had been doing. and she carefully but very firmly grasps him while keeping his airway open. she swings his head and torso in a full 360 degree circle to show me just how firmly she’s holding him, as his head doesn’t change it’s upward tilt during the arc.

i’m admonished to not rap on his back either, and she rolls her eyes when i tell her that’s what the other nurses do. she’s gently massaging his back and right on cue, eric lets out a little burp.

she clarifies that a properly burbed child never needs their back rapped and i suspect that she might be making a comment about the burping skills of some of the other nurses.