Not too much is changing in our world today. The doctors continue to slowly increase Tera's feeds, now to 52cc. She'll be drinking two ounces in no time! She gained a little bit of weight last night, now to 5 pounds 10 ounces (2575 grams). And she got her fourth immunization this morning, this one for Polio.
A few weeks ago, Tera had a reputation for being a Scooter. At some point during the day - sometimes multiple times each day - she would end up outside of the confines of the nest the nurses make inside her bed and into the corners of The Box. I haven't noticed her doing it too much recently, but this morning, she picked that habit back up. When I arrived, her nurse told me that she had already moved her back into place once. Within a half hour of me being in the room, she was back at the bottom of her box.
She seemed comfortable, but it made me feel better to move her back into place.
At each meal time, Tera's nurse has to get a different nurse to sign off on her milk. The new nurse matches the label on the milk to the label on Tera's wrist/ankle tag (wherever it might be that day). Usually, it's the same nurse throughout the whole day, but for some reason today, a different nurse came in each time. Everyone of them said "She's too big for this box. Why isn't she in a crib?" We explained that Tera has the "conservative" pediatrician, and we're just biding our time until she is absolutely ready. She must be getting close. When the nurses sit her up to get her ready to swaddle, her head almost touches the top of the bed.
The first bottle I gave her today was at 11:30. At this time, she had already attempted three bottles in a row (one per feed, not three in one meal time) and had just had her fourth shot for the week. I also decided to do her OT stretches before her belly got too full. One of the stretches involves bringing her knees up towards her chest, which you can imagine squeezes her stomach. I didn't want all of her milk coming up with her knees. The thing is that these stretches are actually very relaxing for babies. My point in saying all of this is that Tera was not in her best state for bottle-feeding. I wasn't expecting much. On any other day, I would have suggested that we just tube it and let her rest. However, today, the Speech Therapists were coming to check on her progress, and a Researcher was coming to observe her. We needed to at least try it.
About the Researcher, when we were in the RNICU, a UAB rep came by and asked if I would like Tera to participate in a research study (I can't remember what they are researching, but I have a handout about it somewhere). All it involved was someone coming to watch Tera while she eats. They wouldn't touch her or be intrusive in any way. "Does anyone say 'no' to this?" I asked. What an easy way to contribute to the advancement of Neonatology! So, today was the day that the Researcher came by to watch Tera. She only needed to see Tera eat for five minutes and record how much she ate. 6cc! For those of you just tuning in, that's not very much, especially in five minutes. We explained all of the variables to the Researcher, but she waved them off as no big deal. If she's not worried, I'm not.
The Speech Therapists stayed on throughout the entire feeding. Usually, when I know how Tera is, I let her give in to the feeding tube fairly easily. Today, however, we were much more aggressive in at least trying to keep her awake. I unwrapped her several times and lifted her up to try to rouse her from her coma. Thirty minutes and just a few more cc later, the Speech Therapists agreed that it just wasn't going to happen today. They said not to worry about the fact that she's not taking only bottles yet. It'll come.
As usual, I held her for awhile after she ate. She's really taken to her pacifier lately. It's cute to watch work at it.
In the early afternoon, I went back to Lydia's. I have forgotten to mention that Lydia and I have a new roommate, Joy. Joy moved in over the weekend. Because of my frequency at the hospital, Lydia's PT sessions, and Joy's job as a nurse working 12-hour shifts, the three of us don't see that much of each other. Today, however, Joy was off work and Lydia didn't have any scheduled activities, so we made plans to go to the Dollar Theater to see a movie. For various reasons, we opted to postpone our date for later this evening, so I decided just to relax on the couch for a couple of hours. After resting, I went back to the hospital to spend the last few minutes of my day with Tera before joining Lydia at the theater. As soon as I got close to the hospital, I knew I wouldn't be able to leave that soon. I called Lydia, and we rescheduled again for tomorrow. I hated to do it, but when my gut tells me to stay with Tera, I just have to follow it.
Nonna and Poppa drove from Winfield to spend a couple of hours with Tera. Her night nurse came in to weigh her and start her next bottle. She's gained another ounce, up to 5 pounds 11 ounces (2600 grams). While she was laying on the scale, Tera pooped all over the towel. The nurse commented that it looked a little runny, and we would need to keep an eye on it. Nonna and Poppa watched me attempt yet another bottle. This time, I unwrapped her almost completely to keep her awake while she ate. Her eyes were closed most of the time, but she managed to take down about 16cc before crashing again. I put her back in her bed while she took the rest via the tube, hoping that letting her sleep completely through to the next feed might make her more alert at that time.
After her feed, while we sat and talked, Tera's alarms started going off. She hasn't been de-satting nearly as much as she used to, really only during meal time and maybe occasionally in between feeds. So, when her alarms went off, so did mine. I looked up and saw that her heartrate was dropping, so I immediately reached in and startled her back into reality. Her heartrate improved immediately, but her oxygen saturation took a little while to come back up. That's pretty normal for her when she bradies like that. The nurse explained that it's probably just due to the fact that she is getting her immunizations. It's not uncommon for babies to de-sat as a side effect.
These are the things I am worried about when we go home. When I'm holding her or feeding her, I can see when she is choked or not breathing correctly, but when she lays in her bed alone, I rely on the monitors to tell me how she is doing. We will have an Angel Monitor for her at home. This will alarm us anytime it detects that there is no movement in her bed. We're counting on brain maturity to get rid of these minor brady issues, but it's still scary to think about. That's why we're all about slow and steady right now.
We left the hospital about 10:30. I was exhausted and Nonna and Poppa still had to drive back to Winfield.
What About Barry and Canon?
When I talked to Barry this evening, he and Canon were going to the grocery store. Apparently, Canon has also had some pretty severe and runny diapers these last couple of days, so Barry is trying to get him some better nutrition. I asked him to send me a picture of Canon:
He looks so old in this picture!
We were able to do FaceTime at the hospital, so Canon got to see Baby Tera as well as Nonna and Poppa. Tera's nurse tonight also has a two-year-old that loves to do FaceTime with his Mommy!
Later tonight, I got the classic bedtime photograph. I'm so proud of how he's doing with this whole Big Brother Bed transition. I shouldn't be surprised. I've often said in these last couple of months that he adjusts better to new things than his mom. He's already a great Big Brother!
I can't wait to see him in it in person.
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