Thursday, October 13th, 2005

Time	Event
12:46a	kangaroo care and nurses So, as with most moms, I'm of course in love with my baby ;) While I occasionally feel a bit burnt out over the course of the day, holding him is all the rejuvenation I seem to need. Likewise, he seems to do much better when I'm holding him once or twice a day. Its nice to know this isn't just fluffy either, as Patri has turned up a multitude of studies about how much better preterm babies do when they're given "kangaroo care." Basically, I just snuggle him on my chest for a half hour or hour twice a day. So far I've been really happy with most of the nurses here. Of his nurses so far, four have been great, two pretty good, and one scared the hell out of me ;) The first nurse we met was Susan. She's fantastic. I was scared to try holding the baby because of all of the cords coming off him, but she assured me that it would be okay, and that holding the baby was one of the greatest things I could do for him. She seemed very confident, to really know her stuff, and as she stated, to love her job. I just let her set him in my arms and tried not to move too much. He was clearly unhappy about being pulled out of his bed, but quickly snuggled up into a little ball on my chest. His face relaxed and Susan noted that it was the most content she'd yet seen him. Every premie at the hospital has a lot of people taking care of them. They have their own team of doctors and nurses. Susan told me that various nurses will be in charge of Tovar, but that the nurses have the option of signing up to be on his "team" to work with him regularly and that some probably would. (He gets a doctor team assigned right away, and it will change every two weeks. I don't know if or how often the nurse teams change) I asked Susan if she was going to be part of Tovar's team, but as with the other three awesome nurses whom I later asked this of, they all said that they couldn't take primaries because they were training other nurses, but if they could they would love to take Tovar because they "love the little guys," think he's really cute, and like working with Patri and I. All of the four have been very excited whenever I've come in to do kangaroo care and eager to volunteer information and help. This seems to be the main difference I've noticed between the pretty good and the great nurses: the great nurses just want to see things go well for the babies and the notion of it being more work for them doesn't seem to even cross their minds, whereas the pretty good nurses seem to see spending time dealing with me and taking the baby out as adding to their work load. But even the less enthusiastic nurses are still friendly and seem to care more about their work than the average person. Even the nurse who was scary wasn't necessarily "bad," she was just very uncomfortable with handling the baby, and in her fear ended up pulling cords a bit and just generally very awkward. At first she actually told me that she didn't think I'd be allowed to hold the baby because of the cords, but I assured her that I'd just done it the prior night, so she went and checked with other nurses and got one to help her take him out. She was our nurse on the second day, so as with her, Patri and I were still very concerned about all those cords, especially given that one goes straight to his heart and another through the umbilicus. (the umbilical line was taken out not long after, so the only super scary line now is the pic line, going to the heart, but its not that scary because they have it secured very well on his arm) It was so stressful to watch scary nurse handle him that I actually joined Tovar in crying, and Patri and I weren't sure at that point whether the kangaroo care was worth it, enjoyment for the baby and us and studies showing its benefits or no. However, we have not had any serious problems since then, and I figure that I will just not take him out on that particular nurse's shifts if she works with him again, which I think she will also appreciate ;) Also, I just learned yesterday that Susan has signed up to take Tovar on as a primary!!! I'm very excited to know that he will have at least one awesome nurse, and I'll make sure that I pick her shifts to come visit him :) (Comment on this)
1:31a	hospital routine improvement As may be evident by my journal prolificness tonight, I'm feeling a lot better today ;) Not sure what the difference is: becoming more efficient, getting 7hrs of sleep, or maybe just not quite so many things to take care of (I've been having a lot of meetings with a lot of different hospital people), but whatever it is, I felt about half as busy as the day before. Maybe I will be able to talk to people who visit, answer phone calls and email, and maybe even get in a little reading after all, but no promises just yet ;) One thing that's definitely gotten better over the past couple of days is pumping. Its still the single most time consuming thing I do, but its *much* easier now that my milk has come in and I'm not trying to suck up every little drop of colostrum with a 1cc syringe. Between pumping, hand expressing, and cleaning up with colostrum, it was probably taking about an hour on average every time. (when I had to do the clean up myself: I had people helping during daytime hours most of the time, so knock around 10 minutes off of my time spent :) My new average is probably around forty minutes when I have to do my own clean up, a half hour without, as I'm making enough milk now to just send it over in bottles w/out having to use syringes, and I no longer have to hand express. I usually just do a couple minutes of hand stimulation now. Multiply that by 8 times/day and its quite a bit of time saved :) Also helpful that I know a lot of the staff now and they know me. I'm no longer expected to sign in, nor do I have to wait for nurses to free up every time I want to see the baby. Although one of them has talked to me about taking him out on my own, I don't feel ready for that just yet, but I do now go in and open the doors and talk to him and put my hand on his head without assistance. Another really nice thing that it took me a day or two to learn is that they'll bring me lunch and dinner! All I have to do is tell the receptionist which meals I will be there for the day before, and a little lunch box arrives for me. Its pretty healthy for the most part: sandwich, juice, fruit, and milk, but they do throw in a cookie and chips, which so far I've had the willpower to avoid although I expect to break down on occasion ;) Since we keep late hours I still typically have one meal from the cafeteria, which will slow me down more once my mom isn't helping, but still, not a big deal, and not going to slow me down as much as having to go get three meals there! And lastly, I'm getting much less stressed about driving the van, and am even getting better at parking it ;) My awesome house mates Rob and Anna have a full sized white van, which they've lent to me and converted to a "nest" for me during the days ;) I have a bed in the back, so every day so far I've managed to sneak in one hour long nap. This was particularly great today, because I was feeling especially tired and grumpy mid-day and a mom in the common room had brought in her three very hyper kids, in addition to the usual kid or two around, so it was really good to be able to get away from all the commotion and get some quiet time. Also nice that its right there in the parking lot: Patri and I had talked about renting a hotel room next to the hospital, but I don't have enough time between pumping for it to be useful. (2 Comments | Comment on this)
6:21p	Patri - misc thoughts The name is official: Tovar Miles Friedman. Shannon & I argue about whether the first or middle name is geekier (hmm, character from a LARP vs. character from an SF novel...). Today I talked to the doctors for a long time. They told us the results of Tovar's "screen" (not sure what for). Everything came back normal, except for one abnormality. "What?" we asked. "He may have a hyperactive adrenal gland." We cracked up, and they looked at us funny. Shannon pointed at me "yeah, him too". They wanted to know more, and were disappointed that I hadn't been diagnosed by an endocrinologist or anything. We mentioned that my heart rate was above 100 for many hours on Tovar's birthing day, even though I was just sitting around. It sounds like Tovar's PDA is starting to close, they said the murmur is much quieter now. This is good b/c they are limiting his IV fluids until it closes. (Because IV fluids contribute directly to blood volume, and what we want is for an artery to close up, and the more fluid in his circulatory system, the harder it is for things to close). So he's only getting ~70 KCal/kg of IV nutrition (although that's for his original 1kg weight and he's down closer to 800 now). Once the PDA closes, they'll slowly move towards double that, so he has energy to grow. It was scary seeing him noticeably shrunken, Shannon had mentioned that he had a rough day a couple days ago and was down to 800g, but it was very different to see it. She says he looks much better now. I sure hope that PDA closes up so he can get more energy. I like to think of his 9 APGAR as having aced his first test :). Tovar's face is very expressive, apparently that isn't always true for preemies. Other than that one eye opens much more easily than another, which looks kind of funny, he has given us a couple heartwarming smiles, lots of yawns, nose wrinkles, and a few cries. This whole thing is very difficult emotionally, because its not like a birth where you do it and then get to celebrate. (well, ok, you get to not sleep much and have to pay attention to your new baby a lot...but emotionally, you get to feel like the ordeal is over and its time to be a family now). Even though things have been going well, Tovar's uncertain future fate, distant primary residence, and semi-un-cuddlability put a big damper on those feelings. But as the doc pointed out, we spend a lot more time with him at home than he spends here, so here's looking forward to a chubby happy baby at home in a few months. (4 Comments | Comment on this)
10:32p	27 weeks picture This was taken by Susan a few days ago before he lost weight. (7 Comments | Comment on this)

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