David has a checklist of criteria to meet before he can be discharged from the ICN. To begin with, he must be able to regulate his body temperature in an open crib, which he’s been able to do now for two weeks. We take his temperature every three hours to monitor this and he’s been in the 36.5-37.5 range every time.
He needs to be free of any apnea and bradycardia episodes for 7 days. Those are the “As and Bs” I talked about discouraging him against in one of my earliest posts. He’s had a daily dose of caffeine since the day he was born. This helps to stimulate his brain enough to remind him to breathe; it’s basically a daily morning espresso shot to keep him “awake.” The docs discontinued his morning caffeine this past weekend and his 7 day apnea countdown has begun. He’s now on day 5 of 7 with no episodes. I sort of hate that I just wrote that because it sounds like a jinx to me. But that he hasn’t had an apnea episode is a double dose of good news; it means his brain is self-stimulated and he’s not a two-month-old caffeine addict.
Most importantly he needs to feed by mouth, either by bottle or by breast or by both. He can’t go home with an NG tube and we certainly don’t want him to go home with an NG tube. David unfortunately won’t feed well by mouth until his oxygen needs decrease. It just simply stresses his breathing too much. It’s a discouraging process, that’s for sure, and the doctor encouraged us at the beginning of this week to remain patient in the coming weeks, because David’s not going to make any quick moves forward. His lungs are damaged from all the intubation and ventilator interventions that he needed for his bronchopulmonary dysplasia. He still has a lot of healing to do.
Fortunately babies can grow new lung tissue until the age of eight. So the good news is that although David will likely go home on oxygen, he’ll outgrow this in childhood. This winter will be the hardest test for him, and even the commonest of colds can be a real danger, so we’re advised to take all precautions. If that means placing Purell pumps in all rooms in our house, so be it. We’ve been through a lot over the last 60 days; we can handle a few more months of obsessive ethanol treatment.
We had a wonderful Christmas morning with David. We thought so at least. David wasn’t as excited about our “First Christmas” photos as we were.
So Graham did what he could to console him.
And once he was consoled we convinced him to put on his Christmas sweater.
He finally agreed, and we thought he looked dashing.
An anonymous graduate family placed stockings at each bedspace Christmas night. Inside we found this, which we thought was so brilliant we wanted to share it. I hope I’ve given you enough of a preemie-lingo lesson to understand it. But if not, I apologize, and then take my word for it, it’s pretty great.
Good health to you all as we enter the New Year.
J & G & D