Monday, April 7, 2014

Two Weeks in the NICU: A Grant Henry Update

The smell of hand sanitizer, the constant tune of beeps, dings, and whirs, the chatter of nurses, the encouraging smiles of other moms and dads, the sweet nursery rhymes sung to a tiny baby swaddled in a crib. This is life in the NICU, a life we are all too familiar with.

Parker was born 5.5 weeks early and Grant was born 7 weeks early. Both of our boys needed time in the Neonatal Intensive Care Unit (NICU) before they could go home. Yesterday marked our second full week here with Grant and this time around has been very similar to our time in the NICU with Parker almost two years ago.

Just like Parker Bear did, Baby Grant has three primary "going home rules". We are intimately familiar with each one. Before we can bring him home, Grant must be able to:
  • Breathe on his own,
  • Nurse from mommy, and
  • Maintain his body temperature. 
Learning to Breathe on His Own:
Learning to breathe on his own was our primary focus for Grant during the first several days of our NICU stay. From birth, Grant used a C-PAP machine to keep continuous pressure going to his lungs.
The goal was for Grant to keep the oxygen levels flowing through his C-PAP machine low so that he could upgrade to either a cannula or just graduate to "room air".

Baby Grant did spectacular and on Friday, March 28th, after four days on the C-PAP, he moved to breathing "room air" without assistance and had no regressions! We are very excited about his progress on Goal #1!

Next we moved onto Goals #2 and #3 simultaneously.

Maintain Body Temperature:
At first, while he was working to breathe on his own, Baby Grant was in a heated bed. Once he was breathing on his own he moved to an Isolette bed, or "penthouse" as I called it, on Saturday, March 29th. That bed did not have a direct heat warmer but rather was a cocoon shape to keep body heat enclosed. He also started wearing a onesie and sleep sack.
Under close monitoring from his nurses, he was able to keep his temp up even as they slowly reduced the temperature of the bed until the temperature reached a point where it was no longer providing assistance to him to stay warm. Once he proved he was able to maintain his body temperature for 24-hours without assistance, he moved to a crib! He has been in his crib since Thursday, April 3rd and has continued to keep his body temperature where it needs to be!
Learning to Eat/Nurse:
We also started working on nursing. The objective is for Baby Grant to take all of his meals (every three hours) orally, either by breast or bottle, and be able to do that for each meal in a 48-hour period. Once we do that? We can go HOME!! However, for premie's this is far easier said than done.

Slowly but surely we are working on Baby Grant eating instead of using his feeding tube. At this point, Grant is taking all of his meals through his tube. We have two obstacles keeping us from removing the feeding tube: waking up for feedings and stamina to eat.


Waking for all feedings:
Baby Grant is waking up for most of his feedings during the day (a step in the right direction) but sleeping through two feedings at night. (When he sleeps through a feeding, it is delivered through his feeding tube while he peacefully snoozes away.) But we need him to wake for all feedings so that he can continue to learn to nurse. We can't take the feeding tube home so Baby Grant will have to start waking up enough to eat every three hours.We do try to wake him with all of the usual tricks: change his diaper, use cold wipes, turn the lights on, talk to him, but unlike term babies, premies require a lot of energy just to wake up and sometimes Grant just doesn't have the energy to be awake. Fortunately he is only sleeping through two feedings at night. I know soon he'll be awake for all of them.

Stamina to eat:
When he is awake, Grant is only able to stay awake for 15-20 minutes and during that time he nurses anywhere from one to three minutes. Usually the time he spends nursing is not in one chunk but spread out over the course of the 15 minutes that he is awake. Since in that short amount of time he cannot get nearly the nutrients he needs, he is still getting all meals through his feeding tub. We need little Grant to have enough stamina and energy to stay awake long enough to eat a full meal!

Although learning to eat is typically a difficult thing for premie's to master and Grant is no different. The one thing we have on our side is his weight gain. Baby Grant has already surpassed his birth weight by 5 ounces! Grant will have more energy as he gets a little bit bigger. Since he is growing and gaining weight I am hopeful we will turn the corner soon.


Occupational Therapy:
We met with an Occupational Therapist on Tuesday, April 1st who specializes in premies. Although Grant does not require any therapy when we leave the hospital, the OT did go over some early exercises we can do with him to help him strengthen his muscles. She said that Grant did very good! He never fussed when we were working with him and now I have some "homework" to do with him daily. Premies are not ready for true tummy time just yet so these exercises will help Grant to be ready for tummy time in a few weeks. 

Many people have asked us how long we will be staying here in the NICU and the answer is, it is up to Baby Grant.  We are now in our third week here and as soon as he is taking all meals orally for 48-hours, we can go home! I wish I knew how many more days that would be...

Thank you for reading this update on little Grant! I'll post soon about our life here in the hospital and what it's like to "live" in the NICU!

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3 comments:

  1. I'm glad he is doing better =) I hope that very soon he'll be eating better and can go home with you. What a sweet baby boy.

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  2. Grant, we love you so much and continue to pray for you as you grow stronger and bigger everyday. I know it won't be long until you are all four at home together!

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  3. Wow, what an incredible experience. Thank you so much for giving a peek into what the NICU is like, and we keep praying little Grant continues to gain strength!

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