05 March 2012

Eyes, Crib, Nasal Canula

So a lot has happened since the last time I wrote, and I am sorry for not updating sooner!  Let me start with last Thursday, March 1st.

Thursday was a busy day for the little guy!  It started with a visit from a friend of mine I met on Iowa Ambassadors of Music (I went on that the summer after high school, we toured Europe as a band and a choir for about 2 weeks), so she is from Iowa but currently lives in New Mexico.  We got along really well on the trip, but this was the first time I'd seen her since then!  Well, she arrived shortly after they had dilated Samuel's eyes for his eye exam with the opthamologist.

Eye exams are pretty standard procedure in the NICU with preemies.  Preemies are at rist for something called Retinopathy of Prematurity (ROP).  Basically when this occurs the blood cells formed incorrectly.  In fact that just went crazy forming vessels and can actually cause the retina to become somewhat detached.  This is a very bad thing of course if it happens and can cause blindness.  If they catch ROP in the early stages there is a procedure they can do to try to prevent blindness.  So around 30/31 weeks gestation they get seen by an opthamologist who then sees the baby every 2 weeks until the due date (more frequently if he sees something of concern).

During his eye exam the doctor's special head gear he uses actually has mirrors on it that allowed me to see into Samuel's eye (of course I had to looking at exactly the right spot, so if he moved slightly I had to move more greatly to find Sam's eye again, but the work was worth it to see inside of Sam's eye!).  The doctor's verdict was that he has immature eyes, which is completely normal for his gestational age.  So for now, and hopefully until his due date, we'll be on the every other week routine.  We are happy to know his eyes are developing normally!

That afternoon he took a bath.  So he had a pretty busy day for a 5 week old baby who hasn't even reached his due date yet!  Ben was somewhat annoyed because on Wednesday Sam didn't seem interested in sleep all day, then he had such a busy day on Thursday, that both nights he was fast asleep by the time Ben arrived at the NICU...  Oh well, he'll see plenty wakeful moments with Sam soon enough I'm sure!

Friday he got moved into a crib!  So that was very exciting!  With him in a crib instead of the isolette, we have easier access to him and are allowed to pull him out to hold him at our discretion.  We were asked, however, to let him sleep if he is sleeping, so that he gets the maximum amount of good sleep possible.  He's been doing pretty well in the crib so far, though they heightened noise volume and amount of lights was an adjustment for him, it's not so muffled and dark as it was in the isolette!

The next big change was to his oxygen parameters.  They set the parameters for his oxygen saturation levels (which is what we look at to see his apnea spells) based on his gestational age.  So far they have pretty much been set at 85-92%.  However at 32 weeks gestation (which was Saturday) they go up to 90-95% and I was told at 34 weeks it will change one last time to 96-100%.  On Sunday we switched his parameters to the 32 week benchmark.  It's very important that they monitor this because having too much or too little oxygen can cause eye problems in the future.

Yesterday, the first day with the new oxygen parameters, he did really well.  In fact, when we kangarooed in the afternoon he seemed to want his paci, so I gave it to him.  It was during his feeding (a time when he's tended to drop his oxygen levels) and he did not drop them at all while sucking on it. Which impressed me because he was sucking on it quite vigorously for about 40 minutes!  He was sucking on it so hard the nurse could hear him on the other side of the room!

Today has been a different story with the new parameters.  In fact all day he's been up and down with his oxygen.  Every time the nurse went to grab a nasal canula to give him oxygen, he'd bring it up and keep it up for a while.  Finally this evening we put him on a nasal canula (you see adults with these in public, the clear tube that hangs on their ears and sticks in their nose).  This is very common when the parameters change.  In fact most of the time his oxygen dropped, it would have been in the perfect place for his old parameters.  It was great to see him so interested in his paci, this is a good sign for the oral feedings that will hopefully start little by little in the next 2 weeks.

We are pleased to know that Sam is progressing quite well and nothing that has happened as been out of the ordinary.  Today he's been kind of fussy, so I kept picking him up to hold him for a bit, then putting him back down to pump.  Before I'd finish pumping he'd be whining again and I would pick him up.  Welcome to parenthood, right?

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