Wednesday, July 17, 2013

Doing What We Can.

For the last several days, essentially since he had the UVC (umbilical venous catheter) line removed and the PICC inserted, we've been asking when they plan to remove the UAC (umbilical arterial catheter) line as well. This is the line that measures his blood pressure and through which they draw his blood for blood gases. They’d told us the lines were only “good” for a week and a half at most, so as we approached two weeks, I was really starting to wonder. We hadn't seen a doctor directly for days, and the nurses each time would agree that it would be “soon.” So, when Kraemer called to check in on Calder this morning, I suppose we were not surprised when we learned they were about to embark on the procedure. Apparently, the line “had gone bad;” "bad" doesn't mean infected, just that it stopped working, so they were forced to remove it.

Unfortunately, they did not have much luck placing a peripheral IV into his arm. Instead of poking and prodding him for too long, which his sensitive and fragile body doesn't very much like (heck, I can barely give blood), they decided to stop trying. This means that they are taking his blood pressure now only periodically manually, rather than monitoring it constantly, and that they have to draw his blood through his heels. I hate to think about the pain this causes him and can only hope that the drugs they give to sedate him mitigate some of this pain.

Speaking of sedation, they say he is moving more, and to keep him from extubating himself, as he’s done once before, they are now administering the phenobarbital every two hours.

He’d had about 1 cc residual after his last feed when we saw him this evening, but he is also now at 6 ccs.

We think he likes our touch (and maybe part of that is our scent) so we do our best to give him about 45 minutes minimum of touching each day. It’s tough to tell, but he usually starts converting his oxygen at higher rates after a few minutes of us touching him; last night he came down several points on his oxygen just while we were there, down to 33% oxygen in the air that they’re pumping. As a reminder, 21% is room air. And while he got down to room air during his “honeymoon” phase, he’s since been regularly in the 50s and 60s since.

We also think he likes our voice, or at least knows it. This one is harder since we don’t want to be too loud, and we don’t like to have the doors open too long when other people are being too loud, either. To keep up the talking, I tried making up a story but got about as far as “once upon a time,” so my mom sent us a nice pile of books from when I was a kid. Thanks, Mom!

As we were leaving, one of the nurses asked us whether we’d considered kangaroo care. There are many benefits, but it can get tricky with all those tubes, and the doctors want him to be medically stable before moving him too much. She told us she’d speak with the doctor about when it might be appropriate.

In the meantime, though, Kraemer and I started each sleeping with cute little blankies two of his cousins sent to us, with the idea that they will pick up our scent and then be placed in the incubator with Calder. I'll spare you all the very sweet photo of Kraemer with his little blue bear blankie with Calder's name on it. :)

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