To cut or not to cut

Calder transferred to Fairfax Children's Hospital today.  In addition to being another 20 minutes away, it is also a Level IV NICU (the big poobah of NICU's) and much, much larger. The NICU here has four rooms to Alexandria's two and 75 beds to Alex's 16. Washing procedures for guests are more rigorous (to your elbow! no rings! no watches! one full minute ... and no fingernails longer than 1/4-in), perhaps reflecting the sheer number of folks who use this NICU. NO guests get to touch the babies; only parents. We are limited to four guests for the entirety of our stay. Including grandparents. The feel is more business-like than community. Needless to say, even though we had been forewarned, we were a bit overwhelmed by the size and intensity. We like it.

Goodbye, Alexandria! It's been real.

Calder's transfer was 'ok': he had a brady when they were loading him into the ambulance and that apparently set the tone for the rest of the trip.  I often wonder what effect this experience will have on his future life. Will he hate people touching his feet since he gets lanced in the heels every six hours, will he hate things in his mouth from his experience with breathing tubes, will he want to be a fireman or ambulance driver from his ride across town? Hopefully I'll get to test all my hypotheses in the coming years.

Taryn and I were at Fairfax to greet the little man but were left waiting while they got him settled in. After about three hours of settling in, we were anxious to meet the thoracic surgeon to discuss when the PDA surgery would occur.  After four hours with no lunch and Kraemer nearly keeling over, we learned Calder was scheduled for tomorrow, during the second heart surgery slot of the day, which means he would head into the OR (actually, surgery would occur right there in his isolette) between 11 am and 2 pm. The head doctor (medical director) explained they would do one more echo to make sure nothing had changed (unlikely, he said, since they had stopped the indomethacin early). We headed out, feeling nervous but glad that his PDA would be resolved and prepared to arrive tomorrow around 11 am to sign some papers and be briefed by the surgeons.

Poor little man's head IV.

No more than five minutes down the road, and after living at the hospital for six hours, the new team of doctors called. Low and behold, the PDA had closed significantly and was no longer pumping blood the wrong direction, at least not in amounts to cause Calder's ventricle to swell.  The doctors were still hesitant to not do the surgery since the PDA had closed the majority of the way once before, only to blow back open and have Calder's vitals tank. But weighing the potential benefits to waiting versus moving forward with the procedure now, they encouraged us to agree to postpone the surgery. This news was welcome (hey! no surgery!) but unsettling (this is what he moved here for and we want it resolved ASAP!). In the end, we decided that the wait-and-see approach was worth it, as long as we were not "waiting" too much and "seeing" quite often.