ChezLark

Things are going very well at the hospital; the doctors were even threatening to send Baby Pluot home today, but decided this morning to keep her on until at least tomorrow to make sure she’s fattening up nicely before releasing her.

One of the things the hospital does in preparation for discharging a baby is they have the parents bring in the car seat that they will be using, bundle the baby into it, and monitor the baby’s vitals to make sure that they will be OK sitting in the carseat for the duration of the ride home. I gather the idea here is to make sure that the somewhat hunched-over position the carseat imposes won’t cause the baby any trouble.

With any luck we will all be reunited at home tomorrow!

So as it turns out, the Pluot’s hearing is fine. A hospital staffer stopped by this morning to do a screening for auditory problems (this is Washington state law), and everything checks out.

The machine they use to do the hearing screening is very interesting. They attach three electrodes to the baby’s head and neck, and put little headphones on her. The screening machine generates clicking noises, and then watches for corresponding electric nerve impulses that indicate that she registered the sound. This just takes a few minutes and is done while she sleeps. Pretty cool!

Now that a parent can stay with the Pluot in Pediatrics, Laura is keen on one or the other of us being with her pretty much all the time. Now, it seems to me that the nurses do a pretty good job while we’re not there, but it’s true that what with the baby being in an isolated room, there aren’t as many people around to notice if she’s crying or fussing, so for now I’m going along with this plan.

Anyway, I did the night shift last night, which involved shacking up in the baby’s room and feeding her at the requisite 3-hour intervals. Of course, feeding her takes 15-30 minutes, so this means waking up at roughly 2 1/2-hour intervals. Having now tried it once, I can attest to the fact that this doesn’t make for a particularly restful night. On the plus side, I got to contemplate the city skyline at night; our hotel room has a nice view towards the Smith Tower.

Baby Pluot got turfed from the NICU early this afternoon; they were fed up with her not needing any medical attention. Instead of getting sent to the “step-down” Special Care nursery, which would normally be the next stop, she has skipped a grade and gone directly into the general Pediatrics ward! Among other things, this means that one parent can shack up with her, and we can bring her clothes and blankets.

This is a big vote of confidence in her condition by the hospital staff, and it’s looking increasingly promising that she will be home quickly. To top it off, she’s off phototherapy, as her bilirubin levels have dropped nicely, and they took out her IV as she doesn’t need supplemental fluids anymore.

Here’s an image from just yesterday, under the phototheraphy lights:

Laura and I spent all day at the hospital today to be close to the baby. We also logged some time working on a name; we’re making good progress.

No brady or apnea incidents since Monday. Milk volume up, IV fluid volume down, and successfully breastfeeding. Bilirubin levels (jaundice) dropping. Digesting everything. Book officially closed on the possibility of sepsis. The nurses have started talking about the possibility that she will spend only 2 weeks total in the NICU, although it’s too early to start arranging her trip home yet. In brief, all going splendidly.

As mentioned in this Washington Post blog and this news site, a recent NBC/Journal poll found that Bush’s approval rating among African Americans is 2%, with a margin of error of more than 3%. That means, obviously, that his approval rating could actually be zero.

Now, in fairness, this could be a glitch. A more recent poll shows that Bush’s approval rating among blacks may actually be 12%.

Here’s Baby Pluot with her “sunglasses”. The blue tint is the phototherapy light being used to treat her jaundice.

I lied inadvertently yesterday: Baby Pluot has dropped a little bit of weight (around an ounce) since she was born, and hasn’t turned the corner of gaining weight yet. The nurses aren’t worried, though; newborns of all ages are expected to drop up to 10% of their body weight over the first week or so.

Laura and I were in the NICU when the herd of doctors came through for morning rounds. The quote of the day is that she would “be a great two-south baby”. Two-south is the step-down nursery. She’s taking all her feedings from a bottle or breast now, and they’ve started weaning her off IV fluids.

I posted some more pictures to Flickr. Here’s me feeding her:

Still no name, although Laura and I are making good progress towards one.

Here’s the baby just minutes after being born. Laura got to say hello to her before she got taken up to the NICU for a more thorough checkup. Notice how alert she is already! Chesty took this terrific picture, and a couple of other ones that are posted on Flickr.

My sore throat seemed to have receded this morning, so I got to spend time with the baby today, and she has been doing very very well. She’s been sucking down bottles like there’s no tomorrow, and her weight is ticking up already. Her last brady/apnea incident was on 10/23, so we’re keeping our fingers crossed that she’ll keep remembering to breathe. Her nurse tonight told us that she could be moved to the step-down nursery quite soon now.

Swedish Medical Center’s motto is “Redefining excellence, one life at a time”. I think this is a terrible motto for a terrific hospital. The way I see it, excellence doesn’t need redefining. The old definition works just fine; it means excellent! It’s pretty much all downhill from there. Besides, what if they redefine it to something like “senseless bureaucracy” or “too expensive”?

There’s an aspect of Swedish’s handling of babies that’s sort of freaking me out. When we originally took the tour of the OB ward, one of the things that the tour guide proudly pointed out and explained was that babies get hospital ID bands that also contain magnetic strips. There is monitoring equipment at all the entrances and exits to the OB ward, and if a baby passes by a monitoring station without having been previously approved for departure, alarms go off and the ward gets locked down.

When Baby Pluot was born, a NICU nurse attached an ID band to my arm (it’s still there) and explained that it was my ticket into the NICU, and showed me how it corresponds to our daughter’s (wow, it sounds weird to say that word) ID band. She assured me that they had never lost a baby (!). Also, the NICU and the regular nurseries have signs posted everywhere saying they are under video surveillance.

So seriously, what’s the deal? Do hospitals sometimes lose babies, so patients need reassurance that this won’t happen? Do people try to steal babies? Maybe there are custody disputes and people try to make off with their progeny against the wishes of the other parent?

Weird.

Laura is officially discharged; we’re back at home together for the first time since we left for the hospital around 2AM on Friday morning.

The cats are pretty indignant that nobody has been around to amuse them for the past several days, but otherwise everything else is in order. We’re trying to establish a routine for visiting the baby in the morning and evening so as to not tire her out too much, and let Laura get enough rest so she can recuperate.

We are so thankful to the staff at Swedish, who were fantastic throughout the delivery and post-care. We’re pretty sad about not bringing the baby home right away, but we know she is in the best possible hands. One of the NICU nurses told us they are the most skilled, and expensive, babysitters available!

I spent the morning feeding time chafing in our hospital room while Laura gave the baby a bottle. Things are going well: no bradies overnight, and she sucked down her bottle in about 12 seconds. One new wrinkle is that she’s gotten pretty jaundiced, which is pretty normal for new babies of all ages, so they’ve started phototherapy, which involves shining a light on her. This means that she gets little sunglasses, which is kind of silly-looking. The jaundice isn’t much to worry about: it means the baby’s liver isn’t fully online yet, which typically takes a little while.

It all depends on her. Premature babies have under-developed reflexes of various kinds, and they need to be in Special Care until they mature. The best-case scenario is that the baby comes home with us in a couple of weeks. The worst-case scenario is that she stays in Special Care until nearly her due date (which was November 30th). At some point she will be transferred to a less-intensive nursery (the “step-down nursery”), where things are a little less intense than the NICU.

Baby Pluot has a few challenges to get over before she can come home. One is apnea. This is like sleep apnea in adults: the baby basically forgets to breathe for a moment. The baby may recover on its own, or might need stimulation to start breathing again. The severity of the spell is measured in part by how much effort is required to get the baby to breathe again. In the NICU, apnea spells are expected and normal; all the babies are on monitors and when their breathing rate drops below a certain point, a nurse comes over to see if the baby will recover on its own, and if it doesn’t, she uses increasingly strong stimulation to get the baby to breathe normally again. So far, Baby Pluot has had a few apnea spells that required someone to rub her gently to wake her up. Apnea spells are normal for preemies and they outgrow them as they develop.

Another challenge is Bradycardia (”bradies”), which is a similar sort of occurence, except where the heartrate drops too low. Baby Pluot has had a couple of bradies so far; each brady buys the baby at least 5 more days of Special Care, so we’re rooting for these to go away. These are also normal for a preemie.

The last major thing that the baby has to develop is good feeding technique. To feed from a breast or bottle successfully, the baby has to be able to suck with reasonable strength, swallow and breathe all in coordination. Some preemies have trouble doing this. So far, things look reasonably good on this front: Baby Pluot has sucked down a few bottles and we’ve been working on getting breast feeding going, which takes a little longer.

To put things in perspective, I was in the NICU yesterday morning when the doctors were doing their morning rounds. They had lots to say about the other unit residents, some of whom are intubated, under treatment for infection, etc. When they got to Baby MacPherson, the salient comment seemed to be that she was being a “model citizen”. They had little else to say. The less the doctors have to say about her, the better, I say.

Not yet. If you keep bugging us, we’ll name her Crash. Don’t think we won’t!

Here is me looking after the baby before the onset of my ostracizing illness:

The NICU has lots of rules. There is a surgical hand-wash station outside the entrance that you have to use each time you visit. The babies can only be handled at the top of the hour on 3-hour cycles to avoid tiring them out too much. Only two non-staff-members can be in the unit for any given baby at any given time. You get the idea.

Anyhow, one of the firmest rules is that no one with respiratory infection symptoms (sore throat, cough, runny nose, etc) is allowed in the unit. Well, last night I noticed the beginnings of a sore throat. That’s it for me; I’m not allowed in to see the baby until my symptoms clear up.

So sad!

Well, the pluot update is that, to our great surprise, the pluot has arrived! Laura’s water broke in the early hours of Friday, and we went to Swedish, where our little girl was born 27 hours later, at 4:23AM on Saturday morning. She was 5 pounds, 3 ounces, which is pretty good for having arrived 5 weeks early!

Sadly, Baby Pluot doesn’t have a name yet, since Laura and I figured we had another 5 weeks to come up with one! In our fleeting moments of spare time, we’ve been working on our list of candidates.

Baby Pluot is currently residing in the NICU (Neonatal Intensive Care Unit) at Swedish, since she arrived so early. She’s been doing very well, though: she started breathing immediately when she was born, and has been doing fine on room air ever since. She has needed very little in the way of interventions so far; she just needs some extra time to cook, and to learn how to feed properly.

I have been staying with Laura on the OB Ward at Swedish since the delivery, but we are going home together this morning. The baby stays in the NICU, so we will be spending a lot of time in the hospital in the weeks to come.

Apparently, the pluot’s lungs are now fully developed. This is bad news to me, because I know just what they will be used for as soon as the pluot arrives…

My friend Timmy is in New York at the moment. This funny quote (which I have shamelessly ripped off) is from Overheard in New York, which you should really go read.

Tourist lady: Does this A train go to Jamaica?
NY chick: The A train doesn’t go to Jamaica.
Tourist lady: Is this the A train?
NY chick: Yes.
Tourist lady: And it goes to Jamaica?
NY chick: The A train does not go to Jamaica.
Tourist lady: But I need the A train.
NY chick: This is it.
Tourist lady: I need the A train to Jamaica.
NY chick: The A train does not…Oh forget it. This is your train, lady, get on!

–Times Square station

This is very consistent with my experience of NYC.