Sunday, July 10, 2011

Week One

This Friday Lillian turned one week old.[1] She's made some good progress over that time:
  • They've taken her off sodium bicarbonate [2]
  • They've taken her off antibiotics (ampicillin and gentamicin)
  • She no longer needs a bilirubin light [3]
  • She will suck on a pacifier specially designed for preterm infants
  • They've removed several of her IVs
That last one is only a nominal improvement. The veins in her hands collapsed so they had to remove those IVs. But she still needed the nutrition and medications she was getting through the IVs, so they inserted a PICC line, which is larger than an IV and goes almost all the way to her heart.[4] They also had to start her on an oxygen cannula [5] because she was wearing herself out trying to breath on her own. Nonetheless, she made enough improvement that they moved her out of the 'Emergency' section of the NICU and into what they call the 'Grower and Feeder' section of the NICU.[6]

WARNING: If you are bothered by pictures of infants in intensive care or male chest hair, you probably shouldn't read on.

video

For a few days this last week I had some gastroenteritis [7], so I avoided going to see Lillian. I missed seeing her, so I asked Leann to take a video so I could at least see her. Leann said Lillian cried quite loudly that time. In this video she still seems to be recovering from whatever ordeal made her so made. Her arms and legs are flailing (this is one of the signs that a preterm baby is in distress) and once the camera gets in close enough, you can actually hear her gasping. I think it's cute.


The nurses took a hat for a term baby and cut it in half. Then they cut the leftover ring in half and tied it into a bow. Even with the size reduction the hat dwarfs her little head. You can also see her oxygen cannula and a purple binkie designed for preterm babies.


Early on the doctors and nurses have encouraged us to hold Lillian skin-to-skin. After one of the first skin-to-skin sessions we noticed that Lillian's little feet left footprints in Leann's tummy.

video

video

She's also had some skin-to-skin time with her Daddy. You can see by her expression that something about this experience was slightly alarming. We're not sure whether it's because I have a different heartbeat from Leann (which she's been listening to for the last 2–3 months [8]) or because my chest hair was tickling her. Eventually she got used to it, whatever it was, and took a little nap in my arms.


Now that things are starting to calm down a little bit, we're starting to look around us again. Outside the hospital we noticed that there are some Stargazer lilies. We've dubbed them Lilli's lilies.


On July 5th, we also spotted this double rainbow east of our apartment. Just a simple reminder of God's love.


Notes:

[1] For more about her unexpected arrival, see here.

[2] Bicarbonate (HCO3) is used as a buffer by the body to keep the pH of your blood stable. If your blood becomes too acidic or too basic, it can cause damage to your organs and tissues—particularly the central nervous system. The pH of Lillian's blood was fine, but the concentration of bicarbonate was low, which put her at risk for acidosis or alkilosis.

[3] Your red blood cells contain a protein called hemoglobin. Hemoglobin binds a chemical, called heme. Heme is made up of a carbon ring, called porphyrin, which has an iron atom complexed in the middle. The iron binds oxygen so your red blood cells can transport it around the body. When a red blood cell dies, the heme molecules must be degraded. The first step of degradation breaks heme down into biliverdin (which is green), iron, and carbon monoxide. The second step converts biliverdin to bilirubin (which is yellow). The bilirubin is then transported to the liver. In the liver bilirubin is further broken down and it eventually ends up in the intestines. Since Lillian's liver wasn't ready to start degrading bilirubin, it continued circulating through her circulatory system, giving her a yellowish hue. Too much bilirubin in the blood stream can cause brain damage. Since bilirubin is naturally degraded by light, they put a light over Lillian to hasten that process.
     If you've ever had a large bruise, you've seen the different stages of heme degradation. At first the bruise is red, black, blue, or purple because of the oxygenated red blood cells. It then turns a greenish brown color as heme is converted to biliverdin. Then it turns yellow as the biliverdin is converted to bilirubin.

[4] PICC stands for Peripherally Inserted Central Catheter. To ensure correct placement, they have to do x-rays. If it is inserted too far, it can enter the heart and interfere with blood circulation.

[5] This is like the oxygen tube you often see elderly people wearing.

[6] This is slightly disturbing since 'Grower and Feeder' is also a term applied to pigs that are being fattened for the fair and/or slaughter.

[7] See my post The Stomach Flu.

[8] Babies can hear things in the womb around 20–24 weeks gestation.

1 comment:

  1. Oh, I'm so glad you posted those videos! Lilli is adorable. It would be so hard to have to leave her each night. It will be wonderful when she can come home. Love you guys!

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