Baby Emmett, NICU

NICU day 59

This morning the doctor prescribed Emmett a prednisone nasal drop to help with the inflammation. He’ll take it twice a day for 7 days. They also put him on a fast-acting diuretic for two days, twice a day to help with lung inflammation and edema. If we don’t see improvement, may look into a longer-term diuretic.

After a rough night last night, I was both looking forward to getting away from the hospital, and dreading leaving Emmett at the same time. The fact that Theo has swimming lessons on Saturday was a good excuse to get away. Sometimes I need that extra nudge to peel myself away. While I was gone, his breathing got so bad again that the nurse decided to suction him even though we’ve been trying not to as much because of the inflammation. It’s a good thing she did, because she got what she described as a “gremlin” from his nose that had formed a complete plug. No wonder he couldn’t breathe. She said she was so impressed with the size that she called the doctor in to take a look!

Unfortunately, both his cannula and the feeding tube may be exacerbating his congestion. The feeding tube is giving all that refluxed milk something to cling to, and the cannula is blowing dry air in, which is basically the perfect recipe for monster boogers that are so far back in his nasal/throat area that they’re really difficult to suction out. We have some humidity on the cannula, but it’s still drier than if he were just breathing room air. The feeding tube also keeps his esophageal sphincter slightly open, which can exacerbate the reflux. Unfortunately, life is basically one giant catch-22 right now. We can’t remove the cannula until he’s having fewer events, and we can’t remove the feeding tube until he gets the hang of breast/bottle feeding. But the reflux and difficulty breathing are inhibiting feeding and causing events. And around we go.

We may try another round of systemic prednisolone, since he responded so well last time. If we do, they may try removing his cannula toward the end of the course while it’s still in his system. Meanwhile all we can do is try to keep breastfeeding him whenever he’s alert and hungry, but he’s working so hard to breathe right now that the nurse described it as like you or I trying to do aerobics and eat at the same time. Our attempt at breastfeedng today was a complete bust, so after about 20 minutes I just pulled him up into a kangaroo hold. Despite my disappointment over continued breastfeeding failures, he ended up having a really good rest of the afternoon. He was calmer than I’d seen him in a couple days while on my chest, and hardly had any desats. Those steroid drops really made a huge difference with his congestion, and while he’s still bothered by the reflux, at least he’s breathing clearly now. His weight was up 24 grams tonight, bringing him to 5 lbs 1 oz.

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Baby Emmett, NICU

NICU day 58

I had the below post all written out last night, and then things took a turn for the dramatic. It was by far the worst night I’ve had with him yet. The reflux has been getting worse and worse, and he’s had so much suctioning to remove everything that keeps accumulating in his nose, that he’s now developed some irritation in his nose from all the suctioning. His nasal passages got so swollen last night that he could not breathe out of them at all. Babies are obligate nasal breathers, so it’s not like when an adult is stuffed up and just breathes out of their mouth instead. So he would turn purple holding his breath, then gasp and cry out (which thankfully would get some oxygen in him), but then he’d repeat all over again. I felt so helpless. All I could do was stand there holding him upright, sobbing, while listening to him gasp for air. This all went on until about 2 a.m., when the doctor gave him some steroid drops in his nose to calm the inflammation. That at least allowed him to get some air through, but he’s still really struggling to breathe and just sounds so miserable.

Anyway, here’s the rest of what I had originally written yesterday. I don’t have the energy to merge the two or rewrite anything.

* * * *

This morning Emmett’s team started him on Prevacid [edit: I had originally written Prilosec – oops, wrong med!] to help him with the reflux. It will take a few days to see whether it makes a difference. I’m really hoping it does, as it’s pretty miserable seeing him so miserable. This evening his nurse mentioned we would take him off of it if it didn’t seem to be making a difference, “because of the potential side effects.” When I asked her what the side effects were, she kind of stumbled and admitted she didn’t, know and then said I could just google it. Um. Not impressed with this nurse so far. What medical professional tells you to google? Of course google came up with all kinds of awful stuff. I’ve been so good about not consulting Dr. Google when it comes to Emmett, which is very unlike me, so I’m kind of annoyed she sent me in that direction. A few minutes later the nurse came back and said she talked to the doctor and he said the side effects are so rare that they aren’t even worth mentioning unless something seems off with him or he stops growing. Reflux is really common in preemies — and even in term babies — and the treatment with antacids is pretty common.

Speaking of growth, he had a wimpy 2 gram gain tonight, but they’re actually happy with a modest gain, as he’s been a little puffy the last couple days and they think he may be retaining water. He’s had several days of large gains, which would corroborate the edema. The nurse earlier today was even talking about starting him on a diuretic to flush him out. I need to talk to the doctor more about this, as the nurses have been fairly vague and I hope it’s not indicative of something potentially more serious.

Theo came to visit his little brother this evening. I had gone into the office today and after work I got him from daycare and we swung by the hospital for a few minutes. He hadn’t seen him since he got out of the isolette and immediately asked where the top of his bed was. He was happy to see that baby Emmett was bigger, and when I picked him up and crouched down low to the ground so T could get a better look, unprompted, he kissed the top of E’s head. I wish I had gotten a photo, but my arms were full of baby. It was a very sweet moment.

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