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Saturday, July 16, 2011

One Less Line

It has been difficult to find time to post now that I'm back to work. I have been getting up at 3:30 am to be at work at 5am. This way I can get to the hospital in time for Lincoln's 2pm feeding. I have been able to get two or three nursing sessions in before leaving each night around 8:30 or 9 pm. This leaves me with about four hours of sleep. I wouldn't be getting much sleep if I had a 7 week old baby at home either, right? Breastfeeding has been going great. Lincoln latches on pretty well and consistently nurses for 25 minutes or more. It's difficult to say how much milk he is getting, so the nurses just give half of Lincoln's feed through his tube if he does well. Otherwise he gets his full feed on top of the breast. I'm thinking of starting him on bottle feeds next week. He will need to take a few bottles even when he is home with me since he is getting protein and iron added twice a day for a nutrition boost.

Lincoln's last IV med was switched to an oral dose yesterday. So around 11 am his IV line was taken out! After 51 days, Lincoln no longer needs an IV! It's one less thing keeping him attached to his bed, and it's so much easier to pick him up now. I don't have to worry about tangled lines and pulling his arm. It also means he can wear clothes the proper way, with both arms in! He still gets morphine by mouth every 3 hours. He is on a wean schedule for that to be taken away over the next few weeks. The morphine just helps Lincoln to not withdrawal from the IV drips he was on. He doesn't need it for any pain. He also gets his hydrocortisone steroid and sildenifil (hypertension med) orally. His steroid is also on a wean schedule, but the sildenifil will most likely come home with him, and he will just out grow the dose.

Linc has progressing nicely with his breathing, too. He is now on 2 liters of flow and usually between 26-32% on his oxygen. I think once he is able to get to 1 liter, the high humidity can be turned off. Linc needs the air to be humidified in his tubing due to the high flow rates. Otherwise, his nasal passage could dry out and give him nose bleeds.

As Lincoln continues to do well, he is getting less labs done on a regular basis. He now only has his blood gass, blood count and electrolytes checked twice a week (vs the Q4 schedule he was once on). It is wonderful to see Lincoln getting better everyday. He has started to move his arms and legs a lot more. He used to always keep them tight to his body and hands in fists in a defensive mode. I think he is feeling more comfortable and happy now that he is getting poked a lot less. Although Linc is not gaining as much weight as the doctors would like to see, he is still beefing up. He is getting a double chin and rolls on his arms and legs. He has a very expressive face, too. He does smile occasionally now, but only when he is sleepy (or gassy). He hasn't begun to talk yet, but he does a lot of grunting to communicate. It's just adorable!

The goal for Lincoln to come home is to get him off of oxygen assistance and taking every feed orally without supplementing through his feeding tube. If for some reason it looks like Lincoln will not be able to accomplish either of those in a reasonable time, he can go home with a version of both. So far Lincoln has not shown any indication that he will not continue to do well and should be able to accomplish both goals, say his docs. They still cannot give an estimated discharge date though. It will all depend on how quickly Lincoln progresses and when he is ready.

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