A's & Beep's

Edward is now past 30 weeks gestationally and will mark 31 weeks this upcoming Wednesday.  He is also now a pudgy 1250 grams, or 2 lbs 12 ounces, which is exactly 1 lb over his birth weight!  He is still receiving 23 milliliters of milk through an orogastric tube every three hours which adds up to a little over 180 milliliters / day.  He remains on CPAP with intermittent nasal cannula trials twice a day.  We hope we can wean him from the CPAP over the next 10-14 days.

Our care in the NICU at UVA has been phenomenal and we could not be more pleased with Edward's progress thus far.  But like any NICU, there is a lot of.....'beeping'.  Unless one has spent meaningful time in an intensive care unit setting, this beeping can be a little bit unnerving.  Throw in the fact that your 25 week old premature baby generates much of this beeping and you might go a little crazy.  Edward, like any premature infant, makes many things alarm throughout the day.

Edward is hooked up to several monitors - three miniature EKG leads arranged across his chest monitor his heart rate.  A foil heart with a sticky underside affixes a temperature probe to his skin.  A pulse-oximeter envelopes his tiny foot and measures his oxygen saturation level and his respiratory rate.  There is some built in redundancy to this system - for example, his pulse-oximeter also measures his heart rate - just in case Edward dislodges one of these probes.  And man do these things beep.  I am pretty familiar with all these different types of beeps and it was pretty entertaining to teach Katie how to discern which beeps are 'good' and 'bad.'  The unfortunate truth is that none of them are totally good or totally bad, but must be taken in the context of the patient.

There is one aspect of Edward's prematurity that causes the most beeping and is probably the most unnerving: apneas and bradycardias, or A's and B's.  They call it apnea of prematurity and it breaks down like this: your newborn, premature child will stop breathing....but only for a few moments.  This will be associated with a precipitous drop in your child's oxygenation level and an accompanied drop in your baby's heart rate.  Your baby will also  turn from a lovely shade of salmon pink to dusky grayish-blue.  Oh and it will happen a few times a day, even when you are holding him.  And things will beep like crazy.  I have a vague memory of A's and B's from medical school, but have to admit I was not completely ready for these episodes.  And Katie......well, she hates them.....with a passion.  Fortunately, these episodes last only seconds and the nurses quickly come running to 'remind' Edward to breathe through gentle stimulation (rubbing his back or chest).   Nonetheless, it is still a challenge to see your child endure such things.  And like many things, Edward will simply outgrow these episodes.  We cannot wait for that. 

Beep.

Let the indoctrination begin.

 This the inside of Edward's Isolette (incubator).  He sees this everyday.