In the middle of the 19th century, a Hungarian obstetrical resident named Ignaz Semmelweiss made the bold prediction that washing one's hands is good for patient care. In a story well-known to modern medical students and residents (and recently recapped in one of Atul Gawande's book, Better), Semmelweiss ran a maternity clinic with a horrifyingly high maternal death rate due to what was known then as puerperal or childbed fever - especially when compared to the midwife clinic. In his effort to improve survival, Semmelwiess realized that it was the doctors and medical students themselves who were transmitting the infections back and forth from the autopsy laboratory to the maternity clinic. Through implementing hand washing, he was able to essentially reduce the maternal death rate to near zero. Of course, as he was way ahead of his time, his ideas were rejected by the medical community and he was dismissed from his job.
Fast forward 150 years - Katie and I wash our hands. A lot. In fact, the act of seeing Edward requires a series of steps and routines to which (for both fortunate and unfortunate reasons), Katie and I have become quite accustomed. First, gather supplies. Camera. Water bottle. Breast pumping kit. Snacks. Camera. Book to read. This list goes on and on. Then, drive to the hospital. Luckily we live a short 10-15 minutes from the hospital. Most parents in the NICU do not live in Charlottesville and in fact live 1-2 hours away - making visiting their children almost impossibly hard without staying locally. Katie and I remind each other how lucky we are to live so close to such high quality care.
Then, park the car, but don't forget to get a parking pass. Then go get the parking pass validated. Then take the elevator to 7th floor. Then pick up a phone stationed outside the NICU. This phone automatically rings the NICU front desk. From there, Katie and I identify ourselves and request permission to enter the unit. The secretary, or hospital-unit coordinator as they are called at UVA (affectionately called HUCs) then calls the nurse on his or her unit cell phone to see if it is a good time to visit. Occasionally, we are asked to wait 10-15 minutes if there is sterile procedure going on within the unit or if the nurse needs a few more minutes with Edward, but most of the time we get buzzed right in.
Then we wash our hands. Quite thoroughly. We remove all outer clothing, bracelets and watches. They do allow for one single wedding band. Katie often just leaves both rings at home as taking off one and leaving another does not seem like the best idea. We approach the motion-sensored sinks, wet our hands and then slather on a heaping dose of chlorhexidine gluconate, a popular and potent antiseptic used within hospitals. We then scrub and scrub and scrub. Rinse. Pat dry with paper towel. Nearly done.
We then push the 'doorbell' of the NICU which allows the HUC to view us on a video monitor and buzz us in through a locked door. We sign in at the HUC's desk and then finally we make our way to Edward's Isolette. It's crazy how foreign this routine was to Katie and I just four weeks ago and how commonplace and 'routine' it has become for both of us. The best part is, though, seeing that little guy at the end of all those steps. Though still small, he brings us so much joy and he is worth every second of this process.
Furthermore, Edward is still doing relatively well. He has now been extubated for over a week and is tolerating his CPAP well. He also is still tolerating his feeds and is taking in almost 150 milliters of breast milk every day. He seems to grow before our very eyes. He is now 2 lb 2.5 ounces (980 grams). He will soon be over 1 kilogram! He has had some setbacks with some on and off signs of infection, but for now is doing well off antibiotics. The basic plan moving forward is grow, breathe and avoid infection. So far so good!
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