Friday, July 4, 2008

A Little More About Yesterday

Maddy is recovering from her surgery this morning. The doctors are running the normal gamut of tests to ensure that there's no sign of infection. Her stats are generally good and she's getting along on relatively little supplemental oxygen. The only trouble spot is her heart rate, which is on the high side. That may indicate that she is feeling some pain, but she's had a high heart rate all along. Just in case, the doctors have given her some extra pain medication.

Meanwhile, in the room next door, Milo was switched to a different type of ventilator to help him expel carbon dioxide. Shortly after Maddy's surgery yesterday, Milo managed to dislodge his breathing tube. His nurses sprang into action and got him back on track very quickly. I guess Milo wanted to be sure that people were paying attention to him too.

Some extra information, pictures, and thoughts on all of this:

Above: Elaine and I with Maddy before her surgery. She is outside her isolette on a warming bed in preparation for her operation. The doctors performed the surgery right here (minus the nice quilt). The nurses frequently shift the babies positions to keep them comfortable and to prevent problems with muscular development. Here, Maddy's on her belly. They also keep her eyes covered because they are so sensitive to light.

Mom spends time with Maddy.

Maddy's NICU room became an operating room and the place was a buzz. Although everyone involved had extensive experience with this procedure, Madeline was the first baby at Alta Bates to receive a PDA ligation at the facility. Normally, the babies go to nearby Children's Hospital for the procedure. Cheryl, the women in the center of the picture at the bedside, is one of Maddy's primary nurses.

Maddy's surgeon, Dr. Olaf Reinhartz prepares Maddy for her operation. (For those of you who know our friend Stephan, check out Dr. Reinhartz's profile. You'll be amazed to learn that Stephan has a long lost brother who's a cardiac surgeon!)

Above: Milo rests comfortably in the room next door. Notice his little hand right next to his mouth? The little guy likes to grab things...

Sandra and Terry, two of Milo's primary nurses, swinging into action after Milo dislodged his breathing tube. At this point he was stable.

So why was I taking pictures of all this? A week or so ago, I would have been a mess, and, don't get me wrong, none of this is easy to watch. But, it's all part of the journey now and this was not the first time Elaine and I have had to see such things. We have a lot of reasons to hope (and maybe even expect) that this is all going to work out OK. Ever since their birth, Elaine and I have pored over the research and talked to doctors about the expected outcomes for 25 weekers. Most of what we've read gives us guarded optimism -- but we're always trying to assess how Milo and Madeline compare to the other 25 weekers who have made it though the first several months and gone on to live healthy lives. Come to find out, Milo and Madeline are progressing pretty much just as expected at this point for babies born at their gestational age. Barring an infection or some other serious unexpected set back, they should do alright. So, if you're a new parent of a NICU baby who has found this blog, take a look at the pictures and know that this is all "normal."

By the way, for those of you who have also been looking at the research online or elsewhere, avoid looking at studies more than 10 years old. Keep in mind also that when you control for factors such as the parents' background, nutrition, education, and the level of support and intervention the child receives, the long term outcomes start to look much better. For those interested, Elaine and I recommend the book Preemies: The Essential Guide for Parents of Premature Babies for the best information. It was written in 2000, but it's still one of the best books out on early babies.

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