Showing posts with label CPAP. Show all posts
Showing posts with label CPAP. Show all posts

Saturday, November 9, 2013

PAM FOD #9 - Preemie complications: Apnea

Prematurity Awareness Month
Fact of the Day
Day 9

Q: What is apnea?  How is it treated?
A: Apnea is when a person stops breathing for 15-20 seconds. You may have heard of sleep apnea. Apnea of prematurity is similar. In preterm babies, though, it's not sleep but an underdeveloped nervous system that is the cause.

JAM sporting CPAP.
This picture is property of momofa23weeker.blogspot.com
Do not use without permission.
That's the easy way to understand it. In addition to breathing support (like CPAP machines) and monitoring breathing and heart rate, doctors may give medical grade caffeine in order to help stimulate the baby's central nervous system and keep the baby breathing regularly.  As sleepless parents, we were more than a little jealous. We were pretty sure Jonathan's caffeine was much better than the really bad hospital coffee in the family waiting room.

All that said, on crazy days when I feel rushed, I find there's a lesson in all this. Learn from the babies. 

  • Breathing is important
  • Some days it's hard to breath
  • Caffeine may help

I sip my coffee and stare at the fall leaves. Yes, this is therapy. Respiratory therapy. Take a moment, sip some caffeine, breath. Calm the nerves. Breath again. A sigh or two may be good, too. Enjoy the moment, wake up the body. Now the day will be easier to conquer.

As always, I am not a medical professional, just a NICU mom. Do not use my website as professional medical advice, please. Especially the parts that are intended for humor only.

Wednesday, September 25, 2013

Week 32 (gestational) - FINALLY a good week.

One of his last days on a conventional vent - and finally
he's lost all that water weight.
Looking so much better.
One of his last days of showing off his beautiful brown hair
before it was covered with a CPAP hat.



September 15 through September 22, 2012 (A year ago) - Things were looking up for Jonathan. We'd finally gotten a good breeze, crisp fall air filled our lungs after a summer of unusually high and suffocating heat.  At least that's how I felt. There was a bit more spring in my step as the weather turned.  We were nine weeks into this NICU thing, and finally we'd found our stride. It was still rough, yes, but he was still alive, and that was enough.

My girls were both at school -- Ella thriving in kindergarten and Mimi enjoying preschool.  I was back at work, and while it was tough to catch up from eight weeks of maternity leave, I was so glad to see the students and my coworkers again. We were all adjusting to this new and busy normal.  Steve was taking the mornings he wasn't teaching (Tuesdays and Thursdays) to sit in the hospital room and work on his computer from Jonathan's bedside. He'd sanitize the computer before he'd start to work, and he'd scrub in again before he'd touch Jonathan, but the ability to answer emails in J's hospital room allowed him to be around when the doctors came by.  Also, when the nurses had a moment, he could get two or three to help him manipulate the vents so that he could cuddle with the little guy.

One of his first days on CPAP
Reports from the NICU were positive. I'd call Steve or the nurses every other time I pumped, so a few times a work day.  After his NEC/bowel surgery, things had been rough for a bit. He kept retaining fluid, and once they did start him on my milk again, it took him a while to digest it, leading me to be so afraid of another occurrence of NEC. Dilating the bowels helped get things going again, and ever since that first overly celebrated poop, three weeks after his first NEC surgery and about three or four days after we started him on food, things had been going great.  His ostomy site looked good, his central line looked good, and I was able to hold him nearly every time I went in. To me, that was worth the world.  Except, of course, that I had a cold, so I didn't go in as much, and when I was in, I was wary to hold him. But STEVE could hold him, and again, THAT was something.

Also, while the previous week he'd fluctuated between needing and not needing the conventional vent, this new week brought new strength to Jonathan's tiny lungs. He was placed on NIPPV, a CPAP machine that gives continuous positive airway pressure as well as puffs of additional pressure to stimulate breathing. After a few days, he graduated from that and was breathing with only the support of a CPAP (Continuous Positive Airway Pressure, in case you missed that the first time) machine. A CPAP is what is worn to bed for those with sleep apnea. It seemed like "no big deal," a step in the right direction. He was breathing on his own.  The machine was a quiet bubbler that, unlike most NICU machines, actually provided a bit of ambiance to the room. On top of that, we'd started being able to put Jonathan in clothes. A friend had knitted a sweater that worked perfect to cover up his ostomy while still providing easy nursing access to his central line (nurses had to observe that on a regular basis) and ostomy site.  If you want to make a NICU baby a cute, cuddly, humanizing outfit that also works well (for most everything except arm IVs) I recommend this pattern.

On the 19th of September I went in to help with Jonathan's evening cares. He was two months and two days old. And I got him mad.  For the first time since the day he was born (when he squeaked upon entering the world), Jonathan cried an audible cry. He had opinions and he was voicing them. I couldn't have been prouder.  Yes, he was mad at me for pulling a cord. But he was well enough to BE mad. My heart was a bit lighter that day. I'm sure I smiled at everyone as I left the NICU. "My son was mad at me. He was screaming these little squeeky screams!" I'd have said, if they'd asked about the silly grin. "Isn't life wonderful?"

A year ago he also finally lost all his water weight. He got down to 2 lbs 6 oz. His highest weight had been 3 lbs 11 oz. He was carrying over a pound and a quarter of water on a two and a quarter pound frame. Poor kid!  And then, just to add to my delight, after we started feeding him milk again, he started gaining. By a year ago, he was twice his birth weight at a hefty 2 pounds, 10 ounces.

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Tinkerbell's fourth birthday
A year ago we took a break from the NICU the weekend of Mimi's fourth birthday. We drove to the hospital, visited baby J, then drove up to great grandma's house several hours away for an over night. Grandma joined us at her mom's house, too. We'd only go over night, we told her. We couldn't stay for a weekend as usual, because we HAD to see Jonathan once each day. It was all we could do, it was our duty.

Great Grandma's house is near a lake. It's one of the great lakes, so it feels more like an ocean. Add the cool fall air and the warm sun, and it's nearly perfect.  Or it would have been. I slept in the basement most of the time, trying to rid myself of the cold.  Steve and the girls went to look at the lighthouses and stones along the beach. Mimi talked about that birthday with her two grandmas for the whole next year. How she'd gotten to see Grandma and Grandma, and how she'd dressed like a tinkerbell.