However yesterday was still awesome, because I dared to do kangaroo care with Tara for the first time in about a week. I'd asked not to because she desatted so horribly for so long the last two times I did. However last night she did an hour and a half on my chest with only 15 minutes of desatting that required mild stimulation. I was ecstatic!
I had worried myself sick yesterday because Vivek had a bradycardia and vomited, and two doctors and several nurses had what seemed like a concerning conversation around him for 10 minutes. I'd never seen him brady, so it scared me a lot. I checked this morning with Dr. Kothiala and she assured me that the reason they backed off on his feeds and switched back to breastmilk yesterday was because he only vomited the one time, and they are re-introducing formula today. I told her that I do think they are too quick to dismiss my reports of bradycardia as a problem with the sensor in my opinion, but she was certain that if the nurse there at the time did not report it to her then her physical check of him at the time would have confirmed itwas a false alarm. A large part of my perception is that I am scared of NEC and every little negative thing I see seems ominious and my fear is giving me an overly active imagination. But my friend Lakshmi today made me laugh when she echoed that sentiment and told me that when Dr. Kothiala has her stethoscope on one baby's chest a few seconds longer she is already thinking something must be wrong and there must be a reason. I guess as a parent you always find something to worry about with your children.
Today was much more productive. Two sessions of kangaroo care with both babies, and Tara did even better and tended to stay above 97% oxygenation...even better than Vivek. She is definitely gaining weight and has chub in her cheeks that wasn't there before and makes her look even more adorable. She is more alert when feeding time rolls around and makes more vigorous sucking and smacking noises with her mouth. That instinct is kicking in for them both, and I found out once they weigh 1500 grams they will start bottle/breast feeding attempts. I showed them my Lact-Aid SNS sytem today, and it turns out they were familiar with it already because of a previous patient. They found it difficult, but were amenable to trying it.
Vivek was a naughty boy today and when he was un-diapered for his nightly weigh-in he peed all over the floor and may have gotten a drop or two on the nurse!
I re-fired Manju, and this time I meant it. Last time Manju was fired, she wound up getting a 2nd chance because it turned out enough surrogates were not available to provide milk. She cleaned up her act for a few days, but then got lazy again and was barely pumping and putting more pressure on Nita to provide the milk. Nita is not happy, and I plan on giving her a big tip tomorrow once Manju is really gone. They had been asking about payment, so today I sorted out payment and paid in full until Monday for the both of them for the milk. It was 430 rupees for 31 days for Nita, and free the first 15 days for Manju but 430 every day after that. They were sharing a room so that may be why it was less than I anticipated. All in all for 31 days I paid 20,210 rupees for two surrogates. It does annoy me that my friend Lakshmi is only paying one surrogate who is a super milk-producer and has enough for two almost full term babies!
However afterwards a clearly upset Nita brings milk that Manju should have brought, and declares that once she had found out I'd paid she decided to take a little vacation to Ahmedabad and not pump today. That was the last straw. Since they are partly on formula this week we can get by with Nita's milk only, so I went to Dr. Patel's office and very angrily demanded a refund for today and every day after for Manju. She needs to resign the contract and go, but any bills come in for any hospital stay or milk providing from her and I'm not paying. They could tell I was serious, and they paid me back immediately. She will not have a pleasant surprise when she comes back from what I guess she thought was a paid vacation.
I treated myself to a nice dinner out at the Noon to Night restaurant on the terrace overlooking the city. It was a nice end to a long day, though finding a tuk-tuk after dark in the rain proved slightly challenging. The French onion soup I ordered had too much pepper, but at least they didn't totally ruin it. I almost ordered the enchiladas, but I knew it was too good to be true so I decided to avoid the disappointment. My quest for grilled vegetables was a bust because the tandoori veg platter had odd patties and paneer instead. I ordered a mango lassi with ice cream like I've had elsewhere, but the waiter told me that is not good and tried to talk me into a simple milkshake. I told him it is too good, and he laughed and brought me one. It was delicious. I can't wait to get to Delhi where the food is awesome. I hate to complain about the food so much, but honestly it is the worst thing about my existence here aside form hours in the plastic torture chair.
I did find out from my father in law and it was confirmed by my friend who lives in India that people didn't get involved in the dead or dying man in the tuk-tuk for two reasons:
1. My initial thought was correct....they thing when someone appears to be dead it is a done deal and rescuscitation is not something they see as the right or necessary thing to do.
2. No one tends to get involved here because any death turns into a police investigation, and you may suffer hours of interrogation because they will think it could be a murder and you are involved somehow. It only goes to show how corrupt and inept the police are here, but unfortunately they have enforcement power. I'd like to understand more about how this is the case, because given my background I find it more than just a little bit disturbing.
But to end on a more positive note, here are some videos of very sleepy babies while their Mommy discusses Vik's indiscretion with them both.