Saturday, September 1, 2012

Day 25: Love hurts

Today was one of those days I wish I wasn't alone here.

It started off on a positive note changing rooms. The air conditioner hardly worked in my original room, the faucet was wierd, and the room setup wasn't optimal. My new room is the same size, but it is set up slightly different in a really good way that works so much better for me. It is also cleaner and has a great faucet though the bathroom is smaller. The AC blows ice cold and no sediment is coming out of it. It's amazing how refreshing and engergizing this small change of scenery is. Now if I can just stop freaking out the new resident of 308 and stop trying to open their door out of habit.

The problem was that Tara had a rough feed early this afternoon and it really shook me up. All the bottle feeds I have done turned out to be when they were hungry and semi-alert. But Tara was not any of those things. She wouldn't open her mouth, blocked the bottle with her tongue, and was determined to sleep. She didn't want to suck, and would barely swallow what she had in her mouth or would start to gag on it. I had no idea bottle feeding could be so difficult and require such subtle skill, but now I have a taste of the bottle feeding difficulties I've read about. I'm frustrated with myself that I seem inept when it comes to detecting her getting cyanotic, because something about their skin coloring being darker must make it harder for me to see when paleness or duskiness occurs. I'll try to focus on the palms of the hands or lips, but it causes me a lot of anxiety. She dipped the lowest I've ever seen her and the nurse grabbed her out of my arms and gave her some painful stimulation until she cried. I know it was good for me to see and learn, but it broke my heart. I felt like an idiot that she got down that low and I didn't realize and stop it. I thought it was a faulty monitor at first because it had just malfunctioned and had to be reattached a few moments before then. I have to be decisive during feedings about when to take breaks and burp them to keep them alert or give them rest, when to turn or tap the bottle, when to back off a bit. I need a third arm to stimulate her while the others hold her and the bottle. Sigh. Sandia assured me this is something that should not be happening around the time of discharge when I asked, because there is no way at this stage I could feed her without guidance from the nurses.

I took a late lunch break after that since I'd gotten a late start with the room switch and ordered lunch from room service, and was determined to get back in the saddle later today and bottlefeed at least one of them again. They have two weeks to improve their weight and bottle feeding skills, but I think it is still possible. I'm keeping the mantra in my head of "The most important thing to remember about the NICU is that it will end." I let Sandia handle the rest of Tara's feedings for the day, and they were equally as difficult it appeared.

Vivek was also a sleepyhead though and I applied some of my knowledge with him and felt I did a better job feeding him. Then as soon as the feed is over he wakes right up, as did she, and is being alert and adorable when he should be asleep.

I tried kangaroo care with Tara after, and then she went and desatted and bradyed pretty hard into 60%/70bpm. This time I didn't hesitate and stimulated her hard and flicked her foot hard enough to hurt until she cried loudly twice, and she went right back into the upper 90's and stayed there. Sometimes you have to hurt the ones you love. 

The most important thing to remember about the NICU, is that it will eventually be over. I ordered Domino's pizza to end the night and remember as Scarlett O'Hara said..."tomorrow is another day."

Vivek foreground Tara background

No comments:

Post a Comment