February 24, 2008 – Adjustments ahead

As I return to work on Monday, my heart is a little heavy with nervous concern.  I have been out for weeks and am sure I will be busy getting caught up over the course of the next day or two.  Resuming work will provide a change to the pattern of daily life for me and my family, and as it is with any change, the disruption will require some adjustment from all of us.  During the course of the past week, I became more and more settled into a familiar routine juggling hospital visits, time with family and household tasks.  All of this will change again in a few short hours, so I turn my prayers to God for serenity and sanity while we adapt.  I would not be honest if I told you that I do not already feel some strain and anxiety over this, but I know that this too will pass.

Today, unfortunately, was more stressful than I would have wanted.  Daria experienced several episodes of bradycardia, or sudden drops in her heart rate (http://www.pregnancy.org/article.php?sid=1601), which is not uncommon in premature infants.  Usually the drops are a result of apnea, or a pause in breathing, as are the oxygen desaturations we have seen Daria go through recently.  While I know the “bradys” happen all the time in the NICU, Jenn-Jen and I happened to come into the room right as one was taking place.  This only adds an extra layer of stress and trepidation which we prefer not to have at the start our day’s hospital visits.  To help Daria through this, the nurse increased her oxygen level and pressure going through the nasal cannula and administered caffeine.  Adam actually went through a little bit of apnea during his stay in the NICU five years ago, so this is by no means a surprise to us.  As much as we are prepared for incidents like this, it still rattles our nerves to see them happen.  At least the bradys ceased during the day and I did not witness any more while I was at the hospital during my evening visit.

Katelynn is doing well and her feedings are still increasing by half a milliliter every twelve hours.  She is now at five milliliters, which is coming close to a full feed.  Once she reaches six and a half per hour, the nurse will discontinue her TPN and lipids.  Jenn-Jen and I are eager for that moment, as it means any blood transfusions that may be required in the future will be going through her Broviac line and there will not be a need to poke Katelynn again with a new peripheral IV line.  I did notice Katelynn’s belly looking a little fuller this evening, so I hope she handles the increases without problems.

On a different note, we are seeing decreasing temperature differences between the twins.  Katelynn tends to run on the high side, which results in an increased heart rate.  Daria, on the other hand, is cooler, so a balance in the incubator temperature is needed to make sure both girls are comfortable.  The remedy, which seems to be working, was to put Daria into a small gown and lower the incubator setting slightly.  The gown is actually quite big on Daria and it makes for difficult diaper changes, but I am glad the nurses found a good equilibrium. 

It is now 12:37 AM on Monday morning.  In a few hours, I will tackle the e-mails waiting for me in my inbox and try to shovel myself out as quickly as possible.  Jenn-Jen will be going to the hospital on her own for the second time since the twins were born, and I will need to adjust to periodic phone updates instead of direct, moment-by-moment contact with the NICU medical staff.  As I have said in some of my earlier posts, this is a long road and I need to remind myself to take it on with a marathon mentality, as opposed to sprinting without abandon.