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Jaundice: Round Three

Posted Oct 18 2012 1:21pm
 
Update:  We are home!  I took the most incredible nap of my LIFE. Seriously, it was only an hour, but it was a deep sleep that left a circle of drool on on my pillow and me feeling rested.  Funny how the body so easily gets used to such little sleep that an hour feels like eight!  I haven't taken any pain pills in two days, as I did not want to be the only person responsible for making medical decisions for Andrew and be under any sort of narcotic influence.  So I did take one precious pill when we returned home and my pain is much better.  I think for being seven days post-op, having had very little sleep in that past week, and being on my feet pretty much for the last 24 hours, I am doing pretty well. We have a follow up appointment for Andrew tomorrow, just to make sure he is continuing to gain weight and stay hydrated, but other than that, it's time to settle in and find our "new normal". 

Both Will and Emma had jaundice.  Will avoided phototherapy after a 48 formula push and Emma needed the bed at home to turn her jaundice around.  Andrew is proving each and every day to be my  trailblazer and we were admitted to the hospital yesterday for phototherapy after home therapy failed to bring the numbers down (they went up). 
 
His numbers are not in any sort of danger zone (25 and up and you are admitted to NICU - we are at 24 and in the normal pediatric care unit), but in addition to the jaundice, he had some other vitals that were concerning to the home health nurse who came to set up the bed (his respiration rate was high again, which was the same issue he had prior to his "episode" last week).  Also, his numbers had gone up pretty substantially in less than 24 hours, and we wanted to make sure that wouldn't happen again.
 
We arrived here about 3 PM.  Admitting took a little bit of time, but then we were brought up to the floor.  The room is awesome and the nurses were seriously incredible.  The room is like a hotel room, with our own bathroom and flat screen tv.  There is a kitchen with soups, ice cream!, jello, juices, sodas, cereals, and more.  They also let parents order a courtesy tray, so I was given a menu and a form to fill out to order dinner.  The pediatrician spent a lot of time with us, examining Andrew, explaining jaundice and the phototherapy process, and answering questions.  We then had two nurses to get us all set up.
 
That's when the wheels fell off the wagon a bit.  Andrew HATED the bed.  He would be completely calm and then we would put him down.  He would start writhing the second my hands left him.  And then he would SCREAM.  After about a half hour of this, I pulled him off of the bed and nursed him again, only to have it all start over when we tried to put him down.  It was during this time that M had to leave so that our Nanny could go home.  So I was flying solo.  I never even got to order dinner from that fancy-dancy menu.
 
I could settle him for a few minutes, and then BAM!  He would startle or just start crying.  I had to stay hunched up with him under the lights, patting, shushing, etc., and he was still crying.  The nurses came in and out, tried different things, but we were getting nowhere.  I kept watching the minutes tick slowly by on the clock and knew I was in for possibly the longest night of my life.
 
After about four hours, I asked the nurse about giving him a formula "topper" since I hadn't had a chance to pump yet and they wanted him on the bed, rather than being nursed. FOUR OUNCES (this is a LOT) later, he was a much happier boy, though he still wasn't loving the bed. We got a couple of hours under our belts and then he seemed to be okay with nursing and being on the bed for a bit in between sessions, but the pediatrician said he still needed more time on the bed. So the night nurse and I got creative and made him a swaddle out of the cover material they use for the bed (side note, why do they not make blankets like this to go with the beds. . . I should patent this idea) and tucked blankets around his legs to make him feel more secure. Since then, he has been happier, though I have learned this guy is a big time cuddle bug. The minute that he is picked up, he plops his head down on my shoulder, sighs and shudders, and goes right to sleep. So he isn't hungry, in pain, or any of that. He just wants to be loved. I have promised him that when we get home, he will get lots of snuggles and loves to make up for the past day. I don't think I will put him down for a week!!

Probably my favorite part of last night is when I was trying to soothe him and gave him his binky. He literally took the binky out of his mouth and hurled it out of the crib. The nurse laughed so hard she was crying, because even though there is no way a newborn could have that type of coordination, it really looked like he did it on purpose. 

It was a long night, but we got labs drawn this morning at 7 AM and it seemed to be worth it - his bilirubin was down to 11.6 (it needs to be below 13 for discharge)!!! We all got very excited until the pediatrician was skeptical of such a quick drop and we realized the lab tech had made a mistake and drawn the blood while the lights were still on. The lights are so good at breaking down the bilirubin that it will do it in the vial while it is being drawn. So, now we have to have another draw and see where his numbers are truly at.
 
The other good news is that the fast respirations were likely from dehydration.  They gave him fluids and everything has been stable since.  Thank goodness. 

So I will update here as I can, but he is making lots of diapers (a fantastic sign), looks less yellow already, and his feistiness is a great sign he is feeling okay despite the jaundice (it makes some babies feel sick, but it doesn't seem to be doing that to him). We are hoping the numbers later on today look good and we are home by tonight.
 
 
 
 
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