Zachary – Week Two

Week two started out amazingly well for Zach. We knew from his cultures on Friday, New Year's Eve /Day that he was septic. By Saturday, he already showed some improvement with fewer bradycardia / apnea spells. By Sunday night (Jan 3^rd), he'd mostly kicked the sepsis! He'd already been on antibiotics when they did the second lumbar puncture, which we hear went very well. We were not allowed to be in the room, but we heard that Zach was on a nurse's lap resting peacefully while the LP was done. We were thrilled to learn that he did not have meningitis! We were even allowed to kangaroo with him after a few days of not being able to hold him while he was on the CPAP. By Sunday, he was also able to start back on feedings. (They'd stopped his feedings because he also had inflammation of the bowel.) On Sunday night, he was dialed all the way back to 9 mls / 4 hrs, which is what he was fed on his first day of life outside the womb.

On Mon Jan 4^th, Todd and I went back to work. I tried to spend part of the day with him, but this was kind of a disaster. Every little move he made drew my attention to him and away from work. And of course, I had to pump every 2 hrs. On Tues Jan 5^th, his weight hit a low of 1735 grams. He came off the vancomycin but retained his other two antibiotics and the supplemental parenteral nutrition. I was allowed to attend rounds for Zachary. Zachary is attended to by an attending physician, a nurse practitioner, a nurse, a pharmacist, and a nutritionist (and a respiratory therapist for a short time). The group gets together once a 12 hour shift to discuss his status and any changes they want to make in his treatment. As they began to discuss his infection, the doctor was trying valiantly to put the information into layman's terms but was having a hard time getting it across. Finally, I just blurted out, "I'm a scientist, I have a degree in Pharmacology". Instantly, vague talk about drug type A and drug type B turned to specifics; cephalosporins, gram negative bacteria, gram positive bacteria, etc. I was surprised to know that the parents status with respect to the child is also an element of the rounds. We both got to hold him swaddled that day and his feedings went up to 17 mls / 4hrs.

On Wed Jan 6^th, the cultures came back with an indication that E. Coli was the bugger bugging my baby. His feeding was increased to 28 ml/4 hrs and he started exhibiting some spitting. By the next day, Thurs Jan 7^th, he was done with antibiotics. On Fri, Jan 8^th, he came off his second stint under the phototherapy lights for jaundice and he wore clothes for the first time!! Apparently, just before getting dressed, he spit up and got it all over his body, in his hair, his armpits, even between his toes. Nice.

During this week, I became increasingly exhausted. Stressed about Zachary's condition and trying to work, keep up a pumping schedule that mimicked a newborn nursing schedule, and visit with Zachary resulted in a failure to do any of the three to the best of my ability. The nurses cautioned me to rest and to take time at home to prepare the house for Zachary's arrival, an activity Todd and I had completely neglected since his birth. I thought it was simply recovery from birth that had me exhausted all day long. By Thursday, I'd also developed intense pelvic pain. Todd had had enough and forced me to see a doctor. I was diagnosed with endometritis, an infection of the uterine lining which is pretty typical for women who have very long labor with multiple internal examinations. A day on antibiotics and I was feeling way, way better. Just in time for the weekend when Todd's parents came for a visit and to help us unpack!

As of Sat Jan 9^th, Zach was OFF antibiotics, OFF all IV fluids, OFF the phototherapy lights, and IN clothes!! He is starting to regulate his temperature and he will start trying to feed by mouth on Friday, Jan 15th!! Just once per day at first but it's the start of his road to going home. Todd's parents visited with Zach on Saturday night.

On Sunday night, I got a chance to kangaroo hold him, but then he spit up when we placed him back in the incubator. So we reverted back to swaddle holding him on Mon, Jan 11^th. He weighed in at 1825 g but, unfortunately, we reverted back to the phototherapy lights on Monday night. All in all, it's been an excellent week for our little Zach!