Thusday, July 24th - Who Needs a Bottle?

When I walked in today I found Nancy, the occupational therapist, at Kinley's bedside. I had arrived just in time to work with Kinley on some "tummy time" and to give her her morning bottle. During tummy time Kinley raises her head the highest I have ever seen it. I think the reason for this is that her arms are getting stronger and she is able to push against the bed a little bit. Towards the end of her tummy time Kinley's eye lids begin to get heavy so we decide to move on to her morning bottle before she falls asleep. Kinley does not gulp down her bottle like normal, but she does finish it (all 10 ccs) in about 4 or 5 minutes without coughing or gagging. As soon as I take her bottle away she begins to cry. We joked that Kinley was getting fussy because she wanted more to eat, but the orders are only for 10 ccs per bottle feeding, so we have to stop. I burp Kinley (while she is still upset) and then I lay her against my chest to try and help calm her down. She fusses and moves around for a little while, but soon she is fast asleep.

I missed rounds, but Anne (Kinley's nurse today) gets me caught up to speed. It does not take long because there was only one change to Kinley's care made during rounds. Kinley's ativan dose will now be given every 24 hours instead of every 12 hours. Everything else (methadone, erythromycin, Prilosec, feeding amount and schedule) stays the same as it was yesterday. Anne tells me that Kinley's 2 month immunizations will be postponed until Monday, when she is off of her drugs. They want to wait for her to get some of the drugs out of her system before introducing new ones. This time frame does not sound possible because Kinley still has quite a ways to go before she come off of her methadone. We (Anne and I) decide that they are probably just waiting for Kinley to be off of the ativan before doing her 2 month immunizations. That seem much more doable by Monday.

At 3:00 pm Laura, from music therapy, stops by visit Kinley. This is Kinley's first "official" visit from music therapy. Laura did stop by once, when Kinley was on ECMO, to give her an iPod with speakers to use during her stay at Children's Mercy. This time Laura is here to interact with Kinley. Music therapy will stop by twice a week to help work on Kinley's mental development by stimulating her with sound, sight and touch. Today Laura did some visual tracking with one of Kinley's toys and she also sang Kinley the ABCs while stroking her head.

Around 3:45 pm Kinley decided to add a little more spice to her afternoon by pulling her NG tube out. Luckily, Anne was able to get it back in on the first try, and right before Kathy arrived.

With Kathy here we can give breast feeding another try because it simply isn't working when I try. Anne pages a lactation nurse to come and sit with Kathy and Kinley. She will observe and provide help to try and make sure these breast feeding sessions are successful. The lactation nurse arrives very quickly and we (Kathy and Kinley only) get started. It takes a little while to get Kinley situated, but once she was comfortable we were off and running. That's right, today was our first successful breast feeding day. Kinley latched on and fed for about 10 minutes. Hopefully we can continue to have feeding sessions like this, but we will need new orders from Dr. O before Kathy can feed Kinley for longer periods of time. Remember, right now Kinley is still receiving full feedings through her NG tube.

Sorry for the lack of pictures the past few days. I will do my best to remedy that tomorrow.