Rounds were pretty short and sweet today. There is only one change, Kinley's methadone dose will be lowered by 10%. All of her other medications (ativan, erythromycin, prilosec & her multivitamin with iron) will remain at the same dosages as yesterday. Also, her feedings will remain unchanged today.
Nancy, from occupational therapy, came by this morning to do some work with Kinley. She started by having Kathy give Kinley her morning bottle. Once again, Kinley ate all 10 ccs without any issues. After Kathy burped Kinley, she and Nancy worked Kinley out with some tummy time and range of motion stretching.
A little after noon a lactation nurse came by to work with Kathy and Kinley on breast feeding, but soon after her arrival Kinley threw up. Needless to say, they were not able to work on breast feeding today. Aside from throwing up some food Kinley also threw up her NG tube. Megan, Kinley's nurse today, had to try three or four times to get a new NG tube in place because Kinley was screaming so much. I arrived (from work) just as Kinley was calming down. Kathy told me that was the loudest that she has ever heard Kinley scream before. I guess we should be happy that Kinley is able to scream and cry, and that she is not as sedated as she has been, but it was still hard to see Kinley so upset. During all of this drama Kinley had a dirty diaper that needed to be changed. Kathy had to leave for work before we can change the diaper, but it was full of poo and that was probably one of the reasons Kinley had been so upset.
I do my best to make Kinley comfortable after Kathy is gone, but she won't stop squirming around and she keeps making faces like she is in pain. Since she just threw up not too long ago I am guessing that her belly is upset. It turns out that her belly was not feeling its best. Kinley blew up her diaper again, for the second time in just over an hour. After changing her diaper I move Kinley so she is laying on her right side. This should help her food move through her stomach a bit easier. Luckily, Kinley falls asleep, probably from all of her morning exercise and mid-day drama.
Unfortunately she does not stay asleep for very long and she wakes up very fussy. I check her diaper first and it is barely wet, so I leave it alone. Next I try her binky, but just trying to put it in her mouth makes her more upset. Lastly, I pick her up and try to rock/bounce her to sleep. This works to create moments of calm, but she is soon upset and screaming again. I agree now with Kathy's comment from earlier. This is the loudest I have ever heard Kinley scream. It is either because she is more upset than ever before or the fact that she is older and her vocal cords are healthier. I set Kinley back in her crib and decide to change her diaper, even though it is hardly wet. It worked, Kinley is calm and quiet after her diaper change. I do not know if it is just today or if it because her methadone was decreased, but Kinley seems to be overly sensitive to dirty diapers today. For the remainder of the day I made sure that Kinley's diapers were clean and dry and she spent the rest of the day calm and quiet.
Around 5:00 pm I fed Kinley her second bottle of the day. She ate all 10 ccs again. I wonder when they will begin to increase the amount of milk she eats through a bottle?
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Sorry Kinley had kind of a yucky day, but hopefully today will be better! It's hard to hear/see them crying when they've been silent for so long, but at the same time we'd all rather hear them cry all day than lay sedated on ECMO all day. I know the feeling!
The Millers
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