Quick update from last night - Kinley had 14 ccs of residual after her first continual feed yesterday. Katie put it all back in Kinley's stomach and was going to check it again after one hour. After that one hour Kinley still had 12 ccs of residual. Katie notified Delores (nurse practitioner) and the decision was made to stop Kinley's feedings for the night and re-access her tomorrow morning.
During rounds today Dr. C decided that there should only be one change made to Kinley's care each day. This will allow Dr. C to more easily track how each change affects Kinley and hopefully determine what might have set off Kinley's "episode" that occurred two nights ago. Three items that will remain the same today are Kinley's oxygen flow rate, at 3 liters per minute, and also her methadone and ativan doses. They will re-start Kinley's continual feedings, but at a slower rate than yesterday. Today Kinley will receive 2 ccs per hour. Dr. C has also ordered that Kinley be given doses of the antibiotic erythromycin. Don't worry, Kinley is not sick. The main side effect of erythromycin is increased motility in the stomach and intestines. The hope is that this side effect will help Kinley begin to process her feedings a bit more quickly. Kinley will receive one dose every 8 hours.
Katie checked the residual in Kinley's stomach after 2 hours of feeding and finds that Kinley has not processed any of her milk. She informs Amber (nurse practitioner) about the residual and Amber decides to have the residual put back in Kinley's stomach and continue the feedings. FYI - all of this occurred before Kinley had received her first dose of erythromycin.
As of 2:00 pm, Kinley is back to "room air!" Room air is 21% oxygen. Kinley had to have her oxygen turned up to 70% the night of her "episode" and she has slowly been working it back down. She started today at 35% oxygen through her nasal cannula.
We have not been tracking Kinley's weight gain since she was born, mainly because Kinley had bigger obstacles to overcome and the fact that she couldn't eat anything, but Katie informs us that Kinley is now up to 9 pounds 4 ounces. I think that's pretty good for someone who was born 44 days ago and only started eating 3 days ago. (I am trying to make that sound really dramatic by not mentioning that Kinley has been receiving IV nutrition the whole time. Shhh, don't tell anyone.)
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2 comments:
Wow 9-4! Good girl Kinley! Just wait until you can really chow down! Glad to hear Kinley got herself quickly back on track. She's always showing her true fighting spirit.
The Millers
What a trooper . . . Kinley is a remarkable little person! She looks soooo cute in her big girl clothes! Team Melcher continues to be in our thoughts and prayers.
Hugs to all!
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