The doctors tried to reduce Jane's nitric setting last night (or this morning, I'm not clear on the timing), and, as is now usual, she did NOT like it. Swoop! Right back up to 20 ppm and 100% oxygen. But Awesome Nurse Karen was totally positive about how Jane was doing and how great she looked, yadda yadda, everything just excellent except for that pesky lung issue.
Tom was not happy to hear about the return to 100% and decided to go down to the hospital. In the meantime, she steadily worked her way down the settings, and when he arrived, ta da!, she was in the 70s again. She was at 72% when he left. The nurses are all convinced that he's her lucky charm, since she seems to do better when he shows up at the nursery.
So: new strategy! Jane gets to receive as much nitric as she wants for as long as she wants. (Great, docs, just spoil her rotten, why don't you?) Since there aren't any significant side effects from the nitric (that I know of, but I'm not googling), there's no real reason to wean her except that that's what they do. Preemie on medication? Wean her off it, STAT! Seriously. That's just what the doctor told Tom today. Maybe not in those exact words, but still. She, too, emphasized how unbelievably well Jane is going in every other respect, so that part isn't just the nurses putting a positive spin on the situation. She hasn't been on the floor in a while and kept saying to Tom how gorgeous she is. But then, you invisible readers knew that already.
In straight-up, unqualified good news, she keeps on gaining weight. Packed on nearly another ounce last night. She's gained enough that they're upping her feed again, to 17 ccs. (There are five ccs to a teaspoon, if you're curious about what that means in normal volumes.) It's totally working; she's getting chubby. For real! Check it out: a double chin!
Those are Awesome Nurse Karen's hands. I realize none of you invisible readers know her, but it still gives a sense of scale, I think. Oh, and she's not posing for Munch there. She's just taking a break from picking at the adhesive that keeps her breathing tube support in place. She's such a stinker about it. On Friday (I think -- whatever day it was that I got to use the fancy-pants oscillator chair) she pulled out her feeding tube three times in a row -- twice mid-feed, dumping the entire contents of her bottle all over her isolette. Joel, the cagey veteran on the respiratory team, is not thrilled by this development.
As further evidence of her growth, she went up a size in her diapers (okay, that was a while back, but I thought I'd mention it anyway, just because as a parent, it's such a big, obvious marker for how big your kid is getting -- plus, cute!) and she's going to be getting a bigger airway tube when she's more stable and at lower oxygen. Which they have to paralyze her to put in. Um, less cute. But good, despite the scary.
10 pm update: she's back at 100% again, and night nurse is going to suction her lungs and is also pushing for the airway change now. Uh, really? Even though the whole lower oxygen level, keep her stable for a while first thing isn't exactly happening right now? I, um, yeah. Don't know how I'm feeling about that. It makes sense (bigger airway = more air), but they tried paralyzing Jane a couple nights ago (WHAT? yeah, we just found out about that) and her heart rate went way the hell up.
Ugh. Not thinking about it right now. My brain went off duty about 20 minutes ago.