Saturday, February 15, 2014

You Are Doing "Suspiciously Good"

Dear Ellie,

A doctor checked on you recently.  “Your daughter is doing suspiciously good,” she said.  I mulled that over for a second and I realize I couldn’t have said it better myself.  Suspicious, because one would expect a lot more to be going wrong at the moment.  But it hasn’t.  There’s still the specter of necrotic intestines or nasty infections, but none of those problem have materialized… yet.   

For the past two days, you’ve been pretty well behaved.  I might be imagining things, but I think you might be breathing a bit more steadily than before and you might finally be settling into the idea of being on your back.  Not completely, but a little.  You are now a whopping 1 pound 10 ounces and the doctors are progressively giving you more and more breast milk, which you've tolerated very well.  You seem to be making gains also on the most important metrics of your progress: oxygen saturation in your blood and voluntary breathes.

Oxygen saturation is the amount of oxygen dissolved in your blood.  If it dips too low for too long, your cells are unable to operate and sensitive cells, like the neurons in your brain, might not develop properly.  Or worse, they might die.  Because you have a fiery little personality, whenever you flail around a lot, it depletes oxygen in your blood.  Your saturation has never dipped critically low, as far as I can tell.  Never below 60 percent (I’ve seen some babies go as low as 20-30 percent!)  Stay too low for too long, and parts of your brain begin to die.

The number of voluntary breaths you take are important, too, because if you breath on your own consistently enough, we can pull that endo-tracheal tube out of your throat once and for all.  Unfortunately, when people handle you a lot, you have this tendency to stop breathing.  One of the doctors was working on you a few minutes ago.  Before that, you were breathing like a champ.  But now?  Zero voluntary breaths.  It doesn’t hurt you to let the ventilator do all of the work, but it isn't a good indicator that you might be ready to breath with less support.  I sincerely hope you don’t get it into your head when you are older that hunger strikes are a legitimate means to get out of homework.

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