Day 52 Doctor: Anna Marie Salva Nurses: Jeremy (night), Sherry (day) RT: Charles/Mike (night), Shilo/Yvonne (day) Gestational age: 36 2/7 weeks Weight: 2366 g or 5 lbs. 3.5 oz. Length: 45 cm (6/1/14) FiO2: 21% (room air) Flow: 1.5 LPM on NC Feeding: 47 ml Q 3 hr. (24 cal breast milk) through NG tube. PO multivitamin with iron (0.25 mg q 12 hr). Bottle every feeding, gavage QS (amount nippled: 47 ml @ 2300, 47 ml @ 0500, 47 ml @ 1100, 47 ml @ 1400, 47 ml @ 1700). New orders: offer nipple each feed. Try nippling all. Gavage to QS PRN. Other issues: ongoing A/B/D, mostly self-resolved. Last apnea with stim 6/1 early morning. No episodes in over 36 hours. Enzo had a great day today! Overnight, Enzo had his buddy Jeremy looking after him. First, he got a bath, so he was squeaky clean (well, at least his next dirty diaper). Then, he got his first nipppling. It went swimmingly, as usual (now). Enzo did really well with the bottle, so that we felt totally comfortable talking with Lucy the OT about increasing the number of feedings he’s taking from the bottle. Jeremy also worked with Charles to wean Enzo down to an FiO2 of 21%. Amazingly, this time, it stuck! Jeremy also did a HemoCue for Enzo’s red blood count and told Sherry it was within normal, but he did not chart the results. Enzo finally had Sherry as his nurse during the day today. It seems like Sherry’s always been working with the baby next door, so it’s great to finally have her in our corner. When we came in at 7:35, she had already changed and assessed him, and it was well more like the Navy’s version of 8 a.m. that Enzo got his (tube) feeding started. Boy, was he happy about that! Lucy came by at 11 a.m. to work with Enzo on his nippling. He really did a great job! http://bit.ly/drinking_enzo At Sherry's urging, Lucy convinced an apprehensive Dr. Salva to give the order for nurses to try nippling all feeds with the understanding that if he was too tired, they would gavage, rather than push him. Well, so far, that looks like a very successful strategy. Enzo took his 2 p.m. feeding completely in stride and gobbled down his 5 p.m. bottle in 25 minutes. Even better, he never needed an increase in his “O”s! Moreover, this was with him being exceptionally fussy every time we tried to put him down. Sherry says that he’s become allergic to his crib. (She even upped his alarm parameters to a heart rate of 240 bpm. So far, he hasn’t accepted the challenge, but he’s gotten into the 220’s for sure!) Growth spurt, maybe? Gogo and G-Dat arrived shortly before lunch and got in some quality cuddle time with their grandson. He was very comforted by their presence. After lunch, he napped with his daddy until we had to leave for dinner. Even though it was about 4 p.m. (around an hour before his next meal), he decided that it was a good time to wake up and look around. Still, we managed to leave without a meltdown. (There hasn’t been one yet!) We are incredibly heartened by Enzo’s progress today. Not only being stable on room air, but handling four out of five feedings in a row from a bottle with aplomb! That’s leaps and bounds ahead of where we were a couple of days ago. It’s also been since early morning yesterday that he had a real apnea spell (that needed stim). Who is this baby?! It now appears that we may actually be in the home stretch!