[Enzo] Day 52 report - I think I need a drink!

  • From: "Kelly Groves" <kelly@xxxxxxxxx>
  • To: <enzo@xxxxxxxxxxxxx>
  • Date: Mon, 2 Jun 2014 21:22:53 -0700

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!




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!


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