[Enzo] Day 60 report - Immunization, de-cannulization and RetCam Examination

  • From: "Phillip Koken" <phil@xxxxxxxxx>
  • To: <enzo@xxxxxxxxxxxxx>
  • Date: Tue, 10 Jun 2014 22:31:40 -0700

Day 60

Doctor: Johnny Novales

Nurses: Leah (night), Sherry (day)

RT: Charles (night), Yvonne (day)

Gestational age: 37 3/7 weeks

Weight: 2649 g or 5 lbs. 13.4 oz.

Length: 47 cm (6/8/14)

FiO2: none!

Flow: none!

Feeding: 50 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: 50 ml @ 2000, 50 ml @ 2300, 50 ml @ 0200, 50 ml @ 0500,  50 ml @
0800, 50 ml @ 1100, 50 ml @ 1400, 50 ml @ 1700).

New orders: so many! Basically, remove cannula, remove NG tube, give first
dose of immunizations, perform RetCam

Other issues: very occasional de-sats, all self-resolved. Last apnea with
stim 6/4 11:30pm during nippling.


Enzo had a good day today!


Leah took care of (now giant) little Enzo overnight after a 4 day hiatus.
She was shocked to discover his progress since her last shift caring for
him. Enzo helped her out by gobbling his bottles and relaxing during his
"off time". 


Today Enzo had Sherry again. She had Enzo a week ago and also commented on
how different he was today. The spells of desaturation and bradycardia had
evaporated in her absence. Immediately after she started her shift at 7am
Yvonne dropped by to evaluate Enzo's respiratory state.  By 7:42 a.m.,
Enzo's oxygen support had been discontinued on Yvonne & Doctor's orders. As
long as they were removing tubes. they also yanked his nasal-gastric
(feeding) tube. We were shocked to discover Enzo completely free of tubes
when we arrived! This was the first time we had ever seen his face
unencumbered! Enzo is now on his own for breathing and feeding. It may seem
odd, as most babies take care of this without it every being an issue. Enzo
has dealt with a number of respiratory issues since he was born, simply
because he was brought into the world 11 weeks early. He has to work hard to
keep his saturation up, and we will be dealing with the effects of this for
a year (at least). Seeing Enzo breathing on his own was a magical moment
this morning! As for the feeding tube, we are confident in his ability to
eat at this point.


Enzo sans tubes


Enzo adapting to his free-breathing lifestyle 


Also this morning - Sherry discovered that Enzo liked Billy Joel (according
to her). We have found that Enzo responds very favorably to music in


This afternoon was quite eventful for Enzo


Starting around Noon, Enzo had his first round of immunizations. Nothing
like a needle shoved in your thigh to get your attention! Enzo did well with
the vaccinations, and Mom & Dad took turns holding him afterwards while he
slept peacefully. Unfortunately the peaceful sleep was to be short lived. At
1:30 Enzo had his (third) RetCam examination. The RetCam is a great tool,
helping doctors to prevent blindness and loss of vision in premature
infants. However, comfortable for the patient (Enzo) the RetCam is NOT. We
stayed by Enzo's side throughout the examination. Kelly was there to scoop
him up afterwards and cuddle him. 


Finally, Enzo had to eat his bottle at 2:00 p.m.. Even though he had been
through the vaccination, and the RetCam exam (without supplemental oxygen!)
he managed to consume 100% of his bottle.


Enzo bottle feeding with his Mom


We left this afternoon full of hope! Enzo is growing up so fast and it is
wonderful to watch him moving past the challenges that he has faced so early
in life.



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