Last night after doing well all day, he pooped out and hardly took anything from his bottle. I was up the majority of the night feeding him and checking in on him. Then this morning when I assessed him, he quite worried me. For all my NICU friends, he just had that look and coloring to him, you know when you can't actually say what's wrong, just to say he looks like crap and he needs help. It was kinda like that. So I called my director and asked if I could take him in for labs now or sit on him for another 24 hours, because in all fairness the tias were NOT grasping the seriousness of the situation and bothering the heck out of him and stimulating him way too much. Preemies don't like lights and noise and being held, ect. They can't handle it and they get tired very easily. He was hotter than normal so I took the hot water bottle out of his makeshift incubator and let him cool off. Within 2 minutes he was too cold. His temperature was just so all over the place. So I let it slide a little and decided that no matter what he'd get everything by tube at the next feeding. When I went to check him, he also needed to be weighed. He lost 2 ounces in the first 24 hours he was here, but there's the adjustment period and then the fact that we were actually feeding him and helping get his bili level down so he was pooping like a mad baby, so I just hoped for the best today. When I weighed him, he had lost another 5.3 ounces on a kid that is tiny! So a total of 7.5 ounces lost in 48 hours (2# 12 ounces now) And his temperature was 104 WITHOUT the hot water bottle and only one tiny thin blanket, a hat, a normal outfit and that's IT!!! That was the end of that.....I brought him to the pediatric emergency room and prayed hard for a good doctor. She was amazing and listened to my whole story, everything I was doing for him, and what his progress and changes had been in the last 48 hours. She then fully assessed him from head to toe (the only other time I've seen them do that was with an unconcious 2 year old that had been seizing for over 2 hours continously! She then said, he's going to stay in the baixa! We'll do labs there. Praise the Lord, but at the same time I'm kinda frightened for him. So I looked through the papers she wrote for him and they are starting him on IV fluids and are going to give food through the ng tube and slowly assess how he is with a bottle. They are going to do a full septic workup to see if he is sick including a urine specimen and a full chemistry panel including a bilirubin. They are also doing an HIV and malaria test. So after 1 stick the peds phlebotomist got the IV and the 10 ml of blood that he drained him of and off we went....except this time we went through the pediatric building, past the wards, and the baixa, and out into the street and down the lane. I thought, where are we going......then they took us this really scary way through the inwards of our 3rd world hospital dungeon and up 5 floors in a creepy elevator and into a beautiful place they call the nursery above the maternity ward. cept it's not for well babies, it's for preemies. With incubators and space heaters to make the rooms warm and iv fluids, and ngt's and lots of posters about how to recognize respiratory distress and keep a kid warm. I thought I was in heaven for a second. it was the most legit medical unit I've ever seen in Mozambique. then she said, just leave him in this crib, take off his clothes, and you can leave. see you tomorrow at visiting hours. So we left him there all alone in a giant bassinet with fuzzy blankets next to the space heater and an old school incubator that I'm sure he'll be in before the night is out.
Please pray with us that the neonatologist team (yup they have a whole specialty team instead of just general peds) will have wisdom and take the time to figure out what is wrong with him. I pray that they let him stay there in a nice warm incubator and feed and grow and rest and mature for at least a week or so!! and that he's FAT when he comes home. I pray that he does not get any other illnesses while he is there and that the nurses will love on him (since a tia can't stay with him....just the nurses). I pray that God will give Jaime a fighting spirit and a sense of peace and calm that will surround him as he is left alone in a crib/incubator day after day!
I will give updates as I know them. Anna, the western nurse helping me will be going to visit Jaime tomorrow and hopefully giving me more information! Also pray for us as we will be admitting a tiny newborn tomorrow 2 or 3 weeks old into our bercario because her mother died last week and her elderly father cannot care for her at this point.
Posted by erin at 20:45