Nicholas in NICU Update #1

When I was driving to the hospital on Tuesday morning, I had a moment of deliberating about whether I should go to the South Austin Medical Center, where the OB on call had directed me to go, or if I should go to one of the hospitals downtown that had more advanced Neonatal ICU's available. NICUs are rated I, II, or III. South Austin has a level II center which can handle newborns around 34 weeks or more and are often focused on bringing healthy babies that appeared a bit early to a point whether they can go home. Level III support a much wider range of problems.

Each time we spoke with a pediatrician or neonatologist about Nicholas' condition, we specified that we were fine with him being transferred, if they felt it was necessary. His breathing problems weren't immediately critical, but if additional steps were necessary, that was fine. We wanted them to have a "low threshold" for determining whether he should go and that we trust their judgment. Each time they assured us that they tend to be conservative with that decision and would transfer him if they felt it was in his best interest.

Although he had some early improvement with some help from a nasal cannula and a does of synthetic surfactant (a liquid that mimics fluid in the lungs that helps them expand), Nicholas seemed to stall out. After basically 30 hours of struggling to breathe and breathing "hard", the pediatrician on call decided it was best to transfer Nicholas to the Level 3 nursery of St. David's Main in downtown Austin. She felt he would benefit from the use of a CPAP machine, which would provide higher levels of pressure and help him be able to breathe more easily. The pressure helps the lungs to more fully form.

Around 7:30 on Wednesday night, a transport team came from St. David's Main and carefully took Nicholas to his new temporary home. This team was great, talking through each of the steps. The incubator he was transported in mimicked nearly all the same equipment in the NICU (warmer, IV drip, oxygen, pulse, breathing rate). Alex stayed with Lissa at South Austin for another 25 minutes after Nick was transferred, and then headed over to St. David's main campus. I stayed at South Austin for the night, to sleep and try to pump.

After arriving at the NICU Alex waited about 20 minutes, then they let him back to see Nick. His nurse, Jenn, answered a bunch of questions, and Nick seemed much more comfortable as the CPAP machine provided a seal around his nose, creating a higher pressure which assisted the lungs opening and closing. His respiratory rate was much better as well!
It was hard to be separated, but knowing Nicholas was getting the help he needed was more than consolation for us!