New Month, New Team

With this post, I plan to update you on the babies, and then, if you care to read on, share a little bit of the in's and out's of the everyday drama in the NICU with the NICU medical team.  It gives me just a little bit else to talk about!

Update First

First, an update on each of the babies!  Cooper continues to do well.  He is continuing to slowly increase his feeds and seems to be tolerating them well.  He is trying to catch back up to his birth weight and weighed in last night at 2 pounds, 6.8 ounces.  They actually considered trying to take him off of CPAP today, but decided he wasn't quite ready and will give him a little more time.  Other than that, we have no real changes, which is great!

Kinley got her 4th and 5th doses of indomethacin that we were hoping would treat her PDA and close her duct.  Unfortunately, her echo yesterday showed that her duct is still open.  Her doctors have decided that for now, they will keep a close eye on her and repeat ultrasounds every week or so to see if it may close on its own.  Our doctor really doesn't want to jump to surgery, and as long as it doesn't seem to be placing her body under too much stress, they will wait.  So far, she is handling it well, so we are praying that she can hang in there and it will close on its own.  Kinley finally got to start true trophic (beginning) feeds yesterday and she is also tolerating those well.  Kinley had surpassed her birthweight and is now 1 pound, 13.6 ounces.

Both babies have had a few A's and B's, but they have been minimal and are not anything too unusual.

"Goodbye" and "Hello"

On the first of each month, the Texas Children's NICU rotates teams.  This means that on Tuesday we had to say "goodbye" to our initial team of doctors: Dr. Mandy, Dr. Lohmann, and Dr. Lui, who had been with us since the moments Cooper and Kinley were born.  I know we were only "with them" for 9 days, but it certainly seemed much longer and we had definitely developed a positive relationship with all of them, especially our attending Dr. Mandy.  

We were however, happy to meet our new team that we will be with for the month of August.  Our main team consists of an attending neonatologist (Dr. Premkumar), a neonatology fellow (Dr. Umbriaco), and a pediatric resident (who for now, shall remain nameless).  We also work with respiratory therapists, physical therapists, occupational therapists, nurse practitioners and pharmacists.  


For those of you who care and may be interested in this sort of thing like I am...

Texas Children's is a teaching hospital associated with Baylor College of Medicine and the structure is as follows:

An attending is a full-blown, completed-all-schooling-needed, neonatologist.  They are the ones who are really "in charge" and make final decisions on the babies medical care.  They are also the teachers and professors of the fellows and residents.

A fellow is a doctor, who has completed medical school and a residency in a certain branch of medicine who has then decided to sub-specialize even further.  For example, an internal medicine doctor may choose to specialize in cardiology.  Or, in this case, a person who has completed a residency in pediatrics chooses to then specialize in neonatology.

A resident, is student who has finished medical school, and is now completing training for their specific branch of medicine, in our case, pediatrics.  They will complete multiple rotations in many different areas of pediatrics such as private practice, oncology, emergency medicine, PICU, NICU etc.

Am I in a Grey's Anatomy Episode?

Because this is a teaching hospital, the resident always starts the rounds by providing a medical history, latest lab results, and any new information since the previous day.  He/she will then make recommendations that the fellow and attending neonatologist will either agree or disagree with.  If you watch Grey's Anatomy, then you have a pretty good idea what I'm talking about...it can be very dramatic.  

Let me just say that the first "round" with our new team and new resident was very dramatic, and I hate to say it, but a little entertaining to watch.  (Like I said, Grey's Anatomy in real life!)  It was the poor resident's first day on her NICU rotation and it was very evident that she was very nervous!  I must tell you, my heart hurt for the poor girl, and even Nurse Sandy admitted that there were multiple times she wanted to jump in and save her.  By no means at all am I claiming to have more knowledge than a medical doctor, but there were points in the conversation, that I think even I would have been better able to answer some of the questions the attending was asking. It didn't help that she was stumbling over her words and unsure about Cooper and Kinley's numbers on their labs and such.  As the nurse, Rachel, Brian, and I were dissecting the whole conversation after they finished, Sandy did say that we would be amazed at her progress over the month, so I am looking forward to watching her "grow" as well!  I can only imagine how much pressure these residents are under, but thank God there are people like her willing to go through what must seem like hell, because that's how we get great doctors! I'm sure she will become a better doctor because of her experiences and we will be silently cheering her on.  

As Always...

I know I get repetitive, but I will never stop thanking you for your prayers and asking you to continue them.  Thank you, thank you, thank you!