Wed - New Pictures

From Birth

I have uploaded some new pictures to the album.

today we discovered that there is a device called a bilirubinometer. This is actually used clinically all over the world to dertemine which babies might be jaundiced and thus draw blood from.

Since our concern was with Kaisers routine drawing of blood, a lot of blood and the extreme stress caused to the 3 day old pre-term babies, we were very excited to learn that Kaiser in fact poseses one!

I waited all night for the pedaitric doctor to come by at 7am to tell us the good news. Unfortunately he never showed up. Instead the head nurse brought it in and told us that there was no battery and it needed to be calibrated! Not a good start.

it went downhill from there. The doctor finally came by at 11am, obviously she was in no hurry to be the bearer of bad news. She walked in with a mask on and introduced herself with "Hello im Dr Ross and I have a cold today and I'm going to do an examination of the babies now"!!.

I leaped out my chair and blocked her from getting near the babies while trying to gently point out that we would not like that at all because of the risk of infecting premature babies with the virus. Rather than leave she decided to ask Barabara a series of questions about her recovery.

After waiting patiently for several minutes, I asked her if we could talk outside. It was very akward trying to explain to a DOCTOR that it is inappropriate to be any where near 3 day old children with a streaming cold. She explained; "I have a mask". The akwardness was compounded by the fact that she was an African American woman and I a white man.

I tried my best to let her know how many precautions we had taken to protect Barbara from swine flu. Pregnant womem are the most likely to DIE from it. The doctor said it wasn't swine flu, but I was not sure if she knew that for sure.

This didn't bode well for the news on the bilirubinometer. Needless to say with little discussion the answer was "its not going to happen". After the nurses introduction i figured that Kaiser was going to not going to change there procedures for us, so I asked who could make such a decision and was referred to the head of pediatrics.

Next a very nice male doctor showed up (without a cold) to do the examination. We talked at length about using the bilirubinometer (which you just press against the skin) instead of blood draw to monitor levels of Bilirubin (that causes Jaundice) in pre-term babies. He said it was a reasonable request and he in fact used to use such a device. When he left I felt we might still have a chance. Since I suspect he would be talking to the head of Pedatrics, I mentioned that we might simply find a pediatrician that did use this device for the first five weeks of development. He understood that this was not a trivial issue for us.

Next the nurse says the head of Pedatrics is coming in to talk to us about this. At 5pm she shows up and says she has some choices that she can offer us but the bilirubinometer is in fact not accurate and her "admitting" nurses do a better job of asesing jaundiced babies than this device! She referred to it as "junk".

So we talked at length about how well the babies had been doing over the last 36 hours. She had obviously studied the charts and agreed, She said that it wouldn't be a big problem to cancel the order for blood draw tomorrow morning if we used the big blue light box overnight.

This box is a stronger form of the blue light than the pad they have been on and is the best treatment for billirubin in the blood when exposed to skin. The problem is that even though babies have a natural reflex of closing their eyes when exposed to the blue light, Kaiser requires that they wear "goggles".

As you may imagine, 3day olds dont quite get the concept of goggles, and the ensuing battle between nurses doing a job and babies who are strongly protesting gets ugly in a hurry. This is why we did not do it in the first place!

she then started explaining some elaborate set up where we would hold the babies and shield there eyes while the light shon on their backs as way around the goggles. I agreed to stay up all night to administer that to both babies and she would then feel comfortable about not doing a blood draw in the morning.

She also said that the follow up nurses are very good at spotting any problems and when they ask for a blood draw they are usually right. We agreed that if they thought it was necessary we would draw blood to determine if there is any risk to babies.

When the blue lights arrived, the nurses set them up as though we were going to use goggles but instead suggested that I make use of the blanket to protect their eyes. This means I will have to watch them all night in between the feedings I do, but when Nico looked at me yesterday with an expression of "how could you let them do this to me?" i realized this is a small price to pay.
This blog should be called the sleep deprivation project.

The head pediatrician also said that she would write an order for us to get a pair of the bilirubin light pads so that we can continue the low level therapy at home for the first critical week. This was great news.

The room we have is very well designed and has just enough space and everything you need. Even the food is good.

The final issue was the car seat test. They have to be taken to the nursery and strapped into the car seats and left for an hour! Yes 3 day old babies strapped into a car seat for an hour! The nursery is like San Quentin on riot day. Babies are being circumsized and weighed and diaper changing. They scream endlessly.

I suggested that we do the test in our room, but they need to hook up an EKG! on a 3day old!! I suggested a small room off to the side and chose 3am to do this ridiculous test that has more to do with the hospital not getting sued because a baby died in a car seat onthe way home from a neglectful, sellp deprived parent. I picked 3am so there will probably be no one in there and no noise. That's we are going next.

Barabara is doing much better. She feels very handicapped. Today Natalie visited and they went for a little stroll around the ward. We have received some very nice flowers that cheer her up and we will take them home tomorrow if all goes well.