The doctors weaned Mitchie off the ventilator toward the end of his first week since he seemed to be breathing on his own quite well. In fact, he forced the issue by extubating his endotracheal (ET) tube. Rather than reintubate him, the doctors put him on continuous positive airway pressure (CPAP) at room air oxygen levels. He received this through a nasal cannula. |
Like all newborns, Mitchie lost weight before gaining. He dropped all the way down to 2 pounds 11 ounces before heading in the right direction. Once his system stabilized during his second week, one of Mitchie's neonatologists, Dr. O'Donovan, began introducing breast milk to his diet. We had rented a hospital grade breast pump so that we could save Vickie's breast milk. The milk was given to him through a naso-gastric (NG) tube, a small, thin tube run through his nose and down to his tummy. |
He was given a small amount of breast milk through the NG tube at each feeding. Then after a few hours, the nurses would have to see if he was digesting it by checking his residuals. They would do this by drawing back on the NG tube with a syringe. Too much residual was a signal to slow down on his feedings. No residual and sufficient stool was a signal to increase his volume. |
Mitchie did really well with his feedings and began gaining weight. Toward the end of his second week, Mitchie actually began to breast feed directly from Vickie! Everyone was pretty amazed that he was able to coordinate his sucking, swallowing, and breathing so well. At this rate, he'd be home in maybe 3 or 4 weeks! |
This was when things changed. Toward the end of Mitchie's third week we noticed that his base heart rate seemed to become elevated. He normally hovered around 135-140 beats per minute but for some reason it was now consistently in the 160-170 range. Every few hours, he also began to experience apnea and bradycardia (A's and B's, so they call them) where he would forget to breathe and his heart rate would drop. This sometimes happens in premies but for him it just wasn't normal. |
Since his hematocrit (percentage of red blood cells) was low and his symptoms could reasonably be explained by this, Dr. Davis decided to transfuse Mitchie. |
Unfortunately, giving him blood did not improve Mitchie's condition. The episodes of apnea and bradycardia increased in frequency and it became increasingly difficult for his nurses to stimulate him to recover. What used to take a little nudge now took resuscitation by "bagging", a process by which the nurses pumped air into him by squeezing a soft bottle placed over his nose and mouth. |
On Sunday, May 29th, 1994, 19 days into Mitchie's life, things got much, much worse. The A's and B's increased, his tummy became distended, and he began to have bloody stools. Dr. Davis discontinued Mitchie's feedings, and began performing tests to rule possible diagnoses in or out. The good news was that his spinal fluid came back clear, ruling out spinal meningitis. |
The bad news was that Mitchie showed all the symptoms of a complication known as necrotizing enterocolitis (NEC). We had read about the gastrointestinal complication since it affects premature infants almost exclusively. If left untreated, it could be fatal. Mitchie was getting worse and would have to be transported to a hospital capable of performing surgery on babies as small as he was. Our insurance covered Children's National Medical Center. |
There we were, just barely 2 weeks after Vickie was discharged and not quite 3 weeks into Mitchie's life. Vickie was only beginning to get around by herself as she recovered from the emergency C-section. We had finally more or less recovered from the trauma of a premature delivery and had really begun to get our spirits up since Mitchie was doing so well. Our world began crumbling that Sunday. |
Mitchie's nurse that day was Ellen. It turned out that both Ellen and Dr. Davis trained at Children's and they both reassured us that Mitchie would be well cared for there. Ellen was very compassionate and really watched over us as well as Mitchie until he was transported. |
They considered transporting Mitchie by helicopter but decided on ground transport instead since traffic seemed to be light. The Children's transport team arrived after 5:00pm and put Mitchie into a transport isolette (incubator). He was doing so well just 2 days before; it was so hard to grasp the fact that he was so seriously ill. When they were ready to transport him, we were given the opportunity to see him. He was reintubated and barely breathing on his own anymore. He was very still. His eyes were closed. |
Vickie and I reached into the isolette to touch him and he opened his eyes. I will never forget him looking up at us. Never. |
At about 6:00pm, Mitchie left the hospital bound for Children's National Medical Center. We watched as the ambulance rolled out of the parking lot. When it came to the final stop sign, we saw the lights and heard the sirens go on. And we cried for the zillionth time that day. |
