Tommy Extubates Himself
The week of Monday, September 5th, 1994, Tommy's doctors
had pretty much decided to let him coast for a little while
before trying anything new. Tommy evidently had a different view
of what was to come next. Much to the dismay of the staff,
on Thursday, September 9, 1994, he extubated himself
from the respirator.
Rather than re-intubate a little fighter who obviously new
what was best, he was put on a less aggressive nasal CPAP. CPAP
(pronounced "C"-pap) stands for continuous positive
airway pressure. Unlike a respirator, the CPAP doesn't actually
mechanically breath for the baby. The CPAP provides continuous
air pressure that makes it easier for a baby to inflate their
lungs when they inhale. It is both less aggressive and less
invasive than the respirator.
The CPAP isn't the most comfortable looking thing. Babies on
CPAP look as though they are all hooked up to go scuba diving!
However, it was a step in the right direction.
On that Sunday, September 11 after a successful few days on
the CPAP, he was once again put under an oxygen hood. He handled
the oxygen hood much better this time and stayed off more
aggressive support for a long while.
Shortly after he was put under the oxygen hood, his mother and
I came for that day's visit. His primary nurse was on duty that
day and asked us if we wanted to hold him. We had been allowed to
hold him from time to time, but always for very short periods of
time with the staff attending to the invasive respiratory
equipment he required. On that day we were both able to hold him
with only a hose blowing supplemental oxygen across his face. It
We were told that babies who are held and handled by their
parents did better than those who were left alone. NICU babies
are necessarily poked and prodded by the staff so much that human
touch was not always pleasant for them. As NICU parents, it was
our job to give him love through gentle and cautious touching. It
was our job to give him something pleasant in his life during a
period of time when not much was pleasant for him. We were sure
to hold him and touch him as much as we could. It was one of very
few things we could do that made us feel like his parents.
That evening, after we had left for the day, Thomas was moved
from his warming table to an isolette incubator. Extremely
premature babies requiring constant care are kept openly exposed
on a warming table. This provides easy access to the staff in
case a situation arises. More mature preemies requiring less
constant attention benefit from the isolation and relative
quietness available inside the isolette. The isolette also
shields babies from airborne germs and such present in the
NICU's are noisy places. Each baby is connected to a pulse
oximeter and a respiratory and heart rate monitor. These monitors
go off frequently and are constantly monitored by the staff. A
beeping monitor was usually nothing to panic about. It usually
signified a false alarm, a warning that something needed to be
adjusted, or a warning that the baby needed some brief attention.
I guess that's why they call them neonatal intensive
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