We had visited the NICU when I was still pregnant because one of Mike's co-workers is on the parent advisory board at the children's hospital and arranged it so that we would feel more comfortable when the time came. We were lucky in a way, that we knew before I gave birth that we would be in the NICU and could prepare as best as possible. We also knew that there was a possibility that both twins would have some NICU time since multiples like to come early.
Before the twins were born, I was very confident that Nicholas would have his surgery, he would dutifully do his 7 day stint in the NICU and then he would be home in our arms. I had no idea of the journey we would face.
Nicholas did have the surgery. And he was quite successful at his initial recovery. As I previously posted, he was extubated within hours of brain surgery, not days as we had been told. Even his nurses were impressed. Then he stopped urinating. And he had a Brady (bradycardia) every time he ate. A urologist was called in. A swallow study was ordered.
The urination problem ended up being a seemingly small issue. The urologist believed it was a reaction to the morphine Nicholas was on to control the pain from his brain surgery so he was weaned off to just Tylenol. A CT scan and several ultrasounds later and the urologist determined that there were no bladder or kidney issues.
The Bradys during eating ended up being a far more complex issue. And a far more dangerous one. During the swallow study, he was given a small amount (5 ml) of breast milk and was watched via x-Ray while he swallowed. Typically, if a baby passes this part, they move on to formula thickened with a small amount of rice cereal to make sure that the baby can swallow thicker substances as well. Nicholas failed the first part and it was immediately determined that it was unsafe for him to eat by mouth. He was immediately placed on NPO (nil per os or nothing by mouth) and an NG (nasogastric) tube was placed.
The reason that Nicholas had a Brady (his heart rate basically dropped to dangerously low levels - sometimes as low as 10 beats per minute) every time he ate was that his tongue and neck muscles were not performing the actions they were supposed to so the milk he was taking in was sitting on top of the vocal chords and was taking the path of least resistance - down his airway. He was aspirating his milk, which could lead to big issues, including pneumonia. He was attempting to protect his airway, so he would stop breathing and his heart rate would plummet, causing his Brady.
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