Carter started his Friday off being held by Daddy for a couple of hours. Dr. Lugo and the medical team did their rounds and gave him good reports. He has continued to do well on the Lasix and today was his last dose. Looking back at his trends they made the decision to place him on Lasix every other day so that they could continue to prevent a build-up of any fluid as his breathing improves. He will get supplemental Potassium since this medication has a tendency to cause the kidneys to get rid of potassium. They were able to reduce his high flow nasal cannula to 1.5L/min today and he has done well with this. He does continue to have some reflux but luckily the effects of that do not last too long. Carter was seen by Speech Therapy today and Occupational Therapy. Speech Therapy taught us many interesting things about the importance of offering him a pacifier as opposed to giving it to him. We learned different signs to be aware of so that we know when he is ready to receive the pacifier. One of the things that we have to watch for is his breathing since sometimes his desire to suck will overcome his desire to breath so he will literally stop breathing while sucking. Overall the Speech Therapist said Carter is showing very good communication signs of what he wants and has well developed reflexes such as rooting and bringing his hands in toward his face while sucking. Once they can wean his oxygen they will begin to attempt oral feeds and move his oral gastric tube into his nose to his stomach. I included a very interesting article written by the Speech Therapist that is seeing Carter, Catherine Shaker.
http://shaker4swallowingandfeeding.files.wordpress.com/2013/03/shaker-cue-based-feeding-using-the-infants-communication-as-a-guide-neonatal-netword-2013.pdf
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