The Cubby Chronicles XXV

Note: Jacob Raymond Walker was born 12 weeks prematurely at Duke University Hospital the morning of Monday, May 19 2008. The following are updates, notes, & observations on his growth & development.

Yesterday was a bit bittersweet here at the Duke hospital as the Cubby passed what we consider his 'halfway point' in terms of when he might come home. He's been here just over 6 weeks since being born right down the hall on May 19. From the start, the doctors told us the general rule is to expect him home at his due date which was August 13. Off the record, we've heard chatter that he's doing rather well overall & he might be able to go home early, but that's something we shouldn't count on.

As if to underscore the point, Jake--who I've started to dub 'Mr. Burrito' when swaddled as above--is doing quite well lately. In fact, his 'halfway day' might have been his best day yet. He didn't have any apneas or brady episodes at all (which is a first for him) and he tolerated his increased feeds just fine. His blood pressure is now under seemingly reliable control thanks to the propanerol which lets us sleep better at night. He also has a new nephrologist assigned to him who at least has a theory on why he's got elevated blood pressure.

As mentioned before, Jake's left kidney is known as a 'pelvic kidney' and its smaller than his right one (which is normal sized for his age). The doctor believes that the smaller kidney has some scar tissue in it that is secreting excess amounts of renin, a hormone that regulates blood pressure by constricting vessel walls. The good news is he had another kidney ultrasound and yesterday and both his kidneys are growing, with the smaller one at a higher rate than the regular sized one. The doctor thinks we'll just need to support him with the propanerol in the short term and eventually he won't need it as the smaller kidney grows.

The day was bittersweet not only as a milestone for the little guy but it also marked the departure of Courtney, one of his favorite nurses. The previous post discussed how the nursing teams work here at Duke & I mentioned that he had a 5 person team plus an 'unofficial favorite'--which was Courtney. She wasn't technically on his care team because she had her own primary patient but because Jake was right across the room from her primary she often cared for the Cubby too (the ICN rooms usually have four babies & two nurses to a room).

In fact, Kristin flipped through Jake's journal (where we write each days notes, medicines, etc...) and he actually had Courtney the most of any of the nurses. Courtney's husband took a job transfer to work at Tennessee, where both of them went to school & while she was excited about the move, she was sad to leave 'her two boys' behind. Due to some scheduling magic, she was able to spend her last two working shifts here in the TCN (where her former primary is too) and it was great to see her before she headed west. We (along with Jake) wish them the best......

Addendum:

• Since I seem to mention the same phrases every so often I'm building a quick reference glossary in the upper right of the main page. It should contain definitions & links to the more common medical terms we throw about