Nurse In Training

Susanne was so exhausted from the day that she had accidentally fallen asleep right before Paxton was due for his midnight feeding. Luckily, her body naturally woke up around 3:00am so she was able to make up for the missed feeding at that time. She had no problem shutting her eyes again while waiting for it to finish an hour later.

Paxton slept right through the night until 6:00am. Susanne wasn't sure if it was due to her skills as a mom or if he was just so completely exhausted from the craziness of the day yesterday that he did so well despite the congestion. He still did not have a crusty nose or any nasal discharge. He didn't have any evidence of conjunctivitis and his lungs still sounded clear. He didn't appear to have a cold yet, which was Susanne's goal. His main problem was that he would build up thick secretions in the back of his mouth that he couldn't clear. It was worse in the morning and at night. During the day, he handled it better.

Susanne took the same measures that she did yesterday evening except repeating the bath. Instead, she had Paxton sit in his bouncer in the bathroom while she took a hot, steamy shower. She was hoping that the steam would help clear him up. She still had to hold him upright for a while. He eventually went down for his early mid-morning nap.

Paxton slept right up until his therapy appointment. He woke up relatively easily when Susanne picked him up out of his crib. He was surprisingly quite happy for being woken up out of a deep sleep. The therapist took time doing some oral motor stretches, gum massage, and cheek stretches. Susanne made sure to show the therapist Paxton's two new lower incisors that were coming in. He was most likely going to have four lower incisors before any of his upper incisors came in. Susanne worked with three different pacifiers to show the therapist how he was handling them. Paxton would explore them with his tongue, but not ever close his mouth around them. He was reluctant to extend his tongue forward underneath the pacifier because of the fear of gagging. They were working on training his tongue to flatten and lay down. Susanne was worried about offering solid food today because of his recent congestion. She was certain he would gag and vomit with the addition of more substances in his mouth. He proved her wrong. He tolerated at least ten spoonfuls of pureed apples. He gagged twice, but recovered quickly on his own without needing to be picked up. He never got to the point that he spit up or vomited. He was actually making what appeared to be a chewing motion. He was bringing his lower jaw up to his upper jaw. He was able to close his lips together. He was moving his tongue well and swallowing more frequently than he ever had. All were great signs of improvement. It was a great feeding session. Hopefully, this wouldn't be a one time event.

As the session was finishing up, the doorbell rang. The nurse that was going to be occasionally watching Paxton came by to learn the ins and outs of watching him. She was a LPN who had worked in a nursing home for years. She had just recently started doing home healthcare. She had cared for a variety of age groups. Susanne went through every detail of his care. Susanne had a spreadsheet with his daily schedule on it. They discussed the important signs for the nurse to look out for to know if he was in distress. She made sure to tell her what to do if he turned blue, had a gagging episode, became overheated, if his respiration rate was extremely elevated, if his G-tube came out, if he needed suctioning, and the proper way to hold him.

Paxton loved looking at new faces. He was staring and smiling at the nurse the entire time. During playtime, Susanne was able to pump while the nurse watched the little guy. She did a good job with him, but she had a lot to learn. Paxton required a lot of special care and close monitoring. Paying attention to the little details was key. She was coming back tomorrow, which made Susanne feel more comfortable about getting more of a chance to watch her go through his routine.

After a few hours of teaching, the nurse headed home. Susanne could finally sit down to eat something. She was getting tired of having days that were filled to the brim with things to do. She just wanted more peace and quiet in her life. She knew this was unrealistic, but she made sure to at least make it a possibility this afternoon.

Susanne made a few phone calls related to Paxton's bills and insurance plan. She was frustrated that she kept getting different information depending on who she talked to. The solution on most days was to make more phone calls and talk to more people to try to figure things out.

Paxton woke up from his afternoon nap struggling to clear his mouth of all of the accumulated secretions. It took another hour before he fully recovered. Susanne was starting to get a routine down with how to treat his congestion. She just prayed that it would resolve within a few days. It definitely needed to be cleared up before the trip to Boston.