Update #6 on Isabella Rose - March 29, 2006 - 49 Days' Old - Gestational age: 31 weeks + 5 days

Isabella was like a busy socialite this week...photo sessions, fundraisers and publicity.

Late Wednesday night, the paparazzi snuck a camera crew into the NICU and snapped pictures of her with a mystery man. Ok, so the camera crew was actually hired by New York Presbyterian, and the mystery man was actually Dr. Jeffrey Perlman, the director of the NICU. And instead of Page Six of the NY Post, these pictures will be used for public relations purposes, beginning with an April fundraiser at the Waldorf to benefit the Pediatric Cardiology Department. The point is, Isabella has done so well since her valve surgery five weeks ago, that she is now the face of outstanding cardiac care for one of the best hospitals in the world. I just hope she can find the perfect dress.

Isabella is now seven weeks old. She gets 22ccs of formula every three hours and weighs 1,240 grams, or about two and three-quarter pounds. With all that muscle she's packed on, she has finally, after four weeks, outgrown CPAP and graduated to a breathing apparatus called nasal cannula. If youve ever watched ER, youve seen nasal cannula, a thin plastic tubing that stretches horizontally above Isabellas top lip, connected to two, thin prongs placed in her nostrils. The air that gently flows through these prongs is made up of 21% oxygen, the lowest possible setting. This is the same amount found in the room air we all breathe. Isabella's lung function has come a long, long way.

The doctors were anxious to test Isabella on cannula to assess her respiratory progress, but they also mentioned another concern - babies who remain on CPAP for extended periods of time run the risk of permanently enlarged nostrils. I made them repeat that last part twice. I know I should have just been excited with her great breathing, but I was equally thrilled that her move to cannula meant she might avoid having nostrils resembling the entrance to the Lincoln Tunnel.

I spend about four hours each day with Isabella and I am constantly amazed at the level of documented care she receives. Her every move is recorded hourly at her bedside computer down to the smallest detail: the weight of her wet diapers; the number of times she stooled, including color and consistency; each time they apply lotion to her skin, every drop of formula she retains; any drop in a vital sign, to what extent it dropped, and what, if any intervention was done to bring it back up. They note the side she rested on and for how long to assure that her head isn’t misshapen, and what her mucus looked like when they suctioned her. We’ve been told again and again by Isabella’s doctors and nurses that babies born at this hospital fare better than babies born at or transferred in from others. They contend that this NICU does many things others don’t, and everything they all do, just a little bit better. For instance, this week, Dr. Perlman suggested that we bring Isabella some music. He believes in the power of Mozart and other classical composers to soothe preemies while they eat, sleep and grow. But he cautioned to only bring her single instrument pieces, such as piano sonatas, because they are generally softer, quieter compositions. Preemies can comfortably handle about ten decibels of noise – anything louder and they tend to get very agitated. Forever mindful of that high standard of care, Dr. Perlman actually has someone come around with a machine to test the volume setting on each baby’s cd player.

Every week, before I hit the “send” button on these updates, I run them by Patrick to make sure I got everything right. This week, he suggested I was being “a little too jokey”, that this is “a serious situation”. I thought about it, and he’s correct - there is nothing more serious than a child fighting to live. But after 49 grueling days in the NICU, I spent more time this week trying to gauge the circumference of Isabella’s nostrils, than I did watching her vital signs on the monitor. I think that’s worthy of a parade and some fireworks and yes, even a few stress-relieving giggles.

Enjoy the pictures of Isabella on cannula – we can finally see almost all of that beautiful, little face. Please note as a point of reference, that in the attached black and white photo, she is grasping Patrick’s pinky finger.

Thanks for keeping us in your thoughts,
Much love,
Marcia, Patrick, Jade & Isabella