Physical Therapy for Preemies

Cayden has been having physical therapy sessions now for a couple of weeks but today was the first time I was able to be there for it.  Everything they do centers around making him feel and move as if he was still in my tummy.  He should be curled up in a tight ball with pressure on him from all sides.  There should be gentle, swaying movement.  But despite the nurses' best efforts to recreate a womb in the isolette with swaddles and bumpers, it just isn't the same. 

Physical therapy for preemies isn't anything like PT I've been through.  Although for Cayden it was stimulating and demanding, from my perspective it looked downright relaxing!  The therapist started by just placing her hands on his head and body, applying gentle pressure.  He had been asleep, so the interruption made his stats (heart rate and oxygenation) less than ideal.  Then she had me do the same thing, saying how it could help because a baby knows his mother's touch, and sure enough, just a few seconds after I put my hands on him, his stats went back to normal. 

Next, she showed me how to "rock" him.  I called it "going for a magic carpet ride".  With both hands, I lifted him from underneath while he was still curled on his side on his little isolette pad and slowly moved him back and forth.  It's supposed to give them the sensation of the type of movement they'd experience inside their mommy's tummy.

Then we showed him where his hands were and how good they could be at helping him self-soothe.  I held his hands together in front of his face so he could see them, then tried pushing them gently toward his mouth.  At one point, he clasped his two little hands together all by himself - it was the cutest thing!  Next, I took one hand and brought it up to his head and held it there so he could feel his soft hair.  The idea of these "exercises" is that he will learn to comfort himself by sucking his thumb, touching his face, or stroking his hair.

Finally, we did what the therapist called "vibration", but I'd say it was more simply just using my hands to apply alternating firm pressure between his shoulders and his hips.

All this excitement must have tuckered us both out because we both slept hard during kangaroo care after his PT.  I thought he had a couple of brady episodes, but the nurse said they were another baby's alarms I heard.  I know I woke up to rub his back to try to bring him out of it and make the alarm stop, but he didn't seem to respond as quickly as he has before.  For all I know, it really was another baby's alarm I was hearing, so no wonder my rubbing didn't seem to help!

Nurse Shawna was on again today and she said she didn't like how his belly looked again this morning when she first came on shift, so she told the docs and they did an x-ray just to be sure there wasn't a problem.  The x-ray looked fine, so there shouldn't be any reason for concern about digestion issues (for now).  They're going to keep him on the lower, 24 kcal supplement for the time being but may increase the quantity of breast milk he's getting to make up some extra calories.

This afternoon, they reduced the setting on his high-flow oxygen from 3 to 2.5, so he's still making progress in the respiration department.

Tonight was his last shot of Epo (to help boost his red blood cell volume).  They will check his hematocrit after he gets the last dose to see if the treatment worked and decide how to proceed from there.

All in all, I'd say it was a pretty busy day for the little guy!