Ruby Hope McKee Starling

Ruby's grandma came to visit again this weekend.  This is the first visit she's had since Ruby was extubated and could be picked up and held.  It is very obvious that Ruby remembers grandma, but it was hard to tell who was more happy:

Ruby has been handling the reduced amount of morphine fairly well thus far.  She hasn't been terribly cranky, but her nose has been stuffy.  Oddly, this is one of the side-effects of opiate withdrawal.  So she has been coughing and sneezing the last two days.  It's really cute when little babies sneeze, but the reason is not so cute.  We went ahead and weaned her Versed today.  So she's at 0.8mg morphine and 0.6mg Versed every 3 hours.  The next step will be to take morphine down to 0.6mg, but we're not sure when we'll do that.  One funny thing about the oral morphine is that it is dyed BRIGHT BLUE so it's easy to identify to avoid accidental overdoses.  When they first switched her to this, we were in for a big surprised the first time we changed her diaper.  I'll spare the details, but lets just say that what goes in bright blue comes out bright blue.  Holly was worried there was something wrong with her bowels until we realized what was going on.  Now that she's taking half as much as she first was, the hues in the diaper are more of an emerald green.  Don't worry, I won't post pictures.

She's till taking two feeds per day through her mouth.  She only got 5ml from the bottle with me today, but Ruby got 10ml straight from the source with mom this afternoon, which made us all happy.  Her reflux wasn't as bad today, so I think the increased zantac is working.  We're holding her steady at 2 liters of airflow with 25% oxygen for the time being.  We're confident she can come off that when the time comes, but it still really seems to help with PO feeds and when she having an withdrawal tantrum. 

She made good progress on her torticollis today and was willingly and happily turning her head to the right to see us and toys and even to just relax and sleep.  The nurse yesterday got a toy out of the NICU baby toybox to help entice Ruby to turn to her right side when we're not around to police her head position.  It's some sort of plastic box thing that plays music and jungle sounds and has lights and dancing monkeys and frogs that is scientifically designed to mesmerize infants.  It probably has a proper name, but we call it the Baby TV.  It works wonderfully, as you can tell:

Grandma brought Ruby a whole new wardrobe and bought her a big girl bathtub.  Once the steri-strips fall off her broviac central line wound, she'll be OK to immerse in water for a proper bath.  Up until now it has just been a sponge bath.  It should be grand fun to watch her splash around for the first time!  I'll have the camera ready to take some naked baby pictures to embarass her with 15 years from now.  Until then, one last photo of Ruby in Grandma's lap, wondering why dad is pointing the camera at her again, instead of paying attention to her: