Yesterday was a reminder of the roller coaster the NICU is. The nurses keep telling us it will be. For the last few days we had been coming in hearing he did great last night! Blood gas tests look improving! I had started to take those mornings for granted. Yesterday when we came in they told us he had been having some bad blood gas tests (which are indicators of how to wean him off the ventilator). Even though this is not terrible news and is somewhat to be expected with his lungs so underdeveloped, it instantly caused my heart to leap back into my throat where it has been lodged ever since.
After that he calmed down and had a pretty good day. But today was more of that roller coaster ride. This morning he was fussy and his oxygen saturation kept dipping into the low 80s (they want him between 88-92). They repositioned him and he started doing great. We didn't hear a peep out of him for 3 hours. Hunter and I decided to step out for a minute to get something to eat. When we came back his saturation was low again. It was a very tense 3 hours of watching our poor sweet baby struggle. Nothing breaks his parents' heart like watching him scrunch up his face with soundless cries. But the nurses let us comfort him, cradling him in our hands and it is such a wonder to watch him calm down at the sound of our voices. And feeling him squeeze our fingertip with his little hand. Those moments are everything to Hunter and I.
Jax day 10: 2lbs 0oz.
He is needing a little extra help with the ventilator today so they performed an X-ray. It looks like the upper lobe of his right lung collapsed so we have turned him to his left side to take the weight of his heart off of the right lung. They are also vibrating his back to help loosen things up. This can occur due to fluid / gunk build up due to the presence of the ventilator line. He can't cough it out with all of that crap down his throat. They suction quite often to help curb this problem. The doctor ordered another 13 ccs of blood that he will be getting today. His hematocrit is at 35% and he would like to see it over 40% going forward. Blood gas numbers are about the same no improvement but they are not worse. The echo results showed that the PDA is not worse and possibly slightly better. So he started his second three day round of Indomethacin treatments last night. The murmur is less audible today and that is possibly a good sign based on the echo yesterday. His next echo should be on Monday to indicate results of the treatment. The primary reason they are focusing so much on this PDA is to get him off of the ventilator. Having that PDA open is causing a mixing of his blood. As his heart beats the non-oxygenated blood mixes with oxygenated blood then is pumped to the rest of his body. His lungs can be working but if the blood is not properly circulating they cannot deliver oxygen or expel carbon dioxide properly. This action is driving his overall oxygen saturation level down resulting in the need for an increased amount of oxygen purity (currently 33%). If we are able to wean him off of the vent and his oxygen levels are good the PDA is not that big of a deal. A lot of kids are okay with a partially open PDA. In Jax's case we just can't seem to get him off of the ventilator yet. He showed a slightly elevated white blood cell count this morning so they are watching that closely to determine if we need to give him antibiotics. No poop today yet but also no bile coming out of his feeding tube. He is peaceful and sleeping. He opened his eyes for mom and dad this morning. He is a sweet boy... But still full of piss and vinegar! FOJSP!
No comments:
Post a Comment