0500 I wake up, shower then head up to NICU, RT is two weeks old today!

I arrive and see his vent settings turned up.  What has changed?

On the board his weight is now 835 grams! Wow he just keeps putting on weight!

The nurse tells me his co2 levels are elevated out of limits so they raised his support to try and get it down.

I stare at little RT through his parted incubator curtain.  He looks comfortable, they began swaddling him more.  His little foot peeks from his swaddle blanket, glowing like a red gummy bear from the 02 senser light.

0710 I impatiently glance at the clock.

0712 rolls around and I quietly tell RT “happy two weeks!” The days all seem to have blended together.  Each day and night is long, but I am surpassed it has already been two weeks.

So much has happened is happening and has yet to happen.
As if on que RT wiggles and his o2 numbers jump down to around 80.

It isnt abnoral for him to do this anymore,  it’s a combination of the vent tube being small for his throat, being a wiggly active peanut, and his PDA causing inefficient bloId circulaton.

I coach him through getting his respiration and heart rate up,  he slowly works his way back up to 90 without needing his oxygen % turned up. They want him between 88 and 98.

Time for another blood gas,  I move to the other side and let him grip my finger with his Itty bitty hands. The nurse warms his heel for better blood flow and pokes him.  He grips my finger harder for a brief tiny white knuckle moment. His grip is surprisingly strong for such small hands.

Then he loosens his grip, he doesn’t de-sat or require a bump on his vent settings this time.

The numbers for his blood gas still don’t look good but are starting to trend the correct direction.  Another adjustment to his vent settings.

0227 echo cardiogram results show that if there was any change to his PDA it is now larger than it was.  That is not what we were hoping to hear but not unexpected due to his increased need for support and somewhat irksome amount of desat.

We will be starting the first round of indomethacin tomorrow, it is rough on preemies with several side effects,including but not limited to perferation of the intestines. Indomethacin has a 60% success rate on closing PDA’s, which out weighs the risk.

Unfortunately we will again have to stop his feeds and restart the emulsified lipids to keep him growing.

Another blood transfusion tomorrow also so at least we don’t have to do that tonight and stop his feeding earlier.

Hang in there little buddy!   We have a present for you later today hopefully!