Stress dreams all night again. Not sure how the wife continues being able to get up and pump every 3 hours ontop of everything.  She is an impressive woman.

Phone call from Dr. this morning.  Everything is ok, just getting an update.

She says the xray shows his upper right lobe getting fluid filed again. Ventilator  Tube position looks spot on,  where she would put it if she was doing a seminar on ET tube placement so it is more likely positional edem, going to try and keep the right side of his chest elevated when positioning.

Oscilator settings are different Pressure down to 18, Amplitude up to 37 from 33, HZ down to 10 fron 12. He seems to be tolerating it.

Because settings are down his oxygen percent will be a little higher, untill his lungs heal.

When checking his stomach contents for residual,  the fluid was pink,  likely irritation from his feeding tube.  Not uncommon to happen.

Lasics appear to still be helping,   the swelling continues coming down little by little.

This Dr. will be on a different floor in the hospital for a bit but will continue checking in on him.

We head in to NICU, his weight is 1420 grams, a loss of 20 grams! Good job RT!  Getting rid of swelling.  The nurse today has had him a few times, she is starting to learn his preferences.

His oxygen percent is at 78%,  a bit higher than we were expecting. Is he worsening,  or is it because settings were changed and this is expected?

His heart rate is 200. Nurse has been trying to figure out what is upsetting him.  We ask if we can check his diaper.  Yup!

We check his temp 37.5 a little warm,  this can cause a higher heart rate.

We check his diaper,  just some pee. We change him.  No poo still.  It’s been too long,  nurse gives him some assistance with a suppository. We need him to continue being regular.  It gives him more space for food and breathing.  Plus it must be irritating being clogged up.

I’m sure he wants to know if we want him to breathe or eat.  We need him to do both.

Last night we were discussing going back up on pressure if he continued needing more oxygen,  and that was at 50% oxygen.  So we ask at what point this becomes a discussion again.

We hang out,  Dr. on for the day comes and stops by talks to us about everything going on.

Hang out some more, first large event of the day he just didn’t want to go above 91% sp02,

🌟 as I’m writing this he earned a gold star.

He slowly crept down and down on his sp02 so they tuned up his oxygen more and more.  He just didn’t want to come back up.  100% oxygen support. It seems like forever still desating. Suctioned,  Repositioned.  Not much else can be done. We patiently wait as they suction him again. I keep encouraging him to get his numbets back up, we know he can! Slowly he begins creeping back up on sp02. Weaned fairly quick.  Must have been a plug?  Then back up to 80% oxygen.

Nurse talks to Dr., Xray ordered. Xray arrives, wrong sized plate to place under RT,  he has to go get one that fits under his incubator.   Shows a loss of upper right lobe again.  They adjust his feed tube to 15 from 17.

We found the point this becomes a discussion again.

Dr. Makes some changes again.  Pressure up to 20 from 18, Amplitude down to 34 from 37, HZ stay at 10. We check out the xray, can definately see dropped lobe.

Dr. Comes and talks to us again and tells us about xray and lobe. We also talk about acidosis and how the lasics effect his CO2.

Reposition to his belly because he usually likes that.

Hard to go out to lunch but we need to eat.

We get a coffee and lunch.  I get a nitro coffee too, yum.

Back to NICU, he is on 71% he is wiggly and seems uncomfortable. We try a few things he doesn’t calm down,  respiratory therapist is called.

1400 they reposition him to his back.  Diaper change,  just pee. He opened his eyes and looked around!

Slowly weaning him down.  His lungs must be opening up again, and he looks more comfy again.

1600 blood gas,  it goes quick.  Mom comforts him during it, he stays calm and doesn’t have to get his oxygen turned up. Blood gas numbers look fine.

He desats down to 84 sp02, we encourage him to get his numbers back up. His momma tells him if he can high sat to 100 he earns a gold star. This is when he earned his gold star! 🌟

1700 another diaper change and temp check.  He tolerated it all well. Didn’t have to get turned up.

His oxygen percent it’s down to 55.9%! Looking good compared to the 78% of earlier,  eventually we will have to wean his other settings back down. But for now,  we just need to keep him stable.  We will have to work on getting pressures down somehow.  He has to keep his lungs open on his own eventually.

Dinner time. One of our friends flew down from Alaska for medical appointments for her little girl. Hopefully children’s hospital is able to get everything straightened out. She meets us at the hotel and drops off a bag of things she brought down for us from home! We have a nice little talk. Hopefully we are able work out a time for her to meet RT tomorrow!

Then pump,  wash pump supplies and back to the NICU we go.

His oxygen is bumped up ever so slightly because of pass down being noisier and bright but he is still doing better than earlier.

Oncoming nurse is his primary. Yay for continuity of care!

He has a few desats but it’s able to recover on his own.

2000 cares.  Goes smoothly.  Temp is 36.7. Diaper is just pee. He needs to work on this pooping thing.  He almost doesn’t need to have his oxygen turned up. It looks like he is trying to scream at me.  He can’t because his ET tube doesn’t let him.  He has an angry face.  Diaper back on,  he is calm again.

I can’t wait till he is able to cry and yell at me.

But he needs oxygen turned up for suction and repositioning. This is pretty normal. Suctioned again after repositioning too, good amount comes out!

Need to get all those secretions out!

After cares the nurse is able to wean him again to 53%. He is liking his tummy more than he did this morning.  He looks tired.

Then feeding time. He needs a little more oxygen as his belly fills and maybe gets some more secretions moving after position change.  Suctioned again,  some secretions.  We say our goodnights to our little man.  He says goodnight with a brief desat.  We wait for him to get his numbers back up and tell him he is in good hands. Everyone loves him.

Back at hotel time for chores like laundry.

2200 Blood gas looks good,  no settings to be changed yet. Another xray in the am. If he doesn’t poop by 0200. He will get some help.

Maybe tomorrow will be a calmer day?

Keep on going my boy.

Xray that shows upper right lobe having issues.

Dark colors in the xray represent areas that are less dense like healthier parts of the lungs . Light areas are more fluid filled/ dense areas. We like lungs looking dark on X-rays….