It takes a while to get RT enrolled in DEERS at base Seattle, there is someone ahead of us that is trying to get an ID but does not have a social security card and is above the age to be eligible for a dependent ID. When it’s finally our turn it only takes a few minutes.

Then back to the NICU, RT is still hanging out at 34% oxygen!! Good job buddy!

A nurse that has not had RT yet, but knows of him.  She seems nice, and willing to accommodate RT’s needs! 

We ask the nurse if anything is new. No changes since we saw him this morning.

1400 he is sitting at 97%spo2 170 Bpm heart rate. His heart rate starts coming down. 150, 130, 120, 110, 104 102. His sp02 is not far behind. Spo2 the high 60’s. Suctioned several times, decent amount comes out. Oxygen turned up to 60%. He works his way back up.

X-ray ordered. X-ray eventually  comes, takes image and departs.

They go out and talk to the Dr. They come back and Change some settings.

1500 blood gas. Shows his co2 is high. They Go out and talk to the Dr.

Respiratory therapist comes back, explain they are changing respiration rate higher and pip lower. Flip flopping our settings to be easier on the lungs.

Peep remains at 7, pip down to 27. Respiratory rate up to 40.

Time for cares while he is awake. Mom checks the temp, I open his diaper. Yup it looks like a yellow jellyfish somehow got in his diaper. I guess they are doing another urinalysis. Good to know. I tell the nurse she has some pee.

“Oh woah he peed a lot!”

Good boy! Nice job RT.

She collects the sample. Then I go back to changing his diaper.

They rotate him to his belly. Suction again. Good amount comes out.

Time to start weaning his oxygen again. 46% oxygen.

Time for a late lunch early dinner.

We find out our milk made it to Alaska without melting! Yay!

We eat at the cafeteria and head back up.

Down to 44% oxygen

Another couple desat.

We ask to see the X-ray from earlier. This nurses personal preference is to not show any X-rays and let the provider show us. That is fine we understand that is her right. It just means we will have to wait longer to see the pictures.

Eventually the Dr. Comes by, we ask some questions. She tells us they have been working on the logistics for RT’s surgery.

Oh so the surgeons are willing to do it? This is news, all we have been told was the Cardiologist would have to talk to the surgeons.

Sounds like we are going to do surgery, move to children’s hospital or Mary Bridge on monday, maybe surgery tuesday. Then come back to Sweedish when stable, it could be a few days, or longer depending on his needs and how he recovers.

So little RT is now on the books for surgery, we are nervous, anxious, and scared. This could be what he needs to keep going the right direction!

We ask to see the x-rays from today, we compare them. Not much change, just his roving atelectasis changes locations due to his position. Atleast this means we haven’t de-recruited.

A couple more de-sats. Mom notices a few where he is coming down quicker than he has been.

1900 nurse preemptively  bumps him up from 46 to 47% oxygen for passdown to try and bribe him,   he won’t be having any of this, he dings his alarm at 87 spo2. She tried though!

Tonight we have one of RT’s primary nurses!

2000 Time for cares. Mom takes his temp, it’s a little bit cold.

He is on his belly so I wait  to do his diaper till after they re-position him. The respiratory therapist amd nurse move him to his back, his heart rate begins coming down, his spo2 in tow. 130bpm 80spo2 115bpm 70spo2 96bpm 60sp02. 50spo2 Oxygen is already to 100 on ventilator, nurse turn on the bag, and  I ask if I should pull the code alarm on the wall. The respiratory therapist says no not yet. I am glad they are both here, they have seen RT do this before. The respiratory therapist is bagging him.

He continues crashng down. They pull the alarm and continue to work on him.  I move the chairs and backpack away from his incubator and we move out of the way. The last thing we want to do is become a hindrance in the emergency. RT’s large entourage arrives moments later. I feel like it’s more people than last time, I loose count. His oxygen is already at 100% they are changing settings, someone starts suctioning him. His heart rate is now in the 30’s and his spot hits 20 then just a ? Instead of numbers.

His mom is crying.

I’m still just watching them work. .

His heart rate comes back up to 140,  his spo2 follows back up to 60,90, bouncing off 100. Back onto the ventilator he goes,  Xray ordered.  Turns out a large amount of mucus likely shifted and clogged his breathing tube when he was repositioned.

They will be suctioning more frequently tonight.

People slowly clear out of the room. RT back to his old self.  Oxygen back to 40%. Pip up to 30, Peep up to 8, RR still 40. Higher support for now to ensure we don’t lose grounds.

Time to get down to business.  I change his diaper. It feels like a good weight,  a little poop. 22gram diaper!

Xray shows up and takes an image.

I check it out, to me it looks about the same.

We compare a few of his past xrays.

RT is comfortable now. Looks calm, I cup his little head with my hand, almost looks like he is smiling beneath his ventilator tube.

He suckles and licks the tube,  looks like he is almost asleep.

We should probably try and do the same.  Long day already.

Now that his mucus is no longer in his vent tube,  maybe everyone can have an uneventful restfull night!

Glad we were there again to not have this get this explained over the phone.

Thanks again to RT’s own tenacity and his excellent small army of nurses,  respiratory therapists, doctors, specialists,  surgeons, chaplains, secretaries, and support sysem, we are still here.

Sleep snug you little adrenaline junkie.