Enter NICU, it’s one of the nurses that has had him a couple times!

Weight is down slightly to 1715 grams.

The nurse tells us they had another lung X-ray this morning. CPT has been discontinued because upper right lobe looks betterish. He is also now on NAVA mode of ventilation. He still has a ET tube down his throat and now has an EDI catheter too, we were on this system back in the first couple weeks of his life. The EDI catheter picks up the signals his brain is sending to his diaphragm and gives him a breath.
This system shows less patient initiated breaths than PRVC mode. he is letting the machine do most of the breathing but he is at 40% oxygen so If he breathes too much his spo2 will high sat which he has started to not like to do.

Nurse tells us because his eye appointment is tomorrow we will put off extubation till the 16th. Do want to do too much all at once. Eye exams are kind of traumatic for babies because they don’t like holding their eyes open.

We ask how he did over the night, the nurse says he was up to 70% for cares. We weren’t here, but I suspect most of that was preemptive turning up for cares because that’s what we have seen last nights respiratory therapist do.

Who knows, maybe he needed 30% more oxygen for cares…

He is at 40% now so atleast he came back down.

We do cares, just pee. His feeds are now 30cc up from 28. And they are fortifying with a higher calories.

After cares which we did not turn his oxygen up for the nurse turns him down to 38!

Quick lunch in cafeteria then back up.

He is at 38 still, so doing good!

She turns him down to 35%, then 33%. That is only 12% more than room air! Getting there little RT! Then for 1400 cares he requires slight more oxygen. Up to 38% again, not even close to 70%.

Then it’s moms turn for skin to skin! Transition is smooth, RT does well, high says a little, nurse is able to turn him down to 33 again. Then he wiggles and goes to 89 spo2. She turns him up to 35%. Still good!

For the transfer back to his incubator we turn him up to 40%, still not 70%. His heart rate goes down to 97 but comes back up on its own. Good boy!

Cares, temp is 37.1. Diaper is 72 grams! We started lasics today to help him get rid of water weight.

After we get him all swaddled the nurse is able to turn him down to, 37%!

1800 Dis Continued morphine, his last dose was at noon!
Time for dinner,  then back to NICU, the nurse we have tonight is one of his primaries!

During passdown he high sats a few times.  He is at 36% oxygen,  good boy! He is actually working to breathe now, not “riding the vent”(not letting the ventilator do all the work)!

After passdown we start his cares a little early, becsuse he is awake,   his heart rate is elevated.  Maybe he is angry about wet diaper.

Weaned to 34% oxygen!

Temp is slightly high,  he is very awake this care and watches everything,  hopefully tomorrow we hear his eyes are doing ok with no sign of ROP.  The respiratory tech we have today is one of the first ones that saw him open his eyes, she is quite familiar with him!

Diaper . Just pee.

Suctioned, temporary suction support but no bump on his oxygen.  just a little secretions, they change out his bedding. Repositioned.  He looks pretty comfy.

He deals with cares well!  Food started. After a while he gets uncomfortable being in his new position. The nurse is familiar with him decides we can reposition him after we tried a few things to calm him down,  they work temporarily but he gets angry when we try and let him be alone.

The nurse he had the last two nights is in the same room as us tonight but with different babies.  She mentions he didn’t like his back last night either.

They reposition him to his belly. He settled down pretty quickly! 34% oxygen!

It was nice not having him bumped up on his oxygen during cares,  we dont have to try and wean back down after cares, we can see if he can progress more,  not fight to get back where we started before cares.

Yay!  After a bit he high sats,  over some time the nurse is able to turn down his oxygen percent to the lowest we have seen it in weeks!!!

2116 down to 31% oxygen, and looking stable. I feel like this is a big success. He is only 10% above room air! The support and pressures he is on its really not that high for the ventilator either.  I am excited! Maybe this attempt for extubation on Friday or Saturday can be successful.  His throat will be able to take a rest!

Anxious about his eye appointment tomorrow,  sometimes the unpleasantness  can increase oxygen needs temporarily. I hope all we get is good news.

Tomorrow he will be 8 weeks old!

Stablessing night hopefully! Maybe they will be able to make it down into the 20’s!