RT is 8 weeks old today!  Eye appointment scheduled for this morning.

Head up to the NICU, weight on the board is 1645, he has lost some weight 70 grams,  possibly from lasics, maybe it will be back tonight.

Checked his red blood cells last night,  it was 40, big jump from 26 before transfusion.

We look at his ventilator settings, settings remain the same but oxygen percent has been turned down to 23%! That is so close to room air!  I was thinking maybe high 20’s. Amazing!

The nurse tells us he had a rough night. One of the respiratory therapist (not the one that had him at the beginming of the night but the one I’ve said has fast hands) repositioned him last night around 0200 to his belly. He braided (heart rate dropped) down into the 40’s. So kind of a larger event needing to be black bagged to get back up,  but he recovered. I wonder if she moved him faster than he likes,  he does like to move slow especially when being turned over.

He also pooped again last night finally!

He also got upset around 5am, heart rate was high 220ish even hit 240 briefly, he cried for a long time. They tried several different things,  one of the nurses came and comforted him with hand hugs and it calmed him down,  but she couldn’t stand there all day. When she had to walk away he got angry again.  He really just likes getting love.  I wonder if he was scared or had a bad dream or something. His temp got high too, so they weren’t sure if he was having withdrawing from the fentanol/morphine and gave him a bolus.

Then it is time for his eye appointment. The eye doctor comes in,  mom goes out of the room so she doesn’t have to watch RT endure it.  The nurse reposions him,  his heart rate dips down to the 80s, back up, 90s back up, nurse suctions him out, he calms down a little.  Then it’s time for the eye doctor to do his thing,  eye drops into RTs eyes,  he puts on a head lamp/magnifying thing. Takes a eye lid spreader instrument and opens up RT’s eyes to their limits,  RT does not like this.  Doctor takes a look around.  He uses a device to position RTs eyes looking various directions so that he can see all the different areas.  Then on to the next eye.  It is a quick inspection,  but I’m sure for RT it was eternity.  Eye Dr. Says his eyes show no signs of ROP as of now not even stage one or two,  but that it can still happen. His notes his eyes look premature but that he is after all a preemie.

Big sigh! 

Any questions?

Yes,  what color are guys eyes?

Haha actually I didn’t even look at that because I was looking for ROP or eye issues. Understandable, I’m sure RT’s eye color doesn’t actually take a Dr. To figure out.

He says he can make a note and look next time.

Next eye appointment is in two weeks.

We hang out,  do cares,  just pee. Suctioned turned, doesn’t need extra oxygen. After cares the nurse turns him down to 21% oxygen! Impressive after the day he has had.

Big sigh! 

He has not been on room air percent in so long!  I can’t remember the last time. This means his lungs appear to be healing! His oxygenation and circulaton is working better!

Lactation nurse comes by, have a talk about mom’s milk production,   her son was up in Sitka for a year,  somehow the car is still up there and she wonders if there is any way too see if anyone in town would want to put it on the ferry and drive it down. I suggest several Facebook groups or raven radio.

Then it’s time for weekly rounds, we don’t really have questions today, we discuss extubation. It is scheduled for tomorrow!  Everyone is excited to hear he had made it Down to 21% oxygen!

Exciting, nerve wracking,  scary. I pray for success,  we will be trying NIV NAVA. Non invasive mode of ventilation similar to what we are on now,  but without an ET tube in his throat.

We mention to the nurse today asking if she wants to sign on to be on RT’s primary care team, no one else has volunteered. Maybe some nurses would rather be asked? She accepts, hopefully it doesn’t overlap with his only other primary day nurse schedule much.

Lunch time,  then back up.  He is back to 23% he desat slightly.

That’s OK he is still doing good.

1400 Cares again slightly early he is a little irritable, just pee. Suctioned turned,  and calms down

1730 we do an early dinner.  Skin to skin later! My turn.

Back up to NICU,  shift change. It’s a nurse he has not had in a long time. He has grown a bunch since then.

2000 cares slightly early he is getting fidgety and irritable again. Just pee,  he requires more oxygen during suctioning and cares because he is still angry.  Up to 30, 35, needs a little more then 40. Cares almost done.  High sats, turned down to 37.

Then skin to skin time! Transition is smooth,  he calms down almost immediately.  The nurse is able to slowly wean his oxygen down during skin to skin.  I can tell he is working on pooping!  Good boy!  By the end of skin to skin down to 33%

2300 it is time to put him back,  transition smooth.  He is still relaxed,  he pooped! Big one,  almost leaked out of his diaper!  Good boy! Doesn’t require any more oxygen for cares,  suctioned positioned.  And the nurse is able to turn him down

2325 Oxygen down to 27%!

Looking happy! Good day!  Keep it up RT! Another big early day tomorrow!

Keep on pooping!

blog updated Time for sleep! See you in about 6 hours RT.