Wake up early to get to the nicu before his eye appointment

Weight on the board is 2065 a gain of 15 grams.

Nurse today is a primary. She tells us the night was better than last night but still eventing,  had two larger events already today.

0800 cares just pee. Good timing,  the eye doctor arrives after a long 45 minutes of cares with pampering and a goodbreak from his CPAP mask. 

He does his eye exam. With the speculum that holds his eyes wide open and tool to move his eye around and look every where.  RT tolerates it well, he didn’t need sweeties or desat. He’s a good boy.

The doctor says everything is mostly looking better.  About what he would expect. He will be back on next Thursday to make sure.  He asks if we have any questions then gives us the exam sheet with diagrams drawn of his eyes.

He asks if we have any questions, I ask what color are his eyes jokingly again.
He gives me a funny look again. Mom quickly tells him I’m joking.

He says they have some blue to them but some brown too. Usually get darker and more pigment add babies get older.

I notice the last eye exam had grade 2 and 3 in his left eye and only 2 in the right.  Now only lvl 2 in the left eye. And grade two in the right eye except for the 10 and 11 o’clock positions. Which are grade 3… this is a change. .. Grade 3 in his right eye,  it only used to be gRade 2. We have the nurse grab him before he leaves.

Turns out this is the change that happened between his last exam and surgery.  So if you compare the two exam sheets the right eye actually looks worse,  but if you compare from the time of surgery,  there is actually slight improvement in the right eye just not as big of a reaction as we were hoping from surgery.  The left eye reacted well to surgery.  He will be back on Sunday to check again.

If we don’t see improvement we will talk about surgery or eye injection again.

Well we are happy there was no worsening for now!

We head out for a breath of air and a walk, and get coffee and a snack print some pictures at bartels.

Then back to NICU. He is on 36% oxygen.

1100 cares. Just pee. More events during cares.

Mom asks if we are going to get an xray.

Nurse asks doctor,  Xray ordered.  Good job mom!

Xray arrives quick,  image looks ok to me,  not much change in my opinion.

We do rounds and discuss Everything that has been going on. A longer rounds today.

After rounds we back in and see RT, he was a good boy while we were gone.  His respiraroty therapist hung out with him while we were away.

Lunch.

Back to nicu.

A few more events.

1400 cares. Temp Diaper.  During cares,  the respiratory therapist swaps to the other cpap that can compensate pressuee for his mouth being open rather than maintaining a constant flow like bubble cpap. Ultrasound shows up,  then he poops. I’ll change it after his ultrasound,  they do his echo cardiohram.  He handles it well the respiratory therapist keeps him on the neopuff because he likes it.

After ultrasound is done I change his diaper again.  Big poop.

Then swapped to nasal prongs on the CPAP.

Then skin to skin time.  He does good only a few smaller desats.  He stays relaxed mostly. Angry a couple times when he is uncomfortable because of nasal prongs and he manages to knock them out.  Mom helps get them back in his nose very well.

Oxygen down to 33%

1725 skin time gets to go longer because we started late,  put him back because he is more wiggly and Knocks ofg his prongs again.

Dinner.

Then back to NICU.

There is a nurse and trainee that have him tonight.  They bumped our primary that we should have had.  While training new people is important,  I wish we didn’t have a primary bumped for someone that has never had him before.

2000 cares he is cold, the rest of cares go smooth. Respiratory therapist in training today too. Cares go smoothly. He tolerates it all.  The pulmonary Dr. comes by and b talks to us.  Explains the plan moving forward and says he is glad we are extubated already. Wants to continue with fluid restriction to help his cough.

Good talk.

Respiratory therapist asks Dr on today if they can lower his cpap, he agrees.

CPAP chaneed from 9 to 8. Because this one can compensate for his pressure leak. Swapped to nasal prongs, he doesn’t mind much this time.

Trainee respiratory therapist did a good job, went his speed and was gentle.   RT stayed calm and had good manners.  After cares we are able to turn him down to 26%.

then after a while he coughs, turns red bearing down and has the larger brady desat of the day to 30 spo2. Heart rate low of 65bpm. He takes a while to come up and goes back down several times.  Takes lots of stimulating to get him to wake up and breathe and get his heart going.

Too relaxed little buddy.

100% oxygen.

Able to wean down to 40% then 30% oxygen quickly.

No results from echo cardiogram yet.  Maybe we will find out tomorrow. Hopefully nothing interesting!

As difficult as it is we should go try and get some sleep, we say our goodnights as he is high sating at 99 spo2. On 30% oxygen. Atleast with trainees around there are more hands available!

Love you RT.  See you tomorrow.