Enter NICU,  weight up 70 grams again,  he needs to poop.

Respiratory rate down from 22 to 20.

To explain the idea of weaning respiratory rate.

Essentially the machine ensures he takes 20 breaths with a higher peak pressure of 28 to get good inflation. Just like us we take a bigger breath occasionally.  

But he can initiate his own breaths on top of that so even though his rate is set to 20, he could breathe much faster if he wants to be can breathe upwards of 60 per minute. But 20 of those 60 would be the 28 pressure while the rest would be more normal smaller breaths.

So if you wean his rate from 22 to 20 that is 2 fewer big breaths per minute which doesn’t sound like a big deal but that is 120 fewer big breaths per hour, and 2880 fewer big breaths per day.  So even a small wean like that adds up over the course of a day and can take a long time to see if he is reacting poorly to it.

Same nurse as yesterday.  2nd time she has had him now.

He is on 32% oxygen.

A few events last night.

The nurse tells us he regurgitated this morning yellow fluid so undigested food.  Told the doctor and he didn’t seem to concerned.  We ask if she could let the doctor know we would like to talk about it. (Not sure if he was too busy, forgot or the nurse forgot to page him to let him know we wanted to talk.  Didn’t talk to him about it tI’ll night rounds at 2100.. not toonly concerned because RT didn’t have higher oxygen needs after that.

Morning cares. With his zopanex and Hypertonic saline he creates extra secretions.  For some reason it seems some people don’t realize it means he will need suctioning soon.  They both help him get out fluids.

I would think by now people would know if he is getting his nebulizer treatments they likely should be ready to suction.

Lunch.

Back to NICU.

Cares. 98 gram diaper!  Just pee.

Skin to skin time.  My turn.  Goes well. It’s weird not having nurses that know the routine on how we do the standing transfer.  I have to explain something that seems so normal to me now. Not all nurses seem comfortable with it but afterwords the always comment on how smooth it went.

Weaned to 28% oxygen.

He needs to be suctioned nearing the end of skin to skin time.

1630 put him back.

30%oxygen.

Temp 36.8. Just pee. I’ve been showing him his book lately and he likes it.  More binky time again too.

He is more awake lately.  Probably getting used to his small morphine dose.

Dinner.

Back to NICU.

Shift change.

Nurse that knows him well.

Suctioned

Mom and I start cares early. Give him a belly massage to help get things moving.

Suctioned.

He will get another suppository if he doesn’t poop soon.

Just pee.

Respiratory therapist that knows him well! suctioned CPT, suctioned.  After cares he takes a while to settle down. Binky time,  repositioned, Reswaddled, show him his book.  Binky time,  hand hugs, Eventally he calms down.

Weaned to 26% oxygen!

Dr. Comes by for night rounds.  Discuss the regurgitation that happened this morning.

Bumped up to 28%!

Fairly stable day! Glad to see him hang out below 30% for an extended period of time!
We say our goodnights!  What a good boy!
A few pictures from yesterday of mom holding him like the big baby he is.