Today was another "typical" day in the NICU in that there were plenty iof ups and downs to go around. We actually just got back from the hospital for the night (it's just before midnight) and I am setting up to pump before heading tonbed. But wanted to post an update since a lot has happened in the past 24/48/72 hours. I'll break it down by system/issue to make it a bit easier.
1. Ventilator/lungs/breathing: so this morning when we called the NICU to check on the little man (as we do every morning), we found out from Connie that his blood gases overnight and into the morning had been really good and the soca were talking about extubating him today. It was a shock to us because just two days prior, his blood pressure was really high despite the fact his PPHN had resolved itself and the nitric oxide treatment had been stopped. We were a little worried that maybe he was being extubated too soon, but trusted that sods knew what they were doing. We got to the hospital around 1 pm and chatted with the neonatologist about it. He would have another blood gas at 3 pm and if everything was still looking good, they would take out his breathing tube. The blood gas did not come back as expected, so he would stay on the ventilator. But then his 5pm and 8 pm blood gases came back great, and they ended up extubating him tonight. So right now Stephen is back on CPAP and breathing completely on his own and he's doing great! His respiratory rate (the number of breaths he's taking each minute) this evening was great and he was nice and relaxed when we left.
2. Dialysis: two days ago his weight was up 200 grams and he was getting really puffy again. He was still getting really good outputs with his dialysis, meaning each time the fluid was drained, more fluid was coming out than going in. That's exactly what we want. But it has been a mystery as to why he had put on so much weight. So the nephrologists had to make some adjustments with his dialysis solution, and it appears to be working because Stephen lost a good amount of weight during the day today and was down to around 4700 grams tonight, which is just over 10 pounds.
3. Infections: We also found out yesterday that Stephen has an infection in his trachea from the ventilator tube. It's a type of yeast infection that grows in warm, moist places such as the throat and is some what common in people who are ventilated. Luckily we found out today that the infection has not entered the blood stream, his lungs, or the peritoneal cavity. If the infection reached one of those three places, it would be very bad for Stephen. Then today, we found out that he has another type bacterial infection they are also treating with an antibiotic. Stephen has been spitting up his milk and mucous the past couple days so they cultured a lot of different things, including my breast milk, to try to determine the cause. The preliminary results came back tonight and it turns out that my breast milk had some positive hits. Most milk does and would never affect a healthy baby, but with Stephens compromised immune system, it does. So we'll wait until the final results come back tomorrow, and then they may need to run some more tests on my milk. Just one more thing for me to worry about!!
But we are saying our prayers tonight that Stephen continues to do well on his CPAP and things keep heading in the right direction. It would be a terrible thing if he has to be intubated again, so we just hope his blood pressure remains low, his breathing stays low, and he stays nice and relaxed. And hopefully if all goes well overnight and in the morning, I'll be able to hold him again tomorrow!!! :)