The Dreaded Phone Call

So yesterday right after I posted, everything instantly changed. While I was writing the post, Stephen was getting his ECHO. The ECHO showed that his pulmonary hypertension (PPHN not PHT as I wrote yesterday) was actually really bad. Much worse than they thought. So they immediately put him on the nitric oxide and nasal cannula. The course of action was to wait about 48 hours to see how things were working. If his breathing and blood gases were good, he would stay on the nasal cannula, but if not, he would need to be intubated. It was around 4:30 pm when they switched him to the nasal cannula. We left the hospital at 6:00 pm and things were looking fair. Not super great, but not bad either.

Around 8:15 pm, we got the dreaded call from the NICU that we should come back to the hospital. That they needed to intubate him and put him on the ventilator. Luckily, our awesome nurses, Jess and Jenny, stayed past their shift and were there with Stephen. We met with the neonatologist when we got there and he explained everything to us that Stephen's breathing wasn't getting any better and he just wasn't able to get any of the nitric via the nasal cannula.

Basically what was happening was that the right side of Stephens heart, which pumps blood to the lungs where it picks up the oxygen, was working on over drive because the blood vessels that go from the heart to the lungs were constricted. And because the right side of the heart was working so hard, it was also becoming enlarged. So he was having to breath really fast shallow breaths to get any oxygen in his lungs. Unfortunately, if not caught soon enough and treated, PPHN can be fatal. But luckily, Stephen's nurses recognized the signs and insisted he receive that ECHO yesterday.

PPHN was actually a concern of the surgeon's prior to his surgery last week, but he only had a very mild case of it last week. Then it went away, and now it's back. But after today's follow-up ECHO, things are looking good and his stats and everything are fantastic. Plus you can tell that Stephen is really comfortable today and feeling better now that he isn't working so hard to breath. And surprisingly, the enlarged portion of his heart has already shrunken back to normal (we were able to get an update from the cardiologist today). Now we just hope that he takes well to being weened off the nitric oxide and the PPHN stays away for good!!!

Here's a picture of Stephen from yesterday with the nasal cannula and then today with the ventilator.