As I was getting ready to go back to bed after the last post, I realized it was the first night Mike & I hadn't called before bed to get Ian's update. So I called in and spoke to his fabulous night nurse (I'm choosing to not use names because I'm not sure if they would be comfortable with that) and am so glad I did. We had a fabulous conversation!
She agreed with his fabulous day nurse that this was a different baby than her last shift. The difference was that the day nurse hadn't been on in a few days, the night nurse was just on Monday night!
Because he was doing so well, she bathed him (a sponge bath I'm sure), washed his hair to try to get the glue out and changed all of his bedding and regularly moved his head around from side to side. She reminded me that the night before, just touching him sent his blood pressure up. During the day on Monday, he was so sensitive that the noise in the room was sending it up as well. Now, she didn't even have to give him any extra Morphine or Ativan to calm him after the handling.
His mean blood pressure was holding steady at between 62 - 65. When she had left Monday night his oxygen was at 80%, now it was @ 55%. All of this change and his blood gas was still terrific. His PO2 was 106. She was staring to get temp to pick up on his belly now which wouldn't read before because he was so swollen which means he's moving his fluid around.
His belly girth during the day Monday was 38.5 and now it was up to 40.5 but now is 40. She replaced the tube that goes into his belly and pushed it down a bit more to help get the air out. Because of the ventilator, air goes in and it can't help but blow air into belly, when he was hooked up to suction it was easier to get it out but because he had bleeding in his tummy, they had to pull that one out. Now has an OG tube which uses gravity instead of suction. She was expecting it to be even lower now because he had a very large meconium stool and he's been peeing more since she's moved him around a bit.
He no longer has sidies (sp?) (fluid accumulation) (today looked at abdomen showing no accumulated fluids) but he does have edema which means fluid builds up throughout his body close to the skin due to lying in one place. She said it makes him swollen and stiff and the fluids leak out into the tissue. When he's moved around a bit the fluid goes back into his cells and he pees it out which is what he seems to be doing now.
Like I mentioned in my last posting, he's got some withdrawal side effects from them weaning him off of Fentanyl. His right arm shakes a bit but when I would hold it, it would stop. She explained they don't like to let the babies experience this for too long so sometimes start them on Methodone which helps with withdrawals. The include it in the mix with the Fentanyl & Morphine but take it off last and it's easier to adjust to not having. She said the long term effects shouldn't be a problem.
His lungs looked a little bit better, the collapsing lung looks better, and when she listens to them they sound equal.
As I also mentioned, he now has arterial line in his hand. Last night she said he barely moved his hands. Now he's moving his arms around and even the one with the line in it, which also has a brace of sorts to keep his hand flat, he moves from up near his ear to down by his side.
She said the probes on his head and the removal of them made his head very swollen and she said it's painful, but some movement helps relieve the pressure. We're all hoping the EEG will not show any indicator of seizures.
She explained that she was thinking about primarying w/him but she's going on vacation. This means whenever she would be on shift, she would be his nurse. What I didn't know is that his day nurse today is his primary during the day. She said this allows them to get to know the baby and be more involved with decisions about his care.
When they are suctioning they are getting less out which means less build-up is happening.
As I mentioned in my last post he seems to be waking up and looking around more. I told her this makes me want to be there even more so he can see us there to support him. She said while he's on all of the pain meds, it's not as crucial but when he's been weaned from more of them that I can record my voice doing whatever I did while he was in the womb, singing, reading or just talking, and they will play it for him while he's awake in case I wasn't there. That sounded terrific to me!
She wanted to clean him up tonight but, in general, they still will do minimal handling.
I commented on all the improvement from one night to the next and she said they sometimes see this when the baby has maybe turned a corner, maybe something has kicked in. I also mentioned that Mike & I were talking about his progress but almost afraid to be too excited about it. She said, we should celebrate it. But we know that there are steps forward and sometimes back. And she agreed the best thing to do is what they all say, just take it one day at a time.
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The word you are looking for is "ascites."
ReplyDeleteWay to go, buddy!
ReplyDeleteIt all sounds like great news - little by little Ian's keeping strong and fighting to come home.
ReplyDeleteI read the comment about you making recordings for Ian to listen to - not sure if the hospital has a system in place, but I have a very small/travel sized ipod speaker set that you can use if you want.