Let me paint a really pathetic picture for you. It's dreary outside, nighttime, drizzling rain. Two first-time parents functioning on no sleep and mentally exhausted gather some books and blankets into their arms and crawl into the front seats of their sedan to make the nightly sojourn to see their newborn. But the tire in one car is flat, and the battery in the other car turns out to be dead, and while they ponder the path of least resistance to the hospital, the doctor calls.
Calder had had a good run on the SiPAP vent but had given all he could give and needed more assistance. The doctor told us our options were to administer more Decadron or to re-intubate, and that there wasn't a clear answer (story of our life right now.) It did not take us long to decide we wanted to avoid the drug and move Calder back to the vent; this route avoids (or at least delays) more risk of side effects from the Decadron but still puts him at continued risk of incurring damage to his lungs from the conventional vent.
Once we used the car with the flat tire to jump the car with the dead battery (in the rain), we were on our way to the hospital. We consoled ourselves with the fact that surely he'd be on lower pressures when back on the vent. When we arrived we found this was not the case, and since Wednesday night, his settings have only been increased. We now understand that, in the most basic terms, while on the SiPAP his lungs shrank, and we need to blow them back open. Not to mention that the little man was working overtime and is just plain exhausted! He has since needed a dose of lasix (diuretic) and a blood transfusion, which means his feedings were also temporarily halted. The nurse said she suggested the docs to do another echo to check for a patent foramen ovale (PFO), a hole between the left and right atria (upper chambers) of the heart, so it sounds like there may be an echo in his future. He has been satting in the 80s and 90s with his new blood, and the nurse told us she got him down to 40 for a bit on his oxygen level last night. They tried weaning his rate but he didn't respond well so they are back up, and now he's needing low 60s. To stave off the ROP, it's really important we keep this level low -- definitely under 60! -- and avoid drastic swings. Poor little guy is clearly plumb tuckered.
But all is not lost! Calder is looking really dapper these days. In fact, he was the hit, you might say the heartthrob, of the NICU on Wednesday night in his very adorable NICU-friendly, preemie-sized cowboy get-up, courtesy of Veena (sorry, folks, no pics yet of this one!) All the nurses were hooting over his new outfits, especially since these are designed to easily fold over all his lines anyway. The next day he sported his turtle-patterned outfit, equally cute. For the first time, I am excited about going shopping for little-boy clothes and see many online preemie purchases in my near future. Kraemer has already tried to ward me off.
The plan now is, you guessed it, to wait. We want him to get bigger and all the while be as aggressive about weaning him as he is willing to stand. When he comes down on his pressures and oxygen requirements, it's back to the SiPAP we go!
This video is from about a week ago, before he was extubated. I had hoped to remove the audio to spare you from my baby talk but am not having any luck. Turn down your volume. :)