He has had a pretty low-key last several days. They are doing blood gases only every Monday and Thursday, which means that changes to his settings are likely to happen only around those times based on the results of those gases, unless the vitals that they monitor daily (breathing rate and oxygen level, in particular) change drastically.
Although for the last few days he's been dropping weight steadily thanks to the diuretic, he managed to gain weight today ... and not look puffy! The tests this morning showed that his potassium is getting a bit low again, but just barely, so for now, they're keeping the lasix coming. He is currently 2095 g, or 4 lbs 10 oz, which is down about 4-5 oz from last week, but still, this is good. His head circumference has grown in the last week from 29 to 29.5, and his length from 43.2 to 43.5. Not a whole lot, but hey, he's a 24/25-weeker! He's not too far from his peers.
On a less progressive note, his gas this morning showed that his C02 has gone up (from 59 last Thursday to 65.8 today.) Ironically, in an attempt to counteract this, they're moving him forward rather than back, trying him again on CPAP, this time on a PEEP of 7. The nurses are convinced his C02 has gone up because it's too difficult to get a good seal on SiPAP -- he's almost never actually getting the PIP of 10 and PEEP of 8 he's supposed to. Of course, we like a move to CPAP, and we're hoping this time it sticks; we'll see. His oxygen needs went up only slightly after the switch was made, a good start, but only a start. Tonight while I was there he was requiring anywhere from 34-38, whereas last night he was mostly sitting around 30. But just like last time, his respiratory rate has also spiked, an indication that he's having to work considerably harder.
Kraemer is sick, which is definitely a bummer. When you're sick, you don't get to go in. (Heck, when your nails are more than a quarter-inch long, you don't get to go in. Apparently, this rule doesn't go over very well with the grandmas with fake nails in from out of town.) For his sake as well as everyone else's, he's also avoiding the waiting room, so he gets to stay home while I go visit. Not very fun for him. (So being the good wife I am, I stopped for some pints of custard for him on the way home. Some do hot tea? I do frozen goodness.) He sent Calder his love, and Calder told him to get well soon.
The many faces of Calder on SiPAP:
|I hate this thing!|
|Haha, just kidding.|
|No, I hate this thing!|