Monday, June 9, 2008

Mikan is down to 10 bpm on the ventilator, but he is up to requiring 52% oxygen. We tried to give him feedings through the bottle or the breast every other three hours today. During trach care this morning, Mikan threw his largest trach care fit ever. He had to be restrained the entire time. This was because I was at work and not letting him know who the boss was during trach care. After trach care, Mikan slept most of the day and was unsuccessful in his feeding attempts until the late afternoon.

Today I was able to attend rounds. Rounds is where everyone in the NICU is updated on Mikan's status and questions or issues are addressed. During rounds, our doctor brought up a couple of possibilities we would not like to see come to fruition. First, it is possible that Mikan will go home on a ventilator. Second, it is possible that Mikan will still require gavage feeding (feeding tube, I think gavage refers to gravity) at home as well (for a couple of feedings each day).

Also during rounds, I asked the doctor why there does not seem to be any respiratory progress since the tracheotomy. (Because before the tracheotomy, Mikan was on a CPAP of 10 but not the ventilator, and now Mikan has been on the ventilator for the past week). We thought the tracheotomy would make the respiratory support requirement go down, but it hasn't. The doctor seems to think that Mikan is requiring more support because after the tracheotomy we tried to wean steroids too quickly. However, Mikan's lung x-ray does not look as bad as it has in the past. Therefore, we think there is a lower airway issue and not just scarred lung tissue that is causing Mikan's respiratory stress. Enough with the isolating variables and whatnot.

Once again, we thought surgery was going to be a pivotal turn in the right direction. The PDA surgery did not lead to a healthy baby. The steroids did not get him right off the ventilator. Now the tracheotomy is taking awhile to see profound positive impacts on his respiratory system.

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