Monday, February 2

Caden had another decent day of small steps of progress forward. During morning doctor rounds, they discontinued one of the blood pressure medications, reduced his nitric oxide and lowered his ventilator rates. They told us they were happy with how he was doing and were going to start feeding him breast milk through the tube in his nose. Yeah1 Finally! They were also giving him some blood because his red blood cell count was a little low. The drainage in his chest tubes and the tube in his abdomen were all putting out very little so they suggested the surgeons might be ready to remove the one in the abdomen.

It was nice to see the nurses turning Caden and repositioning him today. They had stopped doing that after he coded on Wednesday because he had his chest open and they wanted to make sure not to trigger another event. But, now that his chest was closed and had been for a couple days, they were moving him a little bit more. I was starting to worry about his head being in the same position for so long because I thought he would get some pressure sores. At first, Caden really resisted having his head and/or body turned toward the left. But by evening, he was tolerating it more. Now that he is able to move his muscles, he would turn his head slightly back to the right anytime the nurses tried to turn him the other direction.

After shift change, the nurse and respiratory therapist were suctioning him through his tube. They had been doing this fairly aggressively throughout the day in order to clear out all the mucus in the lungs. They had gotten some pretty significant plugs out and could still hear more. As they suctioned him, his oxygen saturation started to go down. This made them stop and the RT suggested they turn him. I said that is what happened right before he coded last week. So, they decided to leave him in his current position and watch his vitals for a few minutes. The RT hand bagged him briefly and his saturation went up. But once he stopped, it started dropping again. It wasn't dropping rapidly and his heart rate and blood pressure were remaining fine, but after about five minutes, the nurse called the doctor in and had her take a look. She ended up adjusting his ventilator settings up just a tiny bit in order to help give him a little more support. Because he was starting to take his own breaths, not just those given by the ventilator, they wanted to make sure those breaths were good and there volume were a little bigger.

The doctor assured us Caden was fine and that we weren't going to repeat the events of last Wednesday. This was my biggest fear because the same series of events took place prior to his pulmonary hyptertensive crisis. He was suctioned, and repositioned and he couldn't handle it. Last night turned out differently and we are grateful. We left after we felt comfortable he was stable. The attending physician on duty this week told us during evening rounds that they wouldn't try to extubate before Wednesday. We were glad to hear that because that would be four days after chest closure and Dr. Reddy said he thought it would be best to let his lungs rest for four-five days before trying to extubate. So, it looked like they were going to wait at least until Wednesday. Now let's just hope they don't change their mind. Greg and I also talked to them about the ventilator settings and asked if it was possible to set it to simulate being on CPAP or even just breathing room air before they tried to remove the tube. They said they could do that and is usually what they do anyway. I don't believe they did this before they tried to extubate last week, but I could be wrong. We will make sure that they do follow this procedure this time before they take the tube out only have to put it back in again. We don't want that to happen a second time!

Every day we keep praying for another smooth, quiet day without any excitement. So far, so good. Prayers are being answered!