Slight Setback

Today, Caden had a slight setback. Over the last couple days, his respiration rate has been on the high side. And, last night his lungs sounded a little course, so they ordered another x-ray (he gets them regularly every morning). His left lung appears to have pulmonary edema, meaning it has fluid in it. And, the right lung (the one affected by the diaphragm eventration) was slightly more compressed than it had been the day before. So, based on these things, the doctors decided he needed to spend a couple more days in CVICU until they could get him to be more consistent for a couple days. They increased his Lasix in order to dry out his lung. And, they started him with chest PT in order to help expand the right lung, in addition to increasing the volume of air flow into his nasal cannula. He is perfectly comfortable and the rest of his vitals look good. The doctors just aren't comfortable with what they are seeing on the x-rays. They had another ultrasound done in order to determine if there was fluid in the chest cavity. Thankfully that came back clean and there is no fluid there. So now they are just trying to resolve the other issues.

However, on the flip side, Caden's third day of OT was very successful. The last two days, if the OT put anything in his mouth he would just gag on it: her finger, the pacifier, etc. He would gag, choke and throw up. Last night when I was holding him, he was mostly sleeping but fussing a little bit and I was able to put the pacifier in his mouth and he started sucking it willingly. So that was good. Also, overnight, they changed his bolus feeds from 35 ml every 2 hours, to 50 ml every 3 hours. I think this change is helping him get hungrier between feedings also which is good. When the OT came to work with Caden this morning, she started by putting her finger in his mouth and he would suck on it. Then she would dip her finger in breast milk and put that in to see if he would suck on that and he would. So she started dipping the pacifier in milk and putting that in his mouth. He would suck on that so she followed that up by using a syringe to squirt milk in alongside the pacifier to help him initiate the suck, swallow, breathe sequence. He did okay with it, but not great. However, it was a HUGE success for him to be sucking the pacifier today. I was so excited about it because it means we're that much closer to feeding by mouth. Of course he still doesn't have a voice, so there is still the concern of aspiration. But the OT said she might try to do some bottle feeding tomorrow, but she would see how he did. Caden did really well the rest of the day today willingly taking the pacifier and sucking without gagging. So I am very happy about that.

The doctors are still concerned about making sure Caden is getting a lot of calories because they want to get him “big and beefy” (their words, not mine). So, they are adding some formula to the breastmilk to increase the calories. And, as of today, they are adding a couple mls of oil to increase them as well. I can't remember what it's called. But they don't want to increase the amount of fluids he is taking in because of the fluid in the lung. So, instead of doing that, they are increasing the calories in other ways.

This afternoon they took another x-ray to see if there was any change in Caden's lungs. It showed that the left lung looked even more wet but the right lung looked like it was more expanded. So, some good, some bad. We're just hoping he balances out quickly so we can get moved out of this unit. Not that we aren't happy with the people there, we just know that once he's well enough to leave CVICU, it means we are one step closer to going home and that is our goal!