Dad came down today to run some errands so he and I went to the hospital to see Timmy before he had to leave. Cassandra was his day nurse and, frankly, she didn't look very excited to see me. We shortly learned why.
Timmy's blood gases for the morning had come back excellent, indicating that his vent settings could be dropped further which also meant that he was a candidate for extubation! I wish I had known that they were, in fact, going to try to remove his tubing so I could have been there. The story, as I heard it, is that around 11, the respiratory therapists removed his ventilator tube. Within minutes, he was breathing very hard and very fast. They worked with him for about half an hour but things did not improve and he began to have spells of apnea, at which point they reintubated him. His SIMV/flow rate value was set at 26. After a good week to get down to 12, this was extremely disheartening.
Beyond that, Timmy had had more residuals from his feedings so they were going to keep him at 4ml. She explained that it seemed like he was just taking longer to digest his food than the initial 3 hours they were giving him. Hard not to wonder just how long it will be before he can digest formula or breast milk and get off the TPN. Hard not to feel jealous watching other friends and NICU neighbors giving their babies full feedings of breast milk every three hours and working on nursing while I just face the dreaded pump every three hours, cram more little bottles into the freezer and keep hoping that, someday, Timmy will be able to have it.
I did find out that when Cindy had finally been able to weigh Timmy last night, he came in at just over four pounds. Crazy! Almost two pounds in one month. I really am curious to know what he would have weighed had we gone to term!
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I had a really nice surprise Saturday night. I wasn't sure whom to expect to be Timmy's nurse but it turned out to be Jenny. I'm sooooo glad she was there. I told her my breast milk woes and she told me that her daughter was able to nurse her son - born at 26 weeks following PPROM - for 18+ months after being discharged. (Must add, however, that he did not have abdominal surgery.) She also has a sister-in-law who could not get pregnant, adopted a baby and was able to bring in milk just through pumping and breastfed the infant for almost two years. Different situations, but always encouraging when people can bring in milk outside delivery.
Timmy's vent settings had gone down again and weight for the night was 4lbs. 4 oz. Still in shock. Although he has filled out considerably since birth so he is obviously growing. Fewer residuals, so feeding is now at 5 mls.
During his 11:00 cares, Jenny noted some old blood in Timmy's ostomy bag. She called the doctor in and Andrea called for another KUB (kidney-ureter-bladder) and left lateral x-ray. The new NICU unit has its own x-ray machine so that was taken care of in under 10 minutes. So nice not to have to wait for Radiology to move their equipment around!
The x-rays came back showing normal gas patterns and the blood was chalked up to being blood Timmy swallowed during the extubation attempt and reintubating. Poor thing! Still just as cute as ever!
During my last photo shoot Saturday night Timmy got the hiccups. Soooo cute! Wish I could hear him... =(
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