Thursday, June 10, 2010
And today's massive thanks going out to Alison and Karim for having our kids over for a playdate. They had never been to the Lawani's before and had a bit of a hard time at first being in a new place, but they sure didn't seem like they were too eager to leave the tricycles when it was time to go!
Consequently, I was late for cares this morning but James and I drove separately and he was able to be there. I ran into Gloria, the lactation consultant, on my way into the NICU and was very excited to tell her my news that my milk supply has returned. Alas, it has gone back to normal after the increase Tuesday night. What powerful things hormones are! Hopefully I can get just as excited about the next extubation attempt!
Timmy has a great resident right now. I caught her in the hall on my way in to see Timmy and she was the one who first told me that, since James was already there, they had already rounded on him and proceeded to catch me up. He is still getting breastmilk with the formula, increasing 1 ml q 12 and doing really well. Hardly any residuals whatsoever. Even though his feedings are increasing, the residuals and output are not. So that's fabulous!
As far as ventilation goes, the steroids definitely seem to be helping. And, as if she were psychic, she answered the question I was just about to ask - the steroids remain in the system for a good three days or so so we would anticipate his amazing sats to remain where they are. The steroids help to reduce the inflammation in his airways. His vocal cords looked much better on the controlled reintubation than the one just prior that was forced by Timmy extubating himself.
Because his respiratory rate and sats have remained so good, they dropped his PC after PEEP to 17 this morning. Melissa told me that Dr. Tsai said they may drop it to 16 but they will hold it there so his lungs don't collapse. Not sure I understand that, but it seems that he probably just needs to move off respiratory assistance slowly. So instead of just coming completely off the ventilator to nothing, he'll move to CPAP, where he'll still have the pressure to keep his lungs open on exhalation, but he will be taking deeper, normal breaths on his own without the PC after PEEP assistance.
I was able to refresh Timmy's milk supply while I was there and came back into the room in time for his 11:00 cares. Boy are they busy in the morning!
Sandy was his wonderful nurse today. I really liked her. She's so nice and really explained a lot of things. I've determined to just offer to do what I can to let the nurses who haven't met me know what I've done in the past and what I'm willing and know how to do. However, this morning he needed so much done that my main job was to be his comfort.
I changed his clothes and diapers and Sandy took his temperature, assisted Victoria (not sure what her title is, but she's the ostomy expert) in changing Timmy's ostomy bag (he has a bit of skin breakdown around the ostomy so they put on a ring of EConceal to help protect and heal the area), and replaced the tape on Timmy's ventilator tube. It's kind of funny that every time they ask each other the size and position of tube, I actually know the answer - right now he's on a size 4 tube, at 8cm. Getting pretty big. Very ready for him to be off that. Have I mentioned that before?
While I was videotaping his blinkety peepers, I also caught a sneeze! How cute is this?!
Sandy did a great job. She was very efficient with everything and suctioned Timmy on a regular basis to keep him comfortable. He still didn't enjoy most of anything. Sandy saved the feeding for last - all told it only took about 20-25 minutes - as she had timed it so he got the feeding right around 11 and had him all snuggled in so I could just comfort him while his tummy got full. He looked absolutely peacefully angelic when I left.
Not to end on a down note, but it just put things in perspective for me. A gentleman was on the elevator heading down from the PICU when I left. I don't recall exactly how we got to talking, but he has a 17-year-old son who has been on life support for 8 days now. Apparently his son has made some bad choices but I didn't get any more details than that. The man seems absolutely beside himself, in shock, mad at his ex-wife, upset with his son, irate at whoever is at fault for him being in the hospital, stressed with a new job that he should be back in Arkansas for, livid that he wasn't able to get into a nursing school (another story - his son was 5 weeks early) and just overall not in a good way. He asked why I was there and I told him my son was 10 weeks early. Other than that, I think he really needed to vent. Happy to be a listening ear all the way to the third level of the parking lot. Having a loved one in the intensive care unit is a very intense experience. I don't think you can truly imagine the depth of feeling that comes with having someone you love hospitalized under such conditions and my heart goes out to all with loved ones there.
Such an interesting day all around.
Now for my near-death experience:
From the hospital, I went to pick up the kids from the Lawanis. I was heading east on Grant, waiting to turn left onto Alvernon. It's a 5-lane road with left-turn arrows. As I waited for mine, I watched the on-coming traffic. The light turned yellow and 2 cars in the outside lane zoomed through. The light turned red and my arrow turned green and I saw one more truck in the inside lane coming just a wee bit fast to look like he would be stopping anytime soon and he just blazed on through the intersection! So crazy! Made me feel good that I was alert to notice so I share, lest anyone reading feel that my states of exhaustion are putting them at risk on the road. I really don't drive when I can't stay awake. But please don't run the red lights!
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