James had another one of his “spells” during the night where his oxygen saturations (sats) dropped down into the 60s. The nurse tried to get his sats back up by doing some repositioning, and suctioning, but neither of those seemed to work. She thought maybe he was having a seizure so tried a dose of Ativan, but that didn’t work either. The nurse put him on oxygen which helped somewhat, but his sats were still pretty low for being on oxygen. She said he appeared to be gasping for breath. Maybe an obstruction in his throat from secretions? Whatever it was, she was eventually able to get his sats back up to his normal range. He was on oxygen from 5 am until 10 am.
Feeding-wise, he is getting 80-90 ml of breastmilk over 2 hours and seems to be handling it without any leakage. The surgeon stopped by to check the G-tube and said it looks great.
Stacy spoke with one of the hospital’s social workers about getting the ball rolling as far as getting James ready to go home. This is something we have been discussing for a while. At some point James has to go home, right? How much longer does he need to be here? Stacy has been with James pretty much every day since day one. I have been at the NICU every night after work and weekends. He might have a lot of issues going on, but we think with the right equipment at home and the right support on the outside that we will be able to handle this. Won’t we?
One of the things that the hospital requires is that the parents of babies in the NICU need to do what they call “Care by Parent” for one or two nights. For the Care by Parent, James would be moved into another room in the NICU where it will just be him and us. Stacy and I would need to take care of James for one or two nights with no assistance from nurses. It’s kind of like a practice run of being at home, but if there is a significant issue or an emergency, the NICU nurses are right across the hall.
The ENT (ear, nose and throat) doctor stopped by to check on James. He has some fluid in his ears, but the doc isn’t sure what we’re going to do about it yet because he is too young for ear tubes. Babies can’t get ear tubes until they are at least 6 months old. The ENT thinks the fluid could have something to do with why he didn’t pass his hearing exams.
The ENT also mentioned that James needs to be spell free for a few weeks before they can safely send him home. If James keeps having his spells, we will have to discuss a trach or medication, but the medication might dry up the secretions but it might also dry him out too much. If you got stuck on the work ‘trach’ in the previous sentence and are wondering what it is, trach is short for tracheostomy. This is a hole in the front of the neck and into the windpipe. A breathing tube, called a trach tube, is placed into this hole and directly into the windpipe. This could help James breathe better and also help us more easily clean out the secretions in his throat. There are some risks and complications that go along with a trach such as infection, or the trach falling out. We’re weighing our options, but we’re not sure we want to go the trach route just yet.
