Intubation

I took a trip to the hospital around 9:30pm last night to visit Reid as I hadn't seen him all day. From the moment I got there, I had a bad feeling about what was to come. The nurse, off the bat, had told me that Reid was requiring 80% oxygen for an extended amount of time. Knowing that those levels of oxygen and not sustainable for the long term, she felt as if the ventilator was in the near future. Oxygen in high dosages can apparently scar the lungs just as bad as any infection could.

The nurse practitioner, Mary, came in around 11:00pm and had told me that Reid's xray from earlier in the day looked really good. There was a fairly drastic change from what it looked like the day before, so it was a little bit of good news. His CBC (Complete Blood Count) test numbers were also good and showed that the infection is most likely out the door. Bad numbers in the CBC would likely show if the infection was still prevalent or increasing.

Mary and I talked for almost an hour (I like to ask a lot of "why" and "how" questions) as I was a little concerned about the nurse's comments about the amount of oxygen that Reid was on. She was quick to point out that intubation and a round of steroids (to help grow the lungs and reduce any inflamation caused by the bacteria) was probably around the corner. She was going to monitor him for the next few hours and then talk to the doctor. She pointed out that he is a "fighter" and his body had adjusted well to the large amounts of oxygen and subsequently the large Carbon Dioxide (CO2) levels in his body which makes it a hard sell to put him on a ventalator. The doctors really try everything else before putting them on the ventelator. However, with his high CO2 levels, she was concerned. Ideally, he shouldn't have a CO2 level above 40% or 50% but his had been increasing throughout the day and was near 80% at the time. This is usually a sign that he needs some assistance.

I left the hospital around 11:15pm and headed home to tell the news to Kristen. Around 12:00am, I received a call saying that his CO2 levels were now around 90% and they were going to go ahead and intubate him, xray him and take his blood gasses. Mary described in detail how the procedure would be done and that they would sedate him with a little morphine to ease the "pain" of having a tube stuck down his throat. They would call me back when they were done.

About 1:00am, I received a second call from Mary and she had explained that within moments of Reid being on the ventalator, his oxygen requirements had fallen back down into the 35-40% range, which clearly meant that this was a drastic improvement. He was very tired and worn out from having to fight the infection and breathe on his own and was now sound asleep.

I woke up at 4:30am this morning with Kristen (her routine "milking session" time) and I got up to head to the NICU. I wanted to see in person what this looked like and how he was doing. Much to my surprise, he looked great. It was nice to see him out of the isolete and no hat and CPAP apparatus covering his face/head. Instead, as you will see in the pictures, he has a small tube in his mouth that leads all the way down to his lungs. The machine that is attached to this tube is quite amazing as it is able to sense when Reid is attempting to take a breath on his own and quickly goes ahead and assists him with that breath. In addition, it is making him have 50 breaths per minute regardless of whether Reid wants to or not. If he decides to breath more than that - that is fine - however, it is going to ensure that he gets at least 50/min. On the inside of this tube, there is yet another tube that sits just above the opening of his lungs. This tube can be suctioned to get any excess fluids/mucus that are sitting there.

Anyway, other than his improved aestetics (removal of the "gear" on his head), I felt really good about how he looked. His chest was no longer caving in everytime he needed a breath (from him pulling to get a good breath), his coloring looked good, and overall, he just looked peaceful. He did open his eyes a few times when I was there so I imagine he recognized my voice when I was talking to him.

Overall, a long night full of activity, but we are hoping that this is the turning point for him. His lungs have to clear up and his lungs have to grow and I believe that he was having to work too hard for his body to be able to focus on these two very important things.

Here is a picture of him when I first got to the hospital (sound asleep):


Here is a picture of his ventelator. In the bottom left corner, you will see 50; this represents the number of breaths per minute that the machine is going to ensure that he gets. In the bottom right, you will see 42; this represents the oxygen level that he was currently at. And in the left/middle/top of the screen, you will see a graph that has a red, yellow and blue line. The red line represents a breath that the machine is taking on Reid's behalf. The yellow line represents a breath that Reid is attempting to take on his own. In this picture, both the red and yellow line are present as he took a breath right after the machine took one for him. This graph changes every second and can sometimes show multiple breaths --- the red line will fade and a new one will come up (in this case, a yellow one). The blue line underneath is showing the exhale of the breath (the machine helps him remove the CO2 that is expelled from his lungs). The other numbers on the screen represent, in some fashion, the volume of air that is being exchanged.

The following picture is of his normal monitor. I had taken this a few days back, but wanted to show how this can correlate back to the ventelator. The green line and large green number (178) in the upper right is his heart rate (beats per minute). The yellow number in the bottom right (92) is his blood oxygen saturation (ideally, this number should hover around 85%, but is acceptable to be between 80 and 95. The lower the number, the lesser amounts of oxygen that are found in his blood. Now, if you go back to the ventelator screen, the oxygen that they give him (42%) is based upon the number that you see in this screen (92). If the saturation goes too high, they decrease the levels of oxygen; adversely, if the saturation goes too low, they increase the levels of oxygen (In the case yesterday with his CPAP, the machine would have read 80 where it now shows 42). And last, but not least, in this picture, you see a blue line and blue number in the middle (77). This number represents the number of breahs per minute that Reid is taking. As I mentioned, this picture is from when he was on CPAP, so today, you would see this blue number somewhere closer to 50 - which is the number of breaths that the machine is taking for Reid. If the monitor shows 50, it means that Reid is "riding the tube" - meaning that he is not taking any breaths on his own and is letting the machine do all of the work for him. However, if you see this number go north of 50, this means that Reid is trying to breathe on his own.

One last picture of Reid making sure that daddy was still around. And he was. :)



Keep him in your prayers --- he has a long road ahead of him. Hopefully we have reached the bottom and we are on our way up!