Reid hasn't had much progress today. His lung collapsed again and they are working hard (frequent CPT) to get it to open back up again. His oxygen levels remain at 100%, but is sat'ing in the 93-97 range. They have also noticed that he is becoming immune to the nurcuron, so they have up'd the dosage (twice the amount). They have also put te morphine and nurcuron on a drip so that there isn' a chance of Reid starting to wake up and become stressed out. They are focused on healing those lungs, and are taking all measures to ensure that he does just that.
8:30am: Kristen called the NICU at 6:30 this morning as we hadn't heard if Reid was going to go into surgery. At that time, they were on the phone with the OR and still hadn't had a doctor or surgeon assess Reid. They did tell us that he had a fair night and had to go slightly up on his breath frequency on the vent. Other than that, I think everything remained the same --- 100% O2 requirement. They called back a little after 7 when Dr. Moore made the decision that they wanted to wait until at least Monday on the hernia repair.
I am doubtful that they will return feedings and will probably keep him in the sedated/paralyzed state that he has been in for the past few days until they do surgery. The milk feedings will require him to work (digestion) and would also require him to be off the paralytic (which would also make him work). The hyperal and the lipids give him all of the essential nutrients and he can live just fine on them. I think there is a mentality that you have to have food in your tummy to grow, and I am trying to get over this thought. The nurse the other day said that you could essentially live your entire life on these fluids if needed...
Anyway... it was a long day yesterday, but Kristen and I are glad it is over with. We are also both glad that surgery was postponed again. When suggesting this to the Nurse Manager this morning when I talked to her, she sounded a little surprised (I think she assumed we were ready to get this over with), but I told her that I didn't him going in there on 100% oxygen. She said that he would probably be fine as he handled his Central Line very well, but that they didn't see the need for further risk.
Anyway, my eyes are heavy and I am still exhausted but I can't sleep. Guess I will go downstairs and eat some breakfast... I smell my parents cooking some bacon and eggs. :)
2:30am: My apologies for not posting many entries today, but today ended up being a fairly bad day for Reid (and mom and dad for that matter). When we were finally able to get into the NICU around 4pm yesterday, we came to find out that they spent 2 hours trying to get the PICC line put in place. Prior to that, they had failed at placing 6 peripheral IVs. The poor little guy looked like he had chicken pox with so many red dots all over his body where they attempted to get access points in place (Kristen counted over 20 marks). The reason this all started was that the IV that he had placed in his scalp went bad and this is the spot where they were administering his blood pressure medication (a very critical medicine). They were desperate to get something in place and tried so many times and they were finally only able to get another IV in another location on his scalp. This wore Reid out and he was then placed back on 100% oxygen because he either in a little bit of pain or his body was too stressed out.
Knowing the issues that they had today, they made the decision to surgically insert a central venous catheter (a.k.a Central Line). Surgery was at his bedside in the NICU and started at 9pm tonight and lasted about an hour. To do this, they make two incision points, one on his chest just above his nipple and another one on his neck, just above his collar bone. The process involves threading the line through his chest, up into the neck, where they insert it into his jugular vein and then all the way down to an area just on the outskirts of the heart. Passing the catheter under the skin (from the chest to the neck) helps prevent infection and also provides stability and is a process is called "tunneling". If an infection is to occur, it is most likely to attack at the chest opening and will take some time to reach the insertion point of the catheter in the jugular vein. This time will provide the doctors the ability to administer antibiotics to thwart off the infection before reaching the critical areas. In terms of stability, if the catheter is accidently tugged on or moved outside of his body, the extra tissue (the area between the insertion point in the chest and the access point in the neck) allows for a sturdy anchor without the threat of it tugging on his jugular. This should now allow the doctors and nurses to administer drugs very rapidly, as they are being administered almost directly into his heart. And it also has the added bonus that this should prevent him from needing to be stuck with new IVs several times a day and can last several months.
Kristen was a little nervous about seeing Reid in his post-op state, so my father and I drove back down to the NICU and got there just as they were finishing up. He looked much better than I had envisioned, but as you will see in the pictures, he had a rough day. Both sides of his head have been shaved in various attempts over the past two days to get some IVs going and his forehead was splotchy from the administration of the blood pressure medicine (which highly agitates the soft skin tissue). The pictures will show the two access points the surgeon used to place the line. You will see some areas of deep pink or redness, but this is just the way the picture turned out as those areas are where there is glue on his chest... Kristen, my mom and dad all thought it was part of the wound, but it's not. Actual incisions are maybe a quarter of an inch long. The new line now has three different things going in: 1) his hyperal (nutrition); 2) lipids (fats); 3) his blood pressure medicine.
His hernia surgery is supposedly to begin at 7:30am tomorrow morning. I am anxious to see if this is really going to happen, but they felt fairly certain that it would go on as planned. With that being said, I have a few hours to catch some sleep before tomorrow begins so I will wrap up. For the faint of heart, look at the images with caution.
Pre-Operation Pictures:
Post-Operation Pictures:
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