11:15pm: Just got off the phone with the nurse and they still have the ventilator at the same settings as they did earlier but it appears that his repositioning and his breathing treatments are working.... his oxygen saturations are now hovering around 99-100%. They are going to reposition him fairly soon so that his other long doesn't collapse (which can commonly happen if one collapses). They feel that the collapsed portion (upper right) has started to inflate again as seen by the high oxygen saturations. Another xray is due at 4am. With that said, this will be my last post for the evening. And now that the house is quiet and everyone in bed.... time for me to start work. :(

8:15pm: After a chest xray tonight, they have located the source of the poor oxygenation: a collapsed lung. This sounds bad, and it kinda sorta is, but he has had them several times in the past. The corrective action is for them to give him some breathing treatments and change his position (usually by propping up one side of his body so that he lays at an angle. Hopefully if we can get this lung working again, he wont need so much support. His 6pm gas test showed a CO2 in the low 80s and at 8 tonight, it was back down into the mid-70s.

5:00pm: Looks like they are going to hold off on surgery until at least Thursday as they want to give Reid a little more time to recuperate. He will most likely stay paralyzed and doped up until surgery. Because of this, he will not resume his feedings, instead, he will start his hyperal (IV fluid that will replace the breast milk for all of his nutritional needs) tonight. He is still on the NO and will probably come off of that tonight, but he is still requiring large amounts of O2 to keep his saturations high (90-100% range). He was administered a blood pressure medicine (dopamine) as his was falling a little. Unfortunately, this required a second IV... so, once again, he is well connected with tubes. Grandma and Grandpa Elley came for a visit today, as did his nurse Rachael from his previous NICU. It was nice to have company as it helped pass the day. We are on our way out the door now, so I wanted to post a quick update. We are both exhausted.

Noon: The cardiologists didn't think that Reid was stable enough for the catheter and took advantage of his PDA so that they could monitor the flow and pressure of the blood in the heart. They took another baseline ECHO and then hooked him up to Nitric Oxide (NO) for 25 minutes. They used this to see if opening up his veins would lessen the stress on his heart. Apparently there was some success, so they are going to prescribe Sildenafil. This is something that is going to help Reid in both the short and long run. I keep relating all of the scans/tests with an immediate need... but I am quickly learning that some of the pokes and prods are just precautionary and looking at long term solutions. It is nice to have a team of specialists hovering around Reid. New nickname: Woody.

9:15am: Surgery has been postponed to at least tomorrow. The ECHO showed signs of the PPHN that was originally shown while at Cobb Hospital. They aren't overly alarmed, but they think that it is worthy of postponing the surgery until he has had a day to calm down after the episode that he had last night. Talking to the doctor, apparently the episode he had, which he called an acute episode, was most likely due to the fact that he had spit up at the same time as receiving higher levels of oxygen and it all went downhill from there. Nonetheless, they got him stabilized.

We got the results of the head/brain scan this morning and everything looked normal. He did have a cyst, but apparently it was the type that is very normal in newborns. There was no evidence of brain bleeding (which is unfortunately a common thing that is seen in premature babies that are born as early as Reid). So, this was good news to us and this adds to things they can check off.

For today, there are going to be some follow ups with the cardiologists to see if a pulmonary artery catheterization is needed to further evaluate the stress that is causing his PPHN. With this catheter, they can get direct readings from the heart and also administer medicines to see their direct impact. This will be a good read to help determine if he is a candidate for Sildenafil (Viagra) to help treat the hypertension. This may sound odd... but if it takes a 'woody' to help him breath, I am all for it. :)

That is about it for now. Kristen and I will hunker down for the day and stay by his side and await any news from the cardiology team. Reid is paralyzed and calm - not a fun thing to see, but at least we know he is comfortable. I would expect that if the cardiology team doesn't take any action today, they will wean Reid off the paralytic and hopefully resume feedings.

8:30am: Surgery is being delayed for the time being. After the rough night they wanted to do another ECHO to ensure that he is still stable enough for surgery. The cardiologist just reviewed the scan and is now talking to the staff of doctors. We are trying to be patient but we are full of nerves this morning. Seeing Reid paralyzed again and on the vent brings back too many unwelcomed memories of the past. They just did another CO2 gas and it came back at 51 (the one at 4am was 65). The vent is obviously doing it's job of removing the excess gas.

6:00am: Reid didn't have a good night last night. After a third dose of arginine that didn't work and a CO2 of 104, they decided to intubate him. They are not sure why he was requiring so much oxygen or retaining so much CO2, but they knew that the needed to be intubated for surgery this morning anyway, so they went ahead and did it. When they did it, he apparently "clamped down" on the tube and stopped breathing (think it is a fairly normal reaction in babies when they have something foreign in their breathing path). He is old enough now to know what is going on, so they ended up using an ambu bag to mechanically breath for him and gave him norcuron to paralyze him to prevent him from clamping down again. Once that took, he relaxed and now the vent is breathing for him. He is on a breathing rate of 45 bpm and at 80% oxygen. Kristen and I are getting ready and will be in at 8am when the NICU opens back up for visitors. I will blog again after he goes into surgery.