6:15pm: well, the respiratory culture has come back with gram stains and shows a sign of infection. It is still too early to know what is growing but we should know within the next 24 to 48 hours. They have started an antibiotic that he will have for 7 to 10 days and depending on what grows, they may have to change it to something else.

They were successful in getting the PIC line in and only took 2 sticks. Thank God!

Feedings are going to resume momentarily at 5cc an hour and will go up by 5cc every 2 hours. At least there is a little bit of good news today...

3:15pm: Just got word that they want to do a PIC line on Reid. His IVs aren't lasting that long and the nurses have started realizing how hard of a stick he is. If they can get this line to work, it will be the first time that anyone has been successful as they have all failed in the past. Please pray that they can accomplish it with not too many sticks.

11:45am: Reid is still holding steady and there weren't really any changes during rounds. They are still holding on feeds for the time being. Nurse reiterated that what she sees of Reid is typical trache post op and that he stoma (site where trache is) looks good. They did an xray and see something in the upper right lobe and are going to do a culture. One more thing to worry about...

9:15am: I called around 4:15 this morning and he had two more episodes of desatting. He hadn't gone all the way down to 5 like he did previously, but had bottomed out around 35-40 both times. They did a manual deep suction again and was able to get some more thick mucus. The RT had explained that every time they suction, it is kind of the luck of the draw as to what you are going to get back. Sometimes, his lungs may be in a position or be tight and may not allow them to get everything that they want to get, so it was probably mucus that was there the first couple times that they had suctioned him.

The ketamine was somewhat doing the job, but Reid was starting to show signs of agitation again and they decided that it was probably best that they use a paralytic to get him completely still (think the drug is called Rocuron). Before they paralyzed him, they had to make sure that he was heavily sedated as they didn't want to paralyze him with him being awake and conscience. That would just render him motionless and allowing him to know that he couldn't move. So, they had a hard time getting him completely sedated, but they eventually got him there.

On top of this, he spiked another fever - this time to 39.1 C (little over 102 degrees F). They gave him some tylenol and it quickly came down. No cultures were taken as they had already sent some off the night before - and since it had been less than 24 hours, they didn't need to pull any more blood.

I called again around 9 this morning and the new day nurse said that since he had been paralyzed that he hadn't had any more episodes of de-satting. His oxygen was back down to 50% and was satting 100.

The doctors will be rounding in about an hour so we will call back after that takes place. We are interested to see what they are going to do about his feeds as he is still on an IV fluids. Oh, and speaking of IVs, he had another one placed in his right hand as the sedatives and the paralytic cannot be run through the same IV.

More news to follow in a little bit...

12:45am: What started out as a good day ended up being the farthest thing from that. Reid had a pretty relaxed day and had been in and out of sleeping for most part. We left about 7:00 to eat dinner with some friends we met in the NICU and when we came back to the room around 8:45p, we noticed that Reid was on higher vent settings and on 100% oxygen. The nurse mentioned that he started de-satting really quick and his saturations went down to 8! They did a quick suction, used the ambu-bag and brought back Reid into the 90s again, but he was still very agitated and he was still working on recovering. We sat in the room for a good 20 minutes and no more than 5 seconds after I mentioned that he was looking better and his sats were looking good, he dropped from 91 to 76 to 45 to 13 to 5 in a matter of seconds. This scared the crap out of us as we have never seen him drop so quick. And before we knew it, all of the lights in the room were flipped on, the nurse ran in, Kristen stuck her head out the room and yelled for help. Within seconds, we had several nurses and two respiratory therapists in the room doing a manual deep suction where they pulled a very thick mucus out. And after a minute or so of bagging him, his sats were back in the upper 90s. The volume of mucus to us was pretty significant, but talking to the RT and nurses, they didn't seem to be phased by it and they said that the way Reid was behaving was pretty typical of post operative trach surgery. The secretions that are generated by having a foreign object in your throat can be significant and can cause "plugs" in the lungs. And when these plugs of mucus are there, they can quickly prevent you from oxygenating.

I felt better knowing that there was a reason as to the madness, but Reid's saturations were still teetering back and forth between the upper 80s and lower 90s. He has little to no 'reserves' and takes time to recover from something like this. The doctor ended up ordering a new sedative called ketamine since the other drugs he was on weren't doing any bit of good. Even after tripling the fentynol, Reid was still awake and thrashing around in pain. Ketamine quickly did its job and you could tell by the monitors that he was relaxed. His heart rate dropped significantly from its elevated state and he seemed to be in a much better place.

We ended up leaving about midnight and on 80% oxygen, he was satting 100. We felt comfortable about leaving Reid and he seemed to be pretty stable. However, they did decided to stop feeds for tonight and put him on IV fluids as a precautionary measure. If he remains stable throughout the night, he will most likely be put back on feeds in the morning.

A very scary night that was full of stress and even as I type this, I am still in shock that it all happened. Seeing this tonight reminded me of the earlier days when Reid was hanging on by a thread. Kristen and I thought that we were prepared for this surgery. We knew what we expected to see visually, but were not prepared for how Reid is struggling to recover from surgery. He has powered through his previous surgeries and when we thought that this one would be somewhat minor compared to the rest of them, we were quickly proven wrong.

When will these days start getting better?!?