6:45pm: Kristen and I just got home from the NICU and the grocery store and we are cooking dinner, drinking some wine (and whiskey... well, I am at least) and hunkering down for the evening. It seems that I brought the snow with me from DC as Atlanta is getting snow right now. It is unbelievable... we are actually getting more than a dusting like we normally get. Looks like we are supposed to get 2 to 5 inches depending on the report you read. The Olympic opening ceremony is on tonight so we will probably turn that on and have a relaxing evening.

We had a somewhat short visit with Reid today as we were unsure of what the weather was going to do. I was afraid of a Friday rush hour on snow, so we headed out about 4:30. Kristen gave Reid a bath today and we delivered his new wubbanub frog pacifier that came in the mail today. His monkey one came home with us for a trip to the washing machine. Reid seems to have had a pretty quiet day... so all is well on this end. I will leave you with some pictures from this afternoon and some pictures of the snow.

Oh... by the way... his CO2 was a little higher today - 62.

Mom and Dad: if you are reading this tonight on your last night of your Caribbean vacation... tomorrow is going to be a rude awakening when you leave 80 degree weather and return to snow. :)

2:45pm: The doctors have made some changes in Reid's care - which I think are definitely a move in the right direction:

* They have weaned his pressures from 15 to 13 liters.

* They want to keep his O2 levels above 40%. Since his eyes are no longer an issue, they want to make sure that they are making him work the least amount to breath. If his lungs can focus on getting rid of the CO2 and growing healthy new tissue, the O2 requirements will eventually go down. Long story short, he can come home on O2, but not on the high pressures that he is currently on.

* They have adjusted his touch times. Currently, it is every 4 hours and they are going to shift them so that he only gets hands-on time when he is awake.

* They are going to try and get him on a day and night schedule. During the day, they will have more lights on in the room. This also means that there will be no "swing time" at night.

* They are talking about giving him his chloral hydrate only at night and see if they can keep him more alert (less sleepy and sedated) during the day.

He also had Physical Therapy today and did well. Kristen is really being proactive about this and I applaud her for her dedication to get Reid up to speed. He has been laying down for such a long time that he is stiff and has troubles doing some of the things that he should already be able to do (ex. holding his head up a little more than he can on his own). If parenting is a full time job, being a NICU parent means working overtime. :)


8:00am: Just when I start to get so upset about Reid's CO2 levels yesterday and my mind starts to go off the deep end and worry about worst case scenarios, he goes ahead and proves everyone wrong -- CO2 of 55 this morning. This is essentially a "normal" gas level, maybe slightly higher. And, in addition to hovering between 30% and 35% O2 all day yesterday, he was able to maintain that level throughout the night. Amazing.

I am still in DC and hopeful that I am going to get home tonight. They have announced that Dulles is open, but have yet to announce that Reagan National is open --- which is the one that I am flying out of. Looking out my hotel window, the roads actually look good, so my fingers remain crossed. I have included some before and after photos:

9:20am: Reid had a high CO2 last night - 68. However, everything else seemed to be pretty good - he was calm, slept well and his O2 was in the 30-35% range. I am assuming that with the high gas, there will not be any adjustments made today. Ugh.

9:10pm: [Kristen's Entry] Reid is having a good day today. He hasn't been fussy at all --just lays in his crib, looks at his balloons and sucks on his beloved "Wub-a-nub". :) He did about 45 minutes of physical therapy today and seemed to really like it--he was so relaxed he fell sound asleep and had a very stinky poo. I learned how to roll him over on his side and stretch his torso a bit. He's not strong enough to stay rolled to one side yet, but he'll get there. He brings his hands to his face or chest while on his side (which according to the PT is very appropriate as it is a form of self-soothing), and he looked very comfortable so I think once he gets stronger he will really like it. We are supposed to roll him to each side a couple of times each visit. We also sat him in a seated position and helped him hold his head up. Reid did so well. He tried so hard to keep his head up--this was evident from the head bobs--but gravity won each time after only a couple of seconds. After laying down for the last 5 months, I'm sure sitting up for any amount of time is simply wonderful. Chad and I are worried that he looks up too much--he is fascinated with the ceiling lights and doesn't like to take his eyes off of them for very long--but the PT said this was normal for him since he's been laying down for so long. It's simply a bad habit that we need to break by making sure we always talk to him at eye level and put his mobile and other toys in front of him, not above or behind him. I was able to hold him for about 30 minutes. He fell sound asleep and then woke up fussy b/c he had taken yet another stinky poo. By this time it was time for change of shift so I said my goodbye's and enjoyed yet another 5 star meal in the Egelston cafeteria. If I never eat a bag of pretzels, a chicken sandwich and a Rice Krispie treat it will be too soon. Reid is now up to 24cc of milk which is being fortified with two different types of fortifiers and he's handling it well. In addition, all of his medications are now oral so there is talk about removing his central line at some point. The doctors are not in any rush to do this, but if there is not a need to keep it in then they won't as it can be another source of infection. His sats are remaining steady at 45%-50% oxygen and I am crossing my fingers for another night of a good CO2. Maybe if tonight's gas is good they will wean the pressures on his High Flow to 14 liters!

6:45am: Reid had yet another good night and a CO2 of 57 - the best he has had in about 2 weeks. He has discovered that his bed is no longer the only place he can sleep and gets fussy after he has been there fora little while. In fact, he slept almost the entire night in his new vibrating seat that we brought in over the weekend. I think he enjoys the change of position.

Anyway, about to board the plane and wanted to get a quick blog out there before I took off. Hopefully we will see another wean of the high flow again today --- will update you later after the doctors make their rounds.

12:15am: Why am I always up so late the night before I head to DC? Ugh. I have to get up in about 4.5 hours, so I will be nice and tired for my flight - that's for sure. Should be an adventurous visit to DC with all of the snow they have had... close to 30 inches.

Anyway, not much to report tonight. Kristen and I had a good visit with Reid. Tonight was the first time that I picked Reid up, put him in Kristen's lap, changed his diaper, his clothes, and when we were ready to leave - put him back. We usually have the nurse help us with all of these tasks, but I requested that we do it all on our own tonight... it was nice that we could do 100% of it on our own. He seems a little easier to keep happy and his saturations seem to be fairly steady during touch times.

I will leave you with a couple of pictures of the outfit I picked for him (take note of the little ears on his hat):

3:00pm: Reid has had a fairly agitated day but is still on about 45% O2. After reassessing his weight, they have adjusted some of his meds and feel that they may have weaned the methadone a little too quick. There is no exact formula for weaning it and they have to take it slow and monitor how he reacts.

He was to get clear IV fluids to replace his hyperal, but they have since decided not to as they don't want him taking on any extra fluids that he doesn't need. His current weight is 9lbs 5oz and they want to get "real" growth and not just a baby pumped full of fluids. They have subsequently increased his feedings to 23cc/hour.

No weaning on the high flow today. While his CO2 gas was probably a "wean-able" number, they want to take it very slow.

10:00am: Reid had another good night. His CO2 was 60 (slightly higher than yesterday, but still good for him). Not much else to report, so I will keep this post short. :)

6:45pm: We had a good visit with Reid today. We brought in a bouncy seat for him to check out and he seems to like it pretty well. We put him in it around 3 and he was still in it when I just called to check in on him. He is currently on 45% O2 and they weaned 1 litre today on his pressures. The big talk during rounds today was how well his CO2 gasses have been. Hopefully with the change, we will still continue to see good numbers tonight. They also increased his feedings to 20cc per hour. Tonight, his last dose of his antibiotic is administered and his hyperal is finished. Since there is now nothing else going into the central line, they will keep a flush running to keep it from clotting up in the event they need it later on. He has made some very small baby steps over the past two days and the doctors seem to be pleased with the results of the prednisone.



10:30am: Reid had another good night last night. His oxygen hovered in the 25-35% range and had a CO2 of 58. Rounds have not been done yet, but talking to the nurses, we are likely going to be weaned again on the methadone and possibly a weaning on the pressures on the high flow. Since he is currently maxed out on the flow, this will be nice to have some wiggle room in the event he needs more support. I am guessing with the small progress we have seen over the past two days, this is most likely a result of the prednisone. Kristen and I are trying to make our way to the hospital soon and will post later this afternoon. We actually brought our camera to the NICU yesterday and took a little video. You might be able to see the amount of saliva that he generates - which is why in the middle of the video you will see me suctioning his mouth (which I think he secretly enjoys).

6:30pm: I dont have much time to write... just wanted to post that our rockstar Reid is down to 25% O2. While he is on his stomach where he breathes much better, we haven't seen this in quite some time.

6:30am: I woke up at 4:30 this morning thinking that I should probably call and see what Reid's CO2 was... but I couldn't make myself pick up the phone as I was too nervous. So I drifted back to sleep and had a dream that his CO2 was 54. Then I woke up thinking I should call again... but then I thought to myself, Reid hasn't had a gas like that in a while, so my dream would ultimately let me down. Again, I fell asleep only to dream that his CO2 was 83. When I woke up, the dream had scared me into not wanting to call.... so again, I fell back asleep only to dream that Kristen was still pregnant with Reid and we weren't facing any of these issues. So, when I woke up again, I picked up the phone with much hesitation... and his CO2 was 63 (which would be closer to around 55 if it were arterial blood rather than the capillary that his came from). Not the best in the world... but we will take it.

Time to make breakfast. My parents spent the night at our house and I am taking them to the airport this morning. They are taking a week long trip to the Cayman Islands with a few other couples from South Carolina. Needless to say, we are j-e-a-l-o-u-s!

11:00pm: Whew! The day is finally over with. I took vacation today, but it has felt like anything but. We got into the NICU around 2 this afternoon to have our discussion with Reid's new doctor. Needless to say, I think we were a little caught off guard with what she had in mind. The conversation, which we thought was going to be with just her... ended up being with the social worker, two nurses, the respiratory therapist and the doctor. Dr. G went down the multiple paths of "what if" situations and, to be honest, it was quite overwhelming. There is too much to write in a blog... so I might have to save it for another day. I will say, the conversation was very blunt, and has forced us to think about some things that we were hoping that we wouldn't really ever have to deal with.

So... today was a bad day for mom and dad... but, overall, Reid actually had a pretty good day. When we left the NICU around 7, he was on 35%-ish O2 and had been awake ever since we got there at 2. So, we were able to enjoy lots of smiles - he was a happy baby. My parents came into today today and the stopped by the hospital to pay him a visit --- they enjoyed seeing him as it was the first time in quite a while that they have been able to see him interact with others (i.e. not sedated or paralyzed).

Kristen just called to check in on him and he was at 50% oxygen and sound asleep. Our biggest concern right now is his CO2 levels as he is borderline on needing to be put back on the vent. Please keep him in your prayers and hope that tonight is a good night and his CO2 levels can come down - even if it is just a smiggin'.

Bed time for us. Long day today and glad it is over with...

11:15pm: Neither Kristen or I made it into the hospital today. Our lonely boy had to fend for himself but I think that we both needed a break away from the monotony of spending about 5 to 6 hours of our day driving back and forth to the hospital and visiting with Reid. We rarely have a chance to get things done... so tonight was our night. Kristen headed up to campus around 9 this morning and came home at 3 and worked until 10:30 tonight. I had a conference call with India at 8am and I am just now wrapping up work for the day. So, when we have time away from our normal routine... what do we do? Work.

Reid's O2 levels have gone back up to 55%. Not sure what is going on there, but they started another steroid today - prednisone. He is continuing to take the hydrocortisone, so I am not sure what their plan is for duration or weaning. Guess we will find out more tomorrow.

He had another eye exam today. He is officially out of the woods and will not have another follow up until he is 1 year old. Is that good news, or what?!? That was one of the reasons we went to Egleston - so I guess we can check that off our list of things to accomplish while we are there.

10:45am: Kristen and I went to visit Reid last night at 6:30pm and found Reid passed out in his swing (at that time, he had been in the swing for about 4 hours). He looked very peaceful but noticed that his oxygen requirements had gone up to about 55%. We also noticed that not only was he sounding a little wheezy, but he was also working a little harder to breathe.

We stayed at the NICU until about 10pm. Kristen had been holding him for over an hour, but it was time for us to leave and it was time for Reid to have his breathing treatments (CPT, aerosols, etc). We were anxious to see how much the treatments would help his respiratory condition and a little nervous as to what we had in store for the evening. Before we went to bed, we called to see how he was doing and he was already down to 40% O2. They were able to pull some mucus plugs out of his nose and also took the tube that was going through his nose into his stomach (and replaced it with one going through his mouth). His nose has been irritated and bloody over the past 3 or 4 days now - irritation from the tubes and high flow, so hopefully this will give him a break. They had originally taken the tube from his mouth and put it in his nose to help prevent the massive amounts of saliva that was being generated.

Long story short, his night went pretty well. He slept soundly and they were able to further reduce his O2 to 35%. His gas test showed CO2 levels of 65 (acceptable, but not great).

Tonight, they are going to start weaning the medicine he gets in the evening for his sleeping. He gets Ativan at 8pm to help with some anxiety and helps calm him down. Then at 9pm, he gets chloral hydrate to help him sleep. They think that he really doesn't need them anymore, so they are going to attempt to cut the dosage tonight and see how well he does. One of their thoughts is that the chloral hydrate suppresses his breathing --- preventing him from blowing off the excess CO2.

His feed are at 11cc per hour and is still on hyperal. I would imagine that he would need to get into the 18-20cc range before they cut the hyperal and in the 23-25cc range before he is considered to be at full feeds. Since the hyperal is the only thing going through his central line, once that ceases, they will hang "clear fluids" to drip through the line to keep it open. They will keep the central line in as long as possible in the event that he needs to be on any antibiotics or on the hyperal once again. It is a nice "port" to have access to in the event he needs it. The less IVs that he has to have... not only makes him a happier camper, it makes mom and dad happy too.

Kristen and I have a busy day in front of us, so we most likely wont get to the NICU until this evening.

10:15pm: I have felt a little guilty today as I have slacked on my blogging duties. I have been trying to think of something creative to write, but there just isn't much going on. The only two things that I can think of are that they have gone up to 9.5cc per hour on the feeds and he had his nails trimmed for the first time (he was looking a little girlie recently). O2 is hovering in the 45ish area.

Kristen and I meet with Dr. Gauthier on Friday as she has taken over for the month of February. Kristen met her briefly today, but we are going to sit down with her on Friday to discuss her plan for Reid. Another set of fresh eyes...

11:30pm: We just got back from the hospital and it is time for bed, but I wanted to get a quick post out there before I called it a day... Reid had an adventurous day today and got to take a ride in his bedside swing for a couple of hours this afternoon. Unfortunately, we didn't make it in time to see him in person, but the nurse was kind enough to take a picture for us (the blanket was used to help keep his pacifier in his mouth).



Other things to note for today:

His oxygen has been in the low to mid 40s today.

He received another blood transfusion as his hematocrit levels were down to 33. To help with this, they have pushed his gas tests out to every 24 hours instead of every 12. Next gas test is at 4am tonight.

He has been battling a little bit of a bloody nose for a couple days now. When they moved the tube out of his mouth to help with the salivating, they put it in his nose. The tube, which is a little larger than normal (to help with the venting), has rubbed his nose raw. Poor little man.

His feedings have been bumped up to 8.5cc per hour.

They weaned the methadone again today and I think that it caught up to him a little bit. He was fussy when we got there tonight, but calmed down when he got into Kristen's arms and then threw a fit after he was put back in his crib. It took a little while to calm him down, but I was eventually able to get him to fall asleep (he loves his head to be rubbed).

Other than that... a pretty uneventful day.

7:45am: Reid had a good night. His CO2 levels came back down to 54 - which may be a few points higher than if it were taken from his arterial line. His O2 hasn't varied much and was at 38%.

Kristen is on her way to work this morning, so I have a quiet house to get some work done. This weekend seemed fairly productive and I feel somewhat rested - more so than I normally do on Monday mornings. I was able to get our 2009 taxes done last night and even had time to pop in a movie before bed. We are getting a decent amount of money back again this year, so it might be time to remodel the two upstairs bathrooms. You know me... when I run into money that I am least expecting, it seems to burn a hole in my pocket. :)

9:15pm: No real updates to note (other than he was moved into a "big boy" crib. We are anxiously waiting for the next gas test around midnight tonight... In the meantime, here are a couple of pictures that Kristen took today:







2:30pm: They have moved the tube going through his mouth into his stomach to his nose and will hopefully reduce some of the excess secretions that he has been having. I asked the nurse last night about this as I was concerned about the amount of fluids that he was losing and wondering if this had any impact on his electrolytes and indirectly on his CO2. Not sure if it is the answer, but I am glad that they are giving Reid a chance to prove himself and try to make small tweaks to see if they can isolate some of his issues of a higher CO2.

When Kristen text messaged me earlier, his O2 was at 38% and zonked out. I love how he has a bib on in this picture to help absorb the saliva that seems to steadily pour out of his mouth.

11:45am: Kristen just took off to the NICU and is meeting my sister, Shannon. I am going to take a break from the hospital today so that I can get some much needed work done. I am starting to hate Sunday's because I always put work off until after dinner and then I start to get grumpy (and nobody likes a grumpy Chad). So today, I am going to attempt to get ahead of the game and get some work done early. There are a couple of errands that I want to run today too --- but we will see if that happens. :)

Not much news this morning on the Reidster. Kristen called about 9am and he was on 35% oxygen and they probably weren't going to take another gas until 4pm.

4:30am: Reid's gas tests didn't go as well tonight as we hoped they would. Around 1am, his gas had a CO2 of 72 and at 4am, it had come down a little bit to 67. Ideally, he needs to be below 65 to be acceptable, but are hesitant in taking any action. The next steps would be either to go up on the pressures again, or go to CPAP. However, being that he is fighting an infection and is taking antibiotics, they want to give him the benefit of the doubt to see if he can rebound on his own. He was able to have normal CO2 readings following the first two days of extubation, so I am hoping that he can turn the corner. They are also curious to see what happens when they give him his lasix to see if that can help take away some of the fluids on his lungs to help bring down the CO2 as well.

On a different front, Reid was weighed again tonight - 4.13kg or 9lbs 2oz. This is a gain of about 3 oz since he was last measured.

11:00pm: We just got back from a great dinner with both of my sisters and their husbands and it is time for bed! Kristen just got off the phone with the nurse and his oxygen is at 35%. His next gas test is at or around midnight and we are anxious to see what it is. We are crossing our fingers and hoping that we can end such a wonderful day on a good note.


3:30pm: Do you know what is better than holding your son, looking at him only to have him stare back at you and start cooing? Nothing. This has made my day.

Unfortunately, Reid's blood work came back with a gram positive infection. The two antibiotics that they started last night will do the job and he will probably be on them for the next 10 days. Luckily, the can be administered through his central line and doesn't need another IV. With his steroids, his immune system takes a hit and isn't as strong as it could be.

His blood gasses this morning were high and they subsequently went up to 16 liter flow. His last gas was acceptable and they will do another gas tonight.

Dr. Cornish said his xray looked really good and better than before he came off the vent. We are just praying that we can turn this corner and steadily make some progress. His respiratory condition remains steady and is currently at 40%.

10:30am: after the Tylenol kicked in, Reid became a little more active and a little more like himself. His temperature came back down to 98.6. They took another set of labs, but still no results. Oxygen ranged anywhere from 40 to 60% and was at 45% when Kristen talked to the nurse.

A little bit of unfortunate news, Reid' arterial line came out this morning. This was a source of being able to monitor his blood pressure and also a mechanism to getting blood for his gas tests and lab work. Now that it is gone, we will go back to getting his blood from a prick on his heal. Not sure if they will try to get another art line in his other arm.

12:30am: Reid has been fighting a mild temperature for most of the afternoon and evening. They sent cultures to the labs to see if he had an infection, but nothing has come back as of yet (this could be a good sign). His temperature has ranged from about 99.6 to about 101. When I called to check just a few minutes ago, it was right about 100. His heart rate is elevated which usually comes along with a temperature. The good news though is that he is not showing any other signs of sickness. Morphine withdraw can produce these symptoms, and he is about at the time when you would start seeing these withdraws. To be on the safe side, they have started two antibiotics and will follow up with another set of cultures in the morning. They will be able to compare the two sets to see if anything has changed in the time between. They are also prescribing Tylenol to help with the temperature.

Oxygen requirements are still hovering in the 40 to 45% range as they have for most of the day. This is also a promising sign that he is not sick... seems like when he has been sick before, his respiratory stability was usually the first to go.

Dr. Piazza called me this evening but I had missed his phone call. He did, however, leave a message and said that today was his last day of service for the month and that a new Dr. will be taking over on Monday. Just when we were getting used to his styles, we will need to adapt to another style for the month of February. This is life at Egleston and we are becoming fairly used to the rotations now. At first, we didn't like it, but we are now seeing the benefits of being at a teaching hospital with the chance to interact with so many stellar doctors and nurses.

Bedtime for us. Keep your prayers coming and let's hope that this temperature is not a sign of sickness. Good night.

2:45pm: Unfortunately, Reid's hernias came back today. We knew it was a matter of time before they did, but was hoping that we could make a ton of progress before we even had the idea of surgery back in our heads. The nurse was not able to reduce them, so she had asked Dr. Clifton (the doctor that was supposed to do the hernia surgery in the first place) to come look at them. He was able to reduce them. This news makes me very nervous, but we won't talk about the surgery until they become very difficult to reduce (and who knows when that will be???).

Other news, the treatment of dexamethasone is over with. This drug did wonders for Reid and hopefully he will not have any side effects from its use later in life. I guess time will tell, but for the moment, we made a HUGE leap in the past few days and very grateful that we are where we are now.

11:00am: Sorry that we haven't blogged earlier - Kristen wrote the blog for me to post and for some reason, the computer decided to reboot and we lost her entry. So, now that she is out having coffee with Rachel and heading to the hospital, I am going to have to see if I can summarize what she had written...

Reid had a pretty uneventful night last night and his oxygen stayed in the 40-45% range all evening. His CO2 was around 60 this morning, but we have started to see that Reid has maybe stabilized a little bit. His work of breathing seems to have increased since the first day of his extubation, but today hasn't shown any increase over what he was doing yesterday.

Kristen and I went to the hospital after she picked me up from the airport last night and we were there from about 8 to 9:30pm. It was so good to see him! I forgot what it was like to be able to hear him make noises, whether it be crying or cooing. He was wide awake for the first half of our visit and was looking around and we entertained him with his bedside stuffed animals.

The pressures that are be exerted by the HFNC are pretty high and causes him to blow continuous spit bubbles. He has a pad of gauze that sits by his face as it is a constant stream of droll. Kristen and I like using the suction device and keep his face clean, but it is a losing battle to take on. Not until his pressures lessen, will we start to see this drool and bubbles subside.

Anyway, not much has changed over the past 2 days... but we are working on our third day of extubation and so far, things seem to be going as planned. His morphine is completely out of the picture now and they reduced the methadone dose even further.

Time for me to get back to work. Hope everyone has a good weekend.

2:47pm: [Kristen's Blog Entry] Reid is having an OK day. He's had several desats and his current O2 is at 50%. He had two diaper changes in a row thanks to the glycerin he had early this morning, his central line dressing was changed and a culture was done to see if he still has MRSA. He didn't like any of that attention and thus the desats. The nurse also noticed that he was working harder to breathe during all of the hands-on activity but once she gave him his daily dose of methadone his work of breathing returned to normal and he stopped desat'ing. His methadone was decreased from 1 mg to .08 mg and the goal for today is to keep him as quiet as possible so that he does not have to go back on the ventilator. When I called he was resting peacefully and sucking on his pacifier. We will go visit our little guy tonight after I pick up Chad from the airport and in the meantime I am heading to the spa to get an hour long massage. I can't wait!!

9:45am: Reid had a pretty stable night last night - his O2 fluctuated between 40% and 60%, but he was back down to 40% when Kristen called this morning at 8am. Their plan is to keep him somewhat sedated over the next couple of days, as the first 72 hours are the most critical of being off the vent. His blood gasses continue to be good.

2:15am: it's been a long day and just now getting around to put a blog together. Dr. Piazza had called me earlier today to let me know how well the extubation went , so it was good to hear from him that things looked promising. Kristen was able to hold Reid even though he was pretty drugged up and out of it.

Reid sat on 35% O2 for quite some time until they gave him his "sleeping" medicine which totally knocked him out. His breathing became a little shallow and required 50% O2. However, they noticed that after the drugs wore off a little that his breathing improved. This led them to believe that they gave him too much medicine at one time. Going forward, they are going to staggar the two drugs so that he doesn't get completly zonked out. As of 2am, he was back down to 40%, on his belly and sleeping soundly.

A big, successful day for Reid and we are hopeful that he can continue to have a quiet night and an even better tomorrow. So far, a big breath of fresh air.

Good night.

3:30pm: Reid was extubated about 3:00 today! He is on 13 litre high flow (weaned from 15 at extubation) and seems to be doing well. They started off at 40% O2 and was on 37% when I talked to the nurse at 3:30. In fact, when I was getting off the phone, his alarms were going off as he was high-sat'ing at 99 and were about to go down on the O2 again. Listening to his lungs, they sound pretty good.

His blood gas test was good - CO2 of 54 - which is acceptable, but even on the vent last night and this morning, he had low-60s and upper-50s, so actually, he might be doing a little better on his own right now. They will continue to get gas tests to ensure that he is able to handle the change and make sure they are staying on top of the changes he just had.

He is "fidgety", but doesn't seem to be agitated.

So far, so good. The next hours and days are going to be the true test to see if he can handle it. They will look for changes in his blood gasses and also monitor his work of breathing (retractions that show that he is having a harder time breathing on his own). We have been ready for this day and upset that I have to wait until tomorrow night to see him. I will have Kristen send me pictures later and will post them this evening.

12:00pm: Doctors have made their rounds and they have decided to extubate Reid after lunch. Not sure what time frame that means... but they have ordered it and that is all that matters!!!

On a side note, I was incorrect this morning when I had mentioned that he was off the morphine drip. They have cut the dose, but I guess because it takes awhile to get out of your system, last night was the time frame as to when he probably would have experienced that drop in dosage. Not sure if they will get him off the morphine all the way today... or if that is something that will be done in the next few days.

Reid is getting "range of motion" exercises now, as the physical therapist had requested. He tolerated these just fine today and maintained his sats.

Reid is also experiencing tremors like he did last time he came off the norcuron. Doctors are keeping a watchful eye on this, but are hoping that it will soon subside when the drugs start making their way out of his system. Most commonly, his hand/arm will shake and if you place your hand on top of his, he usually calms down quickly.

8:00am: Reid had a "test" last night as he came off the morphine and is now 100% on the methadone. Supposedly this can be a big event... and he passed with flying colors. His O2 this morning was at 34%. Hopefully this is paving the way to a great day. They weighed him again last night - 8lbs 15oz. He has lost quite a bit of water weight over the past few days and looks really good.

6:30pm: Just wanted to post some pictures that Kristen took today. She was able to hold Reid for about two hours and he stayed awake the entire time. He has a new best friend in the stuffed dog the Hospital gave him:








2:30pm: Sorry that I haven't posted earlier as I have been either on a flight or slammed with work. I did, however, get a chance to talk to Dr. Piazza this afternoon, so I wanted to let you in on the details:

• PEEP was reduced to 6 (from 7). Vent settings are now as low as they are going to get. BMP to remain at 14.



• Methadone drip was started last night to start the weaning process for the Morphine. Today, the morphine drip was cut in half. Tomorrow, he will be fully weaned off the morphine and be 100% on the methadone. We will probably see some side effects from this: 1) Return of the "shakes"; 2) diarrhea; 3) fussiness.



• The dexamethasone will be fully weaned in about 3 to 4 days. They have already significantly reduced the dose, and will continue to do so until he is 100% off. To compensate, last night, they started an increased dose of the hydrocortisone and this will eventually take the place of the dexamethasone. He is expected to be on the hydrocortisone for the next two and a half months. We were originally told that the prednisone steroid would take the place, but endocrinology decided for hydrocortisone instead.



• No eye test this week. Instead, he will have one next week (Thursday), and one probably every two weeks until he is 2 months old (gestational corrected) --- about the end of February or beginning or March. If everything checks out OK, he won't have another test until he is 1 year old.



• I haven't talked about this much, but he has been producing quite a large amount of saliva and was actually needing fluid replacement as this saliva was being pulled out of his stomach and collected (for about 3 days now). This extra production has now stopped and they have subsequently stopped the replacement fluids. This is most likely a result of the dexamethasone.



• And lastly, and most importantly, they are going to attempt an extubation tomorrow if everything remains steady as it has over the past 4 days. He seems to be stable enough and his vent settings are low enough, so this is the next logical step. When asked, Dr. Piazza said that he is going to attempt to put him straight onto the high-flow nasal cannulas (HFNC) (instead of going back to CPAP) at a rate of 10 liters per minute. CPAP, apparently is very traumatic on older babies, and will only be used as a possible back up to the HFNC. This is very exciting news, but also makes me very nervous. Unfortunately, I am out of town and Kristen has to work tomorrow, so we will be on pins and needles until we hear of the outcome of the extubation. Kristen and I have been ready for this day to come for quite some time!!!

7:00pm: We are starting to get a little frustrated as no one seems to know the game plan for Reid. When I called tonight to talk to the doctor, he had already left for the evening, so I guess I will try again tomorrow. I want to know what was said with the endocrinologist today, if the meeting even took place. We are on day 7 of the dexamethasone, and not sure when he plans on removing it completely. His vent settings are near extubation numbers - we have a few BPM to go and I imagine another wean of the PEEP, but there really isn't much room to go.

We are at the NICU now and about to go eat some yummy cafeteria dinner. I probably won't post again until tomorrow morning as there isn't a whole lot to write about - his O2 is still between 30 and 36 at the moment. I am leaving tomorrow for DC and will be back on Thursday night. I am crossing my fingers that when I get back that he has been extubated!!

12:00pm: Extubation is still not on the agenda for today. We haven't talked to the doctor yet, but the nurse said it was not discussed in rounds. His agitation is continuing to grow, and I am anxious for something to happen. As a result of this, they have increased his anxiety medicine and his morphine to help curb this. On the vent, they have further reduced his PEEP to 7 and his last blood gas after the change was "beautiful". BPM still at 14. Oxygen is ranging anywhere from 30 to 40%.

7:45am: Reid's O2 varied between 32-36% overnight and they further weaned his pressure support from 6 to 5. He got a bath last night that he "tolerated". Not much else to report on this end...

10:30pm: Where did this weekend go? Again, another weekend of feeling like I accomplished NOTHING. Well, I did get one thing done on my list - moving the old refrigerator down to the basement from the garage which involved talking off the door to the basement and the doors of the fridge (thanks Justin). Ugh. But hey, at least Reid has a dedicated freezer for his ever-growing supply of breast milk. He must have a 2 to 3 month supply saved up for him... and he better get back to full feeds soon or I am going to have to go buy another freezer.

Kristen and I drove to the NICU around 3:30 today and faced torrential downpours and flooding interstates. It seems like the streets flooded really quick, and it made for an exciting trip into downtown Atlanta. We made it safe... and that is all that matters.

Kristen was able to hold Reid again today. He has had kind of a "fussy" day, but his oxygen requirements have stayed fairly stable. When we got to the NICU, he was around 50% as he broke into sweats from being under a heater and being fully clothed. He had on his new "one tough cookie" outfit that he was supposed to wear home from hernia surgery (that never happened). Anyway, he got too hot and it took him awhile to cool off and regain his composure.

He has had quite a bit of mucus coming up his ET tube that has a tinge of old blood. They think this blood might be from the extubation/intubation that he had the other day, and it is getting lighter every day... but it worries me a little bit. It seems like quite a bit of mucus, but it doesn't seem to be bothering him too much.

Tonight has been a restless night as well. The nurse ended up giving him 3 boluses of morphine (don't think that he has had any in awhile), but his O2 is still at 39%. At least he seems to be able to control his breathing...

I got some work done tonight, and was able to watch the majority of the second half of the Saints/Vikings game and now that that game is over, it is time for bed. A little ticked that Favre couldn't pull his team for a win; better luck next year (that is if he doesn't decide to retire, again). Anyway... good night. Hope everyone had a good weekend.

12:00pm: Reid was on 40% oxygen when I called this morning but was sat'ing 96-97 and was about to be turned down. So, over the past 2 or 3 days, his oxygen requirements have remained steady. He was awake this morning and looking all around... we will make it into the NICU later this afternoon. Kristen and I are trying to get some work done (lesson planning and project planning) this morning so that we don't have to mess with it later today.

11:50pm: Reid is still at 38% O2 and has had a pretty uneventful evening. We left the NICU around 7pm and he has been asleep pretty much ever since. There isn't much weaning left to do and the nurse said the logical next step would be extubation. She was going to weigh him and bathe him, so hopefully we continue to have another good night.

The nurses have noticed a large amount of secretions coming out of his stomach - clear liquid that has a consistency of saliva (which is what they assume it is). They are curious as to why this isn't being digested so they ordered an ultrasound on his stomach and bowels to see if there was something that they were missing. His milk is obviously being digested normally, but it is being fed to him past his stomach. The ultrasound was looked at by the tech this morning/afternoon but has not been formally read by the doctor. We are assuming no news is good news. Probably not worth mentioning... but there really isn't a whole lot going on in room 2258 these days.

It felt awesome to hold him today... Kristen held him for about an hour and I held him for maybe a little longer than that. He needed some male bonding time as I hadn't held him since about the 15th of December. At one point, we both took a little snooze together. :) Anyway, hope you guys enjoy the pictures (the main reason I wanted to blog tonight).

3:45pm: things are holding pretty steady today. He is currently on 38% O2 and they have reduced his pressure support to 6 and his BPM to 14. Inspiration time down to .55. PEEP is still at 8. He looks like a whole new baby though as he has lost about a pound of water weight. It was about 10.5 pounds a few days back and when they weighed him last night, he was at 9.4 lbs. I am going to keep this blog short as they just finished a blood gas (7.38 pH, 39 CO2 is 39) and he is about to be put into Kristen's arms. Pictures will come at some point tonight.


9:00am: Reid decided to throw up again last night --- the same kind that he did about 3 weeks ago when he had come off of nurcuron and also when he was getting stress levels of hydrocortisone. These steroids tear up his intestines and causes ulcers to form that eventually bleed. Luckily, he only had one episode of that last night, but they did take his feedings away.

I just got off the phone with the nurse and his O2 was at 42 and was wide awake. She said he was looking at his balloons and at the nurse when she was talking to him. He was also holding her hand and just very content, so hopefully when we go in today, he can be as wide awake as he is now.

They are about to start resuming his feedings at a cautious 1cc per hour just to make sure that he can tolerate it. They looked in his stomach and the only thing that was found was a normal clear liquid - so it looks like he got rid of all of the old blood by himself.

I can't remember if I posted this yesterday or not, but his IV in his scalp had fallen out. His nurse at the time couldn't get a new one started (and she is one of the best IV-givers in the unit), so they decided to let him rest and wait and try again later. The nurse this morning found a good vein on his foot and tried that one two times, but she said the vein forked like a road and could get it threaded... so, they are letting him rest again. If there is someone that is working today that is really good at giving IVs, they will try again, and if not, they will keep administering the medicine through his central line. This isn't ideal (as I believe the IV was used for the morphine) as it goes straight to his heart, but they will make use of it for the time being. What they don't want to do is stress him out.

Long story short... Reid is doing pretty good and is requiring a little more O2 than he was yesterday, but I think he is quite a bit more alert now. Looking back a week or so ago when they tried this (taking him off the nurcuron), he was at 100% O2 (compared to 42% today). This kid has some fight in him!


12:15am: It is getting late but I wanted to get the video up on the website that Alison made today. It is so wonderful to see his eyes open again!! Kristen and I have felt very disconnected with Reid over the past week as there has been zero interaction, but with the visit today, it makes everything that we have been going through worth it.



Reid has a meeting with endocrinology on Monday. Dr. Piazza has started the weaning of the dexamethasone today, but is very cautious as to how to move forward with the finalizing doses. Reid has been on hydrocortisone for quite a while now, and he is a little concerned with weaning both steroids at the same time. The dexamethasone can have some impacts on the pituitary gland and he wants to make sure that he is weaning the drug at the correct times. The endocrinology team will help devise a plan.

When I asked Dr. Piazza tonight, he was very pleased with Reid's progress. I had also asked when a possibility of extubating him was... and was thinking that it might be a week or so away, but he had hoped it would be sooner than that. If his oxygen requirements can maintain where they are at, I am curious to see if they could skip the CPAP and move straight to the high flow cannulas. Wouldn't that be the best thing in the world?!?!

Currently, his rate (BPM) on the vent is 16 and his PEEP is 8. We are starting to get close to extubation numbers and it is overwhelming to even begin to think about it.I can't even begin to tell you how excited we are... and are dreaming again about the day that he gets to come home. We deal with this constant fear of the unknown... and it wears on us... but we have a new focus on what we have in front of us and cannot wait for the day that we get to load him up in the car and bring him home.

OK, bed time for me. Thank you to all that have kept Reid in their prayers --- It means the world to us!