Clearing

Well, I feel a lot better after visiting Andrew...he always has that effect on me, as long as he's not really upset. When I got there, he was just coming out of a new round of sedation, as they had just gotten his new arterial line in. It's in his armpit, which last time wasn't a great location, but I think they've done enough to ensure that it'll stay put for a while. They used some sort of "Superglue for skin" to make sure the actual tube stays in place, then wrapped and taped the connector, then added a layer of Tagaderm (a sticky plastic dressing) and a layer of Ioban (a sticky orange antimicrobial dressing).

He slowly came around from the sedation and was a little disoriented, but calm. He had a good gas and then quickly started breathing on his own, so they turned down his ventilator from 30 breaths per minute to 20. Apparently his sedation wasn't quite as deep as it had been for his GJ-tube placement, so he didn't require the same slow wean as last time. After waiting a little while and taking another good gas, they continued to move him down (to 18). They'll proceed with the same strategy tonight, trying to get him down to minimal settings by early tomorrow morning. If everything goes well, they'll start sprinting again ASAP, and continue that through the weekend. The current plan (subject to change, of course) is to extubate on Monday morning.

After spending some time with Andrew and convincing myself that he was as comfortable and happy as possible, I then had a meeting with the doctor and social worker. We talked for quite a while, and she made me feel a bit better about the situation. It's still very important that Andrew shows progress, both on feedings and on his respiration, but I know that everyone has his best interests at heart. They'll continue with feeds at the same rate for a while, to give his digestive tract time to recover from the GJ procedure and hopefully let him relax and calm down with the spit-ups. He had two tiny spit-ups this evening, but with nothing near this morning's volume. Tonight's nurse seems to know how to handle him, and she's already been able to wean to 16 breaths per minute after a good gas.

Frustration level: yellow...much better than this morning.