Grumpy, then Sweet

Andrew was a little fussy today, but he calmed down by tonight. I had to work during the day, so I went to visit him at 10pm. He was awake and getting a breathing treatment, happy and content with good oxygen saturation. He had both legs free and both hands free, though there was a sock on his right hand so that he couldn't extubate himself....apparently he tried earlier today. I reached over and put my index finger in his left hand. He grabbed on tight, then reached up with his other sock-covered hand and pulled my hand toward him. He was essentially clutching my hand to his chest and holding on tight...then he immediately fell asleep like that. It may be hard to picture, but it was a really touching moment; it seemed that he only felt comfortable when he had close contact with me.

He's completed his sprints for the day with flying colors....they're up to two hours each time, twice a day, and it seems that he even prefers those to normal time on the vent. Here's the difference: On the vent, he's receiving ten pressurized breaths and unpressurized oxygen each time he tries to breathe in; they've lowered his additional pressure support from 10 to 5 to 0. On the sprint, he's not getting any scheduled breaths, but each breath he takes has some pressure behind it...having that extra pressure makes it more comfortable to breathe through the tube.

Andrew has been continuing his feeds at 11cc per hour for the last day. He threw up a few times...not a huge amount, and they don't think he has another obstruction, but they want to be safe and minimize the number of times he vomits. They are talking about replacing his G-tube with a GJ-tube, which is a little bit longer and reaches down into his small intestine (jejunum). They think that if the tube goes past the bottom of his stomach, they'll have less issues with reflux. We'll see if it works....he's already doing a bit better tonight, but I think they'd like to have the GJ-tube anyway....it should help when they increase the feeding volume again.