He Never Fails to Surprise

At 10am this morning, Andrew had a chest x-ray that looked as if he had made progress. His heart was moved over a bit and his lung was more clear. He also had a very good blood gas, continuing the trend from the night before. They were able to wean his ventilator rate to 21 breaths per minute, and his oxygen was as good as its been in a week.

Just a few hours later, his heart rate went up a bit and the nurse changed his diaper. A little later, he was looking a little pale and mottled, and they took a routine blood test. His CO2 was in the 100s, and his pH was far too low (right around 7). They took another chest x-ray and his left lung was back to being hyper-inflated, his heart was back where it was a few days ago, and his right (good) lung had collapsed again. In order to help with his CO2 and re-inflate his right lung, they had to put him back on the high frequency ventilator. It's been almost two months since he was on this machine, and it feels like a huge setback to have him back on it. For a while, he was on 100% oxygen, at high pressures and amplitudes. Fortunately, he responded well to it, and his next gases were much better. They went from the 100s, to 88, to 78, to 67....his pH also moved all the way back up to 7.4, where it's supposed to be. They're back down to 77% oxygen and will continue to wean a bit. They've paused the feedings while all this is going on; hopefully they'll restart tomorrow morning.

I think he scared some people this afternoon, doctors and nurses included, and it's good to have him stable again. Our concern is that with each problem, he takes another step backward....it feels like we've been moving in reverse for the last week and a half. First high ventilator settings, then the sedation and paralysis, then the helium, and now the high-frequency ventilator. We're running out of wiggle room....the first time the hi-fi vent failed to keep him stable, the day after he was born, they put him on ECMO. That's not really a feasible scenario now, so there aren't many good options left if he decides to go south.

Needless to say, it was another tough, emotional day. We're both working all day tomorrow, so I don't expect it to get any easier. Hopefully I'll have better news to report tomorrow night, though I'm tired of Andrew making me look silly by following up a positive post with a major setback. Bad baby!