When we got to the hospital this morning, you were doing well. On track to be extubated and start feeds. You did look swollen, but that is to be expected since you just had surgery yesterday.
The nurse said that you were doing fine, and that they most likely would wean your ventilator rate down again. You were at 15 for your RR when I got there. You still needed a bladder scan because you weren't peeing much. When the doctors came around they said they wanted to catheterize you. Once they took a look at you and listened to you they changed their minds because your belly felt soft and you had good bowel sounds. I asked why you wouldn't be peeing and they said it could be the anesthesia and possibly the morphine. They also said they wanted to start your feeds very small at 4 ml's. Once you get extubated you can go on full feeds. They said that you would just be getting my breast milk right now with no fortifier. You would continue on just my breast milk until you got to full feeds and then they would put you on a different fortifier since you are growing so well. They also said that they wanted to wean your RR to 10. If you did well on that you would get pressurized air and they would take it from there.
When it was 10 o'clock, grammy and poppy could come back to your room (visiting hours start at 10). We sat there for a bit and then around 11:30 you had a few pretty big events. One of them you dropped your heart rate to the high 40's and had to be bagged. I cried. Tough to watch your heart rate drop that much and then come back up and then drop etc. There were a few people in the room making sure you were coming back up. Very scary. After that, they did an X-Ray to see the placement of your ventilator tube. They thought it was too far down and it was a bit further than they liked so they moved it. You kept having events. They put your RR back up to 30. You then got VERY pale and I cried even more. You did not look good at all. I was so nervous. And scared.
You didn't have another episode for a little bit after that and your color came back so we decided to get some lunch while you were still doing well. We had a quick bite to eat and then came back up to see you. We missed the neurosurgeon, but he checked you and put you on antibiotics for another 5 days just incase of infection. The resident that checked you out this morning said that your incision looked a little red, but the neurosurgeon said it was the right color.
They fed you the 4 ml's around 1 pm and around 4 pm they checked your residuals. Out of the 4 ml's they fed you, they got 3.25 back. They re-fed it to you and did not give you any new milk. The next time they checked it, they got the same amount back. They told the doctor and she said to get rid of it and give you new milk. They propped you up on one side so that it would help go from your belly to your intestines. If it is not digested again then they will stop your feeds.
They took some labs and your potassium was low. They wanted to wait to give you anything because you haven't been peeing a lot and if they gave you potassium, it could affect your urine output. You went a little bit, so they decided to start the potassium.
Around 5 pm you started having more episodes, but not as close together as the ones this morning. You were awake for about an hour and you just looked so uncomfortable that I started crying again. They decided to try the morphine again now that they put your RR back up to 30. You have been doing fine since and look much more comfortable.
I decided to stay at the hospital tonight just incase since you were having such a rough day. Daddy came to see you for a little bit and will be back in the morning. We love you so much and we hope you are comfortable. We know you are strong and will get through this. We hope you have a better night and a better day tomorrow. I'll be right here all night with you buddy! Hang in there!
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