Day 75 - Baby Spa Day & NG tube
They decided to lower the fortifier additive to Mom’s milk from 24 to 22 calories. He’s still staying at 46 ML every 3 hours. Baby James weighed in last night at 2570g or 5 pounds 11 ounces.
Due to the BPD spasms, a few adjustments will be made to the settings on his ventilator. The Tidal volume will be raised to 16 from 12. This is the amount of air that keeps lungs open. His PEEP is staying at 14. The Rate of 40 is staying the same too. His FIO2 was up to 80 most of the day, but during a nice afternoon with Mom and Dad, he’s down to 63. James was able to lay freely unswaddled for a few hours while Mom & Dad kept watch and even took a nice long nap.
Mom gave James a mini spa day with a facial, manicure, and some oral care, while Dad stood by having man to man talks about how this is totally normal for masculine men to enjoy. 💪
At the end of the relaxing afternoon Mom noticed that his OG tube was getting tongued out by James. Unfortunately the nurse could not push it back in. She had to remove it and replace it with a new one. It makes the baby gag and it's really hard to watch. Well as soon as it was in James was already tonguing this one out too (something "older" babies do)! So we took it out and it was decided to do an NG tube instead (Oral vs Nasal). The 1st picture in this post shows his current set up with his feeding tube through his nose and oxygen tube through the mouth. Can't be comfortable!
James is still getting his Albuterol and Pulmicort. The Albuterol could possibly agitate Jimmy’s lungs and could be stopped. But time will tell. James is still getting his Clonidine, which lowers his blood pressure to relax. And his Morphine, which his helpful to relax too, but could be addictive after getting 8 doses daily for 70+ days, so we might consider Methadone as an acting morphine with 1-2 doses every 12-24 hours.
Mom and Dad spoke with the doctor more about the tracheostomy. The reason this could be an option is since the pressures on the ventilator are high because they have to go from his mouth all the way to the lungs, and by starting at the trach, less pressure would be needed, therefore potentially leading to less agitation to his lungs. This could also help James with using his mouth more for facial expressions and more head mobility. It would also be a more secure line that is more challenging for James to pull out or move.
Obviously there are also concerns with this process due to potential infections and more care that would be needed from Mom and Dad, but we are weighing all options at the moment. As James approaches 37 weeks this Thursday.
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