Day 77 - St. Patrick’s Day & Trach Talks

Wednesday, March 17, 2021

Update:  James got to play dress up today for Saint Patrick’s Day ☘ after his bath. He gets to have tub baths on Saturday evenings and Wednesday mornings. Cute Irish outfit made by NICU volunteers! James is at least a ¼ Irish 🇮🇪! He is also German 🇩🇪, Russian 🇷🇺, Polish 🇵🇱, and Jewish 🇮🇱, with a small percentage of a few others! 

James overall had a good day. His FIO2 has been between 50-54% most of the day.  No changes to his ventilator settings.

Mom and Dad had another lengthy conversation with the doctor today about the tracheostomy. Unfortunately it looks like even with another round of steroids James would not be able to be extubated which is the goal of a 3rd round of steroids. There are pros and cons to every single thing. For example, the 2nd round of steroids (2/21‐3/3) helped James lower his FiO2; however, each additional round of steroids could possibly cause neurological issues. So unless the next round of steroids have a good chance of getting a baby extubated it's not worth it. Since then James had 2 setbacks with having some of his lungs collapse after his CPAP/NIV trial (3/7) and then with his bronchspasm on the (3/13), which really made his lungs start over.

As we approach his due date of April 8th we knew that we would need to start having these talks. Yes, the lungs have been our focus but we also need to start thinking about the brain. For 2 ½ months James has been in an incubator/crib sedated around-the-clock on morphine. This is not how a baby develops. The tracheostomy will allow James to go home eventually where he will be able to thrive.

We are scheduling a meeting next week to sit down with the doctors on the PICU team to discuss the tracheostomy in detail. The reason this is happening  now is because we also need to make decisions on his 2 month immunization shots (he is now 2.5 months). James will need 2 weeks or so to work out any reactions prior to having surgery.

P.S. You can email James your love and support as often as you’d like. Mom and Dad read these email to James as they come in. We all love them!:  JamesWestonAbramowitz@gmail.com