Day 91 - Trach & G-tube Surgery Today!

March 31, 2021

Wednesday, March 31st, 2021

James has his surgery this morning, he is 38 weeks gestational. Originally scheduled for 8am, then 9:30am, and they finally brought him back at 10:30am.

Ventilator Settings:
His PEEP was changed from 14 to 12, and his tidal volume was increased from 19 to 24.

They will be doing a PICC line right after surgery. Since a lot of times babies' IVs will fail, the PICC line will ensure he's getting the sedation he needs. They'll be placing this in his thigh.

As they wheeled James off for surgery Mom and Dad stayed in the room and hysterically cried in each other's arms. 😢😭

11:45am Update: An RN called from the OR with an update...Surgery started at 11am. As of 11:45 the G-tube surgery is complete and went well and the tracheostomy surgery is 5 minutes in. (Mind you we were told by a nurse that the OR is trying to reach us and we need to get on the phone with them. We immediately thought the worst because we didn't expect a phone call with an update). 🫀 #heartpalpitations

12:30pm Update: Surgery complete. The ENT Doctor who did the trach updated Mom in the room letting her know that everything went well and they are just wrapping up. Originally the trach was going to happen before the G-tube but the GI Doctor had an emergency surgery and needed to go first. Dad is currently doing a Zoom call for the Southwest Region in a conference room he snagged down the hall. If only they knew...

Can't wait to see him! ❤️

12:45pm Update: Mom was asked to leave the room and go to a waiting room so they can bring James back. Not clear on this protocol. Could be 30 minutes before they are finished doing their "things" and charting.

*James will be heavily sedated and paralyzed until Monday, which will be the first trach change. They cannot have him move his head at all while it is healing.

((Side Note: Text messages are not going through at this hospital.))

Afternoon Update: Mom was finally able to go back to see him. Photo below! The ventilator settings had changed slightly. They went from a PEEP of 12 to a PEEP of 8, which seemed very drastic because he has never been lower than 11. That only lasted for about 10 minutes until they decided to go back up to a PEEP of 10.

His blood gas that he had yesterday in the NICU that was in the 50s went up in the 70s when they took it this morning around 4am and again right after the surgery. They're doing blood gases very frequently.

The on-call PICU doctor informed mom that since the PEAK was staying lower in the 30s that we had the right settings. Part of the reason was because they increased the Tidal Volume to 24. If you don't follow any of this, don't worry Mom is getting confused too and needs to brush up on some YouTube videos. After all of this it shouldn't be too hard to go back to school to become a Respiratory Therapist.

Shortly after, Mom was asked to leave again so they could put in the PICC line that would take about 90 minutes.