Day 105 - Lots of Firsts!

Wednesday, April 14th, 2021

*Sorry for the late post. 
#exhaustion

James enjoyed his first swing experience and his first tummy time in his boppy. Mom also assisted the RT with the first trach change today! After cleaning the stoma, Mom pulled out the trach and reconnected the oxygen after RT put in the new trach. We then put on the trach ties. It was very stressful and emotional Mom and Dad both cried afterwards.

If you'd like to see the process of changing a trach, this video is exactly the process we follow. The only difference is that James is very active baby when upset. We will be doing this weekly on Wednesdays!

James gained weight and is now 3650 grams (8lbs)!

The Doctor decided to changed some of his ventilator settings by increasing Tidal Volume and lowering his Rate. 

Current Ventilator Settings
FiO2: 28
PEEP: 11
Rate: 20 but then we increased to 30 (originally was at 40)
Tidal Volume: 35

Unfortunately James did have several brady episodes. Some while he was calm and others he caused from clamping down during a BPD spell. They may be looking into him getting another EKG.

There also may be a chance that James has a hernia. This is when a loop of the intestine bulges through and abnormal opening through the wall of muscle. We are keeping a close eye on it. However if that is the case he will need to have surgery. This would have been caused by him clamping down during a BPD spell. ☹️

The GI surgeon stopped by to check on his G-tube site. He said it looked good and that we could start putting aquaphor on the stoma since the bottom area was kind of red. He also suggested only using one piece of gauze because you don't want it to be too tight that the balloon underneath the stomach wall rubs away at the interior stomach lining. Good to know. But overall he did not see why there would be a huge leak. This does happen from time to time. 🤷🏻‍♀️

How do we get James to have less BPD spells?

It takes time. He needs to grow more alveoli in his lungs. As we continue to wean the pressures on the ventilator settings he will grow healthier alveoli. Lungs continue to develop until children are about 8 years old. In the first 6 months, the air sacs in their lungs increase rapidly. After 6 months, the number of air sacs continues to increase, but more slowly. It will take James a few years to heal from BPD. 

How do you get BPD?

In short, babies born too early before their lungs are developed. It is not genetic or chromosomal. All premature babies that are on mechanical ventilation for a long time are likely to have Bronchopulmonary Dysplasia (BPD). We will break this down in detail in a future post.

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