Day 96 - Chapter 4: Withdrawal

Monday, April 5th, 2021

Middle of the Night Update (MOTN- for all the pumping mamas): Last night his PEAKs were in the 50's and 60's so they ended up doing a PRN of meds to calm him down. Around 2am, several RTs were in the room suctioning him pretty often to see if they could help.

Morning Update: The ENT group stopped by to let us know that the trach change will happen tomorrow. They took a look at James to assess him and said the trach looks good!

This morning the IV team changed his PICC dressing because it was peeling off. They are NOT going to try and find another vein for an IV. At this point, all meds can go through the PICC line. When they need to run through the diuretic they will just stop the 3 IV drips (paralytic/ sedation/ pain meds) for 5 minutes to do so. 

Since the trach change is scheduled for tomorrow we will be heading back to the NICU afterwards! They will then start to wean James off of the paralytic, sedation, and pain meds. James has been on morphine since the day he was born. He doesn't know what it's like to not be on morphine. James will go through withdrawal and there is a 99% chance that he will have symptoms. This has been quite a journey for James, we like to think of these as Chapters in a book,

Chapter 1 - Is he going to make it?
Chapter 2 - Chronic Lung Disease of Prematurity
Chapter 3 - Trach & G-tube Surgery

and now...

Chapter 4 - Withdrawal: In the PICU they use the WAT assessment tool versus the NICU uses the Finnegan assessment tool. Below is a list of the symptoms that they will be looking for in James. This could be anything from yawning, sneezing, loose stools, a fever, tremors, sweating, vomiting, being startled when touched, and taking a long time to calm down, etc. Essentially he gets one point for every one of these symptoms and if the score totals above a certain range and they will need to look at giving him more meds. It is important that they keep a balance so that his oxygen doesn't need to be dramatically increased and effect his lungs. So this is the next chapter and will begin tomorrow!

Below are a few photos of the Children's Hospital wing. You definitely know when you've entered! We'll be back here once James reaches 5,000 grams and gets on the Trilogy Home Ventilator with lower settings. Then we'll be one step closer to going home.

Hot-air Balloons just like in Jimmy's nursery!

Hallway to the PICU

Registration desk setup like a hot-air balloon!

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