Day 98 - Diuretics Use in Neonates & 1st Hold with Trach

Wednesday, April 7th, 2021

Today is Pop-pop's Birthday! He would have been 69 today. James Weston was named after his Pop-pop and will carry on the legacy of the great name. His middle name, Weston, means "from the Western town". James was born in Tampa Bay, on Florida's West Coast.

Update:

His weigh in last night was 3340grams (7lb 5oz). So he lost 10 grams.

His feeds were changed from bolus feeds at 56 mls during the day and then continuous feed at night of 22 calories/ 22mls an hour.

James has been making sounds shown in the videos below. There is a leak around his cuff. When he had his ET tube that was a 3.5. The trach is a 3.0. There is a cuff filled with 1ml of saline it goes around the trach. So there is some room around that cuff but also we think when James has these little broncos spasms he bears down and squeezes some of the water out. We had a couple of RTs check the cuff yesterday by taking out the saline and measuring it and it was not measuring 1 ml both times (even after they added more). So because of this we can hear James make noises. We heard him cry a full loud cry with all his might as if he didn't even have a tracheostomy.

Mom spoke with the doctor at length regarding the use of diuretics in babies. Overall there is no studies that show long-term effects of using diuretics on babies with BPD. In fact there are more potential adverse effects that could occur. These include growth restriction, electrolyte imbalance, and affecting the electrical system in his heart. The idea would be to slowly wean him off of the diurell diuretic as well as the morphine, watch for any side effects, and adjust appropriately.

Mom held for 2 hours in the early evening. Unfortunately, he threw up again and desated into the 50s. It was a very slow decline and took about a full 5 minutes, but still no one seemed to notice. After yelling for help she was able to flag someone down from across the hall. Mom was told, "Well it's shift change". So just a heads up, I guess when it's shift change you are on your own. That's why Mom doesn't leave.

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