Day 216 - Cauterization of Granulation

Tuesday, August 3rd, 2021

RT woke James up at 2am trying to switch the CO2 sensor so Mom woke up and showed her how to use the wedge to disconnect the circuit. Then changed his diaper and vented. Back to sleep at 2:45am, 4:30am James desated but they just turned off the alarm remotely from the desk without coming in. Mom got up to see that James was drowning from water collecting in his circuit from the humidifier. James is never just desating in his sleep for no reason. Mom SDVed (suction, diaper, vent) and he went right back to sleep at 4:45am.

The doctor decided that if he was still doing well at 4am, they would extend until 6am. At 5:15am he was drowning again and needed to be suctioned and vented. Again they were just silencing the alarm from the desk and not even checking on him. At 5:30am they switched him back to servo because he was agitated (or was it because he was upset from drowning?). Mom let the RN know that when he is desating at night it's because he needs help, and that she noticed the alarms just being silenced. No response.

Then we changed out the CO2 sensor again because it already doesn't work, filled with water. Mom let the RN know that the RT taught her that the wire needs to be pointing up to avoid it getting wet, she says, "Whatever you want...". Really?! Has Mom mentioned that she's not a big fan of Night Shift?

James had his first bowel movement without a glycerin! The milk of mag is what is helping him with his bowel movements however it is also causing him a horrible diaper rash. So we decreased his dosage from 7.5 ml to 5 ml. He has not had a diaper rash until this point. We went 7 months!

ENT stopped by and cauterize the granulation on the stoma with silver nitrate. It's basically a chemical burn with a q-tip. Mom requested morphine for this procedure mainly so that he didn't move during it. He is very strong! We don't want her burning his other skin around the stoma. After this we left the gauze off for the rest of the day. (Side note, the ENT group is out of network for our insurance. It's interesting that as soon as we found out it feels like they come to the bedside more often.)

Dad came to the hospital in the evening so Mom could run home to shower and organize more frozen breastmilk in our deep freezers. Mom and Dad did trach care together in the evening. There were a ton of secretions around his stoma since he did not have gauze around his trach the entire day. The skin that was cauterized turned grey. James vomited twice around 9pm. Almost made it the whole day!

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