Day 217 - 👀 Eyes,👂🏻Ears, & 🫀 EKG
Wednesday, August 4th, 2021
💩 In the morning we ended up giving James a glycerin because he had not had a bowel movement in 24 hours. This may not seem like long enough time to wait to use a stimulant but when he is constipated that can back up his full belly which will lead to him vomiting. He ended up having a small stool about an hour later. He did not throw up today! Mom has been on top of the venting.
👁️👁️ Something that we just recently found out is James has condition called variably conspicuous strabismus. What are the symptoms of strabismus? The main sign of strabismus is an eye that is not directed straight. Sometimes a child will squint with one eye in bright sunlight. In James' case he has Exotropia when one eye turns outward. It's barely noticeable but it's there. Over time this should correct itself as the eye muscles grow stronger.
🫀 EKG - A 12 lead EKG was ordered since he was having beats with changes in his QRS complex morphology on telemetry. Essentially the monitor was picking up a a weird line for the heart rate and they wanted to check it out to make sure that there wasn't something wrong with the electrical system of his heart. Everything checked out fine.
👂🏻Ears - Mom asked if the night shift doctor could take a look at James' ears. He has been pulling on them recently so much to where he actually scratched his ear and made himself bleed. The doctor said that there was a lot of wax so he couldn't get a really good look but that he doesn't see any inflammation to suggest an ear infection.
😴 Overall James slept a lot today and we think that is because the LTV is like going to the gym and he is just working out really hard. He is also a growing boy!
🫁 Tolerated LTV for 8 hours during the day and 6 hours overnight. At 4am, we did not extend the evening trial to 8 hours because he was tachycatic, his respiratory rate increased dramatically to about 65 beats per minute when it is normally around 30.
💊 Milk of magnesium remains suspended. No stools overnight. Still having lots of gas being vented from his GTube.
🔺 Mom and Dad did the trach change with the Director of the PICU (who is our doctor this week) observing. It was very nerve-racking for both of us because well...doing a trach change on your baby should always make you nervous. The first time it doesn't is when things will go wrong. Mom took out the trach and held James' chin up so Dad could see the stoma. Dad put the new trach in the stoma with the obturator and then removed the obturator. Once completed Mom then let go of James' chin because now Dad has his hand on the new trach. She now has to focus on disconnecteing the oxygen from the trach she removed with a plastic wedge, and connect the oxygen to the new trach. After that it's a simple tie change involving cleaning his neck with soapy water, drying his neck, putting on fresh gauze, and tying the trach ties. They said we did well, even though every time we feel like we could have been faster or more efficient. We have done over 15 of these trach changes, and we'll continue to do them every single week that James has a tracheostomy.
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| Combed his hair! |
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| Selfie! |
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
James looks SO content with mom, his smile is contagious, love that cupid bow mouth
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