In case you haven't been reading all the postings...this will get you caught up:
August 18 (Day 35): PIC line removed; off the IV; up to full feeds with gavage
August 15 (Day 32): Passed hearing test; had ROP test done
August 13 (Day 30): CPAP removed; put on nasal cannula; classified as Level II care
August 11 (Day 28): T gets to hold Evan for first time
August 9 (Day 26): Got his first bath by mom
August 8 (Day 25): Moved into the 3rd pod
August 7 (day 24): Respirator removed; put on nasal CPAP; held by Jen for the first time; moved into a crib
August 5 (Day 22): Oscillating respirator removed, put on conventional respirator
August 2 (Day 19): Arterial line removed
July 31 (Day 17): PDA healed
July 28 (Day 14): PDA discovered
July 25 (Day 11): Off the bilights; bi-carb burn on his right foot discovered; Jen's first diaper change
July 23 (day 9): PIC line inserted
July 21 (Day 7): mild IVH grades detected in brain
July 18 (Day 4): Pulmonary hemmorhage detected; put on ocillating respirator
July 14 (Day 1): Born by emergency c-section in Sierra Vista Hospital and air-evac'ed to University Medical Center in Tucson
Showing posts with label ART line. Show all posts
Showing posts with label ART line. Show all posts
Friday, August 18, 2006
Saturday, August 05, 2006
8/5/06: Day 22 (Sat.) On the Conventional Respirator*
A very good day today! Another small hurdle has been cleared...Evan was taken off the oscillating (high frequency) respirator and is now on a conventional respirator! Fingers crossed he won't have to go back to the high frequency respirator!
Evan's primary nurse, Marianne, told us that Dr. Edde made the decision Saturday morning to switch him over. The doctor just had a feeling it would work, and she was right. When they switched him over, they had to manually give him oxygen (with that squeezy-bag-thing, for a lack of a better term)...but, Marianne said that he was breathing on his own during that time. Another good sign that his lungs are maturing. Now, the next step is to keep monitoring his CO2 levels and if they remain in the good zone for an extended period of time, then they can wean him completely off the respirator onto the nasal CPAP.
He was in a much calmer state today...Marianne has continued suctioning him more often which is helping (although Evan gets so mad in his face when she is doing it). She is also keeping him in a swaddled condition with a thin blanket. She said this is also helping him stay calmer and keeping his arms and legs from flailing around so much. They also say he is keeping his body temperature consistently at a very normal level, and that means he may be able to move into a crib soon. When that happens, it will be much easier for us to finally get to hold him.
Now that he is on the conventional respirator, the respiratory technician (RT) has to do "treatment" on him to help get all that gunk loose in his lungs. While we were there, one of the RTs, Roy, did a session on him. All he does is tap this cup-like thing on his back for a few minutes, then suction him. Evan didn't like it at all and it was evident in his face (he turned bright red and looked like he was trying to cry). It's all progress though!
Momma changed his diaper while dad watched...T still hasn't done a diaper change by himself yet. Hopefully that will change soon! He's still getting his feeds (3ml every three hours). So far, no adverse reaction to the breast milk. Now that they took out his arterial line a few days ago, they are taking all his blood gas test from his heel (which he doesn't like very much either). The burn on his right foot is still healing (it is classified as a third-degree burn, ouch). Hopefully it will be completely healed by the time he leaves the hospital. When Marianne was switching his Pulse Oximeter from his foot to his hand, Evan gave her a big fight...he refused to open up his hand...we were all shocked at how strong his little fingers were. She eventually got the monitor placed properly, but the kid's got grip!
Lots of good news today on Evan's 34-week mark (6 weeks away from being full-term)!
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UMC Charges: $8,171.05
Running Total: $215,331.89
-----------
Evan's primary nurse, Marianne, told us that Dr. Edde made the decision Saturday morning to switch him over. The doctor just had a feeling it would work, and she was right. When they switched him over, they had to manually give him oxygen (with that squeezy-bag-thing, for a lack of a better term)...but, Marianne said that he was breathing on his own during that time. Another good sign that his lungs are maturing. Now, the next step is to keep monitoring his CO2 levels and if they remain in the good zone for an extended period of time, then they can wean him completely off the respirator onto the nasal CPAP.
He was in a much calmer state today...Marianne has continued suctioning him more often which is helping (although Evan gets so mad in his face when she is doing it). She is also keeping him in a swaddled condition with a thin blanket. She said this is also helping him stay calmer and keeping his arms and legs from flailing around so much. They also say he is keeping his body temperature consistently at a very normal level, and that means he may be able to move into a crib soon. When that happens, it will be much easier for us to finally get to hold him.
Now that he is on the conventional respirator, the respiratory technician (RT) has to do "treatment" on him to help get all that gunk loose in his lungs. While we were there, one of the RTs, Roy, did a session on him. All he does is tap this cup-like thing on his back for a few minutes, then suction him. Evan didn't like it at all and it was evident in his face (he turned bright red and looked like he was trying to cry). It's all progress though!
Momma changed his diaper while dad watched...T still hasn't done a diaper change by himself yet. Hopefully that will change soon! He's still getting his feeds (3ml every three hours). So far, no adverse reaction to the breast milk. Now that they took out his arterial line a few days ago, they are taking all his blood gas test from his heel (which he doesn't like very much either). The burn on his right foot is still healing (it is classified as a third-degree burn, ouch). Hopefully it will be completely healed by the time he leaves the hospital. When Marianne was switching his Pulse Oximeter from his foot to his hand, Evan gave her a big fight...he refused to open up his hand...we were all shocked at how strong his little fingers were. She eventually got the monitor placed properly, but the kid's got grip!
Lots of good news today on Evan's 34-week mark (6 weeks away from being full-term)!
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UMC Charges: $8,171.05
Running Total: $215,331.89
-----------
Thursday, August 03, 2006
8/3/06: Day 20 (Thurs.) The Snot-Man
A rainy day up in Tucson today...luckily I got to the hospital before the downpour. It was neat though since we could watch the rain roll in from Mt. Lemmon from one of the NICU windows.
I had a good visit today (not like I ever have a bad visit)...Evan was lucky to have 2 nurses work with him today. Today Marianne was off so he had Karen and Mary. Karen is a nurse at St. Joe's Hospital on the other side of town and was called in to UMC since they had so many babies to take care of. Karen was a real hoot, someone who had a great sense of humor despite all the stress in the NICU. Small world, but she has relatives who live in Hereford and Bisbee, so she's well aware of the boring drive to Sierra Vista from Tucson.
Evan did have a head ultrasound and chest x-ray today, but they didn't get the results interpreted yet. I'll check tomorrow on those results. His right arm was still free from the art line...they are taking blood samples from his left heel instead. Now that his right arm is free, I noticed his upper arm is really chunky! He still tends to keep his arm in an upright position (he doesn't seem to know that he can put that arm straight down now).
Evan's oxygen saturation all of sudden dropped into the 70's...as it turns out, he needed to be suctioned. Karen squirted a bit of saline solution into the suction tube and ended up pulling out a big glob of snot (as she called it). Sorry for the lack of a better medical term! It was amazing to see his O2 levels go right back to normal after she did it. The nurses have been rotating him from his belly to his back and have been noticing a lot more gunk coming up from his lungs (according to them, that's not a bad thing). The oscillating respirator also shakes a lot of the stuff loose. Since he can't cough it up due to the respirator tube, it has to be suctioned out manually.
While I was there, the respiratory technician (RT) made some adjustments to his ventilator. The nurses were about to test his blood gases when the RT appeared, but they decided to wait about a half hour, then pull his blood sample to see how the adjustments affected his results. I was still around when they got the results back from the lab and according to Karen his results were excellent....so they expected the RT to come back and make some more adjustments. So, more positive steps to get Evan onto the conventional respirator (and eventually off it entirely).
I got to change his diaper again...according to Karen, that was the heaviest diaper he has had (it was absolutely soaked). He was acting really fussy prior to the diaper change, so he definitely doesn't like to be wet, even in his sleep stage. The nurses also let me "feed" him through the tube...he's now getting 2ml every 6 hours, which is a step forward.
Evan seems to be having less and less IV drips running...so that's another good sign. All he is getting now through the IV is Fentanyl, Adivan and TPN (which stands for total parenteral nutrition). Once he gets off the respirator, he should be IV free (as long as he can tolerate the breast milk feeds). Fingers crossed we'll get to that point soon!
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UMC Charges: $7,002.30
Running Total: $200,569.79
--------------
I had a good visit today (not like I ever have a bad visit)...Evan was lucky to have 2 nurses work with him today. Today Marianne was off so he had Karen and Mary. Karen is a nurse at St. Joe's Hospital on the other side of town and was called in to UMC since they had so many babies to take care of. Karen was a real hoot, someone who had a great sense of humor despite all the stress in the NICU. Small world, but she has relatives who live in Hereford and Bisbee, so she's well aware of the boring drive to Sierra Vista from Tucson.
Evan did have a head ultrasound and chest x-ray today, but they didn't get the results interpreted yet. I'll check tomorrow on those results. His right arm was still free from the art line...they are taking blood samples from his left heel instead. Now that his right arm is free, I noticed his upper arm is really chunky! He still tends to keep his arm in an upright position (he doesn't seem to know that he can put that arm straight down now).
Evan's oxygen saturation all of sudden dropped into the 70's...as it turns out, he needed to be suctioned. Karen squirted a bit of saline solution into the suction tube and ended up pulling out a big glob of snot (as she called it). Sorry for the lack of a better medical term! It was amazing to see his O2 levels go right back to normal after she did it. The nurses have been rotating him from his belly to his back and have been noticing a lot more gunk coming up from his lungs (according to them, that's not a bad thing). The oscillating respirator also shakes a lot of the stuff loose. Since he can't cough it up due to the respirator tube, it has to be suctioned out manually.
While I was there, the respiratory technician (RT) made some adjustments to his ventilator. The nurses were about to test his blood gases when the RT appeared, but they decided to wait about a half hour, then pull his blood sample to see how the adjustments affected his results. I was still around when they got the results back from the lab and according to Karen his results were excellent....so they expected the RT to come back and make some more adjustments. So, more positive steps to get Evan onto the conventional respirator (and eventually off it entirely).
I got to change his diaper again...according to Karen, that was the heaviest diaper he has had (it was absolutely soaked). He was acting really fussy prior to the diaper change, so he definitely doesn't like to be wet, even in his sleep stage. The nurses also let me "feed" him through the tube...he's now getting 2ml every 6 hours, which is a step forward.
Evan seems to be having less and less IV drips running...so that's another good sign. All he is getting now through the IV is Fentanyl, Adivan and TPN (which stands for total parenteral nutrition). Once he gets off the respirator, he should be IV free (as long as he can tolerate the breast milk feeds). Fingers crossed we'll get to that point soon!
--------------
UMC Charges: $7,002.30
Running Total: $200,569.79
--------------
Wednesday, August 02, 2006
8/2/06: Day 19 (Wed.) Arterial Line Removed
When T and I go up to visit, we really try to be drama-free. Our visit started out to be that way, but of course, Evan had to give us a little scare. His primary nurse Marianne was on duty so it was nice to have someone give us all the news without having to pry it out. On the days she isn't working, Evan will get some random nurse who isn't always the most forth-coming with info. Marianne had overheard the doctors say they may switch him over to the conventional respirator in a few days. Although the conventional respirator is a bit harsher on preemie lungs, it will give Evan more of a chance to breathe on his own. Right now, he is trying to breathe against that oscillating respirator and that is a hard thing to do. They have continued to turn down the amplitude on the oscillating respirator, so he isn't vibrating as badly anymore.
As for Evan giving us a scare...I had thought he had scratched his stomach since I saw a thin line of blood appear on his tummy. He had started to be fidgety again, so I thought he scratched himself with his right arm (his right arm has the art line and a catheter-like thing where they take blood from him). As we stood and watched him, we saw more blood appear on his stomach when he touched his right arm to his stomach and we figured out the blood was coming from the art line.
T told Marianne about it and she ended up getting the doctor on call to come take a look. Evan has had that art line since he got there, so the doctor ended up taking it out, cleaned up his right arm since it was covered in blood and planned on reinserting it later. They also use that art line to monitor his blood pressure, so they put this little blood pressure cuff on his leg to keep monitoring his levels. While the doctor was taking out the art line, Evan's heart rate went sky high (I think I saw it hit 190 at one point). The doctor wasn't too concerned since she said his oxygen saturation was still in the good range. After she was done fiddling with his arm, he calmed down a lot. They said Evan's vital signs are interesting...he'll have a big jump in his blood pressure, but his heart rate will stay normal, or his heart rate will shoot up and his blood pressure stays low. They aren't sure what is causing it, but it isn't something that is alarming them.
Tomorrow Evan will get another head ultrasound and chest x-ray. The head ultrasound will check again on the IVH areas in his brain...since the last result showed no change to those areas in his brain, they anticipate this one will show the same. The chest x-ray will reveal if his lungs have completely healed from that hemorrhage about 2 weeks ago. He is still getting breast milk feeds every 12 hours. So, things are starting to look up...the next stage will be moving him back to the conventional respirator. Hopefully more good news after tomorrow!
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UMC Charges: $6,738.00
Running Total: $193,567.49
-------------
As for Evan giving us a scare...I had thought he had scratched his stomach since I saw a thin line of blood appear on his tummy. He had started to be fidgety again, so I thought he scratched himself with his right arm (his right arm has the art line and a catheter-like thing where they take blood from him). As we stood and watched him, we saw more blood appear on his stomach when he touched his right arm to his stomach and we figured out the blood was coming from the art line.
T told Marianne about it and she ended up getting the doctor on call to come take a look. Evan has had that art line since he got there, so the doctor ended up taking it out, cleaned up his right arm since it was covered in blood and planned on reinserting it later. They also use that art line to monitor his blood pressure, so they put this little blood pressure cuff on his leg to keep monitoring his levels. While the doctor was taking out the art line, Evan's heart rate went sky high (I think I saw it hit 190 at one point). The doctor wasn't too concerned since she said his oxygen saturation was still in the good range. After she was done fiddling with his arm, he calmed down a lot. They said Evan's vital signs are interesting...he'll have a big jump in his blood pressure, but his heart rate will stay normal, or his heart rate will shoot up and his blood pressure stays low. They aren't sure what is causing it, but it isn't something that is alarming them.
Tomorrow Evan will get another head ultrasound and chest x-ray. The head ultrasound will check again on the IVH areas in his brain...since the last result showed no change to those areas in his brain, they anticipate this one will show the same. The chest x-ray will reveal if his lungs have completely healed from that hemorrhage about 2 weeks ago. He is still getting breast milk feeds every 12 hours. So, things are starting to look up...the next stage will be moving him back to the conventional respirator. Hopefully more good news after tomorrow!
-------------
UMC Charges: $6,738.00
Running Total: $193,567.49
-------------
Wednesday, July 26, 2006
7/26/06: Day 12 (Wed.) PIC Line Adjustment
We're almost settled into our hospital routine (not something I'm overjoyed about though). Today I drove up earlier in the day without T since it seems the past few days we've been so rushed to get on the road after he comes home from work, visit with Evan before shift change at 6:45 and then have to turn right around and head back home. It was nice to have a bit more time to sit with him and talk with one of his primary nurses, Marianne.
A tiny bit of good news is that they are slowly turning down the amplitude on his respirator. I didn't have the chance to talk with any of the doctors to ask them what signs they look for to take him off that oscillating respirator and onto the nasal CPAP or regular respirator. Now, it seems like we just have to be patient and let time mature his lungs.
The burn specialists looked at his right foot this morning and they are applying a special dressing to the burn. I got to see the wound and it looks really bad...the skin is all black in a square shape. They have to change out his dressing every 4 hours. Hopefully, he won't have too bad of a scar.
He had an x-ray today to check on the PIC line (to make sure it's in the right position). Marianne said they pulled it back a bit since it wasn't sitting in a optimal position. She wasn't sure if they were able to see the condition of his lungs on the x-ray...but she is sure they are healing well since she doesn't get much discoloration when she suctions his lungs.
Evan was really fidgity today, the most I've seen him move around. Marianne told me they are cutting back on his Fentanyl which is for pain and he is probably becoming more sensitive to the environment. In his right arm/hand is the catheter that monitors his blood pressure (the ART line). Since he's been moving around more, he kept flat-lining the ART line and setting off an alarm. Marianne just moves his arm and the monitor corrects itself. She laughs since he always wants to have his arm up (he usually keeps both his arms up, likes he's being held up at gunpoint). She'll put his arm down by his side, but he'll immediately put it back up. He likes to have his arm near the respirator tube.
That's it for today!
-------------------
UMC Charges: $7,035.25
Running Total: $138,531.99
-------------------
A tiny bit of good news is that they are slowly turning down the amplitude on his respirator. I didn't have the chance to talk with any of the doctors to ask them what signs they look for to take him off that oscillating respirator and onto the nasal CPAP or regular respirator. Now, it seems like we just have to be patient and let time mature his lungs.
The burn specialists looked at his right foot this morning and they are applying a special dressing to the burn. I got to see the wound and it looks really bad...the skin is all black in a square shape. They have to change out his dressing every 4 hours. Hopefully, he won't have too bad of a scar.
He had an x-ray today to check on the PIC line (to make sure it's in the right position). Marianne said they pulled it back a bit since it wasn't sitting in a optimal position. She wasn't sure if they were able to see the condition of his lungs on the x-ray...but she is sure they are healing well since she doesn't get much discoloration when she suctions his lungs.
Evan was really fidgity today, the most I've seen him move around. Marianne told me they are cutting back on his Fentanyl which is for pain and he is probably becoming more sensitive to the environment. In his right arm/hand is the catheter that monitors his blood pressure (the ART line). Since he's been moving around more, he kept flat-lining the ART line and setting off an alarm. Marianne just moves his arm and the monitor corrects itself. She laughs since he always wants to have his arm up (he usually keeps both his arms up, likes he's being held up at gunpoint). She'll put his arm down by his side, but he'll immediately put it back up. He likes to have his arm near the respirator tube.
That's it for today!
-------------------
UMC Charges: $7,035.25
Running Total: $138,531.99
-------------------
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