Back to the tube

Woody's gas tests were fully bad this morning, with bad CO₂, bad electrolytes, bad bicarb, the works. As a result the medical team thought it best to re-intubate Woody, and so the first extubation attempt comes to a sad close. I have been trying hard today to keep Maggie on an even keel, but it's even harder for her than me because all this happened while she was in Arizona trying to relax (it's pretty hard to relax when your kid's having trouble).

After getting re-intubated, he got an X-ray that shows that his lungs are generally doing more poorly than we'd like, which is also suggestive of his just generally being unable to keep processing the gases like he needed to. Also, when a baby has consistently high dissolved CO₂ in the blood, it can lead to a sort of narcosis where he would not be able to react well to anything and would have his senses dulled and be unable to process signals from his body to keep other things in check, so it was important that he not be allowed to get to that point.

So, let's review. As I told Maggie, he's not in any immediate danger. Woody's health issues are all of the chronic/long term varieties, and just because he was getting into bad ranges of the various tests that I refer to does not mean that he is now or has ever been in any risk of dying as a result of what we're dealing with. Second, this does not mean that Woody is not going to be able to do another extubation attempt; it doesn't even mean that he won't be able to try again fairly soon. If he recovers well and can build some new lung tissue, we could make another attempt at extubation in a week or two. Finally, while we are both worried by and mindful of the possibility of needing a tracheostomy to deal with his ventilation, we aren't to that point yet. Woody will get another few weeks to evaluate where he is/was and what could make him do better with his breathing, and we will take it from there. Also, he really could be doing a lot worse. Even considering his BPD/CLD, he is still towards the exceptional end of 23 week babies, and his neurological and digestive performance remain outstanding. In the long run, he'll be fine; we just have to find the right path to get there.

So yeah, it sucks, but it's just reality and that's what we have to deal with.