Finding his voice

It is early in Extubation II (Electric Boogaloo), and yet I've already divined several key differences in this one compared to the last one:

• Woody got his oxygen sats up to good ranges within two minutes, as opposed to last time, when he was sitting at 100% FiO₂ for an hour and a half before he got above 80% consistently.


• Similarly, in our last attempt, Woody's all time best O₂ needs were only just around 50%; within five minutes he had gotten down to the 30s, and has mostly stayed there.


• Woody's way more feisty this time, which is good in the sense that he has lots of energy, but is not so good in the sense that he has been dislodging the apparatus from his face a lot. More on this below.


• Woody's been crying, and even though he has a very hoarse voice from weeks with a tube up against his larynx, he's been just full throat crying when he gets upset.

The upset-Woody thing was expected to a certain degree. As he's older and more aware, he was anticipated to hate the CPAP this time around. I didn't know how much he was going to hate it, though. He gets mad because the prongs irritate his nose, so he thrashes around, which irritates his nose some more, so he screams and thrashes some more, and if you don't hold the tubes he dislodges it from his face, and then you have to put it back in his nose, and that irritates his nose, and you can just repeat the whole process. So far, he's had to get dosed with some drugs to keep him compliant, but I'm hoping he gets used to the whole thing pretty quick, because that's not exactly a tenable long term solution.

The CPAP device, too, is not exactly built to survive this kind of exercise. I'm not sure who designed this setup, but it's basically a couple of glorified bendy straws attached to a soft plastic nose plug, and held on with a very weak piece of velcro. I'm not sure who the inventors thought they were designing this thing for, but it can't have been an actual baby, who observers know tend to do things like, oh, thrashing around and crying and stuff. Although I have to admit a certain perverse pleasure in hearing that cry, since he's been silent for almost every one of his 97 days so far. For the first few minutes Maggie and I were looking at each other like 'oh how cute! he's crying' instead of the preferred evolutionary response, which I understand is supposed to be more like 'stop baby from crying, lest saber-tooth tiger eat us' or something. So we've already had the CPAP fly off his head about five or six times already. Which is annoying.

Well, maddening, actually. We're hoping he gets ok'd to be put back on the nasal cannula soon, because all his stats do seem to be pretty spectacular still.

In short, everything seems, on balance, to be going well so far. I'll try to post more later.