Racing the leak (again)

There does seem to be nothing new under the sun, in the NICU. Woody's growing pretty quick these days; in fact he's just fractionally under six pounds (and may in fact be over now, when I go back in there to hold him). This means, however, that his trachea is growing pretty quick too, and since it grows while the E-T tube does not, he gets a leak around the tube that starts, after a while, compromising the efficiency of his ventilation. The machine itself measures the leak by what amount of the air is escaping out the leak, and it has to compensate for the lost pressure by increasing the amount of air it pumps in, but that eventually becomes impossible as the leak gets too big. So they have to switch the vent mode to a less sensitive setting until they have to re-intubate with a larger tube. Of course, here we are again waiting for clearance for another (his last, I'll remind you) extubation attempt, but we can't do that until his eye test next week at the earliest, and so we're watching the leak percentage and hoping that he won't need a new E-T tube before we can try the extubation, because every new intubation is a traumatic procedure that can damage the trachea, damage the vocal cords, and perhaps introduce infections as well. So we don't want to do that again.

Right now his leak is running between 30-45%, which is marginal to keep him on the best vent setting (PSV-VG, for those following at home; I'm not sure what the PSV stands for but the VG is for 'volume guarantee,' and it allows the flexible increase of volume with every breath described above). It will undoubtedly increase steadily from here, but we'll just have to react to it.

I think he's doing quite well overall. When I stepped out of his room just now his oxygen setting was down to 34%, which is about as good as it's been in the last two months. He's also been cleared recently to sit in a big plush chair for awhile a day. I have not seen this yet, but when I do I assure you I'll post pictures. Thanks for the support again; I know it can be pretty hard to maintain compassion and sympathy for such a long period of time. I will point out, as well, that we now have an Amazon registry for young Woody, posted on the sideboard, should people be inclined to get him something*. Thanks again.

*Why yes, I do feel a little rude and ooky for pointing that out. Thanks for noticing! On the other hand, having a wee little preemie has sure messed with things like, oh, having a shower and stuff, and we're at a loss for how to come up with a bunch of stuff we need when he does come home. So I'll just point it out and leave it like that.