Monday, August 21, 2006

Woody gets snuggly

Young Woody remains feisty and cute. Jeff and I walked in this morning and met another nurse that I had never seen before (how does that happen?), and she was struggling with the CPAP mask and trying to calm down the lil' munchkin, who was squirming and crying and red in the face. I had to explain the facts to her as it relates to Woody; if he's upset then 96% of the time it's one of three things: he's in an uncomfortable position and needs to re-snuggle in; he's got dirty pants; or he's having some reflux during a feeding. Oh, and one other real big one. He will let you know when he's tired of getting messed with, and in the effort to get the mask to stay on, he was getting messed with. And there's one thing that works the best to get him to calm down: the kid needs some cuddling. So I grabbed my boy and we hung out in the chair for a while, and next thing we knew he was very calm, snuggly, and relaxed.

Extubation II (Electric Boogaloo) is now on day 4, and we're well past the honeymoon period time when he'd be looking artificially good because of the steroids, so we can start making some conclusions on how he's handling it based on the signals he's giving us. The best signs are subjective, in that he's strong, feisty, and awake a reasonably high amount of the time. The objective signs remain pretty good too. His blood gases are not bad; they aren't showing improvement, but they're not getting worse either. In fact, they are almost identical to Saturday's, which were almost identical to Friday's. His oxygen needs are stable in the low 30s; his heart rate is still usually in the 130s to 150s, which tells me that he's not working too hard (Extubation I had average heart rates in the 160s to 170s). His electrolytes are very good, his prealbumin is awesome, and he's processing his nutrients so well that he may not get the tests again for two weeks, because the doctors are happy with his progress.

He got his weekly eye exam today too, and it showed no change from last time, which is also good because it means no surgery to impede his progress. Finally, he is probably going to go to the high-flow cannula tomorrow, which is great because it's far less equipment to mess with and will require less messing with him, which he'll like. Also, we can start moving towards getting him to feed once the CPAP isn't blowing air into his stomach regularly. All in all, a great start to the week.


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