Over the Weekend

 We had an eventful weekend to say the least. Friday night Antonio needed increased oxygen consistently, which they eventually found was due to his left lung collapsing again. It sounds scarier than it really is, they use positioning and sometimes make vent changes to open it up again. So that was the plan Saturday, and it appeared to be working on his follow up chest x-ray. Everyone agreed that he was doing well all things considered, so they were okay with us doing skin to skin time. When he is on the jet ventilator it takes 2 respiratory therapists and a nurse to make sure nothing gets pulled while we get him out, especially his breathing tube. There are only a handful of days that they haven't encouraged us to hold him. A few times we've felt uncomfortable getting him out due to his condition at the time, but we know that he needs it so we get him out anyway. Most of the time it's okay, he needs a lot of attention, but he tolerates it if he is suctioned often. Usually we can keep him out for the entire time between care times, which are every 3 hours. There have only been a few instances that we've had to put him back early. This time Fredy went to pick him up, and his heart rate dropped. It came back up so they told him to go ahead and try again. He got to the chair with him and I watched his heart rate drop again, but it wasn't coming up. I asked if they thought we should put him back to bed, but the respiratory therapist wanted to try to suction him. They couldn't get it hooked up and both his heart rate and oxygen were dropping quickly, so the nurse and I both said that we needed to get him back. The nurse got him back in the bed and unfortunately had to hit the code button. The vent wasn't breathing for him, he had lost all color. Thankfully everyone rushed in and got him back very quickly. Most likely his breathing tube shifted slightly and his lungs just clamped down. The vent couldn't overcome the pressure. This can happen really easily and isn't uncommon. It was still very scary. 

Saturday then became a rest day for him, so no forward progress other than opening his lungs up. Early Sunday morning his blood gas wasn't great. They made the decision to switch him to the conventional ventilator again to see if that would help. He has tolerated it much better since then. He was requiring 70% oxygen or even more at times, now he has needed around 50%. They were able to get him down to 35% this morning, but have had to go back up since. We get so hopeful when he's doing really well like that, so going back up hurts. But, he is SO much more comfortable on this ventilator. No more 300 tiny breaths a minute like he was getting on the jet or loud vibrations coming from the box that had to sit inside his isolette. This vent gives regular breaths like an adult ventilator. I would love if he never had to go back on the jet, though I'm very thankful that he was able to be on it to protect his little lungs. The conventional vent can be harder on his lungs if he were to stay on it for a long time. But, it's really nice to see him actually rest and act like a normal one month old, not always angry when we do his cares. 

They talked about taking out the breathing tube this week if he continues to require less oxygen. We would love that, but it's also scary after watching what he went through last time they tried. So we're praying that his lungs will continue to respond to the steroids enough that he won't need such high settings when he comes off, meaning his belly wouldn't have so much pressure on it. They extended the steroid course to 14 days from 10 to give him a bit longer, which we didn't know was an option. I was very happy to hear that. We talked to the doctor today about what happens if he doesn't come off the vent this round of steroids, she encouraged us that there are more options. So we're staying hopeful, they seem to be for now. 

Positives! He is now 3lb 8oz. He's continued to grow well even after missing 2 feeds due to his event and while on the steroids, which usually hinder growth. He's 15 inches now, he was 13 when he was born. Overall he seems much happier and content, which makes everything easier. I touched on the fact that there have been some frustrating times regarding the care he's received, but I didn't talk much about the love he gets from a lot of the staff on the unit. Lots of them stop in to visit us even when they don't have him that shift, and he has a wall full of crafts that they've made. The one that gets the most attention is his mood chart that they've hung on his door. If he's having a hard day he's Antonio, decent day he's Toni, good day he's Toñito, and great day he's Super Toñito! A lot of the providers love it and stop to ask why he's earned whatever name he's earned that day. Things like that make what can be a very depressing place a little lighter, and we're so thankful. 

Also, our three legged cat Lucky is now at my parents' house and is becoming best friends with their cat, Todd. I know people had been worried about him being lonely at our house! You might see some references to him in the crafts.