26 December 2010

Christmas Weekend Excitement
After a pleasant Christmas Eve and Christmas Day, Jereth struggled last night and is back in the pediatric intensive care unit (PICU).

Friday morning we had a parade of doctors. We had 3 hospitalist doctors, the on-call doctor, the resident, and the intern visit first. Then we had two heart doctors, the specialist and a fellow. Finally we saw the lung doctor. The plan at that time was to continue trying oral feeds and a lower air flow rate, trying to fine-tune how much help Jereth needs and get him ready to go home.

Christmas Eve he rested comfortable under the watchful eyes of the nurses while I went to be with the rest of the family in preparation for Christmas morning.

Christmas morning, after the family celebrated at Grandma and Grandpa Hatch's, Roy, Spencer, and I came back to the hospital with Jereth's gifts. We opened the gifts with Jereth, took pictures, and cuddled. Then we sent Spencer back to Grandma's to pick up the rest of the family.

We spent that evening as a family in Jereth's room, only leaving to go down to the cafeteria to enjoy the Christmas dinner provided for immediate family members of patients staying in the hospital on Christmas day.

After Roy and the rest of the children went back to Grandma's, I made my bed and settled down to update the blog. Jereth had other ideas. His oxygen levels had dropped a couple of times throughout the evening, but came back up within 2-5 minutes. This time his oxygen level dropped, he was struggling to breathe, and he stayed that way for several minutes. There were times when the nurse could hear little to no air movement in his lungs.

After consulting with the charge nurse, the respiratory therapist, the on-call physician, and the pediatric intensive care unit physician the decision was made to move Jereth back to the PICU and put him back on high-flow air with the plan to move him back to pediatrics when he was stable on high-flow. So we moved back to the room we were in before leaving the PICU around 1:00 am, after putting him on the high-flow air, having a chest x-ray, a couple of blood tests,and getting a culture to check if he has caught a virus while in the hospital, he was breathing better and he rested comfortably all night.

This morning it was decided to continue to monitor Jereth in the PICU for at least one more night. This morning the cardiologist talked like he wants to do the heart surgery by the time Jereth is 4 months old, but we need to get the airway issue worked out first. We may end up staying here for another couple of weeks to get him stable and growing, and then he'll have the surgery. The preferred choice will be for him to get stable and go home for a month or so, and then come back for his heart surgery. Jereth will be the one to let us know what he needs.

The ENT (ear, nose, and throat) doctor that performed the supraglottoplasty (clearing the excess cartilage out of Jereth's larynx) came by, too. He mentioned the possibility of a tracheotomy if Jereth continues to have difficulty breathing.

For now, the next step in helping Jereth is to move the feeding tube from the stomach into the beginnings of the intestines so he cannot reflux his feeds. If he can't spit up then he won't be at risk of aspirating his feeds into his lungs, and he won't be irritating the lining of his airway which is a possible cause of his breathing difficulties last night. So he is now on an NJ (nasojejuntal) tube instead of the NG (nasogastral) tube he has been on since before Thanksgiving. Hopefully this will allow his airway to heal and he will start growing.