Day 63: April 18th
Ryker had a semi-better night. There were 30 recorded apnea-bradycardia “events” during the night shift, however some of those were activity induced when the nurses were working on him. They needed to draw blood for labs, and he wasn’t having it. As soon as he was touched, he would have an event. So they gave him a bolus of fentanyl to get him relaxed. They also had started him on an anti-seizure medicine. Even though he wasn’t having seizures, it would possibly help with some of the irritation in his brain that his EEG showed he was experiencing. He was also given a shot of caffeine to see if it would help reduce the amount of the severe events he was having. I read somewhere that sometimes they’ll give preemies caffeine when they go under anesthesia, just to help remind them to breathe. I’m glad they decided to give it a shot as it seemed to help stabilize his bradycardia events.
His nurses were finally able to get him tucked in around 2am, and the plan was to try to let him rest and be untouched for as long as possible. I too laid down to get some shut eye. At 4am, I was woken to his alarms going off that he was having another event. It was his first really big event since the day prior. He had about 4-5 of them back to back… the team was rushed in once again to try to determine the next steps. The neonatal doctors ordered an X-ray to see if anything was happening with his lungs.
They’ve been able to rule out seizures (thank goodness!) and heart problems, and both his urine and cerebral fluid from surgery came back clean. We’re still waiting for blood cultures to come back. He’s pretty swollen looking, so they gave him another dose of diuretic, which helped a lot. His X-ray showed a lot of fluid in his right lung, and he’s had a lot of yellow thick secretions. They believe he’s developed pneumonia and had a sample of it sent to the lab to be tested.. They’ve put him on a really strong antibiotic as well as another medication that helps break up all of the gunk in his chest.
He continued to have several drops in saturation throughout the day, the lowest reaching 38%. Overall though, it appeared they were becoming less frequent and less severe. They’ve also noticed just before he’d have a drop, he would be agitated, turn bright red and bear down on his vent tube. It seems that agitation rather than pain is the issue.. they tried a fentanyl drip earlier in the day and it didn’t do much if anything for him. His nurse Tori listed about 5-6 things that would be causing the agitation, from the new shunt, to a vent tube down his throat (which he’s never liked). They started him on another medication for anxiety in hopes to help calm him down from being so agitated. It seemed to work, and he was able to get a little more rest during the day.
They did start his feeds again, and he seems to be tolerating them which is great news! We’re hoping for a calmer night and continued progress in the right direction. 🤞🏻