Monday was a bit of a rough day...or better yet, it was just an odd day. The morning went fine... I got my hair cut (just a bang trim. Nothing too much) and Ryan and I accomplished some grocery shopping. Then, it was off to see Jackson!
As soon as we walked in the door and looked at the monitors, we knew something was wrong. Jackson's O2 saturation was down to the high fifties / low sixties!! Once we peaked into the isolator we saw that the prongs were completely out of his nose! He couldn't breathe!! We searched around for the nurses...someone that was running in his direction... and we saw that our nurse was in the bed next to us not even seeming to notice that Jackson was struggling. (We had had this nurse for three days... she was very inattentive to Jackson in my opinion. Other people in our Pod noticed this fact too. It wasn't just me.) I looked at Ryan for help. He quickly washed his hands (super fast) and put the prongs back in Jackson's nose. He held them there for a while, and we watched Jackson begin to recover himself. ::sigh:: It was the hardest thing in the world to walk into and see. I spent the next hour trying to calm myself down so I didn't tear that nurse apart. I was especially mad after she said (in response to me telling her about the prongs) "well, we want him to struggle a little bit when the prongs come out so that he knows he has to work harder. We don't want him to struggle all the time, but some of the time is good for him. It'll help wean him off the nasal cannula." I wanted to scream! Why does he need the support if they are just going to let it pop out whenever?? He obviously needs it if his O2 sat is dropping into the fifties without! Grr!
So, I asked the Respiratory therapist to come and better secure his prongs. Before, they had them attached with velcro. Seriously? My baby who loves to pull out his vent tube was now expected to keep his prongs in with velcro. Please. That was just begging for Jackson to pull them out. So, the RT came and taped them to his face. Probably not as comfortable for Jackson, but I'd rather him be able to breathe.
So, later in the afternoon we tried skin-to-skin. Usually Jackson loves to be held, but today, he wasn't up for it. He kept dropping his O2 sat, the prongs kept coming out of his nose, and overall, it was not a pleasant experience. It had me so worried! They had to turn his oxygen up to 44 percent. I was so worried and afraid he'd have to go back on CPAP.
After Jackson got back in the bed and repositioned, he spent the next hour adjusting. It was so hard to watch. After a while, his oxygen requirement dropped to 30 percent and I felt much better.
Overnight, Jackson did have two bradys. That is a drop in heartrate. He did require some stimulation to recover, which is okay, and the nurses said not to be too concerned about it right now. Hopefully, that was just his body's way of reacting to the additional stress of the high flow adjustment and they will go away. They are very scary.
By six o'clock I was a little worried because the doctor had still not seen Jackson. That was very unusual. At around 6:45pm the doctor came in to see him and explained that somehow, Jackson had been discharged from the system and didn't appear on any doctor's lists for the day. So, he was called to come see him. ::sigh:: I told you. A day of crazy mishaps.
Luckily, he made no changes and said Jackson was looking fine. He said that he just needed time to readjust to the High Flow (just like he did when he went on CPAP), but that everything should be fine. He did say no to clothes for now (Jackson needs to spend his energy on growing not on maintaining body temperature) but he did say that he wants me to start non-nutritive sucking once Jackson weans down to High Flow three! That could be in a couple of days! He also said he'd begin feedings at High Flow two. This news really surprised me because I thought we'd have to wait longer for all of that, but hopefully, he's not crazy and the other doctors will agree! :)
So, all in all, it wasn't a wonderful day, but we made it through. Adjustment days are always the worst. I've made a new rule with myself: no holding Jackson unless he is requiring less than 30 percent oxygen. If he is requiring more than 30, he needs to focus on breathing and not dealing with stimulation.
Current Stats:
weight: 3 pounds 8.7 ounces.
Respiratory: High Flow Nasal Cannula 4. Yesterday requiring 35-44 percent Oxygen. Today: requiring 26-30 percent oxygen.
Feeds: Full feeds every three hours (25 cc)
Goals:
1. Stay under 30 percent oxygen.
2. Reduce number of desats. (oxygen saturation drops)
3. No more bradys.
With love,
Anna
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