Yep, last Thursday Brody self-extubated and was put on the high flow cannula (7 liters). He has since been weaned down to the low flow (2 liters) and today they took his repogle tube out (tube that vents air out of his stomach). This is a huge step because he can now take a bottle! Brody had his first bottle this morning (4/20) at about 10:45am. The Speech Therapist came over to evaluate him...she checked out his mouth and tongue. Then she put a drop of breast milk on the tip of a pacifier and handed it to me to give to Brody to see if he could suck and let him taste the milk. He went to town. So then we tried a bottle (he still can't actually nurse because he still has the cannula in his nose and it would just be too uncomfortable). He drank 14ml like a champ and then went into a milk coma for about 5 mins. The Speech Therapist called Brody a rock star and said he made her job way too easy today. ...He sure did make me happy. She put in an order to give him two 16ml bottles/day and continue on the trans pyloric tube feeds as well (16ml/hr). Tonight, Adam tried to give him his second bottle but he was slap wore out. He might have drank a couple ml's but a lot dribble down his chin. He was just too tired. They are still fortifying the milk for 26 cal/oz and when cleared by the MD we can try breast feeding. Until then, they want us to practice kangaroo care. I'm excited and nervous and several other emotions that I can't even explain.
Brody's lab work has looked great all week. His PD solution has been changed as to not draw off so much fluid because a lot has been coming out of the pyelostomy site (which is great), the number of passes has been decreased (which I know is more comfortable for Brody), and the fill volume has increased by 10cc's (which is a step closer to going home!).
Today his nurse made the comment that he has really turned a corner and has just drastically improved in the last few days. It's so amazing to watch as he's starting to do things that I remember Ryder doing as a newborn. I think it helps that he's not being pumped full of sedatives too. Yesterday was his due date and all this just goes to show how important every single day in the womb actually is. He has lost a lot of the fluid that he retained last week and looks just beautiful. And now that there is a little less tape on his face I am starting to notice a little resemblance to his big brother. Brody amazes me more and more every day and I am so thankful for each and every prayer sent up for him (and us as well), he is a true testimony to God and I know I've said it before but I CANNOT WAIT to show him off to the world!
Here is what the past week has looked like for us:
Saturday (4/14):
-weight: 3.01kg
-5 liter cannula but bumped up to 7 after getting upset
-lab work good but sodium a little high
-content resting on belly and sucked on pacifier a little bit. Adam and I both held him.
-Morphine and Ativan given as needed
-12 passes of PD
Sunday (4/15):
-weight: 3.08kg
-lab work looks excellent and nephrologist is very impressed. He decreased PD to 10 passes
-Brody is still showing the nurses who's boss and pulled repogle tube out twice.
Monday (4/16):
-weight: 3.06kg
-weaned down to 6 liters cannula
-up to 24 cal/oz EBM
-10 passes of PD
-respiratory rate, oxygen saturation, heart rate, blood pressure, and lab work all look great
Tuesday (4/17):
-weight: 3.04kg (weight loss could just be fluid shift)
-increased EBM fortifier to 26 cal/oz
-O2 decreased to 5 liters
-standard thyroid tests normal
-chest X-ray looks good and lungs sound clear
-PD decreased to 8 passes and fill volume increased to 60cc's
-during night shift, nurse notices Brody had pulled the oxygen cannula out of his nose. His O2 saturation never dipped ;)
Wednesday (4/18):
-weight 3.04kg
-oxygen cannula decreased to 4 liters and by night shift was weaned even more to 3 liters
-PD decreased to 6 passes
Thursday (4/19)...due date:
-weight 2.93kg (6 lbs 7 oz)
-doing really well on 3 liters
-feeds are the same
-Albumin is perfect and all other lab work looks great. Potassium has been taken out of IV fluids.
-PD solution changed from 2.5 to 1.25 (still at 6 passes of 60cc's)
-night nurse said there's a possible occlusion in picc line
Friday (4/20):
-weight: 2.95kg
-PD the same and all labs good
-nurse had no problem with picc line (could have been a problem with postioning)
-weaned down to the 2 liter cannula and breathing beautifully
-repogle removed and began bottle feeding
-wearing a tee shirt for the first time :)
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