We've spent the entire day at Children's. Ryan has developed some issues with constipation over the weekend which has subsequently caused a flare up of his chronic lung issues. I'll play catch-up on the days I've missed on our blog but for the time being I'm going to use our blog as it was originally intended to help keep our friends and family updated on Ryan's hospital stays.
Ryan had his first surgical appointment this morning. He has an ingunial hernia that requires surgery. We weren't sure if that had any impact on his tummy/gut issues. Our appointment the surgeon was fairly uneventful thankfully. As of right now he will have his surgery on the 17th. Since he is still considered a micro preemie he will have to spend the night after surgery as a precaution.
Ryan has been doing well on his oxygen at home until Monday night. His tummy/ gut issues has cause him to beast down and strain to a point were he was beginning to drop his oxygen saturation. We really didn't have a good set of titration perimeters on his oxygen because we havent seen out neonatologist yet.
I have to praise out md's office. I called spoke with his nurse and had a appointment within an hour and a half. Ryan's appointment well. We were given a ton of very good information! We received titration instructions. Ryan was placed on a new formula and received instructions on using pear juice to aide in his GI Motility. The doctor ran some routine labs and then sent us for an EKG. He gates neonates oxygen needs based on their right ventricle function.
While waiting on his EKG our dr's office called over and asked that once they were finished at the heart station that we come back to the office to review Ryan's labs. I knew it had to be a problem and most likely it was his carbon dioxide level.... And it was. He has chronic lung issues and retains carbon dioxide (CO2). His level is normally in the 50's. Today his CO2 was 78. Obviously a number our Dr couldn't ignore. His pH is greatly effected by his CO2 (which is the acid component) and his bicarbonate (which is the base component). Thankfully his little body is compensating for his high CO2 but if it isn't corrected it can cause him to stop breathing.
Once again I cannot praise our doctor and his staff enough. They talked us through the entire admit process and he sat down and told us his plan. He also eased my fear of going to a 'dirty' unit. Since the doctor felt that Ryan was non infectious he placed us in a multipurpose room in the NICU. We are able to room in and continue doing Ryan's care.
So far the plan for tonight is to place Ryan on a higher flow of oxygen. He is on 1 liter of flow and they will decrease his percentage of oxygen as they can. His chest xray was pretty gunky so the doctor is starting him on a steroid inhaler. The doctor think is not sure but the chest xray may be due to some silent aspiration when he is feeding. OT will evaluate him in the morning for further swallowing recommendations. He is going to have chest physiotherapy to loosen any secretions he may have formed in his lungs. He is getting scheduled enamas and will continue to take his new formula.
Soo . . . For now we are going to settle in and pray that our little man will soon be on then mends!
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