Withdrawal & Si-Pap Trials

Last night was another late night at the NICU. Elias has just really had a terrible time with getting comfortable. He is so up and down, one minute he is doing well and comfy then the next he is agitated. It is very frustrating as a parent to not be able to sooth your child, but magnified when when you are limited in resources and ability to touch and calm your child. His nurses strongly feel he is experiencing withdrawal from the fentanyl. They just had to cut him off too quick because of the lack of IV access. In a few days it will improve and we know that, but as Katharine has said before, "there is a place where logic and emotion do not mix." This is another one of those examples. He has been spitting up the last few days, which is a side effect that could be contributed by the withdrawal. It has mostly just been secretions, no milk, until last night where he threw up breast milk for the first time. So far it has been isolated, but we are watching it closely. His OG tube came out overnight (which only used as a stint), so it is possible, however unlikely, that caused it as it worked it's way up. It could be the reflux we have been worried about, again not likely since this was isolated to one time so far and he has had several days of feeds. But, we are again in a position where multiple factors could be the candidate for culprit, but since they are all happening together it is harder to isolate the true problem. We are beginning to notice this happens a lot. It is not any ones fault, nor are we trying to place blame. We are not criticising the care, but there just comes a point where you want a clear answer, not a foggy one.

Now that the venting is out of the way....other things happened overnight as well. They came in and re-inflated the balloon in the G-tube with saline. The balloon seals the opening, since it was deflating there were more secretions coming out. It got to the point where milk was coming out if the sides. Once they re-inflated the balloon it returned to a normal or level of leakage.

Now for some positive news!!

We mentioned yesterday the chance they might try Elias on Si-Pap. They did move forward with this. They are doing trials with him in intervals. Yesterday they did two trials of one hour each. Remember that Si-Pap delivers only pressures to the lung, but does not give breaths for him. Elias has to do the work. He did wonderful and his blood gases came back beautiful after both trials. Even better than when he is on the vent! Such a huge step forward for him! Today they are repeating the trials increasing them to 2 hours each. He is on it now and performing very well. His heart rate looks good, respiratory rate is stable & constant, and his blood oxygen levels are at 100%. This is wonderful news and finally a giant leap forward rather than the baby steps. We are so proud of him and can not wait to get him home.