11/11-15/10

Wow, it's been about five days since the last post. Time flies.

So Omi has had a couple good days, and a couple bad days.
The day after surgery was canceled, he was pretty much on cruise control for the next two days. Just minor tweaks here and there with his fluids. He's essentially been a chemistry set. 
PDA valve open again? Give him another round of indomethacin. 
Blood is a bit acidic? Give him some acetate. 
CO2 is high? Adjust his vent settings. 
Ph level is off? Adjust I.V. fluids. 
Retaining water? Give him some lasix.
During this time his lungs had been pretty cloudy, but getting a bit better.

Saturday he decided again to scare the shit out of us. He does this thing where he bears down on his breathing tube and "de-sats" (de-saturation of oxygen). When this happens, you can usually tell it's going to happen by the way he acts. He gets all cranky and tense for a minute. He de-sats, his oxygen needs go up, then he relaxes, and it goes back down. Usually happens over the course of one or two minutes.
On Saturday, he would de-sat, and instead of his level going down to 50 or 60, he was going down into the 20's. Normal is 80-90. So not only was he going down really low, it was taking him much longer to recover. About five to six minutes. 
At one point, his respiratory therapist had his oxygen pegged at 100% and his nurse was standing by with a manual breathing bag cause it looked like he was going to completely tank. No fun.

He also had blood in his diaper, so they immediately cut off feeding him (again), started antibiotics, x-rays and running tests to see if his bowel was perforated. It ended up being a swollen intestine, which is still going down as we speak.

His x-rays, listening to his heart and echo test confirmed that his PDA valve is open again. Great.
The consensus was to just go ahead and do the surgery so we can stop messing around with it and move on. It's contributing to his lung problems, and we have to keep stopping his feedings to deal with it. 
So, it's getting closed up tomorrow morning. I signed off on the arterial line again, and they are going to start him on pain killers tonight.
Obviously, we're a bit worried about it. There are the standard risks like any surgery, mostly concerns about infection.
The thing that we're most worried about though is the couple days afterward, especially the first 24 hours. 
I guess most babies that have the surgery have vitals that go on a bit of a roller coaster for a couple days. Babies that small just don't deal with surgery too well. They will be watching him like hawks for a few days.
The whole staff at the NICU loves Omi, (the nurses argue over who gets to have him when they assign patients) and we have complete confidence in the care that he's getting.


So cross your fingers, pray to your God of choice, and wish Omi luck tomorrow.