March 6, 2013:

RJ is having to get used to the high flow nasal cannula again (NIPPV). He did great with our kangaroo time last night and slept well. Today he's been real dingy with is O2 sats and they had to go up on his FiO2 (oxygen). He was real restless all morning and afternoon. He would turn his head back and forth and get fussy with his cares. At rounds this morning they said his xray showed right upper lobe atelectasis, but was well expanded. They didn't want to make any changes to the NIPPV settings. He was wheezy and had gotten a lil bit of albuterol this morning. It tends to make is heart rate high, so they wanted to use it sparingly. Due to his situation, they didn't want me to hold him which could cause more stress to his oxygen demand being moved in and out of the isolette. Of course that broke my heart and caused me to be said. It's the worst feeling like I've mentioned before not being able to hold my baby... I was hoping after lunch his lungs would sound better and the possibility existed for me to hold him. His lungs sounded a lil worse, and he was still very figity and restless. The nurse practitioner ended up talking w/ the nurse and I and ordered an xray. It showed less expansion, so she increased the peep setting on the NIPPV. He seemed to be happier with that. She also in talking w/ the Attending ordered for a Xopenex treatment every 12 hrs. It doesn't cause the elevated heart rate like Albuterol. He got one treatment  before I left this afternoon. It's a type of respiratory inhaled treatment which ended up opening up his lungs and they sounded better per the Respiratory Therapists assessment. He was seeming to rest easier as well overall. I left him at 3pm looking peaceful. It's his scheduled bath time tonight, but due to his day events we are going to hold off. It might stress him out too much. It really stinks to be hindered in the amount of interaction I can have with my baby...

I've tried to be productive this afternoon, but the minutes seem to be slipping away. I have my ACLS renewal next week that I need to be studying for, but it's hard when I have so many other things I'm thinking about and pumping every 2-3 hrs. Which reminds me that's where I need to head now. Please pray RJ has a peaceful night of sleep and that he will feel stronger tomorrow. We want to do everything possible to keep him extubated!!