Thursday, our update was not so happy. McKell's lungs were still super hazy, he was still very full of secretions, they are feeling pretty confident that he is developing a nice case of chronic lung disease, and so they just couldn't seem to get the vent settings down without his O2 plummeting. We couldn't even look at him wrong without it dropping. During his diaper change one night, his sats were in the 60s (they should be between 84 and 94) and his supplemental oxygen was at 100%. He was needing between 50% and 60% supplemental oxygen just to keep his head above water at the best of times. The air we breathe is about 21%.
The doc who rounded on him that day (there are about 15 at this hospital) warned me we were probably going to have to use a steroid called dexamethasone to wean him down and reduce the inflammation. I had read a couple of studies that indicated it had some potential long term developmental implications, and I was concerned about using it before we tried other options. I was assured that our other options were limited though, and that if we switched him to a conventional ventilator, he was likely to lose lung volume and have to be put back on the other vent. I pushed just a little bit. I prayed even more...something along the lines of, "I don't like the idea of this drug. Bless the docs that they can find another way. If not, protect his brain." Sometime while all of this was happening, someone "accidentally" changed one of the vent settings. No one knows who or why. I don't understand the details, but for some reason, because of how well his lungs responded to that, Friday morning they decided to give the conventional vent a try before they did anything else. One of respiratory therapists assured me he would fail. And then they all waited for his O2 sats to plummet.
And they waited.
And he breathed. And his lungs stayed the same (which was acceptable; at least they didn't get worse). He was pretty agitated and was a little swingy in his O2 needs, but not worse. They told me that once calmed down and stabilized, in a day or two, I would be able to hold him.
I plotted. I bided my time. I counted my victories for the day against the day shift (I say that a bit tongue in cheek. They were not at all resentful or obnoxious about throwing out many years of medical experience and intuition and listening instead to some psycho who had spent a couple of hours on the internet. Who needs medical school?) I knew who was on night shift. I thought I might be able to convince them that he just needed his mama.
I was not disappointed. The team on night shift thought it was a great idea and laid him on my chest. His oxygen saturation had been in the low 80s with 45-50% supplemental oxygen. His heart rate had been about 180. It took about three minutes, and his O2 saturation skyrocketed (this is good). They turned his FIO2 (supplemental oxygen) down. Then they turned it down again. Then again. In about ten minutes, his FIO2 was at 26% and his saturation was at about 92. His heart rate was about 160. His breathing was stable and steady. We both breathed a collective sigh. It was awesome. I held him for about an hour an a half. When we had to go home, they put him in his isolette (incubator), changed his diaper, retaped his breathing tube, and reswaddled him, and never once did he need more than 30% O2. He stayed stable through the night, slept great, and the next morning, his lungs looked better. We are now on day 3 on this vent, holding him twice a day, and he is much improved (we all are). They were even able to wean his vent settings a bit.
There is definitely something healing about human touch. I feel healed already.