Our Little Rebel To the Medical World

Joshua continues to improve.  He doesn't look so sick today.  He had bradycardia (heart slowing) episodes every hour throughout the night, but the apnea (breath holding) wasn't so bad.  His cultures continue to show no growth, but true bacteremia (bacteria in the blood)/sepsis should show up on cultures by now since it has been over 48 hours.  I was talking with the neonatologist this morning while she was rounding, and she said "your little Joshua isn't behaving very well for us!"  I cringed and thought oh no, what now?  Then she went on to tell me how he isn't giving them a clear, cut and dry diagnosis, so he is confusing the whole team.  I had to bite my tongue to keep from chuckling a little.  If she only knew how every MFM dr was so confused during the last 6+ weeks of my pregnancy!  I think he just thoroughly enjoys baffling the medical community! 

Today the doctor is thinking maybe it's primarily a mechanical gut issue where things just aren't moving so well.  While he has some symptoms of NEC, she isn't calling it that because he looks so good clinically.  Plus, his abdominal x-ray is normal today, and his abdomen isn't as distended or tender as it was yesterday.  They will continue to treat for sepsis with the antibiotics and continue to treat a GI source with bowel rest.  If things continue to look better tomorrow, they'll plan to restart the trophic feeds, meaning back down to 1cc, and increase it more slowly than they did before. 

He is off the high flow oxygen (which forces air into the lungs through the nasal cannula), and he's back on low flow (which means his oxygenation is improving), so they no longer need to decompress the stomach.  When air is forced into the lungs, it also gets forced into the stomach, so the OG (mouth to stomach) tube sucked the extra air out.  Oh, happy day; they took out the OG tube!  Joshua actually grabbed it and pulled it out this morning, so the nurse had to replace it.  He didn't like it one bit.  Once feeds start again, they'll place an NG (nose to stomach) tube.  The skin on his chin is irritated from the tape, but he looks so much better without the tube in his mouth.  On the pictures, his left hand is pink because that's where the pulse ox monitor is taped on, which gives us his oxygen saturation level as a percentage (you may have had the same thing tested with routine vital signs where you stick your index finger into a little plastic device).  96-100% is perfect, and that's where he has been hanging out at through all of this.

 Mom, how many more pictures are you going to take?!

 Say "Cheese!"



This huge pacifier is preemie sized! 

Today he was really sucking hard, so happy to get that OG tube out of his mouth.

Oh, one more thing.  He is growing at a faster rate than before, and here we thought he'd grow less being sick.  Last night he went up to 1200 g, or 2 lbs 10.5 oz.  Yay!