Sunday, February 17, 2013

CHOC Stay #5 Day 2 (and day 3)

Ryan is still doing great.  They weaned his flow down on the high flow nasal cannula last night and again today.  They also started his feeds back up last night, and he's tolerating them fine.  I was actually sort of hoping he would have one of his morning coughing spells today so that the nurse could see it and explain it to the doctors, but he only coughed a little bit and I didn't grab my phone in time to video tape it.  I suppose it's a good thing he's not coughing as much, but then I wonder if it's because it's reflux related and he is coughing less because he didn't get as much formula yesterday.  Or is he coughing less because he's on the tail end of whatever cold he has, and it was actually the coughing that was causing him to throw up more rather than actual reflux?  He didn't actually throw up at all yesterday, so who knows.  Dr. Ho from GI came by today and talked to me on Dave's phone since I was home with Dani but of course had lots of questions.  I explained the coughing, and he does think that in the mornings he's waking up congested and the coughing is gagging him and causing him to throw up.  He is having us switch our schedule around a little bit so that he gets his breathing treatments (which help clear the gunk in his lungs and often cause him to cough that up) before we start his first morning feed.  But I also told him that there are times when he will just randomly throw up.  Like I will be sitting with him upright laying in his boppy to change his diaper, and he will open his mouth and I will see the formula come up and pool in the back of his throat.  He will either swallow it back down or start sputtering and spitting it out if it gets to be too much.  He said is definitely reflux related, so we are increasing his meds a bit.  They needed to be adjusted because he's been gaining weight since we first started them, so hopefully that will help. 

Dr. Nickerson from pulmonary also came by and looked at another chest x-ray.  There is still a little bit of haziness in his right lung, but there are areas that look better than yesterday.  He mentioned a possible discharge of early this week, but we are still hoping and praying he'll be able to come home tomorrow.  It seems like the nurses and other doctors are ok with that as long as he can wean down off the high flow nasal cannula, which he's really close to doing.  Pulmonary is always ultra conservative, but if he's back on the regular cannula, then we can handle things at home.

***At this point, I called Dave to see if they had weaned his oxygen any further, then I got sidetracked and fell asleep.***

So, here we are on Sunday morning.  Sorry for not updating last night!  I just talked to Dave, and Ryan is back on the regular cannula at .5 liters and satting great!!  Dr. Ho from GI came by again this morning because Ryan had another morning coughing episode with throwing up.  I'm glad they were able to see it happen, and they all seem to agree that it's just morning congestion from sleeping that he's having trouble clearing out, and the throwing up is from gagging on whatever's in there.  So, we are going to stick with the plan he set yesterday and see if it helps.  He said from his end, he's fine with discharging today, so we just have to get the rounding doctors and pulmonology to sign off on that.

Thank you for the love and prayers.  It almost seems silly that we needed to be admitted for this, but it was reassuring to have all his specialists see him over the course of 48 hours rather than just the snapshot of what is going on at home when I bring him in for an appointment.  I also think the high flow nasal cannula helped give his lungs a much needed break from working so hard, which made it easier for him to recover from whatever respiratory thing was going on.  So, fingers crossed that we can bring him home today and keep him going on this road to recovery!

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