Good News For Now

If you take a look at the pictures below, you may notice something looks a bit different. That's right, Andrew had his endotracheal tube taken out today...his mouth has been freed. They took it out at 2pm today, and it was still out as of 10pm. We expect that it might have to go back in, but it's great to finally see his upper lip for the first time in forty days. The vent has been replaced by nasal cannulae, which are small prongs inserted into his nose and connected to an oxygen source. These provides oxygenated air, which helps keep his oxygen saturations high.

As it turns out, the respiratory therapist was worried about the wrong thing. Andrew's "shallow breathing" while he is asleep hasn't turned out to be a problem at all...in fact, his numbers are great whenever he's asleep. Instead, we have the opposite problem...Andrew is getting really fussy every time that he is awake. Literally every time he has fully woken up since 2pm today, he has gotten upset, started to cry, and lowered his oxygen saturation. The nurses have been able to compensate by temporarily turning up his O2 percentage, but at some point he needs to calm down. If he continues like this, he's going to tire himself out, and then he won't be able to work as hard as he needs to stay off the vent. The nurse said that it's relatively common for babies to do fine for the first 24 hours or so, then get tired and require additional ventilation. If, on the other hand, they can last more than two or three days, their odds of staying off the vent are much better. I'm prepared to hear that he's back on the vent every time I call, but I am also quite happy that he's off for now, even with the additional tantrums.

It looks like Andrew might have my upper lip, which is something we've pondered many times since he was born. It's very cute, even when he's crying. Speaking of crying, the ET tube sat right next to the vocal cords, leaving them a bit bruised. So when he cries, he's hoarse...I'd say he sounds a bit like a duck, quacking with every sob. He's also shown off his muscles, since he tends to do push-ups when he gets really upset, and he's been on his tummy for most of the day.

The pictures I got aren't great because of his position, but you should be able to catch a glimpse of his upper lip. Everything is a little red from the tape, and covered in spit in the last picture...I'll get better pictures tomorrow.

UPDATE: As of 4am, he's still off the vent. He's behaving only slightly better when awake, but he's been sleeping most of the night. They turned up his "flow" of oxygen through the cannulae, which should help him relax and not have to work as hard to breathe. We'll see if that makes a difference in his moods.