Thursday, May 28, 2009

Thursday Update and CPAP vs Nasal Cannula

Hello all. We are having a pretty good day here so far. Gaines did well last night. His oxygen was at 35% most of the night but he did get down to 33% for a little while. Today he's still doing pretty well. He was very irritable this morning so he required a little more oxygen but not more than about 40%.

I'm not sure what got into him this morning but he was pretty fussy. His nurse (and I) thought it might be his stomach hurting or something so she repositioned him with some new pillow and he's settled down for now. He's hanging out around 36% right now. To me that seems like progress. Hopefully he'll hold on there for a little while and then start to bring it back down some. They have upped his feedings to 38 ccs every three hours and he now weighs 4 lbs 4 oz. A growing boy. Yesterday when I held him he was so alert and seemed much more like a "real baby"...and by than I mean a term newborn that follows all the rules.

Several people have asked about or mentioned the possibility of Gaines going home on oxygen. I discussed this with the doctor a day or two ago. He actually brought it up since he knows we are so far from home. Basically this is the deal: Gaines is on CPAP because the doctors here feel that this is a far better method for getting him the help he needs breathing than the ventilator or nasal cannula (a little nose piece for those that are not familiar). The CPAP actually helps his lung tissue develop and helps create new alveoli (I think) while the nasal cannula does not do this. The CPAP keeps his lung sacs (alveoli) open while the nasal cannula does not. From what I understand, the cannula just supplies oxygen at various pressures (liter, half liter etc.) The down side to this is that the baby is getting more oxygen than what he needs. I won't be able to repeat the chemistry lesson I got on this but basically, too much oxygen creates free radicals in the body and they can be very damaging. I've known all along that too much oxygen is not a good thing, I just never knew why. This hospital rarely sends a baby home on oxygen for that reason. They generally use the CPAP to supply oxygen and eventually wean them from it. Once they get down to 21% oxygen (or room air) they do not immediately take them off of the CPAP. They have to be weaned from that as well. I probably just butchered all of that.

The bottom line is that if Gaines continues to need oxygen, it is better for him to be on the CPAP than nasal cannula. While he could go home (at some point) on a nasal cannula, his lungs are much better off on CPAP (which he cannot go home on). Obviously, if Gaines looks like he'll need long term help breathing that is an option we would have to consider but for now, the doctors feel like the CPAP is the best thing for him...and we agree. I realize that this is probably different from other hospitals and other preemie parents experiences but Beau and I both feel that this hospital is top notch and we fully trust our doctors here. We also realize that each baby is different and what is best for Gaines may be different from what was best for other preemies.

Everything else is going well here. If the weather holds out we'll probably take Reed to a park this afternoon and I'm considering going on a run. Stay tuned to see if that actually happens.

Please continue to keep Gaines in your prayers.

Oh...and yes I think that Gaines looks a lot like Reed when he was little. I've thought that since I first saw him. I'll try and get some comparison pictures on here soon.

Love to all,



Thomas and Jamie said...

YEA for progress!! You did a great job explaining the CPAP thing - and really all that matters is that YOU understand and y'all are comfortable with it!! WAY TO GO Gaines and thank you Lord!

Diana said...

Glad to hear Gaines is making some more progress! We are continuing to pray for your family and will continue as long as you need. Glad to hear that you are a such a top notch medical facility.

Becky said...

When you talk about his oxygen creeping up or that something that the machine monitors and adjusts to his needs? Or do the nurses have to keep an eye on it and adjust?

Love and Prayers,

Lori said...

Thanks for the update. You sure gave us a lot of great info.
My prayers are continuing for little I mean big Gaines.