Hangin in

Yesterday was a big day in room 2507. At 11:00 am I decided to add insult to injury and asked when the surgeon could circumcise Payson. He informed me he could do it at that time and that is what we did. I know, I know how evil is that? Yet, if you look it at from the viewpoint that he is on morphine and verset it was a good decision because he wouldn't have those wonderful drugs if I'd waited until he was discharged. Poor thing!

Then around noon they decided to take Payson off the ventilator which proved to be a difficult transition for a few long moments. Once he stabilized he had a few episodes where his sat. levels and heart rate would drop, but would recover without any help from anyone. Despite his ability to maintain his levels he was still working hard to breath which caused me to be concerned, but everyone else thought he'd be fine. When I switched shifts with Todd I left the hospital feeling uneasy.

I was emotionally and physically torn between Margaret Ruth who hadn't seen me in 48 hours and Payson who was struggling with every breath. Yet, I needed to go home and rest so I grabbed Margaret Ruth and we napped for 1.5 hours. After a couple more hours at home something told me I needed to go back to the hospital. So, with a phone call to Sara I was off to return to the hospital,(God has truly given us a gift in friends who are very flexible and able to be at our side in a moments notice...We are very lucky, thankful and value these friends/family). When I arrived he looked about the same as when I saw him last, but I began to question his breathing. He had labored breathing and I feared that b/c of surgery his strength to continue to breath like that would falter. Earlier when they were discussing taking him off the vent his surgeon stated that he wanted it to happen before noon so that if something went wrong he or the neonatologist would be here to advise and direct the intubation. So, with early morning closing in it was my fear that Payson would kaput in the middle of the night and his doctors wouldn't be here. If he were to go back on the vent I wanted it to happen earlier then later. The "Fellow" dr. came in and listened to my concerns. Being a good doctor she decided to x-ray him and do a blood gas on him to see how he was really doing and to put our minds at ease. His blood and x-ray came back better then it had been hours earlier so we all breathed a sigh of relief and decided that a breathing treatment might help loosen up his breaths. From the moment they put the breathing treatment in his face things began to slide downhill quickly. At first it was his heart rate dipping into the low 50's for minutes at a time, then his sat. levels would drop to the 40's, then he'd stabilize just to start the dance all over again. It felt like an eternity that this dance continued, but it was probably a total of 25 minutes. As he stabilized and we all, (nurse, doctor, respiratory therapist and us) sat around talking about him it was decided to give him a dose of verset, (a sedative drug). With this dose it was as if his body could finally relax and he took his last breath on his own. His chest stopped moving. All you could see was the beats of his heart. If he was going to do this he did it at the perfect time with all of us at his side. The respiratory therapist began to bag him and we watched his chest for any signs of effort from him. I can't tell you how many times I just wanted to grab him and breath into him. I begged to see his chest move up and down, but it remained still. After all I have witnessed with my son...a spinal tap, circumcision, blood draws, suctioning, body manipulations and post op these intense moments were the hardest yet. I just wanted to do something to bring his lifeless body back to life. Several times Todd and I would tap him or give a little shake talking to him to try to awaken the fighting spirit in him, but nothing. We would step back to regroup and would come back at it when we saw the opportunity, but he didn't respond. Breath damn it, breath!!!! He was just too worn out and in too much pain to make any effort! It is a picture that will haunt me for the rest of my life, (never mind that Todd has pictures of these moments so just in case I forget he can always pull these beauties out (: ). After 10 minutes of bagging and watching; the calls began to go out to make the decision on do we or don't we intubate him again. The fellow said she'd call the neonatologist and the surgeon on call. I asked her to please call Payson's surgeon and speak directly with him. She obliged and I appreciated her willingness to accommodate my requests in an emergent time. During the 15 minute interval, between phone calls, every now and then Payson would muster all he had to take a deep breath. We watched and waited for a decision and hoped that before they had made one he'd recover his breaths. He managed to give a few more efforts before totally giving up. After several phone calls and some reluctance it was decided to get him back on the vent. The fellow who was trained to intubate someone said she'd do it, but because of the potential to puncture or cause issues with his esophagus it was decided that a anesthesiologist be present. Within a few minutes of intense pressure and a heavy room (and a dad who took pictures of it all) he was back on his vent.
After he was vented I immediately left to return home since I'd promised to have returned 1.5 hours earlier. Even though last night started out rough we all ended up sleeping well. Payson has woken up several times, but for the most part has been resting comfortably. They suspect they will take him off the vent tomorrow when he has had an extra day to rest and recuperate, but then again it all depends on him!

Even though this might seem like a set back it isn't! It isn't uncommon for a baby to have to go back on the vent after being taken off. They fully expect that his recovery time will remain the same barring any other complications. Oh, yeah it was brought up that maybe though very slight chance that Payson might make his homecoming just in time for Thanksgiving. YUP...as in next week! (Although the thought of it being next week is a little nerve racking for us parents).