Matthew went back on the traditional respirator at about 1:30 this morning. He made it almost 12 hours breathing by himself, but you could tell that it was pretty exhausting for him. When we were visiting him late last night, he had a number of apneic episodes. Most of the time he started breathing again on his own, but several times we had to shake him a bit. It was a scary thing to see, but the doctors weren't concerned. It's extremely common for a preemie this young, and as long as he doesn't stop breathing for more than a minute or so, it doesn't hurt him (it's no different than holding your breath for a minute). Even if shaking him didn't restart his breathing, they could bag him and intubate him in less than a minute.
Jason: June 2003 Archives
Amazingly, Matthew was taken off the respirator today and put on a device called a CPAP. Being on the CPAP means he's breathing on his own now!!! Basically, it provides him air through something similar to a nasal canula, except it provides positive pressure to help him keep his lungs inflated. The respirators he's been on up until now required having a tube down his throat to his lungs. It's so great to see him without that big tube down his throat. Doctors have told us that it's really common to see young babies transition to the CPAP, only to have to go back onto a traditional respirator later. So although things are definitely looking up today, he may not stay this well.
Today has been a relatively good day. They've been slowly weaning Matthew off of the respirator. They've lowered the pressure a bit more, and they've reduced the breathing rate from 40 breathes per minute to 28. They did another ECG and it looked like his PDA was open at one point and closed at another point. They're going to give him a third round of the medicine and see if they can close it for good. They'll do another ECG tomorrow to see how things look.
They're also planning on doing another brain ultrasound tomorrow to see what's happened with his brain bleed. The Neonatologist said that that haven't seen any signs that the bleed has gotten worse, but they won't really know until they do the brain ultrasound. Hopefully we'll know the results tomorrow.
After a recent chest x-ray, doctors said it looks like Matthew's air leak between his lungs and chest wall has disappeared. Because of this, they took him off the jet respirator and put him back on the traditional respirator. This is a good sign that his lungs are improving. He's been back on room air most of the time since he's been off the jet; and since he doesn't fight the traditional respirator as much as he does the jet, they haven't had to give him any sedatives all day. It's good to see him more active.
The also performed another ECG on his heart and discovered that the medicine they have been giving him to close the PDA valve hasn't worked. They're going to try increasing the dosage and give him another round. We should know tomorrow or the next day if it has worked. If it hasn't, surgery will be required to close the valve. This is generally not a big deal, and the doctors have said that babies generally handle this procedure very well.
Matthew looks a little more stable today. Jenn and I both got to change his diaper for the first time recently as well as take his temperature. He usually wakes up when we come by for a visit, and the last couple of times he's opened his eyes and looked at us.
We found out today that Matthew has had a small bleed into the ventricles of his brain. This type of brain bleed is extremely common in babies born this early. With the amount of bleeding so far, doctors have said that it will have virtually no impact on his brain. The doctors will be doing another head ultrasound on friday to see how things are changing. There are two cases they seem to be worried about:
- Bleeding continues into the ventricles causing the ventricles to expand. This can apply pressure to the brain and could cause brain damage if not treated.
- Blood could break through the ventricle walls and into the brain tissue directly.
Doctors also performed a chest ultrasound and determined that his PDA valve (the valve that shunts blood from the lungs to the body in utero) is open. This valve normally closes at birth so that blood can flow to both the lungs and the body. When left open after birth, blood flows in reverse through the shunt, sending too much blood to his lungs. This results in less blood going to his body. They're giving him medication now to help close the valve. We should know in a couple of days whether this medication is working or if the doctors will have to close it surgically.
The doctors stopped by today to let us know that during an overnight chest x-ray, they had discovered a leak between his lungs and his chest wall. They've switched him from a standard respirator to a "jet" respirator. Instead of the normal 15-20 breaths per minute on the regular respirator, the jet breathes for him at 450 breaths per minute (at a very low pressure). They've also had to put him back on oxygen. Hopefully this will resolve the problem.
We saw the doctor this afternoon, and there are some good signs. They gave him a dose of surfactant (a soapy substance in the lungs that helps prevent the alveoli from closing), and he immediately was able to start breathing room air (normally, premature babies are on high levels of oxygen for quite awhile after birth). The doctors were quite surprised that he was able to transition to room air so quickly. His heart is strong and his blood gas levels look really good.
For some reason that the doctors haven't figured out yet, Jenn went into early labor friday (June 20, 2003) morning. The doctors did what they could to stop the labor, but were unsuccessful. Matthew Clay Beaver was born at 8:50 AM, Saturday June 21, 2003. He weighed 1lb, 11oz and was 13 inches long. Jenn was only 24 weeks along (just over 5 months), so he's very early. He's stable for the moment, but things are critical at this stage.
