friday 6/7/2013

Ava had dialation number 3 at 10:30am yesterday morning. It went as smoothly as the first two. In rounds Friday morning (today) the surgeons told the nurses they wanted them to try to take out her repoggle to see if she would swallow her secretions and protect her airway. One way we expect her to protect her airway is to cough up secretions and swallow rather than just let them block her trachea, cutting off her oxygen. Babies who have this Esophageal repair tend to secrete more mucus/spit and she also may be secreting more because of irritation from the repoggle tube, NG tube, and dialation procedures. So, like any reluctant nurse would do, they finally took out the repoggle at 1pm. She had one desaturation spell while Shaun was there, where her oxygen saturation went to 82% and was solved with aggressive suctioning and basically "gagging" her to force her to cough up secretions. She did not desaturate for me while I was visiting, but she was very gurgley when breathing. They had to bump her oxygen up to keep her in the 90's. (The machine will beep anytime her oxygen drops below 92%) Removing the repoggle is just a Trial, and some nurse might decide to put it back in if they are having to suction her more than a couple times in a 12 hour shift. Last night and today I was able to give her tastes of breastmilk on her pacifier during her feedings so that she can associate the two. She has a very strong suck, but she just doesn't swallow as often as she should. This week it was decided that Ava was not gaining enough weight, so her breastmilk given through the NG tube is supplemented with liquid protein. This is in addition to the extra calories that they fortify her milk with.