Well, I ended up staying til about midnight last night. I just needed to see that even when he had episodes of lower saturation, that they could fix it easily. So once I sat through it a few times and he was resting comfortably, I knew I needed to get home to get some sleep. I woke up worried about him and headed to the hospital shortly after I pumped for the morning.
He had a good night, according to the nurse. However, I'm learning that they don't give a lot of details out right away. So, after I'd been here for a while, I learned more about the lay of the land. He had remained on the CPAP overnight, but when the surgeon came through this morning, he didn't like that his BP was a little high. So, they messed around with his drugs a little. When I first came in, they were talking about the possibility of having to put him back on the ventilator because of the BP and because he was breathing a little too hard. This wouldn't necessarily be a setback, it would just mean that he needed a little more time before he was able to take over the hard job of breathing. If he hadn't just had open heart surgery, it wouldn't be a big deal at all, but they don't want any unnecessary strain on his heart.
Before rounds, they switched him over from the CPAP to just high flow oxygen through a nasal tube...like the one you see people use when they have to carry oxygen around with them...the prongs that go into his nose a little and are attached to the clear tubing. They thought the CPAP mask was making him uncomfortable and irritated him. The mask has been removed for about 2 hours now and his BP is lower; so, apparently he has a little temper when things aren't just the way he likes them. :)
The rest of the report given during rounds was status quo. He still has heart block, but his underlying rhythm is still 90+. This is in the long term wait and see. His blood work is fine, and the rest of his bodily functions are doing well. He's has a ton of dirty diapers in the last 12 hours, which is always a good sign. He will actually get his catheter out in a few hours, since his urine output has been good. They will continue to monitor him throughout the day and if all goes well, he may get to lose some other lines. He may not, but that's ok, too. At this point, it doesn't mean one thing or another that he still has them in.
He's been awake much of the morning, but has just drifted back off to sleep. It was good to see him awake and alert. He was able to follow my voice and find me with his eyes when I switched from different sides of his bed. It's so good to see him alert and calm. If his levels remain well with the oxygen, then he will get to eat. I hope this happens soon because I have a feeling he will be happier with a little food in his belly.
I'm going to go back home and rest for a little while. Travis is here, so we will continue to play tag today like we did yesterday. We'll update when we know more.
Sam has had a pretty uneventful afternoon. I returned to the hospital around 3 after going home to take a little nap. The ICU doctors were in a couple of times shortly after I arrived, but didn't change anything. They checked his blood work and were satisfied, so they've left him alone much of the day. He continues to have the oxygen in place through the nasal prongs. They removed the catheter after lunch and that has been an easy transition. They didn't remove any other lines, but like I said, that's not a big deal. They are still holding off on feeding him because of the high flow oxygen. It gets a lot of air into his belly, so if you add food to the mix, then he would most likely throw it up and there is a possibility of aspiration and we just don't want that. His oxygen flow is at a 4 and they want it at a 3 before they try food. He's good for another day without it, so they aren't going to push it. He's getting nutrition through his IV for now.
I've had a quiet afternoon of sitting in his room, talking to him while he was awake and helping him keep his pacifier in. He's been asleep for over an hour now, so I went to get dinner. The nurse figured out a way to swaddle him that would help prop the pacifier in his mouth. He's never really been interested in a pacifier at home, mostly because he hasn't needed one. The low muscle tone around his mouth that keeps him from nursing well, also affects his ability to keep a pacifier in. But I tried just about every type of pacifier that they make and finally found a brand that is shaped in a way that isn't so hard for him to suck on. I brought one from home and it's been a useful tool in helping him calm down. And now that they have a way to keep it in, we don't have to stand by his bed and pop it back in all the time.
I've also been bugging the nurses and eavesdropping on every conversation so that I can learn more about what all these machines are doing and saying about Samuel. Today, I learned more about the pacemaker and how to read it's output. His heart is being kept at a rate of about 140. His heart is doing half of that work. For every two to three beats, his heart is firing on its own once. The rest of the time, the machine has to fire it for him. This is a good sign because it means that his heart does have a working electrical system...it's just not perfect. As they've told us many times, this can continue to improve and they will give it every opportunity to do so. He is still par for the course for the type of surgery that he had.
We've been weaned down to sharing a nurse with the kid next door, so we are definitely off the super critical stage. Yay for baby steps!
Things to pray for tonight:
-Continued improvement of his heart function
-Improvements in his ability to breath deeply and calmly on his own so that he can start feeding
-Patience for Travis and myself as we sit and watch monitors all day long
-And as always, good rest and energy for Travis, myself, and Marmie as we face this long week