Sunday was a BIG DAY!!!

So...as many of you may or may not know.  When Hudson was born, he was taken right away by the Riley NICU team.  When Ben and I saw him again he was in this travel isolette in my delivery room.  And then later that afternoon saw him in his isolette in the NICU.  (I call it his box while some others call it his plastic thing) Well his isolette has to be changed out every 2 weeks, which meant I got to hold Hudson today for the FIRST time!  It was only for a few minutes, I told the nurses they could take their time...geesh!  Unfortunately we both weren't able to hold him, but in two weeks Ben will get to do what I did:)  And I'll take pictures of him holding Hudson!

What does getting to hold Hudson look like? 

First Family Picture - Hudson is 18 days old

10-7-12

However, getting to hold Hudson was not as simple as it looks in this picture...below is just a peak at what went in to getting to hold him:)

1. They wrapped him like a burrito

2.  I got to sit and wait in anticipation while they prepped for the move 

3.  Took two nurses to move him and his tubes and his RT to carry his jet box 

4.  Getting him all settled in my arms 

5.  First picture with me holding Hudson...and his RT Andy is smiling in the background:)  He had to squat behind me holding Hudson's jet box to make sure it stayed at a specific angle. 

6.  Another angle of us and all Hudson's baggage... 

7.  A closer picture of Hudson 

8.  The Murray Family 

9.  And they took him back...and inched their way back to his new isolette 

10.  Getting him all situated back in his new home 

Once they got him back home, they had to replace the tape that is holding his tubes in place...easy right..

1.  Get him situated...right now you see hands from 3 different people and the RT hadn't put his hands in the mix yet

2.  Tape removed...cleaning his face before they put more tape back on 

3.  Closer view 

4.  He has to be "restrained" and my hands are holding his legs and arms 

5.  All finished and snuggled back in bed 

Daddy and Hudson:)

And the Colts won!!!

Our lil Colts Fan!

Ventilator Talk

Due to Hudson's lung issues I thought it would be important to discuss some of the respiratory treatment talk as best as I can.  This discussion will be to the best of my knowledge and how much I understand about the various changes the doctors do to Hudson's ventilator settings.  The five main areas I will discuss are PEEP, PIP, MAP, Rate and Oxygen level. 

PEEP - is the term used to refer to the amount of constant pressure Hudson's lung have from the machine.  It will never go below this amount of air pressure.  Because Hudson is having parts of his lungs  collapse at various times, they amount of air pressure he currently needs is pretty high, at 11.2 with a setting of 12 being on the high end.

PIP - is the amount of deep breaths given during a minute. From my understanding, the deep breaths allow the lungs to get rid of the Carbon Dioxide easier.  An ideal number the respiratory therapists or RT's want is low 20's.  That would mean that the patient is taking the deep breaths on their own and does need the support from the ventilator.  Friday Hudson was at 40 (high) and due to his continual improvement he is down to 35.  Small, gradual changes are great.  We do not want anything quick. 

MAP - this is the mean area pressure (i think) and it is basically exactly as it sounds.  It is the average amount of pressure the vent is providing to expand Hudson's lungs.  If I had to guess, MAP is the combination of PEEP and PIP.  In the picture below, Hudson is at 13.4.

Rate - This is the amount of breaths he gets a minute.  Hudson has had rates of 360 and currently is at 300.  If you do the math, that is either 6 breaths a second or 5 breaths a second.  That also helps keep his lungs expanded to prevent or open up from collapsed lungs. 

 The top numbers are actual and while the yellow numbers are the settings the vent is set at.  I don't know about the rest of the settings. 

 

 

Oxygen - This is the amount of oxygen Hudson needs to be at his best.  Room air is 21% oxygen and that is the amount they will get him too.  The last day or so he has been between 35% - 50%.  This is much better than the 100% he was on only a handful of days ago.  The oxygen amount is on a different machine and is the knob or dial on the bottom right.  It's hard to see, but that's the oxygen dial. It is underneath the blue tag with 122 on it.

 

 

These are the two vent machines known as the JET ventilator.



Zzzzzzz's

Hudson had a great day of sleeping.  He didn't budge much at all.  His blood gas at 8 am and 4 pm were good, so good they will do another one at 4 am.  With each gas today, they decreased his PIP and increased his PEEP.  After the doctors examined Hudson's chest X-Ray, they increased his PEEP a little more.  They did a chest X-Ray on him around 8 pm and it was better than the previous one today, his right upper lung was collapsed but a small improvement is better than no improvement. 

Hudson slept all day!! He must've been worn out from his fussiness yesterday that he was plain exhausted.  I can't blame him.  Overall, an uneventful day. 

A look at today: 

"My favorite time...BELLY TIME!!!" - Hudson

"Check out my new spider man car from my friend Rylan!  I can't wait to play with it when I break out of this plastic box.  And Rylan's sister, Dilynn, baked me some cookies...they were yummy...I did share with my Mommy and Daddy too!" - Hudson

"My arms are restricted, but you can't keep me from moving my feet!  I'm pointing my toes at you!" - Hudson

"Hoo Hoo Hoo HOOSIERS!" - Hudson

Running Man

Today started out pretty typical...I walked into the NICU, his nurse greeted me and told me what a good boy he was being and that his last blood gas test was great and they lowered the PIP vent setting a little.  Said his chest xray looked better than it has and that the ECHO results were back, and the doctor wanted to be paged when I got there to discuss both results.  I finished washing up and then she said, oh yeah and Hudson and I had a photo shoot this morning.  I said what do you mean and when I walked around to the other side of his bed I saw this:

My heart instantly melted:)  I was so touched that his nurse took the time to think about doing this, make the lil prop and work with him on getting a picture with his eyes open!  I was so touched by this.  I thanked her over and over again, she's like no worries.  I knew today would be a hard day with Ben going back to work and I made his little message to be a math equation since Dad is a math teacher.

So finally the doctor comes back and tells me that he is very happy with Hudson's chest xray today.  It looks the best it ever has!  The right upper lung that has continuously been collapsed or partially collapsed was neither of those today!!!  Granted, his lungs are NO WHERE near out of the woods, but this is in the right direction!  The doctor said that with his blood gas being what it was today that they would do another gas at 8pm and depending on those results possibly making another minor vent change.  He said he wants Hudson's lungs to be maintained by the vent, but slow and steady they would continue to lower his settings to get him off the vent.  Doctor doesn't want any big changes made because we'd just take steps back then.  Then he went on to discuss the ECHO results, he said the PDA that they were looking for in the ECHO was not there.  Which was a good thing and that was one more thing we could cross off our list!  

Hudson had a major temper tantrum today for about 90 minutes straight!  He was mad!!!  I was watching him and all of a sudden both legs start stretching, then kicking and then his arms were going and it looked like his right hand was trying pull his hair and his left hand kept grabbing his tubes.  Basically in that time the nurse with my help a few times changed his position (belly, back, side), changed his diaper 2x, both of which were poopy, which surprised me but the nurse said it was still normal for him to be working that out of his lower half of his intestines.  The RT came over and suctioned his tube thinking maybe he had something, but no.  All the while carrying on his his arms, legs, and the most pitiful face ever!  Another RT comes in that has had Hudson and said, what's going on, are you training him for a marathon, he looks like "Running Man".  So for the rest of the afternoon, that RT referred to him as Running Man.  The nurse also suctioned out his feeding tube to see how much was left in his stomach and she had gotten some air, which probably caused him pain and might explain him being so unhappy!  Because he was so unhappy and over breathing the vent, he was causing his Oxygen to drop so they kept having to up his oxygen.  He started out at 50% and ended up at 75%.  Here is a glimpse of how the poor lil guy looked:

"I WANT HELD, I DON'T WANT TO BE IN ISOLATION ANYMORE!!!!!" - Hudson

Our last ditch effort was to give him a preemie pacifier, which still looked way too big for him.  Because he kept trying to get his thumb in his mouth and he just wasn't figuring it out.  Now granted, yesterday he hated the pacifier and wanted nothing to do with it.  Today...different story...he secured that pacifier in his mouth and gummed it like it was food!  

"The doc says 1 ml of food per hour, I'd like to see him survive on that and not be grumpy!" - Hudson

The surgeon did come in this morning and look at Hudson's stoma and looked at his output, he is very pleased.  Said everything looks great:)  

Also, from pictures I'm sure you noticed he's no longer enjoying his tanning.  His numbers went down significantly, but will be tested again over the weekend.  So, he very possibly could have to go back under the light and enjoy his shades.

Hudson and I enjoy looking at each other, he tries talking to me (but the tube down his throat makes it not possible...so I can't even hear his cry), I read him his books, tell him about all the family and friends outside of his box that can't wait to meet him...overall we had a really great day!  Hudson and I missed his Daddy like crazy, but we can't wait to see him after work on Friday!

Here is a more up close picture:)  My favorite picture of him so far!!!

"i love you, thank you for loving me" - Hudson

That's it as far as Hudson update and news...

I'm going to take a moment and just express how thankful and blessed Ben and I are for Hudson.  Yes, he is a preemie and has some issues.  But, all in all he is as stubborn as his parents!!!  We know that we will have good days and bad days with Hudson, but we just have to continue to take it one day at a time.  NICU is a whole different world and until you experience it, you have no clue.  I thought I knew what NICU would be like, and it is nothing of the sorts.  There are 55 beds in the NICU, almost to full capacity and there are babies that are there for a variety of different reasons.  Cases like Hudson, just wanted out in the world too soon, to full term  and anything from intestinal issues, heart issues, brain issues, genetic disorders, kidney issues, a combination of issues, etc. And now the worry of cold and flu season...oh and RSV season is here, so siblings of babies aren't allowed to come visit any more.  I was told if I feel the slightest of a cough, runny nose, etc, I needed to wear a mask or not come to the NICU.  Ben and I both got our flu shots.  I have met some pretty amazing families and cannot imagine what they are going through.  So as you continue to keep Hudson in your thoughts and prayers, please remember Hudson's friends at Riley as well.   

And for anyone that knows me...knows that I love food!  Anyways, very thankful for a special delivery of taco bell today for lunch and then topped my night off with a special delivery from my work family of baked goods that flooded the kitchen of Ron's House, thank you Lauren and Resa for bringing it down:)  There are 52 rooms here, the goodies were very much appreciated and gone in no time!!!  I did snag the container that said Kim and Ben on it because I heard those were made strictly for HUDSON from Dilynn:) And I cannot wait to read Hudson the new book he got written by Rylan and show him the spiderman car!   

Lots of Love

Happy 2 Weeks Old Hudson!!!

Let me start off by saying Hudson was a good boy today!

Day started off with his usual...labs and a chest xray.  The chest xray showed very little change from the one the night before, but somewhat improvement.  Vent settings had gone higher over night due to his blood gas tests.  His need for oxygen was down though!!!  It was 100% end of day yesterday, this morning it was at 65% and when I left this evening it was down to 50%!!!

Hudson seems to be tolerating the breast milk:)  He was given the go ahead to continue his feedings by his team today.

When his team met and did their rounds this morning we had just missed them:(  We always like to hear what they have to say.  But thankfully the resident LOVES Ben...geesh!  He came back over and talked to us about Hudson's care plan for the day.  Since yesterday and last night were so all over the place with his blood gas tests and the settings continuing to go higher and he was maxed out on his oxygen for most of yesterday and last night they decided they wanted to do an ECHO to see if possibly the PDA was open in his heart.  If this valve is open, it might explain why Hudson is having such a hard time with fluid on his lungs.  They were also going to do another chest xray to see how his lungs were doing after the vent changes that they had made.  Results from the chest xray really had no change.  However, his blood gas test throughout the day continued to improve.  No ECHO report yet...hopefully in the morning.

Ben and I both did hands on care today...every 4 hours:)  Some nurses love it and encourage you to do hands on care, others have a set system and just do it without saying one word that they are doing it. But our day nurse let us be as hands on as possible.  Ben took the temperature both times and together we changed his diaper...geesh!  I'll be so glad when we can change his diaper without having to go through an arm hole door on his box!  I was taking the first diaper off and Hudson was still peeing a little so I put the diaper back on and then Ben is Ben and is doing a play by play for what seemed like everyone in the module to hear.  Finally got that diaper off and changed!  Then 4 hours later the next one...this one was going good until Ben kept pulling the tab of the diaper to fasten it and had successfully given Hudson his first wedgie!  The nurse and I were laughing so hard.  Ben didn't see anything wrong with his diaper.

Today was a hard day for Ben and I.  We learned this morning that Ben's great grandma had passed away.  And this evening Ben went back home to Lafayette.  He is back in the classroom starting tomorrow.  I was instructed though to send as many pics throughout the day of Hudson as I want and to send all blood gas numbers to Ben so he can keep track and to report on anything and everything from Hudson's bedside.

I told Ben I was not going to caption the photos as quotes from Hudson and he was a bit offended...he said but it is funnier.  So, I'm going to attempt to be as funny as Ben.  I love it that Hudson already has so much personality and facial expressions...but really who is surprised?!  After all, he shows traits of Ben and I both...wowza!  Enjoy our memories from today:)

"Daddy...SERIOUSLY!  I'm trying to look cool for my nurses, you holding my hand is really making me not look as cool" -Hudson

"Mommy thinks I'm smiling for her, really I'm just planning my escape route" - Hudson

"Mommy, Daddy gave me a wedgie!  Please don't let Daddy give me another wedgie" - Hudson

"Let's shake on it" - Hudson

"I want a pinky promise too!" - Hudson

"Thanks Mommy, we just won't tell Daddy about this...ok?" - Hudson

"I'm comfortable, please quit moving me and waking me up.  Sweet Dreams" - Hudson

Roller - LUNG - Coaster

Today was just an OK day.  We were both excited to hear the news that he would finally get his first feedings of breast milk.  The anticipation of this event made the news great to hear.  However, it was overshadowed by the doctors telling us that they may need to stop feeding depending on how he reacts to it.  In other words, can his body digest it or will it reject it initially?  We are still waiting on this outcome.  We are both hopeful he loved it, but we are biased.

Hudson has continued to be difficult with his lungs.  More specifically, his carbon dioxide output.  They keep making changes and expect to see his numbers go down, however the reverse has happened.  The adjustments they are doing are either having no effect or making it worse.  We talked to Doctor Jonathan tonight and he showed us Hudson's chest X-rays from today - one at 9 am and another at 6:40 pm.  The 9 am X-ray showed over-expanded lungs - so they decreased his PEEP (or constant pressure on the lungs).  The 6:40 pm X-ray showed areas of both lungs that had collapsed, thus making it hard for him to release or get rid of CO2.  The adjustment was to increase his PEEP and decrease his rate to 300 breaths a minute.  He is already at 100% oxygen going into his body, so that could not be increased.  The goal is for the JET vent to re inflate his lungs, thus allowing him to get rid of the CO2 better and then they could ween him down from his need for oxygen.  It was described to us like this, "The lungs are like a balloon.  It takes a lot of initial pressure to blow the balloon up, but once it is full of air, the amount of pressure to keep it open is less than the initial amount to blow it up."  Hudson's lungs are getting the initial burst or increase in pressure as I write this, let's hope they decide to expand. 

I asked a question regarding how much pressure or PEEP can he tolerate and the Doctor informed me he is at the medium to high medium level of PEEP. 

Thus, Hudson's lungs have put us on a Roller - LUNG - Coaster.

 

"I'm love belly time, especially belly time while getting fed!" - Hudson

 

 

"I'm just like my daddy, I do not do well when I'm told to relax and do nothing. I kept moving so the nurse strapped me in and now I can't move. They said it's for my own good. I better ask Daddy!" - Hudson

 

 

"I could get used to this. Mommy loves to tan too. This is the life." - Hudson

 

 

"I love it when Mommy reads to me!" - Hudson

 

 

 

On the 12th day ...

Continued improvement is what we like and we are getting it from our little man.  Hudson's intestines are working so well they took out his suction tube from his stomach and inserted a feeding tube.  The plan is to let gravity take its course with stuff in his belly and let that go through his intestines.  If he is able to work it out of his stoma into his new bag, then he will get small amounts of breast milk tomorrow through his feeding tube!!  This is exciting news!! To us this means his intestines are healed and working properly so now to get the focus on his lungs. 

His blood gases are being spaced apart farther which means his little heals won't endure constant pricking to get blood.  His latest one done at 2 pm read: PH 7.28, CO2 68 (high), acid level +3.  Not excellent numbers but also not terrible.  They are keeping his rate at 300 breaths a minute as to not over-expand his tiny lungs.  His lungs will take awhile to heal, grow and improve to the point that he is able to breathe on his own.  His Oxygen level when we left was down to 45%, compared to mid-60%'s yesterday.  More improvement and tweaking on the JET ventilator. 

He is getting his daily doses of Morphine and Versad (might be misspelled) to sedate him to allow the ventilator to work its magic.  Hudson loves his belly time and was taken off the billy light today, hopeful his number drops from its 4.4 level this morning due to his ability to stool.  Who knew stool could mean so much - introducing feedings and a billy light turned off which means no more goggles!!

Let's hope for another solid night of improved performance and his ability to get his CO2 level down to around 40-50. 

 

"Look at my new bag, I have already put some stuff in it from my intestines." - Hudson

 

 

"Not only do I love my belly time, I also got this orange feeding tube to give me my first feedings tomorrow!! I'm so excited I think I'll nap to pass the time away." - Hudson

 

 

 

 

"I'm glad they put smaller diapers on me, now I can pee through them and make nurses change my bedding.  This way mommy gets to hold to me, which I love!!" - Hudson