The 4am Teeter-Totter

At 4am, I woke up as if someone had kicked me. Nobody had done such a thing.

In the dark, I stared at my phone which was charging on my nightstand. I stared at it and expected it to ring.

It didn't.

So I decided to call the NICU to check up on my boys and found out that Cameron wasn't having a good night. He's okay, which is why they didn't call me. But he's struggling. 

I had noticed he was having more A's and B's than usual the day before and was a little bit concerned. A's and B's are when they stop breathing and their heart rate gets low. A=Apnea. B=Bradycardia. This causes their oxygen levels to fall. But the CPAP mask doesn't work as well as the prongs and can explain is increased number of A's and B's.

In the past, when he starts having more than usual, it means something is going on. Last night, the nurse was having to intervene by patting him on the back, moving him around, etc. Anything to wake him up enough to get him to remember to breathe. She's one of his primary nurses which are nurses we've asked to be assigned to each boy when they work so they get to know them well and know when something is "off" but isn't showing in labs or vitals just yet. It's an extra level of protection for my boys. 

She knows Cameron well and knows this was unusual for him. Being a small premie, the part of the brain that reminds them to breathe isn't completely developed yet. Some A's and B's are expected. 

The nurse said his caffeine dose was changed from twice a day to once a day. The caffeine helps remind them to breathe. It sounds like they'll probably go back to twice a day.

More evidence that something is going on is his HeRO score. The HeRO score is constantly calculated by his monitor and is an early indication of infection. It's based on his vital signs and goes up to 7. The lower the number, the better. Cameron has been floating around at a 3, but as of late is a 7. 

The other problem is he started to get bruising around his nose where his mask sits, a sign that his skin isn't taking the pressure of the mask. They switched him back to the prongs which scares the crap out of me because that's what damaged his nose in the first place. They positioned them carefully and the plan is to rotate him between the mask and prongs if his A's and B's settle down. If not, he may get intubated. The number of A's and B's he's been having concerns them because he's having too many. 

They took a chest x-ray and his lung expansion wasn't the greatest which is something else that may push them towards intubating him. And as a reminder, being on the ventilator damages their fragile lungs. It's always weighing the cost/benefit of each procedure or medication. There's always a downside. 

Wyatt is having a good night though. His PICC line went in nicely. He's tolerating his food. He's been stable.

They seem to teeter-totter. When one is up, the other is down. Wyatt was the one who's been down and Cameron was up. Sounds like they've decided to switch. 

I hope they figure out what's wrong with Cameron quickly. Last night was his last dose of antibiotics for an infection he's been fighting.

You can see the sore starting on his nose from the mask despite all of the foam and protective barriers they've used. Poor guy. 

I want them to be better. Just fat, happy, healthy babies in their cribs with no IVs, no tubes, no tape.