Ssssshhhhhhh... do you hear it? That's the sound of peace and quiet from Parker's corner of the NICU. For the last 23 hours, 59 minutes, and 40 seconds, he has been happily snoozing with no drama.
*I wish I could type in whispers. 'Cause that's what I feel I should be doing so he doesn't overhear me and start acting a fool*
I have to reserve 20 seconds of the last 24 hours for his two tachycardic episodes-- one last night and one this morning. For about 10 seconds each time, his heart rate shot up into the 190s to 200s (he normally cruises around 130). By the time the ECMO specialist could adjust her dials or the nurse could push the button to silence the monitor, it was over. Unknown causes.
My initial fear was that it must be some sort of seizure. Nope. They thought it might be from the ECMO cannula "tickling" his heart. Could be, but doesn't look like it from the xrays. The general consensus is that he has run out of other tricks, and has resorted to this to keep everyone awake. Nobody's really concerned about it, as ECMO can have all sorts of wacky side effects. There are zero other indicators-- no change to his blood pressure, oxygen levels, or outward appearance. Still, I'm his mommy and I'd like it to go away.
Apart from those two 10 second intervals, Parker has been remarkably well-behaved today. He continues to pee what seems to be impossible amounts from his tiny little body (granted, they are pumping alot of fluid into him, so alot comes out... but he's managing to pass all the fluid they are giving him PLUS some extra. This is good news as it helps greatly with his swelling.) His stats were AMAZING today... yesterday they tried to bump his ECMO down to .28 and his oxygen started plummeting. Just 24 hours later, he is at a .22 and his oxygen has been 96+ all day. His blood gas draws have been spot on. PRAISES FOR HIS IMPROVING ABILITY TO OXYGENATE HIMSELF AND GET RID OF CARBON DIOXIDE!
*Here's where my whisper typing gets even quieter*
Yesterday, Parker's ECMO was at .31. It is currently set to .22 and he's doing great. Dr. Williams' goal for him is to be at a .20. Just sayin'.
They have ditched the paralytic, but have increased his sedation. Obviously, I would prefer a baby who isn't as drugged up as he is, but that's what it takes to keep him calm. He REFUSES to be still unless he's sedated, and we simply cannot have him thrashing around while he's on ECMO. Believe me, he does thrash-- I've seen it. He can wiggle a good bit now without the paralytic, which is helping with the fluid reduction. There will be plenty of time for him to flail his arms and legs when he doesn't have giant tubes stitched into his neck.
All in all, it was a quiet day of rest and progress. The ECMO team has a saying, "ECMO is 95% boredom, and 5% sheer terror." I'd like to think we have used up our 5% of terror for our ECMO run and will finish up with some smooth sailing.
Just don't tell Parker. :-)