A moment that we have been dreading, yet hoping for, has arrived. The ventilator is gone! You can see in today's picture that it's gone, and has been replaced by CPAP. At first glance, the CPAP looks worse than the ventilator, but it really is a step forward for Andrea. Instead of a tube in her trachea, she now has little prongs in her nostrils. The prongs are connected to a tube, that is fastened to her hat to keep everything in place. Her head is so small, the tube dwarfs her face, but she looks more comfortable without the tape on her face. We knew that the doctors were discussing the removal of the ventilator, but didn't know for sure when it would happen. We know it is necessary, but it's also scary to contemplate the loss of the protection the ventilator gave Andrea.
The ventilator was removed at 8:20 this morning. As of our visit at 2:00 this afternoon, Andrea was adjusting well to CPAP. Her nurse told us it was common for babies to need more oxygen while adjusting to CPAP, so we're not concerned that Andrea is on higher oxygen right now. Her head will get a little squished from the sponges that hold the tubing, and her nostrils will be a little larger from the pressure, but those are minor issues, and will eventually resolve once she's not on CPAP any more. The tan strip on Andrea's chin is holding her feeding tube in place. Without the ventilator, she generates more saliva, and the tape keeps getting unstuck. Andrea is trying to push THAT tube out, too, but she needs to keep it for a while longer. She cannot have a bottle or nurse on CPAP.
So far, Andrea has not had any apnea issues, which we pray will continue. Her nurse told us that Andrea is trying to make some sounds, and in a few days may be able to actually cry. Since her throat is sore from the tubing, at least in the beginning, her voice will be hoarse and raspy. Still, those cries are something we can't wait to hear.
At her last weigh-in, Andrea was measured at 740 grams, or slightly more than 1 pound, 10 ounces. However, that was before the ventilator was removed, so she is likely to weigh less for the next few days. Her new breathing equipment is lighter than the old stuff, plus I think they weigh her without the CPAP on at . Since they are still working toward putting weight on her, Andrea now gets 13 ml of milk every three hours. Right now, that seems to be what she can tolerate and digest in the time frame they're looking at.
Ken got a chance to be hands on today. It's not often that he can time his visits for the baby checks, which usually take place about 20 minutes before a feeding. The feedings are every 3 hours, at 3, 6, 9, and 12. Ken was able to take Andrea's temperature and change her diaper. It's harder than you'd think to change Andrea. She's so small, and the wires really get in the way. Still, it's a treat to care for our baby, even under such limited conditions.
We are happy the ventilator was removed... it's an important step in Andrea's development, and necessary for her to come home. Still, we are apprehensive, because she no longer has the ventilator providing constant support for her breathing. Please say an extra prayer for Andrea tonight, and continue to pray for her ongoing recovery.
"You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, 'I have lived through this horror. I can take the next thing that comes along.' You must do the thing you think you cannot do. "