Ajay had a rocky day, lots of ups and downs and trouble regulating a normal breathing pattern. He had change in CPAP and BiPAP machines all attempting to regulate his breathing. He was thoroughly exhausted and his body couldn't fight the machines anymore, so he finally gave in and let the machine help him take good breaths. It may not sound too stressful to most but to witness a small child struggle for each breathe is daunting.
They also had to place an NJ tube to start feeds again, but instead of using his gtube, they wanted to feed him directly to his intestines, which required placement of a thin tube through his nose passing through his stomach and into intestine. Again, not an easy task. It took 4x to reach the exact spot and required 4 xrays to ensure placement or in this case to try again. Pulling on this tube in and out of his nose is very uncomfortable. He became distraught, causing irregularities in heart rhythms, and oxygen levels. After 4 attempts over a few hours, they decided to leave the tube in where it is and see if naturally moves towards the intestine from all the pressure from the bipap. The nurse did a wonderful job. However, they are going to continue TPN feeds one more day and start feeds in his intestine tomorrow. (Its safer for feeds to be inserted directly into intestine vs stomach because of the amount of pressure and air being forced from the BiPAP, which will induce vomiting. They obviously don't want that to occur.)
Respiratory treatments every 2-3 hrs and chest percussion...followed by suctioning....
Then he had a 2 hr echo and was bothered again , all while on the BiPAP machine. This mask on the BiPAP encompasses his entire nose and mouth with a seal so tight it can cause skin breakdown. (overtime)The amount of airflow in this mask is like driving down the highway at 60 miles per hrs and hanging your head out the window!!!
He ended his day much quieter than it began. He's resting now and I am grateful he is much more comfortable.