Sedated & Paralyzed

Roscoe's first day with a trach tube was an eventful one. The first night he started waking up from surgery, so they'd adjust the amount of IV pain killers he was receiving. As he kept waking up, they would give him more pain medication to prevent the pain, but that still didn't prevent him from moving around. When he moved, it would agitate the hole in his neck around the trach tube and cause leaking, so they gave him a paralyzation drug to keep him from moving around at all.

The doctors said that it isn't common to need to paralyze newborns for trach tubes (since they don't move much anyways) but that it is more common to need to paralyze older kids for the few days (or up to a week) after their trach tube surgery. Here is the result, which is a little hard to watch:

Alisha and I stayed away from the hospital because Alisha is dealing with allergies and there wouldn't be much benefit of us being there, since he's paralyzed and sedated. I came in to drop off milk for his feedings (which have started through his new gastronomy tube) and happened to walk in while they were preparing to swap out his trach tube.

The first trach tube the surgeon put in was apparently too small, so air was leaking out around the hole. Since the air was leaking out, it wasn't delivering enough oxygen to his lungs so he would occasionally need to have his breathing support drastically increased. When this happened it caused bronchospasms (similar to an asthma attack) where the nurse needed to manually push air into his lungs using a bag valve mask, which they call "bagging". Last night they swapped out the tube in roughly 4 minutes for a larger one and there was immediately less leaking (meaning his breathing support was more effective).

The only remaining problem is that since he's paralyzed, his mouth and nose hang limp. This allows air to escape out of his mouth and nose, rather than being pushed into his lungs. Throughout the duration of the night he had only one episode where the nurse needed to "bag" him (although it was a severe one). This was better compared to the previous day when had several such episodes. To remedy this remaining air leak, the doctors plan to get another trach tube which has an inflatable cuff that can be used to block air from coming back up out his nose and mouth (just while he's paralyzed and unable to close them). They are having trouble locating one in his size, but once they get it I think they plan to put it in immediately.

Please pray that Roscoe is able to stabilize and avoid any future episodes where his lungs tense up and require manual intervention. It is stressful for us and stressful for the nurses and doctors attending to him. Yesterday one doctor was at his bedside for 2 hours straight. He is in a fragile state right now and just needs God's gracious hand to help him recover.