Bryan Todd’s Story

Site created on July 17, 2018

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Newest Update

Journal entry by Natalie Mitchell Dorsey

Th8s week has been crazy and busy. B3 is officially on the discharge plan. 



MONDAY

Monday we started out with a blood gas to see how his 2L was going. He did great in his normal 62. His doctor said let's try 1L low flow tuesday after attempting bottel feeding. That way he will have enough support if he needs it.

Pt came by and he did so well she pulled out a bumbo seat. This is a floor seat allowing him to sit up with supervision. He can do 15 min at a time to improve headcontrol.
He also had his next hearing exam. The first one last week they put caps over his ears and a sticker on his head. The computer beeps and the head probe picks up brain waves indicating he heard them. He needed to be at 160 in both ears. He did not pass. Monday they did another similar but they used diffrent forhead sticker and stuck little probes in his ear and behind his ear. He had to be sleeping so they came by 3 times to complete the test.  They also manualy test and find his level of hearing. He did not pass. He can hear it just sounds like we are under water or muffled. He has conductive hearing loss and it should be temporary. She explained it is likly fluid behind the ear drum. Like sinus fluid not water in the ears from a bath. It comes from spending so much of his life on his back. The remedy is to it up more and the fluid should drain over time. At the follow up appointment he we be assessed again and we will see if he needs possible drains placed in his ear. Drain are common they do them for kids with frequent ear infections to drain the fluid. Follow up in 1 month. 

B3 did get to take a bottel for the first time! Sarah with speach therapy started by holding him side line. Think how you hold and run a football tucked under your arm. She then tipped the bottle in allowing him to latch. She started him out with a dr brown brand preemie nipple. It has a really low flow.  On of the lowest you can purchase in the store. She tipped in the bottle allowed 2 or 3 sucks and tipped it out. This was to pace him the milk tastes good to him and the last thing you want him to do is drink toofast and choke. He did great after a few minutes she was able to see him suck swallowing the milk and taking breaths. This was the major concern. He sucked well with the pacifier but how would he do with the swallow and breath. once she felt he was doing ok we traded positions and i got to feed him. He did soooooo well. He took 35ml and didnot have any monitors go off indicating distress. 35ml for his first bottle is unheard of. For being 6 months without the ability to feed 35ml is remarkable.

Tuesday

Tuesday because his feed did so well he was bumped dow to low flow canula. It looks diftnt its smaller and looks more like what you see adults on o2 with. The low flow is 100%O2 and provides no /hardley any presure. The 2-15L he was on was high flow and the higher the flow the more presure he had in his lungs. Specificaly for exhaling it helps keep lung capacity. When we exhale we dont force alllll air out we always have a reserve. Holding the alveol open.
  We watched him Tuesday and did 2 bottles. One at noon another at 6pm. He  took 52 and 50 ml. Vice the other speach therapist came by. She was the one we mainly worked with. She had us try not tipping the bottle just holding it so the nipple was 1/2 full. This allowed him to pace himself. He did so well.

We talked to his doctor and they are happy with his progress. We decided to see just how far he can go.

Wednesday she bumped him down to 1/4L. He did really well. She decided that if his gas in Thursday was good she would order home equipment. 
Feeding went well and he took another 55ml at noon and 6pm.
The plasti bell from the circumcise fell off. It is healing well. The g-button is looking great too. The other incision is healing well and the steristrip has not fallen off yet. His surgeon visited and is happy with his progress.

Thursday we had a lil curve ball. He had his blood gas 8t was great. The endocrinologist had labs done and befor he is discharged they want to check his patuitary glad to see how its effecting his thyroid. Before they thought it was small due to prematurity. Now hes older and they can do an MRI and look. The MRI is scheduled for friday. They also wanted a fasting test. He was fed at noon and starting at 3, his first missed feed, they checked his blood sugar every hour till 6pm. He passed with flying colors all in high 80s to mid 90s. 

At 6pm he took his whole feed by mouth. ALL 90 ML! 

Fridays plan is to do MRI and car seat test.
Saturday and sunday  we room un and get to know home equipment. Sunday or Monday am he gets his last routine echocardiogram 
If all goes well Monday afternoon is discharge.


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