Yesterday they planned to extubate James, but he was acting up all day thanks to his vaccinations. When I arrived in the early afternoon, it seemed as though the plans had been tabled. In the course of a half hour, Dr Irish K decided to try the CPAP mode on the ventilator and see what James was capable of. He seemed to be doing well and I went upstairs to meet with Maisie and the Developmental Therapist, who wanted to evaluate her.
After my time with Maisie I headed back downstairs to James to find him off of the ventilator all together and flying high on the SiPAP in a new space in the NICU! (He was moved to a new space to accommodate a baby who really needed isolation). The SiPAP provides intermittent breaths to help remind babies to breathe, while keeping a continuous pressure of air through the nostrils. James is totally breathing on his own with reminders from the SiPAP.
We braced ourselves overnight and tried not to jinx his progress. He never dropped his sats lower than 75 and was quiet as a mouse overnight. Of course, a bit of Ativan helped with this. By morning his cry was audible, though hoarse, and he was definitely proving himself.
This afternoon when I arrived I broke my cardinal rule of the NICU: no tears. I walked in to discover James in an open crib, doing awesome on SiPAP, and dressed in a cute outfit for the first time ever. I could barely hold it together. I listened to his faint and beautiful cry, thinking back to the last time I had heard it: over nine weeks ago, when he was pulled from my abdomen screaming.
Tonight at 9:00pm James was moved to the Graduate Nursery. Though they're still trying to shuffle babies around to get James and Maisie together, we are super excited for his progress. We will be here for a while- we have to work on growing, lungs, and eventually a reintubation, reanastomosis and hernia surgery. But there is an end in sight. We couldn't be prouder of James and all that he has overcome.