Two Steps Back

Rough day at the NICU for Lewis. Joanne (Josh’s sister) and Jenn arrived and heard that Lewis’ secretions had been sent off to be cultured…it looked like perhaps the antibiotics for pneumonia hadn’t done the job…or perhaps he had aspirated into his lungs again. Just after we arrived, Lewis vomited quite a bit. On one hand, this is good, because it shows he has the reflexes to do this. On the other hand, the vomit was a greenish color and ended up on Jenn. From this green color, we were pretty well able to determine that Lewis might need more antibiotics.



Respiratory - Lewis was struggling to breathe and sounded very congested. He was able to cough on his own (good!) but needed more frequent suctioning to get rid of the large amount of secretions he produced. He needed more help breathing and ended up with a nasal cannula (breathing tube) inserted again with 40% oxygen. (There’s 21% oxygen in the normal room air.) After having the extra boost of oxygen from the nasal cannula, he appeared to rest more easily.

They did an x-ray and determined that Lewis has pneumonia again. The doctor sent an order out to get antibiotics for Lewis, and suspected the infection had spread to Lewis’ blood, so they put in an order for a blood culture. Then they had to have an IV re-inserted so that they could administer the antibiotics. Lewis didn’t like having the IV inserted, so the first time, he kicked it out.

Speech - Lewis was exhausted and slept through his speech therapy. All in all, he was pretty “floppy” today and not himself; likely because he doesn’t feel well.

Physical Therapy - it’s also possible that Lewis just had a rough workout. The physical therapist said Lewis was awake and did a great job today with his therapy, which happened early this morning. His trunk development is still a bit less than optimal but his arms and legs are doing well, as evidenced by his ability to pull out his IV by himself.

Feeding - with the additional calories Lewis is being fed, his weight has stabilized. Jenn was able to talk briefly to the surgeon about the potential Nissen surgery, but until Lewis feels better and has a week of antibiotics in his system, the surgery’s on hold.

Last Straw - we heard from the surgeon that Kaiser, the insurance company, didn’t have a contract with Georgetown Hospital and that Lewis would have to be moved to Children’s Hospital (much farther away) to have this surgery. As you might imagine, this is NOT the best scenario for Lewis as he has great care at Georgetown and this is already his second hospital experience. (He was born at Arlington Hospital.) We are pursuing this right away with the insurance company because a baby with pneumonia shouldn’t be going anywhere.



Late day update - by 4:30, Lewis’ nasal cannula was down to room air (no added oxygen) at 2 liters and he was sleeping comfortably, at 8:30 he was awake and still doing fine.