Thank you all so much for your comments and prayers. Jimmie is very sick. He is in serious condition. His vitals are stable, but he is still bleeding.
Yesterday Rachael left Jimmie with my mom at the hospital and came to the studio and taught a dance class for the first time. I needed help and she thought it would be okay. It was refreshing for her. She got back around 3pm right as Jimmie was finishing his blood transfusion. They had justed started his feed when he started crying really hard. Rachael put her hands on him and it didn't help. Then his vitals started dropping and his hands and feet turned blue. His nurse started bagging him and hit the emergency button. So many people started working over him Rachael had to stand back away and just watch. They intubated him and started trying to figure out what was going on. There were 4 or 5 people working over him for hours trying to stabalize him and figure out what was going on. Justin, Rod, Kathy, dad(Jay) and I all got there as soon as we could. At times we were able to be back with the baby.
Rachael and Justin were/are terrifyed. We have been doing a lot of praying. Rachael has not really slept or eaten. She will not leave Jimmie's side. He is much sicker than he has ever been. His ventilator settings are higher than the night he was born and he is not taking any breaths on his own. He is not tolerating touch very well. They have him sedated and on i.v. for nourishment.
There is a lot of information, conjecture and guessing going on right now. The doctors really don't know anything for certain.
This morning one piece of news is a bit comforting. They are starting to think this bleed is not originating in his lungs. As sick as he is- they think he would be much sicker if it were a pulmomnary bleed. This morning his lung x-ray looked a little better with most of the haziness in the upper portion of his lungs. However they are still continuing to see bright red blood (indicating it is new blood) when they suction him.
They are suctioning blood from his mouth and throat as well as his lungs which makes them think this bleed is originating somewhere above his lungs maybe even from his nose. When everything happened yesterday as they were intubating him they could visually see blood pooling in his trachea area.
On Saturday they had moved his feeding tube from his mouth to his nose. They originally tried on one side and couldn't get in. They were not sure why. So they put it in his other nostril. Monday morning his blood gasses came back showing that he wasn't expelling his co2 well. They thought it could be his nose was irritated by the feeding tube and swelling. So they took it out, reinserted it in his mouth and put some steroid drops in his nose to reduce swelling. After that his next blood gas came back much better. They also had x-rayed his lungs yesterday morning and they were perfectly clear.
So their latest theory is this: there are 2 specific bacteria infections that can be present in the babies body at birth that commonly come roaring back when the preemie is about a month old. They are thinking perhaps one of these bacteria was present in his nose and when they messed around in his nose as they pushed the feeding tube down into his stomach- the bacteria was pushed way back into the back of his nose/throat and caused an infection which has caused the bleed and now pneumonia in his lungs. They have sent his blood to be cultured. We should know within a week if it was either of these two bacteria. They have started him on the antibiotic of choice for this scenerio.
He also recieved a blood transfusion yesterday because his hematocrit was all the way down to 23 that morning. It has been very hard for us to seperate what happened from his blood transfusion because he went down hill almost instantly not too long after they finished up his transfusion. The first theory the doctors investigated was that the higher volume of blood in Jimmie caused the PDA in his heart to pop open. This could have cause blood to back up into his lungs. So they called in one of the expert cardiologist who did an echocardiogram on Jimmie's heart. He said Jimmie's heart looked beautiful and that all of his ducts were closed as they should be. We have asked if it could pop open and then shut leaving no sign. They said this is extremely unlikely. That if the duct were weak enough to pop open like that it would not close that easily or quickly.
We've asked if it's possible that a small blood vessel burst because of the blood transfusion. Their answer is that they give numerous transfusions to micro-preemies during their stay in the NICU and that they have never had that happen. Some have said to us in 20 years there has been no report or suspicion of this. They execute the transfusion with the utmost of care measuring everything minutely. They take into account the babies weight, they recieve the blood over 3 or 4 hours. They are carefully monitored (blood pressure)the whole time. They are given a dose of lasix to counteract any extra fluid. There is probably more they do that I have not mentioned.
They are testing Jimmie's blood to make sure there is not clotting/anti-clotting disorder. They are keeping an eye on his potassium, sodium(electrolyte balance). So far all of these things indicate nothing. They are all in normal ranges. They have taken urine samples as well for testing.
The thing that has everyone mystified is that Jimmie was totally fine one second and the next he was basically- for him- screaming in pain. Then all of his vitals dropped. Oxygen sat. and heartrate. If he were developing a bacteria infection and pneumonia that would be an extremely bizzare presentation. Rachael continues to insist something happened suddenly that caused him to be in severe pain. The doctors have not really answered our question about that. They just don't know. I was wondering if perhaps bacteria could cause a blood vessel to burst and that Jimmie felt it burst and that was the pain he felt???
Jimmie is recieving some more blood as I type this so pray that goes well and he is safe. Pray hard for the doctors and nurses to have wisdom in his diagnosis and care. Two of the nurses helping with Jimmie yesterday were in tears as well as the Nurse Practioner. Everybody is doing everything they can for Jimmie!
So all of you- our prayer warriors lets get on our knees and fight hard for Jimmie.
Todays news has been a little encouraging. Pray the bleeding will stop and that all bacteria and infection will leave his body. Pray for him to have the breath of life in his lungs. This is Jimmie's first *real* bad time and unfortuantely it's pretty bad. He is so strong and such a fighter. We have to have faith he will get through this!