i did it!!

We were very excited to let Emerson sneak another peek at her baby brother this afternoon:
She would have loved to stay longer, but it was only long enough for john and I to do our shift change. After we had gotten her coat on, John said, "K, Emma, let Daddy give Baby Chi a quick kiss before we go." To which she replied, "I wanna give Baby Chi a kiss! I wanna give Baby Chi a kiss!" It was super cute, but we didn't want her to spread any toddler germs on his little fragile body, so she was only able to blow him a kiss from across the room.

A few changes have been made. There seems to be little carryover from NICU to Infant ICU and his new staff seems to just be treating him as a completely new patient (which in some ways is good) and not showing much regard for WHY things were done the way they were in the NICU. Today his formula was changed and they attempted condensing feeds even more (from 2 hours down to 90 minutes). Yesterday, he had a VCUG done to assess his urinary functionality in regards to possible VU reflux. Urinary tract infections can be a sign of this, and Malachi has already had two. Sure enough, he does have some sort of VU reflux and is not being treated prophylactically with antibiotics. I found out on evening rounds that the antibiotic was amoxicillin. There was question in the NICU as to whether or not he has a sensitivity to that med surfacing as a rash. These details didn't get carried over with the transfer. I told them to be on the lookout. Sure enough, before I had left the hospital tonight a rash started breaking out on his tummy. Thankfully, he is not due for another dose on night shift and it should be changed first thing in the morning. Also, he had some almost-apneic spells through the night and this morning they decided to give him a rate of 10 bpm (breaths per minute) on the vent in order to keep him comfortable.

I mentioned earlier they tried condensing feeds even more. Well, it is hard to tell if he truly tolerated it because the nurse started going over trach care with me right at the end of his feeding and he upchucked. Poor little man. I was just going to watch and take mental notes as the nurse washed around the trach a bit and changed the dressing. JUST as she had placed the fresh dressing, formula and secretions starting coming out his mouth and nose. After we got all the puke suctioned up and away and out of his mouth and nose, the new trach dressing was junk. The nurse assessed the situation, looked at me, and said, "Wanna do a trach change?" I immediately did a mini-freak out in my head, regained composure, and said, "Sure!"

She gave me the big long run down and asked, "Do you want to pull the trach or do you want to place the new one?" I asked what she thought I should do. "What scares you the most?" to which I replied, "Uh, it." She kind of chuckled and then said I would place the new one. I did it! Granted, I forgot to take the obturator (trach plug) out and was semi-suffocating him, but the nurse quickly reminded me and I took it out. I think i was just in shock that I did it and forgot the next step. So today I was checked off on training for trach care (dressing change), trach cleaning and putting the ties back on the trach, inline suctioning, and I would have gotten checked off on trach changes, but I missed a very huge, crucial step. A good day. Enjoy a couple more pics!




This is Emma's frog, Lily. She brought her to the hospital today and forgot to take it home when she left with John. I'm excited for her to see this picture in the morning.
Current prayer requests:
Marissa would continue to make progress of seeing Malachi amidst all the tubes.
We would get comfortable with all the nursing work bringing him home will entail.
Enjoying our "mini-vacation" this weekend with Emerson.
Our second (old) car would hold out for as long as possible!