I may start talking in circles here, but things have been pretty hectic and confusing.
Nothing grew from her cultures, the fever subsided and antibiotics discontinued. A follow up CBC/CRP (because I begged) this morning still looks good.
Natalie started to do better Friday afternoon and overnight. In the morning she was down to 56% O2. They made a vent change (moving her to pressure control/pressure) and her O2 went up by 10%. A short bit later, another nurse was babysitting and Natalie had an event. She spit up, pooped and desatted down to 19%. That is AWFUL. The rest of the weekend was just as bad. Steve was with her until 3AM Sunday morning when she finally stabilized. She was "ok" until Sunday afternoon when things fell apart again. This time an X-ray showed her ND tube in her stomach rather than her intestines, so they attributed her event to that.
She is still not bouncing back. The new talk is that she may be microaspirating gastric juices. The surgeon came by last night and suggested we change course. Rather than G tube/nissen, which would be a pretty big hit for her recovery wise, he suggested a G-tube to drain gastric juices and a J-tube for feeding. The J-tube would go directly into her intestines.
Here's the problem....if her respiratory status is due to microaspirating and that can only be addressed surgically she has to be in a better place with her respiratory status before she can go for surgery. it is yet another awful catch-22.
As for the trach, the neonatologist thought a cuffed trach was worth a try. We are hoping that controlling her air leak will help matters greatly. There is an added bonus that it may help protect her airway if she is aspirating. It was a funny-this weekend while I was in panic mode people kept saying "Have you heard we are going to try a cuffed trach? It will be here next week and maybe that will help." Have I heard? Yes. I was the one who researched the trach and asked for it. Seriously. It is amusing that anytime we have a good suggestion the team immediately forgets where it came from.
So, this is where we are. I am desperate for this trach to arrive and hoping it will make some positive improvements. I hate where we are right now. This weekend was the worst kind of fear.