TWO MONTHS OLD!!!

Yesterday, our Samuel celebrated two months of life. And there was lots to celebrate. The last few days have shown some heartening progress.

In terms of sedation, having Dr. Ferrin from Acute Pain Services involved has been amazing. Samuel is off of morphine and ketamine and almost off of medazalam. He is doing well on oral methadone (yep, the drug used to treat heroin addicts) and clonidine. He is waking up more often, looking around and taking in those of us here loving him and tending to him. Since he has no need for IV nutrition and has only two medication infusions left, Samuel's major central line was removed so he has just the PICC line in his arm. Woo hoo!

In terms of ventilation, Samuel is doing beautifully. With the right sedation on board, he is now having very few desats and bradycardias. His sats get droopy when he needs a suction, where they help pull secretions from his lungs since the ET tube prevents him from coughing on his own. He cries if he is annoyed about a blood test poke or diaper change or if he has gas pains - things that a normal baby would get annoyed about. However, Samuel recovers on his own most of the time now without additional medication or oxygen support. This indicates that his cardio-pulmonary bed is getting less reactive or, to us lay-folk, that his heart and lung muscles are getting stronger.

The weaning of ventilation over the past days has brought Samuel close to the settings he would need for extubation. He has not flinched in response to these changes so his team is quite optimistic. If everything stays the course as it is - and this is always a big "IF" with Samuel - then he will likely be extubated within the week. They will try moving him from the endo-tracheal breathing tube to a system called bipap - a mask that can provide oxygen and pressure as needed. We will see how he does from there.

In terms of feeding, Samuel was weighed this week and delighted everyone (especially Roxanne the dietician!) by having gained a whole kilogram since birth. He is now just shy of nine pounds. His feeds have been increased to account for his new weight. He has thrown up a few times but this may be a bit of sedation withdrawal or some of the reflux so common in these babies with mixed up innards. It may also be an infection so the cultures have all been sent off again just in case. I told Samuel in my very most authoritarian mama voice that he is NOT to get an infection now. No stinkin' way, Mister!!!

Once again we ride the waves of feeling so excited and also cautious. Our excitement has brought us to a plummet several times now. Every day is another reminder to be in each beautiful moment. I cuddled Samuel two days in a row this week, sometimes with him peacefully sleeping and sometimes with him awake and gazing up into my face. I get to rub his soft belly and exercise his wee chicken legs and stroke his little head. He is delicious.

AND... Chris finally got to hold Samuel on Thursday evening. I called him at the hospital to see how his visit was going and I noted rather quickly that he had that "drunk on baby" quality to his voice. Chris told me, "I'm holding him! I'm holding our son!" The nurses and RTs who engineered this hold were almost crying watching this pure daddy happiness. Soooo lovely.

Thank you all for prayers and love sent Samuel's way as we negotiate these next few days. I will update as I am able.

Samuel sleeping in my arms (with cap at a jaunty angle).

Well hello, mama! I trust you have a darned good explanation for all of this!