Tom had his first solo shift at the hospital today and it was a doozy.
Jane has been diagnosed with bronchopulmonary dysplasia, or BPD (more here: http://kidshealth.org/parent/medical/lungs/bpd.html). We knew it was coming, and here it is. According to the head nurse practitioner (who is the only one who doesn't put the smiley spin on shitty news) Jane is on the severe end of the spectrum. The fact that she's still eating so well is good news: she needs to grow to beat this thing -- there's no cure except growing new lung tissue to compensate for what's been damaged -- and severe BPD kids often have digestive issues. So at least there's that going for her. And she doesn't have other, exacerbating problems, so that's good, too.
There's a kid who is NINE MONTHS OLD who is being released tomorrow (with a trach, on oxygen) who has severe BPD. Nurse P said Jane is NOT as sick as he was. Yay.
The cagey veteran (to use Tom's term) of the respiratory crew was far more blase about all this than Nurse P. Tom bluntly asked if this was life-threatening, and he was all, "Nah, she's fine." (Nurse P, in her reassuring way, answered the same question with "She doesn't have us in a corner yet. Yes, it can be life-threatening, but we still have options." But Tom's dad very wisely pointed out that if anything were really horribly wrong, the doctors would have been looking for us, and not letting us just chat with whatever staff was around.) On the other hand, the cagey vet wasn't far from her bedside all day. Jane had been on 100% oxygen and high pressure on the vent this morning, so he gave her inhaled nitric oxide, and within minutes her oxygen was down in the 60s and they were able to reduce the vent pressure settings again. Her lungs are still hyperexpanded, so as Tom was leaving they were going to give her her THIRD chest x-ray of the day. (No, I am not spending any time worrying about the radiation exposure. I'll get back to you when Jane's in her twenties, okay?)
As of this evening's phone call, there's a little collapse in her right lung. They tried suction out some secretions and changed her position in attempt to help, but instead it pissed her off and put her back on 100% oxygen, but they're going to start adjusting the O2 level back down. Oh, and she's been active and uncomfortable, so they're considering administering morphine orally to calm her without irritating her further with IVs, etc. Jesus.
So we've been freaking out in our bookish way today, parsing every word Tom heard today and looking BPD up in our various preemie books and online. Which is So Much Fun! We have learned, for instance, that there's a survival rate of almost 80%. Almost.
You know how, when you look up medical stuff, there's always this "majority of the time things work out beautifully, unless you're one of those poor bastards with X, Y and Z" caveat in there somewhere? Well, in Jane's case, she's got the X (respiratory distress syndrome) and Y (birth weight under 1000 grams). But Z (digestive issues) is not one of her problems. So we're batting .330. She could totally start for the Red Sox. Especially these days. And she's not all that much smaller than Pedroia.
Ahem. Anyway. Not one of our better days, I'm afraid. It's gonna be a long damn road.