Surprise!!

The neonatologists were rounding at about 11:30 this morning and the nurse practitioner mentioned that she thought Gabriel should be extubated today!! Actually, his nurse today, Marcia, and some of the other nurses heard about the plan for Thursday and were really hoping to be present for the big moment so they talked to the NP about it and she agreed that he was ready. I guess there is some risk for being at low settings for too long since he was essentially breathing on his own and doing it over a tube, which can get challenging. The NP (Kathy Nawa) was worried about possible collapse if intubated at the lower settings for too long. So the decision was made and the time set for noon! My jaw dropped, and then ofcourse the huge grin came out. This is a big test for him and I was very loathe to leave him once it was done, which is why it has taken so long for me to blog it, and post the pictures!! It was very emotional for me b/c I knew how much was riding on this step, and hearing those first "cries" was another long-awaited for moment. OK, so those cries sound more like squeaks right now, but they'll get stronger, I am sure. It was also wonderful to see his whole face, without the tape, for a few seconds. They let me snap a quick picture of his screaming face before they put the cpap mask on and then more tape for his feeding tube. To keep the cpap secure, he wears a special cap with fasteners, and he doesn't like either very much. As long as they keep him on his belly, he is pretty content. When he is on his back, and even when I am rocking him, it is work to keep him settled down. The night nurses have talked to the Neos about vapotherm (oxygen with a humidifier, which is what the day shift was hoping he would be on after extubation) and they prefer to see how he does through the night and maybe try it tomorrow. When I left him, he was on his belly, well fed (he also shows his temper if his feeding is late) and dozing off. What a day and what a big surprise! Dr. Duffy wants to hold off on pulling the last two chest tubes until Gabriel is at "full feeds", as appropriate for his size. He should be at full feeds (85 ml) at 2 AM this morning, so hopefully they will be pulled tomorrow and he will get into a crib AND be able to wear clothes!! I brought up a suitcase full of clothes (with two predecessors, also born in warm weather, we have plenty) so I can't wait to try something on him. I'm guessing the 0-3 months items are NOT going to fit!! He's a big boy. Speaking of clothes, Kaci found him the perfect onesie - I'll let you see for yourself below! OK, I need to get going before it is too dark to walk back. Check out the new photos!