The adventures of Joshua Alexander Cobb: Challenge Accepted

Every morning the doctors and nurse practitioners round at the bedside of each patient in the NICU to discuss the plan of care for the babies. For the last 2 weeks, the doctors have rounded on Josh and discussed when would be the right time to remove his breathing tube. Every day they say about the same thing - he isn't quite ready yet, BUT if he were to self extubate we would see if he would be ok on CPAP. Well, Josh has been listening to this for the last 2 weeks and each day he becomes increasingly interested in helping the medical team reach their goal of extubation. At first he would pick at the tape holding his breathing tube in place, then he progressed to holding on to the tube, then pulling on it, then he tried stealth maneuvers, impressing the nurses with is physical abilities, all to no avail. Well today when they rounded and said the same thing - he just needs to grow for a few more days, perhaps next week we will take out the tube - Josh made up his mind. He accepted their challenge and he decided to go after his goal!

This afternoon an unsuspecting Mom and Dad were sitting next to his isolette commenting on how cute of a baby he was and what a big boy he was becoming. Then it happened... Josh was laying on his tummy, he cracked one eye, picked up his head and turned his head completely the other way. Mom and Dad were horrified by this occurrence, he has managed to completely kink off his breathing tube! After looking around frantically for a nurse, Mom gently grabbed Josh's head and turned it back to the proper side. While Dad stayed to watch Josh, Mom went to find someone to make sure Josh was ok. The respiratory therapist came over to assess Josh and said he was ok. Then it happened again... Josh looked right at her and turned his head again, burying his face in the bed, while trying to face the other way. She quickly turned him back and then placed a bean bag around his head to keep him from being able to move his head as much. Two minutes after she walked away from the isolette, he did it again! Mom again gently turned his head back in the right direction.

Now despite the horror of watching him do this several times, we have to admit we were a little proud of him. How many 19 day old babies do you know that can do this? So we decided that when his nurse came back over we would ask for her to reposition him a little early since he appeared to be tired of facing in that direction. In the mean time, Dad stood ready with the camera should Josh attempt to do this amazing feat again. We think Josh realized that the camera was out because he stopped trying to turn his head after that. So we are sorry to say that we do not have any pictures of this amazing feat, perhaps next time.

In other news, Josh's weight is essentially unchanged from yesterday (although he did gain 10 grams). He is continuing to tolerate his feeding with just a minimal amount of reflux. He remains without any IV fluids or IV access. He ventilator remains on minimal setting and room air. We are holding steady right now, just waiting for Josh to gain some more weight.

Mom got to spend two and half hours kangarooing with Josh today, which was relaxing to both of them. Dad got off work a little early and we all got to spend some good quality family time together, complete with a little drama thanks to Josh.

Prayer Request:

Josh would not manage to pull out his breathing tube before it is time to come off of the ventilator (unless he is ready and the rest of us just don't know it).
Josh would not develop any infections while in the NICU, especially while on the ventilator.
Josh would begin to gain weight steadily so that he can begin to meet other milestones.
Mom and Dad would get some good rest this weekend and remember to take better care of themselves.
The new medicine Mom started would help increase her milk supply and not have side effects.

Praise:

Josh is growing stronger everyday and becoming more aware of the world around him.
Josh is tolerating his feeding well and his reflux is stable.
Josh and Mom got some good time Kangarooing today!
Josh looks better overall and is filling in some with the weight gain he has had. His breathing also looks better overall, he isn't using as many muscles to take deep breaths.