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On his seventeenth day, Will had been taken off his muscle relaxants. This is a yet another step in his recovery. He was able to move his arms, hold his rabbit and even opened his eyes slightly (a bit more in the presence of the nurse). He also tried to breath a bit. Despite all his efforts, his general condition (oxygenation, blood pressure, pulmonary hypertension) remained under control. In the afternoon, his other grandmother came over for a visit.
On his eighteenth day in life, Will deteriorated. During the night, the oxygen levels in his blood took a long time to recover from being put on his other side. In the morning, just after his father had left the room, his oxygen levels dropped again. The nurse tried a suction of the pipe into his lungs, but that did not have the desired effect. The staff tried muscle relaxants, medication to help his heart pump a bit quicker, and increased ventilation pressure. This did not bring his oxygen level back to the required level. Sarah was called to the hospital and arrived after x-rays had confirmed that Will's lungs had developped another air leak. A new drain was inserted into the right side of his chest (a cream-coloured line on the picture) and he was switched to a different ventilator (JET). This finally brought his oxygen level back up. A suction in the afternoon caused it to drop again, but it recovered fairly smoothly. We are left waiting for the air leak in his lungs to heal itself.
On his nineteenth day in life, Will's air leak played up again during the night. A doctor put in another drain and moved the first (these lines are visible just above his elbow pit on the picture). This drained the air from his chest effectively. His oxygenation levels did not drop far and it was presumably the same air leak as the day before. On muscle relaxants his oxygenation levels improved throughout the day. The intravenous groin line was suspected of causing an infection. As it proved difficult to put in a new line in another spot, the old line was taken out and replaced by a new line in the same spot - not an ideal solution. This mini-operation set Will back in terms of his oxygen saturation levels. As many of his drugs cannot be mixed in intravenous lines, doctors need five lines to administer all his medication, so they could not simply take out one of his lines. Some of his medication will be antibiotics to treat the infection. His siblings can over for a short visit to the hospital and a longer visit to the nearby zoo.
On his twentieth day in life, Will's air leak played up again during the morning. A new drain was put in, replacing the two earlier drains, which may have clogged up. An intravenous line was changed from his left hand to his head. All this threw his oxygen saturation levels off balance for most of the day, but they were back to fairly normal in the evening. Will remains in a fragile condition.
On his twenty first day in life, Will finally had a fairly stable day again. He was even allowed to go off muscle relaxants for a few hours. He normally does not tolerate suction of his lung pipe very well, but with precautions consisting of a shot of sedation, muscle relaxants, extra oxygen, a backup breath and higher ventilator pressure, he endured the suction without a deterioration in his blood's oxygen saturation levels. In the evening, two intravenous lines were changed from the inside of his right hand to his left foot and from his head (see picture; this line had only been in for a day, but did not seem to work properly) to the outside of his right hand. Mum stayed in the hospital until all was done. Will did not fall back too much during these line changes. He needs many more days like this.
On his twenty second day in life, Will tolerated being turned onto his other side at 4am. At 5am, however, a routine x-ray showed an airleak from his left lung (the very small one). The night shift doctor found the x-ray using Will's hospital number, as the admin department had changed his name from Will, under which he was admitted, to his legal first name Willem - his blood group needs to be redetermined again. The night shift doctor informed Jan of the airleak while he was already on his way to the hospital. A new drain was put into the left side of Will's chest (visible on the picture). His mother arrived in time for the 8.30am doctors round, coincidentally attended by 20 staff, where all were informed of the obvious intention to just keep Will stable for the rest of the day.
As this leak was picked up by a routine (twice daily) x-ray, intervention was so timely that Will's blood oxygen saturation levels (sats) did not drop much. At is was Thursday again, his parents sang him happy birthday in Dutch. In the early afternoon, daily care and the removal of the stitches from the wound near his neck threw Will back for the rest of the day.