GOSH...

... or Great Ormond St Hospital for the uninitiated.  Adam was transferred yesterday when a bed suddenly became available.  Before this, he'd had another rollercoaster week.  On Saturday, he was put onto steroids to try and treat the lungs directly.  Despite a big blip in the night, when his heart rate dropped so much he needed CPR, by Sunday, he seemed to be responding well and improving, seeming more stable and needing to inhale lower levels of oxygen to keep his blood saturated.  On Monday, however, he went downhill and seemed really agitated for much of the day, so the doctors chased the referral to GOSH as they thought the steroids weren't working well enough, making fixing the duct more important.  On Tuesday, he seemed better again, but then had another scary moment, this time when I was with him.  As the nurse turned him over to lie on his other side, his blood oxygen dropped steadily and his heart rate fell to under 50 bpm (it's normally well over 100).  Time slowed down as I watched to see if he would recover on his own, but he didn't, the nurses pulled the emergency cord, then suddenly lots of people were running into his nursery, lifting the lid of the incubator and ushering me out of the room, while handing me his little soft monkey.  It seemed much longer than the minute or so it was, standing outside the nursery clutching the monkey, until someone came to tell me that he was OK, they had replaced his ventilation tube and he was recovering well.  It meant that he went back onto higher oxygen and seemed rather distressed for a while, but was basically OK, but it was another reminder of how fragile his state is and how dependent he is on the ventilator for keeping him alive.

This was all a rather stressful experience, so it seemed like a mixed blessing when they told me, just after this, that he was going to GOSH that evening.  While it was clearly important to make him better by whatever means possible, be that steroids, or surgery, or both, he was clearly not very stable, so moving him around London and then cutting him open seemed like a risky business. We waited around nervously for the transport team to arrive, then followed them over to the other side of Bloomsbury to GOSH, where we waited some more while they settled him in. Miraculously, when we got to see him at about half eleven, he seemed remarkably calm.  He was also really calm and settled when we arrived this morning, and stayed like that all day, despite having fairly lengthy scans of his heart and his brain (confirming that he still has a duct that needs fixing, and that his brain looks fine - hurrah).  During these he got cross but, unlike previously when handled and proggled about with, he didn't desaturate (decreasing the oxygen in his blood). He also managed to do some very cute looking around, pulling faces and sucking at his fingers and tube.  This newfound stability could be a random good day, the steroids gradually taking effect, the fact that GOSH are just trying to keep him stable not wean him off high oxygen and ventilator pressures, or that GOSH is just magic.  Maybe he realises, like us, that he's gone from a place where he is one of the sickest patients to one where he is one of the well-est.  His duct operation is really standard for the cardiac surgeons, and currently there are a lot of very sick cardiac patients who aren't stable and who need much more complicated surgery.  In addition to that, there are emergency patients, or intensive care patients who are degenerating, who need surgery very urgently.  Given that, we're lucky that they should be able to fix Adam's duct tomorrow.  It'll be really scary, but kids are flown into GOSH for similar procedures from all over Europe, so the surgeons know their stuff.  Hopefully they'll continue to work their magic and he'll be better for it afterwards.  Go Adam!

P.S.  I should say that during all his lung problems, Adam's been getting on with developing in other ways.  His skin has matured enough that he doesn't have to be in a humidified environment any more, which means he can have soft toys (the monkey and his teddy blankie) in his incubator.  He's grown to an almost-whopping 850g and he's begun pooing of his own accord, partly thanks to being back on the milk (we're very proud).

Adam at 30 + 3 weeks (19 days old), with teddy blankie