Connor Shane Hall Initial Update

Connor Shane Hall was born 6 lbs 12 oz, 20 inches long, at 8:30 on March 14.

He's a precious, lovely boy. His first hour or so he was very calm (video notwithstanding). We were amazed with how much his eyes were open - probably for 30-45 minutes straight. He's got a head full of what was at least initially wavy-ish hair. Brown eyes. Long & skinny. Long toes & fingers.




However, about an hour into life he began to grunt consistently. This is a sign of distress in a newborn. They took him back to the nursery and his oxygen saturation was 85%. Oxygen saturation is basically how much oxygen the blood is carrying. A newborn should be at least 95%, usually closer to 99 or 100%. 90% or below is very worrisome.

They gave him oxygen and initially it would go back to 97%.
However, his oxygen kept dropping, and he kept needing more supplemental oxygen.
Within an hour or so he was on CPAP, which you may have heard about as treatment for sleep apnea. They also use CPAP when people are having respiratory issues, and it usually works well for newborns in respiratory distress.


Initially he was also treated for an infection, which is a common source of respiratory distress. However, the initial chest x-ray was very hazy, which indicated a lot of fluid on his lungs. That combined with his increasing oxygen requirements/demand suggested to the neonatalogist a diagnosis of Respiratory Distress Syndrome (RDS). This is basically a disease where the lungs aren't fully mature for a number of reasons, one of which is a lack of something called surfactant which helps the lungs get oxygen from the air into the bloodstream.

So, to try to treat this, they usually give surfactant directly into the lungs. To do this they have to intubate him, or place a tube directly into the top part of his lungs. They then basically squirt the artificial surfactant into his lungs.

However, a risk of both the disease, RDS, and of ventilation, is something called a pneumothorax which is basically where the lungs collapse. The neonatalogist was worried this might happen because he also had a pneumatocele, or a bubble-like thing on his lungs that can essentially rupture under too high of a pressure.

Sure enough, when he was intubated he developed a pneumothorax. It was large enough that they had to treat it by sticking a needle into his chest to pull out the free air that is not supposed to be outside of the lung (if you can picture a lung like a balloon fully inflated inside of a 2-Liter bottle...if that balloon deflates, it leaves a pocket of air outside of it, but still inside the bottle...that is the area they have to remove air sometimes with a pneumothorax).

So, he actually was doing ok last night after having the air removed from around his collapsed lung. In fact, Connor even extubated himself, or removed the tube from going down his lungs. Despite this, he was stable back on CPAP last night, so we thought he was improving somewhat when we went to sleep last night.

Unfortunately, this morning the neonatal nurse practitioner (NNP) came in early and said the pneumothorax came back on the right, and actually looked a little worse than before. They tried to remove more air from around the collapsed lung to treat it, but there was no improvement. At that point, the neonatalogist (the NNP works under the direction of the neonatalogist) made the decision to intubate him again and give him another dose of surfactant, as his lungs still looked like they had a lot of fluid on/in them.

We were even more worried at that point, because the neonatalogist ("neo") said he may need a chest tube to treat the pneumothorax, and if this happened, he would probably be transferred to a higher level facility.

The first good news of the day happened after he was re-intubated to give him more surfactant. The neo said that the pneumothorax/collapsed lung actually did not get worse, but in fact was stable if not a little improved.

So, that was this morning. His best point today was when he only required 50% oxygen (again, normal air that we all breath has 21% oxygen).

However, since then he has worsened some. He now requires 70% oxygen, although the last time we checked they thought they might be able to wean that down some.

At this point we're waiting on a 6 or 7pm chest x-ray to check his status.

It's a lot of waiting and praying to see how he does.

He currently has an IV line in his right foot, an arterial line through his belly button for blood draws and monitoring his blood pressure,a tube into his stomach to suck out secretions and to help feed, and the ventilator down his throat into his lungs to help him breathe. He is on IV antibiotics as well as IV fluids that provides glucose/sugar to help give him energy. If he continues to be on the ventilator, he probably will need nutrition through an IV, which comes with its own set of risks/potential complications.





Heidi's mom came up with the idea of having music/lullabies played by his bed. The NICU nurse was ok with this, so we've got lullabies playing for him.

Hopefully this will help keep him calm. One problem is that sick newborns with RDS generally don't do too well with stimulation or stress. Stimulation or stress causes them to need more oxygen, and when they are in a very fragile state like this, it can make things a lot worse very quickly. So, we're hoping the soothing music helps.

I will try to keep this blog updated. Feel free to forward this to anyone you would like.

We have heard from so many friends and family with words of support and prayer, including churches of friends and family saying prayers for Connor and our family, and these are so very appreciated. If you are a praying person, please do continue to pray for Connor and for us.

Shane & Heidi