So, today had two major events for Sam.  The first was an echocardiogram and the second was the efforts to get an arterial line in place.

It took a number of attempts to get an arterial line into Sam.  The hope is this line would allow for accurate and constant reads on his blood pressure as well as continuous access to a vein for blood draws without poking Sam.  Unfortunately, they had a hard time getting the line in and each attempt took a little out of Sam's energy reserves.  By the time I got there to see him, he was exhausted and just wanted to be left alone.

The echo took place at around 8 this morning.  From what the doctor tells me, it was obvious even without a radiologist interpretation that Sam's PDA has gotten bigger.  More than that, they are starting to see evidence that his heart is working overtime to pump blood through his body.  With both of those discoveries, the decision was made for us that Sam must have the PDA ligation surgery.  What the doctor has told us, there is no way Sam will progress unless his PDA is closed.  They are hopeful that closing the PDA will  help restore his kidney function- among other things.  The surgery is set for Thursday at 8 am.  It will be done bedside in the NICU at Alta Bates.  The surgical team from Children's Hospital comes to Sam as opposed to the other way around.  The surgery should take about 30 min.  We have been warned that the week after the surgery will be very hard and Sam will get much worse before he gets better.  Thank god I got a Xanax prescription!

And now for you moment of zen:

Just chillaxing with my feet up