So Ira's surgeon walks in. We think he's come to tell us about inserting a G-tube - a feeding tube that goes directly into the stomach. So it was a surprise to us when he said that Ira has a "recurrent diaphragmatic hernia."

Turns out that 15% of CDH babies that had ECMO support experience a recurrent hernia. You might remember that they built a diaphragm for Ira out of goretex. Ira's goretex diaphragm pulled away from the skin and the stomach, intestines, and possibly more started inching their way up again.

I asked the surgeon if this could explain Ira's inability to make strides with his breathing. The surgeon wasn't sure but did say it could explain Ira's pissy mood.

So Ira will go in for his sixth surgery sometime this week. It will be a difficult surgery that will take about three hours. Ira will be re-intubated which means he'll go back on the ventilator.

All this is a significant step back.