Breathing and Pooping
Shirley is having a pretty good day. Her HFNC was set to 7LPM this morning and then 6LPM this afternoon. Her RR has continued to hover in the 50-60s. The faster they wean her the sooner she can get to the step down unit. She has to be <4LPM for 24 hours and maintain a RR that doesn't strain her too much. Shirley is starting to make us feel more like parents these days. It used to be a real adventure to change her diaper. After surgery we had to take extra precautions to change her diaper and we still do but we have come a long way. She used to be on a medication that made her bones very soft. They even have a sign that warns people about "fragile bones." Before her PICC line came out you had to ensure that her foot was nowhere near her bottom when changing a poopy diaper. If her foot came in contact with her fecal matter you ran the risk of getting a blood infection. Those things are behind us now but a lot of the wires remain. I've changed a few diapers so it not just a learning curve! Today was the first time though that we changed her diaper, went through the whole ordeal and then 2 minutes later changed it again because she soiled it immediately after we were done. Even changing diapers can be the highlight of the day.
Heart Function
Shirley had another echo today, the first since she was taken off milrinone. In case you forgot, that was the vasodilator that also helped her heart contract. The echo wasn't the most positive but it's also not bad news. Her heart isn't contracting as well as it was when she was on milrinone which they expected, they just wanted it to be better than it is. The right side of her heart is also not up to par in the function category. These aren't things that will necessarily keep us in the CICU but they may be things that will need to be treated with drugs. If her heart is stressed beyond what it can handle and left to try and fix itself, there can be some rather negative results. They are going to give her a few days and continue to monitor her BNP levels. If her heart is up to the challenge she won't need more drugs but if there is no improvement they will add something to help her heart contract. Its a fine balance though. They don't want to do all the work for her but they also don't want her to begin to struggle. Pray that her little heart can strengthen before they have to intervene with more drugs.
Shirley keeps turning heads in the CICU, doctors and nurses are always stopping mid-sentence to remark about her cuteness or her calmness.
I'm still new to this whole blog thing but I figured out the comments and subscription thing today. There is a comment box at the end of the post as well as a link to receive e-mails when there are new posts!
I got some really great photos of Shirley being her usual happy self. Hope you enjoy.
-Joseph
