Wednesday, August 5, 2009

Evening Update (8-5)

Karsie is doing well.  She is so calm lately.  Her feeding came with good news and bad news.  She took her 5:00 feeding well.  However, her 8:00 feeding produced a lot of liquid and so they are stopping the feed until that goes down.  The nurse practitioner told us it would be like this, so as long as we continue to try to feed, she should hopefully improve.  For you nurses, they gave her 2 mL of pedialyte and she produced 8mL of liquid, which is much more than you want after a feeding.  We'll try again later.

Karsie's blood gases came back as being good while we were there and she was one point away from being weaned.  We're actually happy about this because we would like a little more time on the pain medication, but she's so close to being off.  

There was a little redness in one of her stitches, but it isn't too terribly concerning because if there was an infection it's being covered by the antibiotics that are already killing Lucifer. Speaking of Lucifer, he's almost dead.  The nurse this morning told us that her CRP (Reactive Protein) was close to normal.  

Random (Graphic Picture)

A couple of errors to fix:  First of all, we apparently spell it "Pedialyte."  Thank you Cory and Google.  Secondly, one of our nurses that read this blog (apparently a lot do as we have had multiple say that read it) corrected something about an earlier post that said her PIC line goes up an artery when it actually goes up a vein.  Arteries are way too fickle to deal with as we have found out.  We also wanted to make an addition to a post a long time ago about our neurologist. We wanted to put that we were really impressed with his explanation and how nice he was.  We really liked him even though we had to wait, which he apologized for even though it didn't seem like it was his fault.  He also saw us in the hall another day and said hi and asked us how Karsie was doing, even though he didn't need to and he was obviously busy on his way to do something else.  It's the small things that win us over.  

A thousand thoughts:  Yesterday we decided to install a traffic counter at the bottom of the blog just for curiosity's sake.  We became curious when we had been told by numerous people that people that they know and other people that THEY know read the blog.  We're very humbled at what our little girl means to so many people, we just didn't know how much.  While we may take it off, we just wanted to share that in less than two days' time, we had over a thousand people visiting the site.  We know that this could be our family obsessively pressing refresh every day, but it still means that Karsie is being thought of a thousand times in two days, which we are so very thankful for.  This means during the course of all of this we have had tens of thousands of times you have all thought of her to go on the blog let alone just thinking about her throughout the day.  We don't even know what to say to that other than thank you and we are so blessed!  This is truly a captivating story that is unfolding, and she is our daughter!  We are very proud of her and very thankful for her support.  

Karsie's Patch:  As you can see it looks like four stitches ripped and maybe one or two more are getting ready to.  We realize you may not have ever seen this side of her, so you're probably shocked at how much skin she actually does have here.  None of it is new; it was like that right after surgery.  However, the gross "new" skin is new.  That was explained to us as the liver with a coat of granulation protecting it.  That is the stuff that her skin that grows under the patch will eventually become.  The green guacamole looking stuff is just secretion coming from the incision for the past week and a half.  It's normal, it's just gross.  We're praying the stitches hold for a while, but Dr. Saenz did say right after he put it on that some stitches would rip, but I'm not sure he meant this early.  Stay still Karsie. 

Update (8-5)

Lots happening today.  First of all, the good news.  She has weaned down on her bpm to 12.  She's real close to being able to get off of the ventilator.  She had a string of good gases last night, so a few more and we might get to hold her.  Also, they will quite possibly start to feed her today.  She has stopped producing such dark green bile and is only producing very small, light green liquid. This means that she is dealing with her situation well.  They will start with very small doses of pedialite (we have no idea how to spell it, so it's phonetic) which is a nutrition that is easily run through the body.  If she handles that well, with no vomiting (which we're afraid would also cause trauma to her patch) then they would slowly introduce breast milk to her.  They took out her nose tube and put in a new one for feeding when we were there.  They are planning on waiting for four hours to see if she vomits.  If not, around five o'clock they will give her a little Pedialite. Finally the pain medicine has seemed to keep her very calm throughout the day.  While this didn't stop her from throwing an all out temper fest when her nose tube was put in, it has been much easier to calm her and the rest of the time when she is not being messed with, she is quite comfortable.

The concerning news:  Her rip is still a cause for concern.  We were able to briefly meet with Dr. Saenz today and he said basically the same thing as Dr. Losasso said yesterday night, which is that it seems to be looking okay for now as long as NOTHING else goes wrong.  If so, it is a trip to the O.R. and a new sewing of the patch.  The granulation that we are seeing is basically a scab over the liver, so the liver is kind of exposed with the skin matrix over it.  This is obviously much better than the actual liver being exposed and it is extremely reassuring that she is stooling because that means that while things are exposed, the bowels are still working properly.  If we can get through a few more days of not having to restitch anything, we hope that the scab will become hard and tough enough for it to be less of a worry.  But for now, it is. Also, the doctors are going to start to wean her off of the pain medication.  While we understand this is necessary and a good thing, we definitely don't want to be back where we were before she was prescribed where we felt like there was a "wait and see" policy for three days.  We hope she still takes to the smaller doses of medicine so we don't have to worry about it.  

We plan to put up a picture soon of her exposed patch just for our records.  If gross-looking goopy wounds bother you, you might want to pay attention to the post title before scrolling down too fast.  Hopefully tonight's post will have some feeding information on it as well as some pictures of us holding her again.