Friday, August 7, 2009
Karsie was happy when Michelle came in and sat with her. She was apparently pretty fussy for the day shift nurse, but when we got there and Michelle touched her, she calmed down and was that way until we left. She has been weaned every gas she has done, which makes her down to 14.
Karsie has also been taking her food fairly well. She has been fed two times and done well on both. We'll see how it goes from there, but even if we have to stop for a bit, she is improving. Her bowels need to wake up, so it's a slow process.
Karsie still is having her tantrums, but she seems to be consolable after some work. However, her stats and gases seem to be going well. She is still on the new ventilator and her blood gases so far have been great. She is being weaned off of that starting at 20 yesterday. This new machine gives Karsie air pressure every minute so it is an easier transition, but it's still very bulky. She has been since weaned to 16 and 10 is again our goal. If she continues to produce such good gases she may not be on this one long.
Just before we left there was discussion about starting to try and feed her again with pedialyte. The only stats that have been not so good are her blood pressure and heart rate. However, with the boosts of steroids just given, those are expected to be high. Hopefully Karsie will just get some rest.
This picture was taken last night. We are getting ready to see her and find out if this stays. The "beard" or chin strap is to keep her mouth closed while resting so that the oxygen goes to her lungs and not out her mouth. In addition, she has the oxygen tube and a hat and a blanket. This is just after one of her tantrums, so her eyes are puffy from the wailing. Bad news for the nurses: she's audible now. She hasn't quite learned her cry and her vocal cords are still swollen, but look out. It won't be long now!
Ok...these darling pictures that we are putting up of Karsie are in the minority lately. She is starting to fight against herself. I just came back from the hospital (yes...it was crazy early/late but I wanted to see how she was doing off of her ventilator) and am slightly concerned over her anger. The poor thing has been through a lot, but the doctors say that her fury lately is not as much about pain, but about being mad (and some uncomfortableness). While this seems to be an issue her parents are going to have to deal with, Karsie herself is becoming her own worst enemy. She was just extabated and put on another breathing tube. This one goes in her nose and is given oxygen. With her anger, she is not only bearing down and wiggling a ton (which we believe is causing her stitches to loosen) but she holds her breath, which depletes her oxygen thus making her CO2 gases higher. If she doesn't calm down, she may have to go back on the ventilator.
Hopefully this is just a transition phase and she will break out of it soon, but tonight's a hard night as we are not sure which way she is going to go. When I left she was calm and her stats looked good. However, everyone is a little on edge not to disturb her because any little thing does. She will be messed with in a few hours to change her diaper and do assessments, so another storm is coming. We'll see tomorrow morning (or later this morning). Anger management Karsie! Out with the bad air, in with the good. Namaste.