Friday, April 27, 2012
Day 13 Post Op and Cath Day - Again
Day 13 - Tuesday - C did well overnight but was grumpy and uncomfortable. Started back on Tylenol and she would feel better, so figured she was just still feeling some lingering pain. Got back to her pretty early as wanted to spend as much time with her as possible before she had to go for her cath. Our awesome nurse for the day went and got a whole bunch of stuff C to play with including a little table and chair so she could sit somewhere other than the bed. I am so grateful for this because getting C out of bed is crucial. The nurse brought all kinds of fun stuff to play with including markers to color, play doh and C's favorite, bubbles. We had a grand time playing with all this stuff and C even played with the intensivist and cardiologist blowing bubbles and coloring. So good for her but sad to me thinking that in just a few short hours she would have to go under again and what if this time we really did lose her. Fortunately, one of my dear friends from childhood came by to visit and kept my mind off of what was coming up. She works for the hospital administration that oversees the hospital we are in and she wanted me to know that she had made contact with the higher ups about moving C to the picu like they did. Very grateful for at least we had our concerns heard. Cath was supposed to be at 11:30 but as usual things always run behind so they did not come to get C until 1pm. The cath nurses and anesthesiologists came up to C's room instead of making her go to the pre-op area and wait. They let me ride on the bed with her all the way into the cath lab and stay until she was asleep. I am so grateful they let me do that because C was so calm and not all at scared. Less trauma. Cath actually did not take that long, an hour maybe, surprised the hell out of me. So at first I stated to panic thinking he found something horrible that could not be fixed or something that could only be fixed with surgery. Again, to my surprise, he did not find anything wrong. No collateral, no narrowing and nothing additional opened up. Um, ok. Pressures are great in heart and lungs. Function looks great. There is absolutely no fluid in her left lung. All very good news. But still no explanation for the lower sats. The only things he found were oxygen desaturation coming back from left lung to heart, not great but not horrible either. She is shunting a bit more across the fenestration than they would like, but again, not horrible. And she has a pericardial effusion (fluid around her heart) but small and not horrible. He did place another chest tube, small, like the pigtail ones used for the lungs but the thing was not actively draining so he figured he pretty much got it all during the cath. So after all of that, no real answer to why such low sats even on oxygen. The cath doctor told me I was right, there was nothing there and the plan would be to send her home on oxygen and wait for her left lung to heal completely. Awesome. I so enjoy not getting any answers. But at least the news was all good about her heart. Even better, the anesthesiologist did not intubate her. He worked extra hard and just used her cannula. She did awesome and was awake pretty quickly. I cannot even tell you how relieved we were. So back to just waiting her out. The awesome NP that night was working overtime to get all of C's stuff done so we could move towards discharge. C was done with the heavy duty iv antibiotics so she went back to her normal amoxicillian. She got the EP cardio to change the iv amiodarone to oral, stopped the milrinone and increased the oral enalapril, and switched her lasix to oral to start her lasix wean. With ner chest xray clear, cath confirming no fluid in lung and cath draining of fluid on heart we were looking god to go. The NP got all her prescriptions written and discharge orders done. She also got the pacer disconnected, although wirex still remain. Now we are starting to see the light at the end of the tunnel. We are starting to see home. Neuro did visit Monday confirming there was nothing concerning on the ct or ct angiogram and that we would follow up with him in clinic. Plan is to see how C is doing and maybe get rid of seizure med at one year. Right now he wants to keep her on meds and let her brain relax. Fortunately the med she is on is the safest one they have with few side effects and no interaction with any of the meds she is currently on. So there is that. Now waiting on pace wires to be removed, chest tube removed and C to show she can tolerate all her meds orally. Plan is to have tube and wires removed Wednesday. Have oxygen people come by to give us the oxygen and supplies and then hopefully get out of here in time to be home for the weekend. For the first time in over 2 weeks, C can sleep unencumbered by wrapping tubes and pump alarms going off. She just needs to behave to keep her monitor from alarming.
Posted by Ashley at 4:45 PM