Monday Overnight/Tuesday Morning Update

Annie continued to do as well as expected overnight last night.  I, on the other hand, am clearly remembering how hard it is to pretend to sleep in the ICU!  But I think we had a much calmer night with her on the ventilator than we would have had otherwise. 

Several nurses were in about every 30-60 minutes to check on Annie or suction out her breathing tube and also do an x-ray.  They also continued to monitor her bleeding and blood gases throughout the night as they gradually lowered the setting on the ventilator. Pressure sores on her hips have improved dramatically, but the one on her forehead is still pretty bad.  Annie is on an air hospital bed which I thought was just an air mattress to help prevent pressure sores, but the nurses actually came in several times to turn the bed on!  It actually circulates air in a wave pattern so that pressure gets redistributed regularly over her body.  They have the air-flow in the bed run for 10-20 minutes or so at a time and repeat that about every hour or two.  It's a pretty high-tech bed!

Yesterday there were some concerns about her red urine and having too much blood in her urine.  They said that can be a sign of an allergic reaction to the blood transfusions she received.  It gradually turned less red and more orange and now they believe that there's no blood in the urine, but she is just dehydrated due to all the fluids she lost yesterday during surgery.  The color continues to very gradually improve.

Annie's ventilator was at a level of about 15-20 last night and overnight they've been able to wean her down to a level of 6.  They did a chest x-ray in the night which looked good.  So they plan to continue to wean her down on the vent this morning until it is down so low it is more like a CPAP setting.  They'll monitor her O2 sats and blood gases and if she's managing to breathe well on her own on that lowest setting then they'll extubate her.

Overnight Annie began bleeding through the dressings on her back, but the orthopedist just wants the dressings reinforced for now and he'll check back with us in a few hours.  She still has her drain in place which is collecting blood from inside the incision in her back, but it is only draining her lower back and her upper back is bleeding through to her sheets.  The doctor suspects that bleeding to continue over the next couple days.  They're monitoring her hemoglobin which looks good now at 12.5.

They stopped Annie's blood pressure med--she's hanging out around 70/50 on her own now.  She's still on Fentanyl to keep her sedated and control her pain, but she is starting to stir more and gets agitated when touched, pulling a grimace on her face like she is in pain. We'll be working harder to manage pain today as she's transitioned off of the Fentanyl and on to other pain meds that are less sedating.  She can't cry with the breathing tube in, but her face lets me know she's not comfortable at times.  It's so sad to see and I just feel so helpless.

Annie opened her eyes just a tiny slit just now while she was agitated from being touched.  Her face is still very puffy and her eyes are nearly swollen shut.  It was hard to tell if she could see anything with them open just ever so slightly.  I'm anxious to have her open her eyes again and try to get her to look at and track a silent toy.  One risk of surgery is blindness, but we still don't know the condition of Annie's eyes now.  With all the swelling, it will probably still be a while before she opens her eyes and we get a good sense of her vision.

Annie required a fair amount of suctioning out of her breathing tube in the night and continues to need suctioning this morning.  But generally I'd say she's doing fairly well given the circumstances, but easily gets agitated.  She's stable and vitals look good, but we've got to get her off the ventilator and get her sitting up today.  The orthopedist checked on her this morning and gave nurses permission to sit her up either on the side of the bed or in a special chair from the PT.  The original plan was to get her in her wheelchair today and have the medical supplier make more adjustments to her chair, but she's not in any condition for that today, so maybe we'll try for that tomorrow.

Today's exciting news back at home is that today is Lexie's and her grandpa's birthdays!!  It's fun that they get to be together to celebrate. I'm grateful that they are here to shower Molly and Lexie with attention and love. Justin is also administering his final exam this morning in his Pharmacokinetics class, but after he's done making his students cry he should be able to work from the hospital after that.