Today has been a good, good day.
Hannah went 6-1/2 hours on her CPAP trial, and she did great. The docs decided to stop it because it was her first trial post trache about 10 days ago, and they did not want her to overdo it her first time. But she handled it great! This is one step closer to getting her off the vent completely, hopefully!
They did the echo today, and unofficially, her echo came back normal. Meaning, no endocarditis, no strep infection. ASO blood titers still pending. It was a longshot, but it would also explain her choreathetoid movements.
They are upping her feeds more aggressively now that she has been off IV sedation for more than 24 hours. She is at 30 mL/hour right now with a goal to get her to 38 mL/hour. The PICC line is now on hold because if she can tolerate full feeds, we don’t need to get her one for TPN because she won’t need TPN anymore.
She is finally getting more sleep! She is still getting oral sedatives like pentobarb, ativan, and methadone through her G-tube because we are still in the weaning process (plus chloral hydrate every 6 hours if she hasn’t slept), but it seems like the more sedations they remove, the better she is sleeping. She has slept more today than she has slept in a LONG time! So far right now, she has slept for 4-1/2 hours — this is AMAZING! They are talking about weaning her methadone (I think) starting tomorrow — well, if not methadone, one of the ones remaining.
Her movements have definitely improved since yesterday, hence the reason she is also able to get more sleep. I would say that it was a 10 out of 10 at her worst, and now I would rate them as a 5 out of 10 when she is awake and a 4 out of 10 when she is tired. They decided to increase her Klonopin to three times a day. I found out that she is at a low dose as it is, so we can even increase the dosing plus go 4 times a day if need be. They are still trying to figure out if this is a temporary thing or a permanent thing requiring lifelong medication, but the fact that they are markedly decreased over a week ago is a big deal, regardless of the reason.
The best part…
They are moving us up to the PCU tonight. It is their progressive care unit, which is for kids who are not in need of critical care (PICU) but need more care than the average patient on a regular floor. This is HUGE!!!! This means my beautiful baby girl is NO LONGER CRITICAL! 28 days in the PICU, and we are finally graduating to the PCU. AWESOME!!
We will still be working with all the same issues (neuro, feeds, etc.) up there, but they feel that now that she has passed all her PCU transfer goals with the completion of her CPAP trial, which went better than they expected, she is ready to move up. We thought it may be a couple more days down here after, but the attending who we like (different than the guy this morning) is moving to the PCU floor, and he will be the one leading her care. That is awesome because he knows everything about her, and we don’t have to start over with a new attending! He also made sure that we are put in a room in his “station.”
Of course, as any mom who has been in the PICU before knows, transfer times could be anywhere from 10 minutes to 10+ hours. We got the news about 3 hours ago, and we are still hanging out down here in the PICU. But at least the transfer plan is coming together. Once they can get a bed up there for her, we are MOVING ON UP!
The bestest part… (Yes, I know it is not a real word)
We get to start coming up with a plan to transfer us to Sunrise Children’s Hospital in Vegas once we are up there! It is VERY conceivable that if all goes as hoped, we could be in Vegas within the next two weeks to finish her recovery there!
A beautiful, beautiful light is becoming brighter at the end of the tunnel…. I am still cautiously optimistic because I don’t want to get too excited, but things are finally looking up, finally!
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