Wednesday was a pretty uneventful day. Anna was quite comfortable the last couple days and has been wide eyed a fair amount. We had a good snuggle in the afternoon.
On Thursday morning at 10am they extubated Anna. They had prepared for the extubation and started steroids to help with swelling before. She was very mad after the extubation and surprisingly noisy! Someone found her voice! It is still quiet but definitely louder than before. The only way she would settle down was for her mom to snuggle her. Her breathing was quite noisy (strider) so they gave her a dose of epinephrine and she settled right out and slept most of the afternoon. She did well most of the night - until about 3am when she became unsettled and they have her another dose of epinephrine.
The infectious disease team has been following Anna's progress and giving advice. Listened to some interesting discussions between them and my regular team of doctors and nurse practitioners. They decided on 14 days of antibiotics. It came down to Anna having either has tracheitis or pneumonia - but cannot rule out meningitis as they could not do a lumbar puncture because of her cyst and tethered cord (although it seems unlikely).
The infectious disease team has been following Anna's progress and giving advice. Listened to some interesting discussions between them and my regular team of doctors and nurse practitioners. They decided on 14 days of antibiotics. It came down to Anna having either has tracheitis or pneumonia - but cannot rule out meningitis as they could not do a lumbar puncture because of her cyst and tethered cord (although it seems unlikely).
On Friday she had a bit of increase of breathing, so they increased the peep on her cpap. That seemed to do the trick and she was quite happy to sleep the day away. Unfortunately her hemoglobin had also dropped and she was very pale, so they decided to do another blood transfusion. Since blood can't go in via a picc line - this meant getting an iv line in. This proved to be a challenge again - after 3 picc nurses, a couple breaks and various pokes, a resident who seems to have a knack for it got one in try. Needless to say - Anna was not too happy. They decided to do a chest xray to see how her lungs looked as they were a little concerned about hyper inflation. She had just woken up and was mad during it - so the image wasn't great. The Dr and nurse practitioner were concerned that she had air leaking out of her right lung, but they wanted to redo the image to be sure. Thankfully it came back fine and her lungs looked no different.
They also started her on another steroid and since it often causes thrush - put her on nystatin to prevent it.
They also started her on another steroid and since it often causes thrush - put her on nystatin to prevent it.
Ryan and I came together on Saturday and he got to enjoy some daddy snuggles. Her color is quite a bit better now that she has had the blood transfusion. They have weaned her from a peep of 9 on cpap down to 7, but she is still pretty wheezy. Anna seems to struggle with breathing positionally - which makes the doctors wonder if something is not developed or growing correctly below her vocal chords (as she has a scope down that far). As she continues to grow it could be causing more and more of a problem. In one position she will breath perfectly and in another she will continuously desat. She needs to be good and stable before they will do that scope to check to see.
Keep this little bundle in your prayers! Pray that she can fight off this infection completely and be back breathing with no support soon! This has been another trying week and we thank the Lord for being with us and giving us all that we need.
For as high as the heavens are above the earth, so great is his steadfast love toward those who fear him; as far as the east is from the west so far does he remove our transgressions from us. As a father shows compassion to his children, so the Lord shows compassion to those who fear him.
Psalm 103:11-13
No comments:
Post a Comment