Another good day, no thanks to us. I was only able to spend about an hour at the hospital before we had to leave for LA for my grandma's service. During that hour, Andrew slept for about 55 minutes, then woke up just before I left and got upset. He was inconsolable for about ten minutes and the nurse had to keep turning up his oxygen. Even when they got him calm, he was a little grumpy, frowning in his sleep. However, that was about it for bad news....the rest of the day he was great.
In the morning, he took a little field trip to radiology for an upper GI study. They put a special liquid (barium) in his stomach and then do X-rays to figure out how far it can travel through his digestive system. We still haven't heard the results of the study, but he did a great job during the transport. They didn't have to sedate him at all...in fact, he was doing a modified sprint throughout the trip. During a normal sprint, they turn off all the breaths being given to him by the machine (normally he gets 10 per minute). There is still some flow, what they call "pressure support," in order to overcome the difficulty of breathing through a tube, but all the breaths come from him rather than the machine. During his trip, they left the ventilator in his room and just attached his tube to a constant flow of oxygen. He was able to take all his own breaths, and ended up with a completely successful three-hour sprint.
While I was there (and once more later in the day), Andrew spit up some of the barium he had been given in the morning. This liquid is thick and often hard to move from the stomach, so it may have been giving him an upset tummy....it's possible his grumpiness before I left was due to that discomfort. Later in the day, a doctor and nurse suctioned the remainder out of his stomach, and that seemed to make him happier.
He had a second sprint in the afternoon and is working on his third while I write this. He was well-behaved for the first, and just as happy during this one. They'll take a blood gas later in the morning, in order to see how he's doing today. They may decide to continue with this sprinting strategy (three hours, three times a day) or they may try to challenge him even more (four hours, or four times a day).
He also received his two-month vaccinations a few hours ago. They smear a topical anesthetic onto his thighs, then give him the shots (three of them!) as quickly as possible. Because some kids have an adverse reaction to the vaccines (fever and grumpiness, mostly), the nurses give them Tylenol and watch them closely for a while. Andrew was a champ...he didn't even seem to notice the shots, and hasn't shown any signs of a reaction since. If this continues to be the case, it shouldn't delay his extubation at all. I'll post more details as things progress, and there's always a possibility of the plan changing yet again. Perhaps I'll write a post on the concept, mechanics, and importance of extubation, for those of you who have seen how important it seems (since I mention it in every entry) but don't really get the underlying idea.
Have a nice Thursday!
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