I don't even know where to start describing yesterday. This post-surgery ride has been more of an adventure than I'd hoped.
I'm staring at those two coherent sentences that I managed to squeeze out of my sleep-deprived, hospital-mom brain and wondering what to write next. My mind is much more willing to get lost in the beep, beep, beep coming from Bean's monitors than it is to form an intelligible sentence. But I'm going to try anyway. (English-major friends, don't judge me for this post.)
So...the big news from yesterday is that Bean is off the vent! She has had a few small issues with oxygen desaturation since coming off, but she's doing very well overall. And you can see her little pink lips ever-so-much better now.
The doctors took Bean off all sedation meds before extubating her so that she would be awake enough to breathe on her own. This meant she was not taking anything for pain control, so yesterday afternoon they gave her a dose of morphine for the first time. Around the time that Bean was given the morphine, she had a desaturation episode that was a little more severe than usual. Her sats dropped into the mid-60's and took a minute to rebound.
After this episode, Bean seemed unusually lethargic. She was staring blankly for a while and then got very sleepy. Her nurse suggested that I hold her, and I was more than happy to do that. (Because, you know, it's exactly what I've been dying to do since 7:15 Tuesday morning.)
While Bean was in my arms, she was very relaxed and sleepy. Everyone assumed she was just happy to be held and was resting well. We Facetimed with Jeremy and the kids, and Bean did not seem to notice them at all. When we moved her back to her bed, she was almost completely unresponsive.
At this point, I was getting pretty concerned. Even when Bean was sedated, she had moments of lucidity where she was very much aware of her surroundings. As hard as it was to watch, it was encouraging to see her wake up and look around and fight to get out of all the wires and tubes attached to her body. Yesterday evening, she did not seem to care about any of those things.
We gave her a small glass of apple juice, which she did wake up to drink. A few minutes later, she vomited. While the nurses cleaned Bean and her linens, she was limp and quiet. She didn't respond at all to the wipes on her body or the movement.
The nurse asked the doctor to come in and see Bean. She did nothing for him: no movement, no sounds, nothing. She wouldn't respond to her name or even to the flashlight the doctor used to check her pupils. Thankfully, the doctor was also concerned. (I think I would have cried over a Let's-Just-Wait-It-Out at that point.) He wasn't sure whether the morphine or the desat episode or something else precipitated Bean's unresponsive demeanor.
His first guess what that her body was having a hard time metabolizing the narcotics she's been given over the last few days (including the morphine). However, he said he did not want to wait and hope that was the case. He ordered a head CT to check for anything unusual going on in Bean's brain.
Seeing Bean unresponsive was so scary. My little girl is full of spunk and humor and life. Last night, she wasn't showing even the smallest spark of any of those things. The thought that her body might be recovering but her mind might not was terrifying.
Bean woke up a little when the nurses moved her onto the CT machine, and the initial results of the scan were negative. Bean was a bit more alert when we got back to the room. The doctor was encouraged by the fact that she was somewhat more alert, and he said we might just have to give her time to get the narcotics out of her system.
Overnight, Bean was still pretty lethargic. She woke up several times, but I was able to get her back to sleep very quickly. Around 7:00am, I was trying to get a little more rest on the couch in the back of Bean's room. The doctors were doing shift change and stopped outside Bean's room. The night-shift doctor started telling the day-shift doctor that Bean's CT was preliminarily negative, but the radiologist had called at 5:00am to say he saw a small area of possible bleeding.
What?!? Of course, I hopped off the couch (in my PJs) to hear more about what was going on. After a lot of discussion with the night-shift attending, the day-shift attending and Bean's surgeon, the consensus seems to be that a brain bleed is unlikely. All three doctors still feel Bean is struggling to metabolize the narcotics and anesthetics she's been given this week. Neuro is going to look at Bean's CT, just to double-check.
This morning Bean was still pretty out-of-it, but she had improved from last night. As the day goes on, she is slowly becoming more and more alert. A few minutes ago I dropped the side of the hospital bed onto my toe, and she said, "Ow!" It is more amazing than I can say to see glimpses of Bean's personality coming back.
The challenges today are managing Bean's pain without narcotics (because of her reaction last night) or ibuprofen (because her kidney function has been down just a bit). She's on a regular dose of Tylenol, but she seems a bit less comfortable this afternoon. Bean is also vomiting every time she tries to drink. She's interested in apple juice, but she's not tolerating it. Her nurse is going to keep trying in hopes she will start keeping fluids down.
Even though things are moving slowly and we've had some hurdles to overcome, I am very thankful that Bean is making progress. We almost got a few smiles today, and I'm hoping her bubbly laugh shows up very soon. Thank you again for continuing to pray and support our family.
No comments:
Post a Comment