Field Trip to the ICU

Last night was very scary over here.

As yesterday progressed Cora continued to have trouble nursing.  She'd try and then stop.  I could hear the liquid getting caught in her throat, choking her and coming out her nose.  But still, nobody seemed too concerned.  She had a wet diaper at 6pm so the doc decided not to start an I.V.  So after an evening of fussing and taking meds (a bit late), and just all around being stressed and tired, Cora and I finally both slept at about 1:00 am.

At 2:00 am I woke up to lights in the room and found 3 nurses huddled around her suctioning.  Apparently when they came in to do their spot check of her O2 sats they were in the 50s.  On a normal day-to-day basis she's at 100% since her heart surgery.  And so far throughout her stay she had been in the 90s even with her loud somewhat labored breathing post-op.

But last night they dropped big time.  So I watched as the nurses suctioned her and put in a nasal oxygen cannula.  They were worried about her breathing and the sound of her lungs so put in a call to her doctor, which took awhile.  In the meantime I was holding her in the room as she grunted, struggling seriously to breathe, her chest sucking in and rising and falling, while her oxygen levels continued to drop. So they started a full face oxygen mask.   Then we had a repeat performance of her breathing getting very labored and her grunting to breathe, obviously very upset.  Another nurse walked into the room as she was desating and got VERY worried.  She pretty much refused to leave, insisting that the chest x-ray get there NOW and constantly paging the magic-IV man, who was on a transport and wasn't responding.

During this time I was calling and updating Nick, who actually had gone home to sleep prepping to go to work today.  Eventually I had to insist that he came in, as a visit to the ICU was impending and her condition was getting scarier and scarier.

By that time, a chest x-ray had been done and the pediatric nurses attempted an IV on my very dehydrated, in pain (past her pain med dosage with such difficulty breathing that they couldn't give her anything by mouth due to fear of aspiration).  Picture a screaming Cora with no tears, open eyes that just didn't seem to focus, and several very worried nurses.  Let me tell you this girl was not happy about any of it.  But by this time she was so dehydrated that other than crying she had no energy to fight.

The call finally came to the get her into the Pediatric ICU, but while we were waiting for a room, things weren't remotely stable, so the nurses paged the rapid response to her room (yes, a hospital intercom announcement called the Emergency Pediatric Rapid Response Team to our room number) and then the room filled with a whole bunch of other specialists  A respiratory therapist, the charge nurse at the PICU and who knows who else were there in a second.

We ended up in the ICU shortly thereafter, where in fairly short succession, the magic-IV man came and successfully got an IV in her scalp and they were able to start fluids and meds as the doctor updated us on the plan. 

At the moment, it seems that all of this has been caused by severe swelling in the airway after the T&A.  Initially the ICU doc expected that he'd have to intubate her just to treat her, but now they are hoping that she continues to improve.  She is slowly improving.  Her blood gases initially were pretty bad, but are slowly improving.  She's on pain and anxiety meds, fluids, and steroids to help reduce swelling in her airway.  And it seems to be helping.  When we got here she was on 100% oxygen, but is now at 60% (although as I type this her sats are again in the 80s and dropping... maybe they'll be turned up again).  She's sleeping finally, but again isn't breathing as well.  Now they're shifting her around, thinking that her sleeping position is obstructing her airway.  That's the tricky thing with sedation. They need to keep her calm (a necessary thing for my agitated girl) but then that can contribute to her airway problems).  Again sigh.

We're just waiting, hoping that the swelling goes down enough with intubation, which would allow her to breathe but would worsen the actual swelling and contribute to the problem.

So I'm happy to say that things are slowly improving, but still not good yet.  And that's hopefully where you can come in.  Any thoughts and prayers would be appreciated.

I'll try to update as we go.