Woke up from another 5 hour sleep at 4:30 to find my girlie doing much better. The oxygen percentage and volume were lower and her respiration and oxygen saturation were fine.
She was obviously feeling better, as evidenced by her very upset little self. Knowing that she was starving, we opted to give her some Fentanyl to calm her down for a bit without sedating her and to make her forget about her hunger for a bit. She slept for a few minutes, then was awakened for a chest x-ray. In the ICU there are frequent interruptions, so she was kept agitated and upset for what seemed like forever.
Then the doctor came in and gave me some good news. He said it was OK to try and breastfeed her. Hallellujah! That also meant that he is confident that she doesn't need to be intubated!
I was counseled on what to watch for to look out for aspiration and the nurse watched her at first, then left us alone as Cora began to doze contentedly, occasionally groping around for another quick snack. Things seemed pretty good. But then I got a bit of a scare as she sputtered and spit up a small amount. Worried she was aspirating again, I paged the nurse, who was busy with another patient so another nurse came in. It was kind of inconclusive, but I don't really think that she aspirated. But still, it worried me. A few minutes later her sats dropped a bit and her respiration and heart-rate got higher. But it was pretty hot in here, so that could explain it. Another Cpap treatment and all her numbers normalized. But she was still pretty aggravated.
I eventually got her to sleep a real sleep. Then I could relax for a second for the first time in several hours. Funny. Things were better, but still stressful, still exhausting, still worrisome. I so want her to be able to nurse, but am afraid of the possibility of aspirating again. I guess that's a pretty normal and valid concern.
Her next nursing session was better, although she did gasp a little a few seconds later. Based on the nurse's opinion aspiration would happen while she is drinking, so again, she is not too worried. And all her numbers are good, so it seems fine.
At this point her oxygen is at 30% and the high-flow volume is at 3. That's down from 100% and 12 initially.
Her doctor thinks that at this rate she will likely be moved from the PICU to the pediatric floor on a regular oxygen cannula (rather than the high-flow) tomorrow. Then once she is able to be off oxygen and is eating with no problems she can go home. He says her lungs probably won't be perfect at that point, but definitely stable. They are continuing the antibiotics at this point, so that her aspiration pneumonia doesn't turn into a full-blown lung infection.
For now we're encouraged to sit her more upright, although she's so weak that she can't really hold herself or her own head up. Hoping that she doesn't experience any significant regressions in gross motor as a result of all this, especially since it's not her strongest suit anyway.
Yep. Major swelling causing aspiration causing pneumonia. Certainly not a routine recovery from a tonsil and adenoid removal. But we are very grateful for the excellent care she is getting and for all the love and support being sent our way. Thank you to all!