Saturday, 16 November 2013

Baby steps

Friday was a long day. We arrived on the ward first thing in the morning presuming everything was ok because we hadn't had a phone call during the night telling us otherwise. So we were horrified when the nurse told us Martha had been unstable over night.
She had been unstable after they took her off the Bypass machine in theatre so they decided to give her a pacing box. When we went to see her once she'd been settled in on the ward she seemed stable. Her stats weren't as crazy as the last time and everyone seemed happy with her. So for her to become unstable was frightening.
After her last op she held her own brilliantly, the main concern was her fluid balance. This time that's the least
of our worries.


She did finally stabilize on Friday but only because she was on a high level of support. Three cardiologists spent well over 2 hours performing an ECHO late in the afternoon, speaking amongst themselves while we had no idea what was going on. We managed to pull one of them to the side for them to tell us that the reason they were taking so long was because her chest is still open so they couldn't get clear enough images. But from what they could see the repair to the VSD looked fine. All we can do is give Martha's heart time to recover from the trauma of surgery. The plan on Friday night was to do nothing, keep Martha's support as it was and let her rest.
Mark had to drag me out Friday night just before 12:30am, I was too scared to leave, scared that she'd have another unstable night while I was fast asleep and completely oblivious to her struggling.
As soon as we arrived back at our accommodation I called Michaela (Martha's nurse) to check up - luckily she was just as she had been when we left.
I must have been exhausted because the next thing I know it's 7am. I called Michaela for an update and was relieved that Martha had remained stable throughout the night.
Today has been a better day. I'm sorry but I'm going to get technical now and it's probably only going to be fellow Heart Parents who will understand how massive a deal today's Baby Steps have been.
Yesterday she was being paced at 140. I almost had a stroke when Troy (the cardiologist on Ward round) turned the machine off to see what happens - what happened was that her heart rate plummeted. She is still in complete Heart Block. Her escape rate is 88. Today she is being paced at 120 and she is still giving out the same readings (pulse at 135) as she was giving yesterday. This is good.
This morning they weaned off the oxygen concentration from 55 to 50 and her mixed Venus sats stayed the same. Later on in the afternoon they weaned it again to 45 and they continue to be happy with her Blood Gasses. This is good.
They have weaned off her Adrenaline from 0.10 to 0.09 and her Blood Pressure remained stable at a mean of well above 45. This is good. But when they tried to bring it down to 0.08 a few hours later it plummeted to 42 so they've had to put it back to 0.09. This isn't great but it's not the end of the world.
They gave her a Vecuronium Holiday yesterday and it took her almost 10hrs to wake up. Today it only took her 2hrs to wake up. This is good because it shows her kidneys are working efficiently (when you're ill it's you're kidneys that suffer first)
Her chests drains are on minimal drainage. This is good as she isn't bleeding hardly at all from her pericardium.
Tonight we've started her on TPN. They've also started giving her Anatrophic feeds to help protect the lining of her stomach. This is also good.
Finally...she opened her bowels today. This is good as it shows her body is finally starting to get over the shock of the bypass machine.
She still has a long way to go. At the moment her fluid balance isn't negative enough to close get chest. But she is definitely heading in the right direction - she's just taking baby steps to get there.

GM 
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