Another good night & day with no events.

The Good

• They were able to stop one drug named Dopamine, it was used to help regulate her blood pressure. She is doing that very well on her own.
• ENT was in yesterday and feel confident about the success of extubating by the end of the week if all else goes well. End of the week is code talk for early next week.
• Clinically she looks well, all of her vitals are good and holding.
• She is tolerating the lowering of ventilator settings without any problems.
• The sedation continues to work!

The Bad

• Infectious Disease (ID) was in again today and said she will most likely require 4-6 weeks of IV antibiotics. Now this doesn’t mean she needs to be hospitalized all that time she can receive it during rehab and also home. The trick is they will need to start a PIC (Peripherally inserted central catheter) which is of course another source for infection and clots and requires nursing maintenance.
• The specific bacteria has been identified as Klebsiella, the bad is that yet another bacteria not yet identified but gram-positive (as opposed to the current gram-negative) has also shown up in cultures. She will be restarted on another anti-biotic (Vancomycin). It may be a fluke as it could have been from skin contamination or culture contamination. Better safe than sorry.
• Faith had blood cultures each day since 4/21. She went septic on 4/22 so subsequent cultures after starting antibiotics should be negative. The one from 4/23 came back positive for the bacteria they are treating her for.
  • One theory for this would be bacterial endocarditis in her case it would be a clot in the heart that is harboring bacteria and redistributing it along the bloodstream. She had a full echo cardiogram again today and cardiac has cleared her completely of any of those nasties and in fact said the heart looks really good.
  • Another might be that her IGG levels are very very low (200 when 600 is considered low). They are going to give her IV Immunoglobulin to assist her immune system in fighting the infection along with the antibiotics

Overall we are pleased with her progress to date. Lots to do and a long long road ahead.

As parents in an ICU you sometimes build relationships with other parents. The experience we have there and the things we have seen aren’t very relatable to our other friends who don’t have the same frame of reference, so we support one another. One such friend is Nina and her son Peter. They have been there for as long as we have. His course is much more difficult than Faith’s and prognosis is much worse, she gave us the news today that he is in the early stages of heart and respiratory failure. This is indeed a bad indicator for a successful recovery, please keep them your prayers as their journey may soon be coming to an end.