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.

Another good night for Faith & Mom.

Yesterdays blood cultures came back negative which indicates that the antibiotics are working, she will need to be on them for about two weeks. She is slowly adjusting to the ventilator wean but it’s still a while off before we get away from it. She also has a lot of fluids to mobilize and get rid of. The type of bacteria she had causes the veins to get leaky and lots of fluid is lost to surrounding tissue. They infused her with Albumin on Saturday to help suck it all back into the bloodstream so the kidneys could get rid of it.

They pulled the foley today since they think it was the source of infection as her urine cultures were positive. They have also called in infectious diseases on a consult to see what can be done to prevent more infection and make sure her immune system is operating at it’s best. It’s a known fact that kids with Down’s Syndrome can have weakened immune systems.

It’s safe to say she is on the mend back from yet another complication. It is also safe to say that we are not getting out of the hospital anytime soon, which most likely will make inpatient rehab more a possibility. She was so strong after her last discharge we thought that inpatient was a bit of overkill and we might be able to do it outpatient. We will see how she does with time.

The family would again like to thank everyone for all their kindness and help over this whole ordeal, you are so appreciated. Thanks to all of you who take the time to read my rantings about our little girl and her antics.

Not superstitious or anything but glad to be beyond day 13!

Good night, actually was able to get some restful sleep. Faith behaved very well and has improved somewhat overnight. They were able to stop one of her medications to keep her blood pressure (BP) up (vasopressor) and have been able to start weaning the other (dopamine). Oxygen levels are very good will still quite a bit of support from ventilator but it is also on a very slow wean down.

Long road ahead, hopeful we are taking the first steps.

Roller coaster ride of a day. She had one more major episode requiring some rapid infusion of fluids and some additional medications to keep her blood pressure up.

She “seems” to have been mellowing out since midday today, we will know better in the morning where we stand.

Wild night. Faith took a turn for the worse last night. At about 3:00AM her blood pressure started to drop very low. They pushed fluids into her as quickly as they could from all the access she had along with two medications that increase blood pressure. She responded right away to the fluids & meds. About an hour later we were in the same circumstance.

The problem was she was in septic shock a very scary scenario especially when you are waking up to it.

They have started a central line to give her the medication dopamine which will help them better regulate her blood pressure, and additional peripheral IV line and an arterial line where they can monitor blood pressure in real-time and draw blood for blood gasses.

She is currently get a lot of support from the respirator but her vitals are holding. I asked and was told the next 8-12 hours (till around 6PM Saturday) would be telling how well she is responding to the antibiotics and supportive care.

For our friends in the medical field: gram-negative rods, Vanctomiacin,Tobramycin & Zosin

I will post early evening today on how her day went.