Tag Archive | Good Day

DAY 29 – CPMC/CHONY PICU

May7

Good Day/Bad Day – Hard to call the day, you decide. Here are the details, see yesterday’s post for details about the tests.

  • Cardiology decided that the “bubble test” aka agitated saline echo-cardiogram would not reveal any beneficial information. All of her standard echo’s were so good they can say with certainty there is no shunting.
  • The doctor from the pulmonary hypertension (PH) team also reviewed all of the previous echo-cardiograms and said absolutely no to pulmonary hypertension. Just a side note the doc who is now an attending on the PH team was training as a fellow back when Jonathan was here and remembers his case clearly, kinda cool and scary at the same time.
  • We cannot do a CT scan with contrast at this time because her kidneys are still recovering from sepsis and all the antibiotics she is on. Contrast would be too much of a shock to them and could cause failure. They are weighing the benefit of just a CT without contrast and what information that might contribute for the effort involved in getting one done.
  • The “gold standard” V-Q scan also is a big logistical challenge and it’s not clear right now if the benefits outweigh the risks.
  • Faith had a good morning getting her FiO2 (the amount of O2 the ventilator is providing) was all the way down to 30% when she got into one of her episodes where she could not recover and maintain her own O2 level. They had to go all the way back up to 100% FiO2 to get her to 90%. I can safely say we are now back down to 60% FiO2 and she is doing 95% so some good news.
  • From an infectious disease (ID) perspective the nasty bug is officially under control along with the fungal growth. There is still a persistent Staphylococcus epidermidis that is still not fully under control. She is also still having spiky fevers.

Tomorrow is a bit more of the wait and see game and to hear back from pulmonary on what they would like to do.

I would also like to say a quick welcome and thank you to the Down’s Syndrome (DS) Facebook group. I posted a link to this blog there last night in the hopes someone else might have had or heard of similar circumstances and might be able to help, if this is something specific do DS. They have almost 4,000 members so you never know.

DAY 28 – CPMC/CHONY PICU

May6

Good Day – No adverse events

Faith continues pretty much the same as yesterday, no better, no worse. She continues to have fluctuations in her psO2 and blood pressure. The good news is she is only on 35% supplemental oxygen along with 5% Nitric Oxide (NO).

Monday (5/7/12) is going to be a busy day:

  • The ICU team will be meeting with the Pulmonary Hypertension (PH) team and the Pulmonary team to determine what to do next. There is no PH diagnosis at this point just the fact she is acting that way in certain aspects.
  • They will be performing a bedside agitated saline echo cardiogram . They want to determine if any shunts exist either a pulmonary shunt or cardiac shunt. Each would indicate there is an abnormality in either system.
  • Presuming the aforementioned test is negative the next test they would like to perform is a CT pulmonary angiogram to further study the pulmonary embolisms and their progress, etc.
  • Presuming the aforementioned test is negative the next test they would like to perform is a VQ Scan this test will let them know two things. 1) Is her blood properly perfusing into the lungs 2) Are her lungs properly ventilating. Incidentally Jonathan has had at least 3 of these tests in his life. The reason they are leaving this one for last is because it is in another hospital on the CPMC campus and she isn’t too portable these days.

We can’t say they aren’t asking the right questions, we hope we get the answers we want.

DAY 27 – CPMC/CHONY PICU

May5

Good Day – No adverse events

Faith had an improved day today, less support and better vitals. Still negative on all cultures so I think it’s safe to say the infections are finally under control. There are still some daily fevers which don’t make sense one explanation is drug fever especially when you consider fentanyl withdrawal and all the antibiotics she is receiving.

Something is working because even after suctioning today she is NOT having the low O2 saturation she has been having over the past few days. Was it the new ET tube, Nitric Oxide? We will see as the NO gets weaned if it was the cause or if it was replacing the time-worn ET tube.

Lets hope we are done adding days to the bad bucket and continue to accumulate them in the good bucket.

I’ve added a photo gallery there are some cute cards up there right now and I hope to get some more happy healthy Faith pictures up there soon too.