DorrieDorrie

Ms. Floppy-pants3

Probably time for an update.

It took a good week, but the staff at the PICU have finally managed to get Dorrie in a good, stable place. Monday last week, she was doing fairly well — oxygen at 40%, sats in the 90′s, etc. Tuesday, they tried to let her come out of paralysis, but she fairly quickly started trying to breathe against the ventilator, with the result that her sats dropped, and they had to turn her oxygen all the way back up to 100%. So they started the vecuronium and turned her back into Ms. Floppy-pants, but even then, they were struggling to bring her oxygen requirement back down — the lowest they got was 70%, and that did not last long before they had to turn it back up again. Finally, they decided it was time to try nitric oxide — and lo and behold, that seems to have done the trick. Right now, her sats are again in the high 90′s, and her oxygen is down to 40% again. They did increase the pressure on the ventilator a little because her x-rays had shown some collapse in her left lung, but her latest x-ray looked good, and we are back to the point where they are going to try to start weaning down her settings in order to get her off the ventilator again.

The main drama this weekend has been dealing with IV access. They had mostly been using peripheral IV lines with her, but they had decided that they needed to get a central line in. The attending decided to try for an internal jugular line, and was successful in placing it, but it did not last long — whether from moving Dorrie around, or from the fact that she’s been drooling a lot and the dressing came unstuck, the line failed yesterday and had to be removed. Then he tried to put in a line in the other jugular vein, but he apparently missed and went into the artery instead, so that had to be taken out too. So then their next option was to put in a subclavian line, but by this time Mom was disinclined to give them the chance to screw up another central line, and did not want to give approval for the procedure. However, the attending and the surgeon declared that it was necessary — there were no more available sites for a peripheral line, and so no other way to deliver the meds she needed. So, we let them proceed, and so far, the subclavian line has held. Hopefully, this one will work better than the last two subclavian lines she had, each of which failed in under a week.

In any case, yesterday’s drama notwithstanding, things are stable now. What’s more, the care team seems inclined to give her another day without any major changes, which is what we would prefer as well. And on top of that, the attending’s plan, after getting her ventilator settings to an acceptable level, is to start by letting her come out of paralysis, which is also what we want. (There must be some weird alignment of stars for our wishes and the care team’s plans to agree so well for a whole day like this.)

Posted by dad, under hospital crack, moving forward... or not, our little witch