December 23rd: Emmy continued to vomit with her NG feeds throughout the night so the feeding plan has changed slightly this morning. The team feels she will tolerate the feeds better if the tube is advanced into her duodenum again and her stomach has more time to rest. Her feeds are also being changed from boluses every 3hrs to a continuous drip. They will continue to increase the volume every 2hrs until they reach her goal feeding rate of 18cc/hr.
Now for the not so good news...Emmy's chest x-ray looks worse again this morning. Her right side seems to be collecting fluid again and she is having more difficulty breathing. The plan is to resume the EZ-pap treatment every 4hrs as needed and see how tomorrow's chest x-ray looks. They may try giving her another diuretic to help flush out more fluid, but her doctors have differing opinions on that approach, so for now we will just wait and see how she does.
Evening update: Emmy definitely tolerated the ND feeds better, but she is still vomiting several times a day. The emesis is now just bilious secretions since there is no milk going into her stomach. I'm sure that's not comfortable, but at least she is retaining all of the calories she takes in. Proper nutrition is really important at this stage of her recovery to ensure optimal healing.
Unfortunately, I haven't seen much improvement in her respiratory status. She still seems to be working really hard. The respiratory therapists tell me she sounds like she has better air movement after an EZ-pap treatment, but I can't see a difference. I am nervous that tomorrow's chest x-ray will be worse and I'm disgusted at the thought of her chest tube going back in. The physician caring for her tonight has decided to give the additional diuretic in the hope that it will help her clear some of the fluid off the lung. I'm saying lots of prayers then we'll snuggle in for the night and wait to see what tomorrow brings.
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