Post-op day #3...weaning the ventilator

December 15th: Every day I attend the medical team's morning rounds so that I can hear their perceptions on Emmy's progress and what they plan to accomplish for the day. Today, the goal is to wean her from the ventilator. This morning, the settings on the vent were changed to allow Emersyn to initiate all of her breathing on her own. The breathing tube is still in place and the vent is still hooked up, so if she doesn't take a breath for more than 12 seconds the machine will breathe for her. So far, so good...she is doing all of her own breathing- BIG stride for such a sick little girl!

The ICU doctor says he doubts she will be able to be extubated today because she is still so swollen. The excess fluid in her chest and on her lungs will make breathing on her own more difficult, so for now it is better to have the ET tube in just in case she needs some respiratory support. He anticipates that the tube will be able to be removed tomorrow. That's great news for me because when the ET tube comes out, Emmy can be held again...fingers crossed that tomorrow will be the day!

Evening update: The day is almost over and I'm sad to say, we've made little progress. Although she is putting out more than adequate amounts of urine, Emmy's swelling looks worse than ever. Her head has become so swollen that her ears can no longer lay flat...instead they stick straight out to the sides. Her head, torso, and perineum are swollen to the point that her skin is tight and firm to the touch. It just looks so uncomfortable. The medical team discussed adding a second diuretic several times today, but ultimately they came to the decision not to change her medication regimen because of her lab work. Her BUN and creatinine levels have been slightly elevated indicating that her kidneys are working pretty hard so they fear that adding another diuretic would overload her kidneys.

The ventilator weaning went well during the day. Emmy remained in the "auto" mode all day, which means she was doing all the work. Unfortunately, this evening, as she is sleeping more deeply, she is needing more support so the vent settings were changed to give her some additional assistance. The respiratory therapist told Bryan and I that she most likely will not be extubated until Saturday or Sunday. So once again, we are playing the waiting game...agonizing, but we are doing our best to remain optimistic!

Our one big win for the day: Emersyn was taken off of the Dopamine. Hemodynamically, she has become more stable and her blood pressure is trending upward so they were able to discontinue one of her BP medications...yay, anytime we can get rid of a something, we consider it a WIN!