When we still hadn't seen her almost 2 hours later, I knew that they had a hard time getting her stabilized. When we were finally allowed into her room, she had already experienced first degree AV heart block and her systolic blood pressure (BP) had shot up to 160 and then plummeted to 40 in a matter of minutes.
The risk of high blood pressure is that it can make the surgical sutures come undone which causes internal bleeding. Not a good thing. So, the goal was to keep her systolic BP in the 80s or 90s. Easier said than done.
Nurse Keri struggled until midnight (about 6 hours after Sophia was admitted to the ICU) with her BP to make it stop swinging. When it got too high, she administered more Niprid; when it got too low, she increased the saline solution drip. The decision was finally reached to stop the Niprid which worked out initially but then her BP would stay really low and more liquids were required to bring it back up. Then more Lasix to drain her of all the liquids. More visits from the fellow on duty. A delicate dance throughout most of the night.
Sophia was also on Dex to stay sedated but she wasn't really totally out. Once in a while she would struggle to try and sit up and wave her arms around. That's the reason why her arms were tied to the bed, apparently.
Paul went back to the house at 11 PM. I finally hit the snooze button at 2 AM but got woken up an hour later because Sophia had started to "talk." Anybody who ever was on a ventilator knows that it's impossible to talk but she was given a pen and a piece of paper to write down her thoughts. Nurse Keri is brilliant!
Sophia was still on a Morphine drip and between her demand "I want water" when she couldn't even swallow her own spit, and her confusion on "why am I in the ICU when I first woke up at Yawkee Family Inn" it became apparent that the "kicking and yelling in my dreams" was drug induced.
I was pretty impressed with Nurse Keri's ability to decipher the handwriting of a lefty who is so heavily medicated.
The thought occurred to me that it must be incredibly frustrating for a patient who either can't write yet or doesn't speak the language of the caretaker to make him/herself understood.
|Room with a View|
Around 4:30 AM I tried it again and got another hour of sleep in. YEA. The X-ray lady wanted to get a good picture of Sophia at 5:30 AM. Our sweet child inquired "Can I at least put some clothes on?" even though she was in a hospital gown and covered with blankets. Perhaps she thought it would be her class picture?
Back to bed at 7 AM and up again for the daily rounds at 8 AM. It turns out that the attending cardiologist knows Dr. Duncan who had performed her first open heart surgery back in 2000. Apparently Duncan used to first be a pediatric cardiac surgery fellow and later staff at Children's Hospital in Boston. Small world.
We also met the clinical nurse Dot who used to work with Brian. Apparently he and his wife liked her pet bunny. This is a small community after all.
At 9 AM my night was finally over and the day nurse Stephanie started pulling wires and turning off medication one by one. Sophia's recovery was going in the right direction! Paul's arrival put a big smile on Sophia's face, and she granted him a hand squeeze.
Around Noon is when she had her little episode. She was just about to be extubated when her heart decided to have everyone stop and pay attention. And that we did! All of a sudden there was a flurry of activity in the room and people were piling in. We stepped out into the hallway to make room.
After she was put on a pacemaker, she stabilized. But she also started to run a fever. Nurse Stephanie learned from the German housewife (that would be me) what a Wadenwickel is. Not sure if the wet cloth wrapped around Sophia's lower legs, the cold room temperature or the medication ended up sapping her body heat or a combo thereof.
Next in line - an echo cardiogram to make sure the operation didn't damage any tissue or that an area was bruised or something had come undone. Now, I have seen many echos in our child's life and I can honestly say that her heart has never looked this beautiful. Her surgeon had done the most amazing job!
Before she could get her tube out, the nurses had to suck out a bunch of phlegm that had accumulated in her lungs. Just when they were in the middle of that business, our cardiologist Dr. Marx stopped by. It also happened to be the time when Sophia decided to throw up a sizeable amount of bile from the depths of her stomach. (They had already removed the stomach line when attempting to get her off the ventilator initially and the bile had nowhere to go but out.)
All of a sudden Dr. Marx was gone. What happened? Apparently it wasn't the first time that he had made a bee line out of the ICU. Looking at a heart in an open chest cavity is one thing but dealing with bodily fluids? Completely different. :)
Sophia finally got her tube out at 4 PM. Complete with mouth wash and tongue scrub. She has been resting ever since.
Tomorrow morning she will be able to eat! Simply amazing.
|All better now. Notice the Medtronic 5388 to the left of her foot.|
More from us tomorrow,
The Petrucci Familia