Sunday, July 14, 2013

Day 44/45 NICU Post-op

Pre-op family photo

Immediately post-op
I was telling the nurse the other day that a tiny silver lining of Clarity's circumstances is that she is getting way more photos taken of her and much better documentation of her early life than many second born children.

We have been thrilled with how Clarity has done after her surgery. She came back up to her room for recovery and she was already back on her nasal cannula at that point. She's had a few doses of morphine but they're weaning her back off of that pretty quickly.

While she was under, they did a bronchoscopy to check on her lungs and suctioned out quite a bit of mucusy secretions but there was no sign of infection. It looks like the aspirant just mildly irritated her lungs and now the output they produced to deal with it has been cleared. Her lungs showed no signs of "floppiness", which suggests that the tissue is healthy and functioning properly. All of this was good news. Poor girl seems to have a bit of an irritated throat after all that though. She's been drooling a lot again as though she's avoiding swallowing and there has been a tiny amount of bloody tinge a couple of times.

They started tiny "trophic" feeds into her tube (1 ml/hr continuous) on the day after surgery and started increasing them by 1 ml/hr every 6 hours on Saturday at 12p. Assuming she continues tolerating them we'll be back up at full feeds by midweek and then they can start working on making them non-continuous.

I got to learn how to change the g-tube dressing on the day after surgery, easy but precise and careful work. The more carefully the site is protected from irritation, the less likely she is to have complications like granuloma. We'll have a more thorough class soon on how to care for it as one of our steps toward getting home. I'm still hoping we won't have to have it for very long after we get home but we'll see. Oral feeding trials will start as soon as she's feeling better from the surgery.

I got to hold her for a nice long time on Saturday and she spent a long time in the quiet alert state, taking it all in. I'm so looking forward to bringing her home. I'm not sure if feeding or O2 requirements will be our more time consuming factor for getting home. I think that once she's on full stomach feeds through the g-tube she can be released. I haven't been able to get a good handle on how close she is regarding O2. Apparently she can go home on 25-50cc but can't find a good way to translate between that and her current 40% at 1l flow. I think it will be easier to estimate when they put her back on the wall (100%) and decrease flow, since I believe we will then be working at the same scale that home O2 works. My fear of having her home with O2 and feeding needs like that is gradually getting overcome by a desire to just get out of the NICU to let her start leading a more normal life. As she's becoming more awake and starting to hit places for developmental milestones, I'm more and more struck by how hospital life, no matter how carefully done, can not compare to the healthy stimulation of home life. Let's hope that the g-tube was the answer and she'll rapidly continue to improve now.

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