Saturday, March 10, 2012

Quiet day

Daniel here, taking over the blog for the day for Kim (who's now at my folks' house, hopefully catching-up on some sleep).

Today was a quiet day, as-anticipated.  I spent the night at my parents house, to spend some time with Owen, and Kim stayed at the hospital with Evs.  The night for Kim was not a great one, as there was a lot of "in-and-out" of the nurses overnight.  They described Evs aptly, I think, as "stable, but not quite balanced" - primarily, this is just due to trying to balance her blood-pressure and seizures.  Which one wouldn't THINK are directly interrelated, but here's how.  ;-)

In short, her blood-pressure has been a little low since surgery.  Perhaps not unremarkable for most, between coming out of surgery, as well as being on anesthetics/sedatives.  Most new trach patients are on paralytics - e.g. medically paralyzed - in addition to being sedated, for the first few days following surgery, just to help assure to keep them still for the site to heal.  For a number of factors, all of which I am not 100% certain - I believe relating to the fact that Evs is not the most mobile patient in the world anyway, and that perhaps adding the paralytics can increase low blood-pressure or muscle-tone issues, etc - the docs decided to forgo the paralytic.

However, Evelyn of course does have 1 movement down pat:  Her seizures.  So as the sedation was reduced slightly to try & help keep her blood-pressure from being so low - along with saline & dopamine, which were added to help up her blood-pressure, but also keep things "flushing out" (e.g. sedatives and her regular seizure meds) - she started having more seizures.  You know your seizures are pernicious if they persist through all manner of sedatives - it might make a good future anecdote when we get an suspicious eye-brow raise when we tell some new medical staff "her seizures are not controlled" - "No, really - she can be sedated by IV and have Versed drips, and still have seizures."

Anyway, they are largely milder than usual in intensity, and ordinarily ones that would be of no concern; however, the word of the day for today & the next two is "still".  So, they've been adding in Versed and Ativan PRN for seizures (but of course, too much Versed will lower your blood pressure...).  Up/down/back/forth - just a lot of little "toggling" of the various medicine "switches".  None of which, again, is terribly serious - just "balancing things", to use the example of our nurse.  On the positive side, they noted that Evs has been breating around/above the vent some, which is a good sign - e.g. while she's still getting lots of support from the vent right now, she is taking breaths over & above what the vent is supplying, which is "good".

So, that's the long of it.  A lot of sitting, some reading, a few good visits, but all-in-all, a quiet (though not necessarily restful) day.  Evelyn is "doing fine", all-considered.

Meanwhile, "back in the world", I took Owen for a hike up Stone Mountain, to try & enjoy the beautiful day some.  Not his first time there, but it was his first time up the rock, and I am very proud to say that he hiked it up AND down on his own two legs.  It did take a little prodding near the top, but he was a very big boy.  I think he also may have inadvertently shamed a few huffing-and-puffing ladies ("Well if that two-year-old can make it..."), but they still said he has beautiful eyes.  ;-)


Katie's how to said...

So happy to hear she is such a trooper and all seems to be going well so far. We are all praying for your family at Grace North Atlanta, in church, in community groups, and individually. Know that God is with you in this every step of the way!
God bless, Katie