August 4, 2009
This morning we came in to see Jenna and she had been very calm through the night. They were able to lower her ventilator rate down to 12 and she was doing well breathing over top of it on her own. She had been on the new sedation for some time, which was working ok for the most part. She is more awake now, body wise, her eyes are still closed but her body is attempting to wake up. They rounded and decided that the foley catheter monitoring her urine output could be taken out. Also they decided to do an echo to see how her right side heart pressures are doing before they take the ventilator out. So the test performed and we found out this afternoon the results. In the mean time Jenna slept fine and just tried to relax. The results of her test came back and it turns out that her right side of her heart is working more than they would like it to at this time. When the echo was done the other day her pressure was 2/3 of the left side. Today her level is what they call systemic, which means that it is the same as the left side. Her surgeon stated that as long as she stayed at 2/3 of the left he was fine, but if she jumped up to systemic or 100% or 200% of the left than this would be an issue. So, at this time they decided to place her back on the Nitric Oxide machine to help loosen the vessels in her lungs so that she is pumping blood easier back to the heart and they changed her from the Viagra medicine to another type of medicine similar, which works the same. They also are going to increase her Lasix and take her off of the dex sedative for now. They increased her Versed and Fentnyl drips back up to what they were and will begin the dex in the am. They do not want her on the dex for too long because it can become toxic to her after 48-72 hours of being on it continuous. Her chest xray indicated that she had a little more fluid on her lungs than before, so they hope by adding these medicines back on it will help to diurese her better (get fluid off) and that way her heart pressures will go back down. They are going to do another echo in the morning to see if she has improved. Right now they are transitioning her back onto the drips, they have stopped the dex and started her NG feeds of Vital Jr. (similar to the Pediasure she is drinking at home) at 10ml per hour. They had stopped her because they did not want her to have this in her stomach when they extubated her. So hopefully in the morning her results will come back better and we will be able to extubate her (take her off the ventilator). We are going to cross our fingers. They have removed the foley catheter now also, which should be fun for the nurses since she is on so much Lasix! But she was already starting to leak around it she was peeing so much, so they thought that this would be better. She was visited by her favorite Nurse Practitioners Janie and Holly earlier who wanted to see how she was doing. This was a nice visit and we were able to catch up from our last visit in May. They will be rounding later today and hopefully we will be able to know any additional plans for her situation at that time. They said that this was a setback for her, but the goal for tomorrow is to extubate. They hope that being so agressive in the next 24 hours that this will do the job of bringing her pressures back down. We will see. We would rather them take their time with her anyway, but we do not want her to be pushed and make sure that she is ready. But anyone who knows Jenna, knows that she always changes in her status quickly and she has always had things done her way. So, they said that it is up to her as to what happens with the situation and obviously she is calling the shots. Go figure! Anyway, I will post more later this evening on her status. Thanks to everyone for your thoughts, prayers, support and love.
Love, Jenny Justin and Jenna