Yesterday, for the most part, was pretty uneventful. Kinley's high frequency vent support was lowered a bit and we are hoping that she will be able to move to a conventional vent soon. Her blood oxygen saturation remained consistently in the 90s and the oxygen from her vent ranged anywhere from the high 20s to the mid 30s. Kinley continued to show signs of withdrawals, mainly vomiting, but Kathy and I did learn a new sign of withdrawals from Kinley's night nurse Stacey. Sneezing is a sign of withdrawals and Kinley must have been having some serious withdrawals around 9:00 pm last night because she had a little sneezing fit. It was about 4-5 sneezes right in a row and, to be honest, I thought it was really cute until I found out it was a sign of withdrawals. The nurses keep score sheets on Kinley's withdrawal symptoms to help the doctors make decisions on how fast or how much to wean her narcotics. They have also begun to weigh Kinley each day. She is around 8 lbs 13 oz.
We have Phyllis back! Phyllis is the first ECMO nurse that Kinley has had since moving out of the operating room. Many of the ECMO nurses have stopped by to visit Kinely, but Phyllis is the first to be scheduled to care for her outside of the ECMO and operating room. Now don't get me wrong, every nurse here at Children's Mercy has been absolutely amazing, but we will always have a special bond with all of Kinley's ECMO nurses. Kinley's first 28 days of life, and therefore 28 straight days of our lives, were spent entirely with Children's Mercy's NICU ECMO nurses.
Phyllis gets us back up to speed on Kinley. Last night she required two extra doses of morphine and versed to calm her down. They also increased her morphine drip from 20 to 25 because Kinley had scored too high on her withdrawal symptoms score sheet. This morning Kinley has been calm and sleeping. The oxygen from her vent is at 37% and her blood oxygen saturation is in the mid 90s.
For rounds today we had Dr. K, Delores (nurse practitioner) and Dr. W. It was really nice to see Dr. W again. Based on all of Kinley's numbers Dr. K has decided to increase her methadone dose and stop the morphine drip completely. I will be interested to see how Kinley handles this, but it will be nice for her to have one less narcotic running through her tiny body. Kinley will continue on the high frequency ventilator, but Dr. K has put in an order to have the support turned down a bit more. The reason that Dr. K wants to keep her on high frequency vent is because it helps to keep the lungs constantly expanded. This will put constant pressure on any fluids collecting in her chest and force them out of her chest drain. We will also continue to wean Kinley's vent oxygen as appropriate.
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1 comment:
Hello,
I left a post but I'm not sure where it went. I was searching for a friend of mine and came across your blog. I live in Lee's Summit and saw that you are a neighbor. The pictures of your Precious Kinley shows she is a fighter. I have read your story and wanted to let you know that I will be praying for a speedy recovery.
I have three boys and my two year old is a frequent visitor of CMH clinics due to severe asthma. Please stop by Mythreesons9506.blogspot.com. I will be thinking of your family and again will continue to pray for her as well as mom and dad.
Kaci
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