Kathy and I arrived this morning to find Kathy (a surgeon) and Brecklyn (Kinley's nurse today) hovering over Kinley with the bed lights on. What's going on? Kathy, the surgeon, is here to clamp Kinley's chest tube, clean her surgery site and also remove some, not all, of the sutures from Kinley's diaphragm repair surgery. Kinley is kicking and silently screaming, even though Brecklyn has already given her an extra dose of both morphine and versed. Kathy, the surgeon, was able to clamp the chest tube and remove a few sutures, but not as many as she was hoping for. Kinley is simply moving too much for her to work safely with sharp scissors. If Kinley is able to get her head MRI today then Kathy will return after to finish. The reason Kathy wants to come back after the MRI is because Kinley will have to be sedated for the MRI and then she can work on removing more sutures without Kinley moving around.
Due to Kinley's earlier kicking and flailing, she is now without an art line. The art line was in Kinley's left foot, but she kicked it out entirely. The art line was used to draw blood for her blood gas tests and monitor her blood pressure. Now that Kinley is without an art line she will need be poked every time to draw blood whenever they need to do a blood gas test and the only way we will know her blood pressure is if they put a blood pressure cuff on her. The blood pressure cuff is the exact same as the one at your doctor's office, it is simply smaller. Not having constant blood pressure readings will probably be hardest on me since I tend to focus on her screen of stats, but at least I know that her blood pressure has been really constant since coming off of ECMO.
Good news! Brecklyn has received word that Kinley's MRI might be moved up to 11:30 am. Originally Kinley's MRI was scheduled for 4:00 pm. All we can do now is keep our fingers crossed that the 11:30 am slot stays open.
We made it in time for rounds today. Dr. K was planning on decreasing Kinley's versed (sedative) drip a little bit, but since she will hopefully be going to MRI today he decides not to make any changes because she will need the sedation during her MRI. Before Kinley can be extubated (breathing tube taken out) Dr. K wants her to have her head MRI and have her chest tube clamped for 24 hours. Since Kinley's chest tube was clamped this morning, Dr. K will take a close look at tomorrow's chest x-ray and make a determination then of if Kinley is ready to be extubated. Back when Kinley's original PICC line looked irritated they took a blood sample to check and see if she had an infection. While they waited for results they started Kinley on some antibiotics. Dr. K has decided to stop those antibiotics because the blood sample is showing no signs of an infection. But a recent tracheal aspirate (test of lung secretions) is showing a possible infection so they will begin a different antibiotic today.
Kinley left for her MRI around 11:45 am. It should take between one and two hours depending on what they see and how well they can keep Kinley sedated. She needs to remain very still during the MRI, but she is known for burning through her sedation very quickly. Remember this morning, Brecklyn gave Kinley an extra dose of both morphine and versed and it didn't even slow her down.
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