monday 6/17/13

I'd like to say she's improving, but the only thing that improved was her white blood cell count went from 61 to 50. She is in a lot of pain, presumably from the chest tube, so her morphine is now scheduled every 3 hours instead of give "as needed." She is also now being given versed instead of ativan because it's nicer on the veins. The chest x-ray, yesterday, found a pocket of fluid around her right lobe in her lung. The fluid was mobile, not fixed like a pus pocket would be, so the hope was that the chest tube would drain the fluid if we got her in the right position, but its been a day and it still hasn't drained according to the latest x-ray. The x-ray shows that the right lobe is either collapsed or has pneumonia, which is a major contributor to her difficulty breathing. Additionally that pocket of fluid is likely making it difficult for that right lobe to function properly as well. I'm getting mixed reports between the attending and the surgeon as to when the next esophagram is- to see if the tear healed itself. One says "this week" and the other says in "a month." So I'd really like to get that cleared up.  amber

10pm The pocket of fluid that was found around the base of the right lung lobe has become larger and more fixed. Tomorrow she will go down to interventional radiology and they will suck out the fluid with a needle-thoracentesis. Then they will culture the fluid. Hopefully this will reduce a little pressure on that side of her lungs. She is now positoned only on her left side to take as much pressure as possible off that right lobe. She hates it. She's used to being in many different positions all day and all night. They still will not let me hold her which annoys me to no end. Thankfully, she is still on the CPAP breathing machine. THey've had to bump the settings several times but at least we've been able to avoid intubation thus far. She also no longer has her own nurse. She is sharing her nurse with another very needy baby. I've been told that her esophagram is scheduled for either Thursday or Friday. Pray that the tear has repaired itself and we can remove the very painful chest tube.