Ava has two main challenges today. One is that her chest x-ray looks worse than yesterday and she has a ton of mucus in her lungs. The other is that she is having to put up with symptoms of withdrawal. She had a spontaneous trial on the ventilator, which is where they turn off the rate to make sure that she will breathe on her own. She will breathe on her own just fine, but she will not take deep enough breaths to keep her right lung inflated. She'll have another spontaneous breathing trial sometime tonight. Even if she's not ready to be extubated, the trials are good for her to use her own breathing muscles and remember how to breathe. Ava was on a steady dose of ativan and morphine in the NICU and she was stopped pretty much cold turkey down here. she has "as needed" doses available now but she doesn't really get them until she has the signs of withdrawal. This has been a source of contention between me and staff. We hope she'll be extubated tomorrow, but I wouldn't be surprised if she isn't. Her heart echo looked good today. She has a small leak across the patch and still has some blood flow through the smaller hole in her heart that they couldn't find when they were doing surgery. These leaks aren't causing problems. Her white blood cell count is up, but her temperature is just fine. She may have a little cold virus. If she spikes a temperature, then they'll suspect other bacterial infection. I'm not going to update every tiny little medical thing now because I don't want to explain all the medical jargon. So, this is all the big stuff.
I finally registered the boys for preschool. I'm extremely irritated that I have to pay so much more than other people for public preschool just because I live in non-title one boundary lines. But the elementary school on this street doesn't even offer pre-kindergarten any more because everyone up here sends their kids to private preschools or ones with extended daycare. So, I have to pay so much to go to a rich-kid preschool that doesn't exist. If I lived pretty much anywhere else in the city, we'd probably pay about 50 bucks a month, but now I'm stuck with 200 a month to go to the exact same low income school. They gave me a discount too, it should have been 450 a month. The boys are desperate to interact with some other kids though, and they need some stability and predictability, so I think it will be worth it.
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