Wednesday, October 20, 2010

"I Don't Think Anything Here is Life-Threatening"

That was the theme of yesterday afternoon and overnight. After surgery, Owen's O2 sats remained much lower than the surgeon would have liked to see. He also developed a right-side pneumothorax (pocket of air in the right side of his chest). His respirations were fast and shallow, his blood pressure was low, and he was tachycardic (fast heart rate).

Sooo...

A chest tube was placed to drain the air. After more chest x-rays and an ECHO, this appears successful and no other air or fluid buildup was seen as of last night.

After surgery, he was on a dopamine drip. Then milrinone was added. Then epinephrine. These are all drugs to help keep his blood pressure up and maximize the efficiency of his heart. He also got several infusions of fluids, albumin, and another blood transfusion. After the loss of fluid during surgery, he needed a boost to get some volume back in his system.

He is on 3L of oxygen via cannula, and there really wasn't much to be done last night about his sats except wait and see. His fast respiratory and heart rate may have been pain related, but even after he got doses of pain medicine, they remained high.

In the end, last night we didn't really know what was causing a lot of these issues. The surgeon came to see him late in the evening, evaluated him, and made the statement that I used as the title of this post. We seemed to be chasing our tails with him, and didn't know why.

This morning, the picture looks a little different. Owen has been able to come off the dopamine, and they are weaning his epinephrine now. His blood pressure has stayed up during this changes, which is good. His sats are still low, sitting in the high 70s to very low 80s. Dr. Abraham (our surgeon) expected the sats to be in the mid to high 80s, if not 90s. So there's a possibility that Owen will need to go to the cath lab today (or at some point during this hospital stay) for some tweaking.

His respirations are still in the 40-60 breaths per minute range, and his heart rate remains around 160-170 (yesterday it was 180-200). With every breath, he lets out a little whimper/grunt. It's obvious he is very uncomfortable, but he doesn't necessarily seem to be in pain.

So today, we're waiting for Dr. Abraham to see him and make a decision on whether anything else needs to be done today, or whether we should give Owen's heart more time to adjust after surgery and see if his condition improves.

And that's where we stand.

-Adrienne

PS- I'm sorry I wasn't able to update this last night. First, things were just too up in the air and I didn't want to leave his side. Second, once Mark brought my laptop in, I couldn't sign in to the blog. Hopefully I'll have more luck today.

2 comments:

  1. Thinking of you and Owen ...
    With Love,
    Michelle Long

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  2. Sending love, prayers and smiles! He is such a fighter. He will concur this too. Just wanting to show Mommy how all those drugs work.
    Thinking of you,
    Nikki

    ReplyDelete