Her LA line came out this evening (Rob called it the LAP, but I think its more commonly known as the LA Line). It can be somewhat uncomfortable (the removal), but she just kept on sleeping. They were able to turn off the pacemaker. Its still on as backup, but her heart rate is back up to a normal rate that they are happy with.
She also got her first dose of Enoxaparin. If you remember when she had the blood clot in her groin, Rob had to give her Enoxaparin injections into her thighs? Well, here we are again. They put a Gortex shunt into her heart, which has a higher likelihood of clotting, so the Enoxaparin is preventative. The nurse tonight said she will likely only be on it while in hospital, but once she leaves she will take a daily dose of aspirin to keep her blood from clotting. The amazing part was that the nurse gave it, and again, she kept on sleeping!
Oh right, our nurse tonight. "Nurse Chris." She is wonderful! I adore her. Absolutely meticulous. She came on at 7:00pm and has been fussing over Abbi ever since. We find each nurse has their own routines and ways of doing things. I suppose in some ways it can get a bit annoying, but it also shows that they want to provide the best care they can, the best way they know how. She is very interactive with Abbi and Abbi really seems to be responding well to her. She readjusted her and she also got a sponge bath. I was able to put some pigtails in her hair. She is looking much better.
Abbi slept very little last night apparently. Or if she did sleep, it didn't appear to be very restful. So today she slept almost all day. Minus the odd wake up to ask for water (which she can now have) and jello (we may have a Jello addict on our hands after this hospital experience!).
Its been just this evening has she really woken up. She has a little portable DVD player on her bed and she has watched Dora a few times. This seems to be entertaining her somewhat.
Her major discomfort at this point is her oxygen nose prongs. She is breathing on her own, but when she gets worked up or in a deep sleep her SATs drop fairly low (low 80's). So to help her they had a mask beside her face blowing air, as well as prongs in her nose. Well, Abbi is not at all impressed with this! She has pulled off one sticker on the one side of her face, and is halfway through the second one. I'm sure she'll have them pulled out by morning.
She didn't get her sternal drain tube pulled out today unfortunately. It was still draining deep red blood. Its not a considerable amount, but not really thining out as much as they would like. So they will do that first thing tomorrow morning. Apparently this is the most painful and uncomfortable aspect post-op. Older children say the actual incision is nothing compared to the drain tube. This is resting under her heart (or on top, not sure which). So whenever she moves it is quite uncomfortable, and its a fairly rigid tube. So once that goes, apparently its night and day for pain management for them. She has two other drain tubes on either side of her heart, but apparently those are much softer and irritate much less. Those will stay in for a few days yet, but do not keep us from moving to the ward. We could even potentially go home with those still in if needed.
She is down to .5 of morphine. Not really sure what that means, but I do know that it was much higher right after the surgery (maybe 2.5?). They have been lowering it throughout the day, so that is good to see such a heavy drug go. She is also getting regular doses of Tylenol, and she just got a anti-inflammatory drug, similar to IB Proufen. That seemed to help with her discomfort for a while. When I stepped out to write this, she still seemed fairly uncomfortable, but again, that's mainly the nose prongs at this point.
You see little glimpses of Abbi more and more. When asked if she wanted to watch a Dora movie, she said "I love Dora and boots." Then she was stretching her arms up over her head and Chris said that if she continued to do that, she might just have to tickle her (which she wouldn't because that would likely cause her a lot of pain). Abbi said "I love being tickled" and then grunted out this mini-laugh. It was sweet. She is becoming much more expressive. The morning of the surgery while in the PAC, Abbi was in love with everything. "I love trains, I love butterflies, I love..."
Tomorrow they have a list of 5 things they will do first thing, including pulling out the main drain tube. They will also remove her catheter, and I'm not exactly sure what else. These are all very good things. Once the main drain tube is removed and she stays stable we will likely go up to the I.C.E. unit. Hopefully the oxygen will also go.
As for the rest of us, I think we are all getting by. Our "schedule" seems to be working. I really am a night owl, so staying up here until midnight works much better for me. Ruth was able to get home this afternoon and get in a bit of a nap before coming back this evening to give me a break to run and get some dinner. Rob and his Mom left around 7:00pm for the night. They took Gabe with them, and have a bottle ready to go at home. Hopefully he will take it again. He really is being such a doll for this entire experience.
When we first arrived in the PICU it was fairly empty, but now its filling up. Not sure if that's a long weekend or just life. Actually the little guy I mentioned yesterday in the bed next to Abbi was the reason we got bumped for our surgery time. He appears to be stable, but has a long way to go. The parents are from another Province and only arrived last night to see him (so he must have been airlifted). They walked into see this little guy under a tent of plastic and tubes everywhere. So hard to imagine. They've also had a 15 year old girl come in tonight. From our eavesdropping (which one does much of when there is so many people in such a small area) she was in a car accident and had to be brought in via STARS (Alberta's air ambulance). The family looks pretty shaken up. So again, even in our little corner of PICU, you see so many hurting families, and know that you are not the only one experiencing something like this.
I better get back in and get ready to say goodnight. It really is hard to leave when she is so much more alert. But I also find that there is always one more thing to stay for. Last night I thought I would leave at midnight, but then Suzanne was doing her checks and I ended up being there until 1:00am! So tonight I'm hoping to be home by midnight. But again, you never really know...
Thanks to everyone for your encouraging comments, and for those of you remembering us in your prayers. I wish my updates could be a little more timely (AKA not at midnight!), but it seems to be the best time to update. I will be updating again tomorrow morning sometime.
Much love,
The Nepper Team
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