We weaned the flow on her oxygen down to 1.75 liters and she tolerated it well. Her oxygen was at 30% when I left and her saturations were okay, but not fabulous, so we'll see if she continues to tolerate that or not. Room air is 21% oxygen, so we're getting very close! We need to continue weaning the flow, too. In order to move to Intermediate, it has to be a liter or less. And in order for her to be able to feed, it probably needs to be at least that low, too. Her morning nurse today described the high flow like sticking your head out of the window while driving down the interstate. Adding eating to that would be like trying to drink out of straw while sticking your head out of the window driving down the interstate. We have to take the oxygen wean very slowly. It's likely to be two steps forward, one step back again and another one of these dances as we get it weaned off. If we don't give her enough support it could trigger a pulmonary hypertension episode. But we also don't want to give her more than she really requires because the oxygen can be damaging to her lungs. Tomorrow we will check her electrolytes and we hope that they will all look a little better. If they do, we'll drop a dose of Lasix and maybe be able to reduce/drop the sodium chloride and potassium that she's on right now. Both of those supplements can cause nausea and vomiting. Which brings us to the next issue - she is still spitting up some. Today Clara went through four outfits. She pooped through the first one and spit up on the next two (Tomorrow we're initiating Plan: Bibs). We're still not 100% sure of the cause of the spit up and whether it's just normal baby spit up, acid reflux, or one of the other medications or withdrawal from. So, we're hoping we can continue to reduce her meds overall in order to improve that situation too.
So, the prayer list remains the same:
- Continued weaning of O2 and flow.
- - Successful weaning of sedatives and painkillers without the wicked side effects of withdrawal.
- - Transition to oral feedings
- - Management of spitting/throwing up
- - Healing of her wounds
- - Protection from secondary infections
- - The physicians and staff caring for her and making decisions about her care.
- - Penelope and her family – surgery is scheduled for noon tomorrow. Please pray for them on this important day, just as you prayed for Clara five and a half weeks ago!
Like I said, we went through four outfits today. I only have photos of one of those though:
|Kiss you? No problem. Over and over and over....
I will give thanks to the Lord because of his righteousness;
I will sing the praises of the name of the Lord Most High.
Give praise to the Lord, proclaim his name;
make known among the nations what he has done.
Sing to him, sing praise to him;
tell of all his wonderful acts.
Glory in his holy name;
let the hearts of those who seek the Lord rejoice.
Look to the Lord and his strength;
seek his face always.
Remember the wonders he has done,
his miracles, and the judgments he pronounced.
1 Chronicles 16:8-12