Since Tuesday or so, Mia had been having high heart rates periodically for a few days so I figured she was on the verge of getting sick ... but there were no other changes which was strange to me.
It finally happened on Thursday evening that she was starting to not do well. You could hear the junk in her lungs, but it was too deep to suction up through the trach. She ended up getting a PRN albuterol breathing treatment to open her up and that seemed to work. Her breathing got deeper which is always good.
Friday morning, Robert had left home with enough time to spare, so he decided to drop in to see how Mia was doing. Unfortunately, she had a rough night and needed to get maxed out on her ventilator settings order to keep her stable. Her co2 got as high as 69 and she was requiring more oxygen. I told the morning nurse to please keep her resting and not to send her to school or group activities for the day since she had a hard night. I'm the Mom, so she had to listen to me. :)
Mia's respiratory therapist for the day was Jan, and she worked with Mia non stop trying to get her stable. Mia was, no kidding, like a fountain. Secretions were just flowing out of her nose and mouth and she was requiring very frequent suctioning to her trach. Finally around 5pm, Mia was pretty stable - still maxed out on the vent settings and needing 2 liters of oxygen. (She normally only needs half a liter.) They got a urine sample to check for another UTI, and thankfully that was clear.
Yesterday, she was OK, not terrible but not good enither. Her co2 was stable - in the 30's where it should be, but she was still needing lots of trach suctioning. Something that is unusual for Mia.
I got a call this morning from the noc nurse Tony saying that around midnight her co2 was in the 60s and her heart rate was high so they gave another PRN albuterol treatment and also Tylenol, but through the night she was still needing lots of attention. Around 8:45am i got a call from the charge nurse saying that at the beginning of the shift, Mia's co2 was in the 60s and had climbed up to the 90s and that the doctor was on his way to look at Mia. Yesterday I had asked if she might need a chest xray, and at the moment, they didn't think she needed one. Today, however, she got the xray and according to the doctor, her lungs look okay, but the trach looked a little twisted. Slightly turned to the side. They did a PRN trach change and now secured the tubing so they stay midline on her chest to keep the trach straight.
I skipped church and am with Mia now instead. They gave her Motrin just before I arrived and her heart rate has decreased from 170 to 133. Still high for her totally asleep, but a lot better. Her co2 is down to the 40s, and she is still maxed out on the vent settings. She's satting 97% on 5 liters of oxygen. Quite a bit (around 41% oxygen) considering she normally only needs 23%.
I'll try to update again... I'm getting better at this! :)
Rachael
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