Post-op Day 4

If you saw the previous post, you know already that Rebekah is doing well this morning! She was able to sit up for a bit with the help of Daddy and the respiratory therapist, John. It didn't last long, maybe a minute or two, but at least she was up for a bit.

Rebekah had a good night and rested well. She had a few periods of being alert and looking around, but for the most part she slept all night.

This morning brought a few bumps in the road, although Rebekah seems to be handling them well. Each child in the PCICU has a chest x-ray in the early morning hours, and this morning's x-ray found that part of Rebekah's lower left lung has collapsed. This is not uncommon or alarming, but it does merit concern since this is Rebekah's only working lung. Rebekah's lungs also sound very "junky" and the doctors and respiratory therapists are working hard to get that junk cleared from her lungs before it becomes an infection. Right now the plan is to sit Rebekah up three times during each shift and maybe start a bit of chest PT if Rebekah can tolerate the pounding on her back. That part is still up in the air. Rebekah is on an antibiotic to try to prevent a bacterial infection, so that should help.

Dr. Graham did another echo on Rebekah this morning while we were there and said that the function in the left side of Rebekah's heart looks great. In fact, he said it looks better than they would have expected. The right side is still not squeezing like they would like to see, but he expects improved function over time. Rebekah's pressures are back up today, so we're kind of waiting to see what comes of that.

Also, Rebekah had started getting some pediasure in her g-tube last night, but the feeds were turned off this morning because she is holding food in her stomach and not digesting it. That's not a big deal, and certainly not uncommon post-surgery, but is something that they will watch. They will probably try feeds again later this afternoon.

Today's plan is mostly just focus on getting the lungs cleared up. Dr. Graham said there had been talk of pulling one of the chest tubes and maybe the pacing wires today, but since Rebekah's pressures are up again, they want to leave everything as is. They are planning to let Rebekah try some food as soon as she wakes up from her nap.

Oh, one other thing I have forgotten to mention the last couple of days is that Rebekah is struggling to keep her Potassium levels up. Most all post-surgery patients struggle, but Rebekah seems to be having a tougher time with it. Partly it is due to the diuretcis, which pulls potassium out of her system, and partly it is due to DiGeorge syndrome. The nurses are very on top of giving her replacement potassium around the clock. We are all hoping when she gets off of more of the diuretics and she starts eating again that the situation will take care of itself.

That's the news for now......will update later this afternoon or if something changes before then! :)

Nancy