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September 6 - 2 weeks post op

posted Sep 6, 2010, 10:31 AM by Sean Molby

Yesterday was definitely an eventful day. Sean and I headed to the hospital early so that we could spend some time with Tristan before they attempted his extubation. Eight o’clock came too soon let me tell you. With a total of 17 people in the room, 1 heart surgeon, 1 cardiac nurse, 3 ENT specialist, 1 attending doctor, 2 resident doctors, 1 fellowship doctor, 1 charge nurse, 2 respiratory therapists, 2 room nurses, 1 pharmacist, and 2 very worried parents, he was successfully extubated at 8:15AM.


ENT (ears/nose/throat) did a quick evaluation and determined that they would have to come back in two days to re-evaluate because he was really too swollen to get a great idea of how everything was doing so let me tell ya they were real helpful! They did say that it “appeared” that both vocal cords were working but the left seemed floppy, I think was the word they used. So most likely no vocal cord damage…extremely good news!


 He did fairly well for about 45 minutes and then he suddenly stopped breathing. Not a fun sight for a parent to experience, especially since this was the 3rd time I had to watch this happen. Being it was Sean’s 1st I think he had a slight harder time and realized how difficult last week was for me. Luckily after a couple of different respiratory treatments and some successful secretion suctions Tristan started breathing on his own again and has now remained extubated for a total of 16.25 hours and holding.


Last night was fairly uneventful, aside from an inattentive nurse he was no worse for the wear. I made it to a bed finally around 4 in the morning and that was only because when I left the nurse was in the middle of doing an assessment and after that he was due for his respiratory therapy and then quickly after would be shift change so I knew that someone would definitely be with him while I was resting.


After AM rounds they reduced his dexmedetomidine (a sedative) to .1mg/kg/min down from .7mg/kg/min and he should be completely off of that tonight, possibly tomorrow morning. They reduced his milrinone to .25 micrograms/kg/hour down from 1.25 micrograms/kg/hour with completely weaning him by tomorrow morning. After that it will just be a matter of weaning him from the IV sedation drugs to oral and then up to the floor he will go.  


His vitals have been good since extubation and his blood gases are normal. WOOO WHOOO!!! They will restart his feeds today; they had to stop for his extubation, so that may help with his restlessness a little as well.


For now it is a different kind of waiting game. Mainly the focus will be on helping him through his withdrawals from being on heavy sedation medications for an extended period of time.


Tristan definitely still needs tons of prayers he is a far cry from being out of danger.


Thank you all again for everything that everyone has done. All your thoughts and prayers mean a great deal and have definitely helped pull Tristan through.


He is a very loved little boy. ~Christy