"Upgrade"

It's still Tuesday, August 30th 2011
Let me Upgrade Ya....


We got a call around 5 this afternoon from the charge nurse in the Pediatric Unit here at UCSF saying that we were going to be moving Cayleigh to the ICU. She was originally admitted this morning as a normal admission for a Sleep Study that the Pulmonary Doctor wanted done as a final step before being given a tracheatomy. Insurance required this test before they'd approve the trach.

Anyhow, last night she started having a hard time breathing and we increased her oxygen to 1 liter. Her heartrate went high, she was breathing shallow and rapidly, and we managed her heartrate with Tylenol. Despite all of the boogers pouring out of her nostrils, she made it through the night.

We packed Juliette in the car with us this morning, leaving at 8 am, and made it to the hospital around 11:00 am with traffic. We checked in, waited for a bed and were taken upstairs to the standard Peds Unit. Our nurse was a 7 month pregnant lady who was quite nice, very pretty but obviously busy with discharges, dressing changes, meds and etc with other patients. We started noticing that she was breathing even more rapidly, shallowly and wasn't paying attention to us like she normally does when she's focusing so hard on breathing.

A few hours later, and about ten people told over and over by Nic and myself, they finally came in and decided that because she'd desated to 78, staying in the 80s for quite some time and even on 2 liters, and not responding to two breathing treatments or deep suctioning, they needed to transfer her. Apparently, the doctors who were there (when we were not) were concerned with her focused up to the right and having super stiffness and so they gave her a mild dose of some seizure medication. When we got to the ICU she looked stoned, heartrate was up in the 200's, BP high, respiratory rate really high and oxygen not high. Praise the Lord that both bloodgas draws were normal!

She had an apnea episode where she stopped breathing for a few seconds and the nurse called out "We need to tube her!" but the doctor on call said no, put her on high flow (10 liters in the cannula) and let's see how she does.

The other doctor, main old pulmonary guy, had her scheduled for a bronchioscopy in the morning which is when they'd put her under and do a scope all the way down to her lungs to make sure everything looks good, that there arent any abnormal structures to her airways, lungs or vessels around her lungs that might be causing the breathing problems before they do a trach.

I think I have everything on here right now but I'm pretty sleep deprived as it is. We'll post updates as we can. She's currently at 18s on heartrate, her oxygen is 100, respiratory rateis 68 and bp looks ok I suppose. No tube yet but they're preparing to possibly do that because she's struggling to breathe so hard.