Bumpy Day

I am home for a nap and a sandwich with tomatoes from the garden. It has been a hard day so far. The team is trying to balance pain and agitation without too much sedation. Sedation makes it harder for Wren to breathe and since it has been only a bit over 3 hours since he was extubated they are still watching respiration closely. However, if he wakes up too much his pressures go up because (even with pain management) he becomes aware of his discomfit and situation and wants to pull out lines, remove hand splints and just get up and go home.

For example, shortly before I left Wren woke up and was speaking in his hoarse little voice. He wanted more milk now. I asked for a binky with some sugar water to dip and Wren became very alert and calm taking the binky and dipping it in the sugar water then sucking it carefully. He did this for 15 minutes, talking a bit and being serious but very much himself.

Suddenly, he had a tantrum. He started kicking wires, I hadn't given him sugar water fast enough and he wanted to move and turn over but was prevented by supports and chest tube. His pressures started going up and up, his heartrate and resp alarmed and his left arm line occluded. It was chaos.

So, then he received doses of morphine, versed and is going to get chlorox. They just want him to rest more than he is able today.

Concerns
Wren's chest sounds rattly because he isn't coughing much. He has stridor and strains to breathe when he is asleep and stressed. When he is fully asleep it is much better.

His left eyelid is droopy. While this could be an effect of drugs we hope it wears off and is not a sign of a stroke. Wren is talking and moving normally so we are hopeful it is nothing serious but the nurse also noticed it and is monitoring it.

Left arm pressure. This continues to spike up to 29 when Wren is agitated. We hope it settles as he settles! It remains around 15 most of the time.

Good signs
Wren is extubated, moving around, talking and alert between doses. He is having a good recovery according to docs at rounds. More for my own records than everyone's interest - I will post some of the comments from Rounds later. As I said earlier, I learned a lot.

Got to nap now.