Big Fears and Small Setbacks

LAP Line and other Progress
The LAP line is out. The cardiologist who did it said there was no bleeding but since Wren's platelets and hemacrit were low he ordered a blood transfusion. I think he is getting 150 ml.

The EKG is pending and the echo was brief. It did not confirm or deny the location of the LA line tip but they are looking on another screen to see if they can visualize it.

One of the residents came by to do an exam. His chest tube has been allowing air to gather under Wren's skin. If you touch his belly around the tube and quite far down, you feel a strange crunching of bubbles. Its called crepitation or subcutaneous emphysema. They redressed and packed gauze around the tube to try and slow it down. The chest tube is still putting out more than 50CC per 24 hours and won't come out just yet.

The Plan
Next line for withdrawal will be the arterial line in his right hand. I hope that will come out later or tomorrow.

They may talk about the "move to the floor" tomorrow.

How am I doing?
My feet are sore. I know its small potatoes compared with heart surgery but I would love to sit down and drink tea and talk about... well, potatoes or the news or the weather or fall trends in woman's boots. Or sleep.

If you have ever done a really long haul intercontinental flight this might feel familiar. Its as if you are just keeping on hopping from NY to London to Joburg to Dubai to Paris to LHR to Hong Kong to Sydney. You have no idea how long you've been going or what day it is or what time it is in that day. You see flashes of sunlight but it feels wrong - too bright for afternoon or too dark for lunchtime. You wish you could have someplace more private than an airport lounge or a chair 100 people have sat in last week.

You worry about your luggage and whether you will find it again. You have no idea when the flight will end or whether you will end up at your destination or somewhere obscure and unfortunate that is not written up in guide books. You learn to compromise and be thankful when you are not sitting next to someone with SARS or broad shoulders. You are constantly afraid you have lost your passport and you really love a latte and an internet connection.

What the H*CK is up with the LPCH internet gateway!!!! (I am now standing in the LPCH courtyard using the Stanford Hospital Gateway by pointing my laptop a certain direction.)

Worries
I am pleased by Wren's progress. My worries are about how long this improvement (halving the gradient so far) will buy us. I knew this was the risk in trying a less invasive procedure like either valve replacement option and I very relieved Wren has made it through but we have to ask "is it enough?" "Will his LV improve with the remaining gradient and how long will it take to recur if scar tissue forms?" I am thankful that we have come so far but it is always nice to think that you have done this FOREVER and there is no long term outlook without surgery sooner or later.

The Rennovation
While this is not really of widespread interest, all the nurses and staff are keen to talk about 'the move' to the new CVICU and ORs on the first floor. The new CVICU will have a parent lounge, space for parents to sleep by beds AND will double the CVICU and PICU beds. It will also increase ward space and have a transitional area between CVICU and 3-West.

I peaked down the corridor to the new ORs when workmen were going in and it looks very high-tech and pretty but I guess all ORs look that way uninhabited.

Apparently, they will not be getting more surgeons but will be able to schedule more surgeries - slots are currently booking into March right now - but they still expect the same delays and backups as beds on Ward hold up the moves.

Today, they are short of beds again and our neighboring 15 year old with a pulmonary valve replacement is moving down to a lower priority area (farther from the hub) and the transfer patient from Cleveland will be our bed-mate.