PICU

I know it has taken me a couple of days and hundreds of unanswered messages to update everyone, but here it is. As you read in my last blog, Ava was taken to the hospital for what I thought was broken ribs and was sent home. She did ok through the night and by mid morning she was breathing quite a bit heavier. She seemed like she had a lot of secretions but nothing would come up. I called hospice to come out and eval her. They felt that it could go either way and since we had a dr appointment on Monday morning anyway, that it was my call. Less than an hour later, Ava Grace was in full distress. Luckily my cousin, (Doctor) Brandon Oakes, came over for a suprise visit and reinfored mothers intuition. We immediately jumped in the truck and flew to DRMC calling in a botched report on the way. Poor Brandon was probably thrown all over the back of the vehicle with my NASCAR driving skills. Drifting into the ER parking lot, my good friend was ready and waiting. AG was struggling to breath, her lungs were struggling to circulate oxygen and one had partially collapsed. They started line and gave her the first dose of lasix. Her heart was smothering from so much fluid surrounding it. Once they read the X-ray report from the night before, the ER dr said that she was diagnosed with fluid around her heart and pneumo last night. Oh my gosh!!!!! They sent us home with pneumonia and fluid around the heart! I will save my feelings about this for another time when i can prepare a full disclaimer prior to reading. The repeat X-ray showed partially collapsed right lung bc of the pneumo. Upon seeing Ava struggling for air and hearing that she was in fluid overload, it was time to make the decision to intubate or not. Since we knew that her need for intubation was not related to her Trisomy, we decided to intubate and transport to Batson. They know her and her dr's are all there. I will give cuddos to the nurses and Dr at DRMC for being so proactive and on top of everything. From door to helicopter we were in er for about an hour. I was impressed. Once they intubated her, she calmed down and was not as feisty. Air care got to the bedside and made me aware that I could not fly with her because of the isolette they were using was too big, do Bryan and I set out for Batson. We made it to Jackson about 20 mins after the chopper. According to the pilot, AG gave him the stink eye the whole way. That's my girl!!! Keep them straight. Two great ladies were waiting on the chopper to land. They followed Ava to PICU and stayed with her until we got there. Thank you Jackie and Amanda!!!!! Once they evaluated Ava Grace they found out that she had a large air leak around her ET tube and bc of this leak her left lung was not ventilating well, so it completely collapsed. So we are working with a half a lung. They also had to extubate and reintubate, which was a bit scary since they didn't have the right size blade. It took a little bit and was a bit of a struggle, but PICU doc prevailed. The plan of care was since they could not tell if it was true pneumo or aspiration, they were going to treat aggressively for pneumo. They started two antibiotics and had to go up on her vent settings. Even with a half a lung functioning, my little peanut was still breathing over the ventilator. Super proud!!! In case any of you have never had anyone on a vent, breathing over what the ventilator is trying to breath for you is a good thing. It shows that you're not dependent on it to breath for you. They also are doing CPT and IPV. CPT is basically where you take a cup (soft) and beat on the outside of the chest to break up secretions and get things moving. IPV is just like CPT, but it's actually hooked up the the breathing tube and blows strong puffs of air into the lung to pop open the little sacks in the lung, so it will open up. Ava did not tolerate this treatment. Her oxygen and heart rate would fall when they tried to do this with her. She does not like CPT either, but it's helping. After a full 24 hours of CPT and medications, AG is taking a turn for the better. Her left lung is starting to open up and her left lung is not as hazy. She has not ran fever through the entire process. Now she has gone from 100% O2, to 40% O2. They are thinking that if she keeps progressing like she is, then they wil extubate her tomorrow. She will take baby steps to decrease each support measure until she is back to her norm. Right now she is laying in front of me sleeping comfortably and has sats on mid 90's, which is more than the dr wants her to do, so they will most likely decrease her again. I can not praise the Lord for putting people like Brandon, Adam, Dr O, Amanda and Jackie in the right place at the right time. It truly mad this experience a lot more transitionable. Toni has been a Godsend as well. She has been running messenger if I have any questions or issues that they nurse can't answer. I am truly blessed. The Lord just keeps blessing me. I have a awesome and supportive husband, beautiful kids and a nursing background that allows me to understand what is happening. There is no doubt why the lord sent me into this field of study. As far as her plan of care, we will keep doing antibiotics, d/c the ventilator as soon as possible, keep doing CPT, suction and there is no plan for her ribs at this time. Please continue to pray for Ava Grace and for her friend Karis, who is also visiting the NICU. Please pray for strength and recovery as this will be a hard battle to overcome. My little spunky peanut can do it! She is already proving this. I have had my moments as so has her dad. You just breakdown bc you feel so helpless and broken, but if she can keep it together, then so should we! I dive into my faith to send up my prayers ad wishes for complete recovery and sanity. A chaplain for the hospital came by and prayed with us. It was wonderful. Even our pastor made a special trip to pray with her. I love it!!! There has been so many casualties lately, so please cherish each moment with your loved and living ones. In a flash they can be taken. Thank you all for your support!! We love y'all for all the prayers, gifts, food and encouraging words.

“Today I have made you a fortified city, an iron pillar and a bronze wall to stand against the whole land — against the kings of Judah, its officials, its priests and the people of the land.” (Jeremiah 1:18 NIV)