Tuesday, November 6, day 44

Miss Emma has had an eventful 24 hours. After a blood transfusion last night, her little system was still not happy this morning. She is still ‘leaky’. The fluid around her heart began causing some problems and this morning was the right time to act on it.

At 9:00 they began. There were 8 docs, a radiology tech, 2 nurses and 1 mom in the room. I am constantly amazed at the amount of equipment and people that can fit in the rooms. I think our personal best is about 15. 😦 With the guidance of an echocardiogram, the cardiologist put a needle in the sac around her heart. Then he pulled a ton of fluid off. 35 ml of fluid came out. He inserted a catheter that will continue to drain over the next few days. The whole thing took about an hour. Emma has continued to drain fluid. Obviously needing to drain fluid from around her heart is not ideal but if it had to be done, this was a good time. The whole thing took about an hour. Emma did really well for all of that. Please pray that the sac will not continue to refill and the drain will not cause problems.

With all of the fluid shifts she has had today, Emma is having some trouble with her BP being too low. The hope is that with a little help, this will normalize. In the mean time an arterial line is in order. An art line will give a more accurate and continual BP reading.
Hopefully they can get one in place. Her vascular access points are limited in number and very hard to stick.

On a good note, the PD is working! It is not as controllable as the CVVH but it is working fairly consistently. I am optimistic about this, and the possibility of going home. The PD nurses have even started talking about getting some training lined up on the cycler (the dialysis machine that we would go home with). It is still probably really early to start thinking about that. We have this week and next week with the same doctors. I think we would all agree it would be nice to get out of the PICU before the next change out. Not likely.