Today was a good day with better results on the sedation issue- every time I was able to be in with Emma Kate, she was either sleeping with heavy sedation or just giving little wiggles and chewing her ET a little bit. I didn't see any of the really awake episodes like yesterday when she was moving a lot and looked like she was trying to cry. At least once she did come-to enough to try to reach for her ET but they got her calmed back down and rearranged her arm restraints so she should be safe. Her arterial line in her right wrist had started to leak blood a little bit around the entry site, and it had been in for a long time, so they elected to go ahead and pull it- now the only catheter she has is in her neck, and it's a double-lumen catheter. We're a bit in limbo on the catheter situation too, since her IJ (internal jugular) catheter has been in for about 1 1/2 weeks and they were talking earlier in the week about wanting to get that changed out. The thought was to take her to the OR again and have a longer-term catheter surgically placed so that we could pull the IJ and not have to worry about constantly moving catheters from site to site any more. We were supposed to get that done today, but they realized that if this plan is working, we might be able to manage with the IJ for several more days then get rid of it. If it looks like we're running into complications or if her trachea isn't holding open like we need it to, and it looks like we're in for another few weeks of treatment or surgery, then we'll get the surgical catheter placed.
They're weaning down the ventilator slowly, to allow her to build up her breathing muscles again, and they're starting with the ventilator respiratory rate going down so that she's having more frequent independent breaths. When I left the hospital for the night, she was breathing pretty much independent of the machine (the machine still supports her each time she takes a breath though) with only an occasional breath initiated by the vent. She's still looking good and hasn't yet started with the forced-abdominal exhalation like she has done in the past. She's been off the paralytic for about 30 hours now, and previously she was having issues develop by about 18-24 hours off the paralytic, so hopefully this means progress. Weaning from the vent will be a several-day event, and we're not sure yet when to expect she might be extubated if all goes well- we've heard as late as next Wednesday or Friday.
Little Gretta is still doing well although she's hit that phase at a few weeks old where tummy issues start to show up- she's had some gassiness that has made her daytimes a little more difficult- she's frequently fussy throughout the times when she should be sleeping, and often only gets short cat naps between little belly aches. She finally had a good long nap yesterday on top of me, and luckily she's still doing well at night. She's very strong and is holding her head up pretty well at this point although there's not a lot of control there yet. She's smiling and focusing on us more and more each day, and she's losing the hair on top of her head! She's going to look like she's got a serious receeding hairline soon- the hair on the sides and back isn't letting go, and it's so long... it looks so silly with barely any hair on top! She's growing like a weed too, she's fitting snug in clothes that Emma Kate couldn't fit into until she was a few months old! :) And man, this little girl has some big feet- we've had to buy 6-12 month size socks for her since all the others are too short in the foot! She's going to have big canoes like her big sister does! We haven't been taking many pictures because of the circumstances, but Mimi did manage to capture Gretta doing her first thumb-sucking practice:
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