Thursday morning

Here's a picture of Emma Kate's private jet- she's moved up in the world in the last two months... :) This is how she and Daddy got up to Cincinatti so fast.

Emma Kate has done pretty well in recent days- they are getting less and less out of her ET tube, and she has been relatively awake and calm. She looks around a lot and sometimes you can tell what she is saying even with the tube in- like yesterday I asked her if she needed a new diaper (I already knew she did...) and she mouthed "no." She has been silly about her diapers since all this started, and she usually says no if we ask her if she needs it. She's watching a fish tank on the TV (comes complete with bubbling noises), and her uncle Ryan got her a big sparkling snowman snow globe and little Brittany chipmunk doll- she loves them both! I wonder what that snow globe looks like when she's had Ketamine...

There have been a few fevers off and on, and nothing had been conclusive on the cause until her last respiratory culture that was taken the other day grew Moraxella. Apparently it's a common respiratory bug in kids and can cause ear infections too. Fortunately she was already on several antibiotics (Vanc, Zosyn, and Gentamycin) that are total overkill for that bug. Today they switched her to Rocephin. We're still dealing with some diarrhea issues, and we've just gotten the 3rd stool culture necessary to rule out C. difficile. Hopefully it's just all the drugs and antibiotics she's been on. They've been giving her Lactobacillus to try to help things a bit.

She's been doing well with the NAVA device on the ventilator, her peak pressures have been in the teens for a day or two now, and she has been doing well getting rid of CO2. Her blood pressure has been pretty stable lately except when we had her really really comfy and it just dropped a little below the acceptable range. It has not required any further medication to maintain it since they were stopped a few days ago.

The nurses have been getting less and less out of her ET, as far as secretions go, and she at one point was able to cough well enough to move secretions up into her ET where we could actually see them. The ENT folks came in yesterday evening and did a quick bedside scope through the tube and said they didn't see much in the way of significant secretions. Hopefully things are really settling down in there. There may have been some confusion about whether they were all the way to the carina or if they were right where the pig bronchus branches off- it can be pretty misleading in there!

Last night at midnight she was started on Propofol and her fentanyl and versed drips were stopped. She's had enough time to get the drugs out of her system now, and we're hoping to attempt extubation here in just a few minutes. We're very anxious to see how she does without the tube in- hopefully she will do well enough to just stay on positive pressure nasal canula O2 and won't require reintubation.

Gretta has been a night owl lately, with two nights starting at about 11pm... yesterday we decided to get bedtime going early and be serious about it, and she got to sleep shortly after 9pm. I hopped in the shower, and she must have known I was enjoying a nice steam bath because she decided to wake up screaming shortly before I was done! Luckily she settled back down and went to sleep again easily. She continues to develop her little personality every day and is really engaging lately. She smiles a lot and makes some pretty funny faces. She's got everyone at RMH fooled- they have no idea what the pterodactyl is capable of! We're working on setting up a wellness check for her here at the hospital since she's coming up on 2 months already. I can't wait to see how much she weighs- she's a chunky monkey.