Game On

We have the green light, Elli will be having her surgery sometime after lunch, the plan between 1 and 2, there is a baby in the surgery suite right now, but he will be moved out and Elli will be moved in so she can get settled and stabilized on the OR table for about an hour before her surgery. She is going to get to stay in the surgery suite for a couple of days pending there are no emergency cases that need the room. This is a big relief to Mommy and Daddy since she will be so critical after surgery and any movement will increase the chance of bleeding. After much debate this morning, the doctors and nurses decided that they would wait until after Elli's surgery to put in a central line. As of right now Elli only has her ECMO cannulas and one small IV in her foot. When it is time to wean her off ECMO, all her meds will have to find another way and since the IV in her foot is so small, and also TPN (kind of like her food for now) cannot be given through a peripheral IV, she needs to have a central line placed. We were hoping that they would do it before surgery since afterwards, I don't want her to get worked up, but I guess the decided that they didn't want to do it while she was on so much Heparin.

As for last night, I called and talked to Elli's nurses around 2 after I got done pumping and Elli had to have her ECMO flow turned back up slightly. Her blood pressures were staying fine, it was her blood gases that didn't look as good as they were with the higher amount of support. Last night her gases were slightly acidotic meaning that she wasn't able to blow off enough CO2. The reason for this is that because Elli's vent settings are so low because they don't want to expand that right lung too much which would cause the heart to be compressed, her lungs were not doing enough of the work to get rid of the extra carbon dioxide. Dr. P did not seem to concerned with this since none of the vent settings were changed, he wouldn't expect her to be able to do the oxygen/carbon dioxide conversion herself. So we didn't really take it as a set back, more of a trial run before surgery.

Elli has been really sleepy all morning, even when they turned her at 8:00, she didn't even wake up, which usually makes her pretty cranky. The nurses have not given her any PRN meds since they changed her cannula site on Tuesday. I guess she is just getting her rest for the big afternoon. I hope that she wakes up just a little bit before the surgery so I can get one last peek at those beautiful blues before surgery. Don't worry we will keep posting throughout the day with updates on Elli! Thanks to everyone for the comments, it was so awesome to see how many people posted when we got to the hospital this morning. Check back later..... Brian, Cassi and Elli