Pain Management

Overall on a whole, Elli had a good night and day today considering she had surgery yesterday. Last night when Brian and I were getting ready to leave, I went to give Elli a good night kiss and she felt very warm to me. I took her temperature and it was 38.1 C (around 100.6 F) and I noticed that she was sweaty and had little tiny water blisters on her face. Of course this was around 2 and our nurse had just gone to lunch so another nurse was babysitting. I moved the radiant warmer off of her and she finally started to cool down. Needless to say we didn't leave until around 3:30 when Elli finally calmed down after another round of PRN pain medication. Last night at midnight Elli had her best blood gas ever, luckily they were cautious and didn't try to change any vent settings last night and let her rest and recover from the surgery.

This morning Elli was doing very well and the nurses were able to decrease the MAP on her vent settings (helps with oxygenation) and lowered the FIO2 (% of oxygen delivered via the endotrachial tube). I guess that once all the sedation meds from yesterday's surgery must have worn off because Elli started getting really fussy around noon, and her saturations were hanging in the low 80's. Even daddy holding her hand and humming a little tune didn't seem to help her calm down. She had been thrashing her arms and having a lot of facial grimacing, so Dr. K had the nurse turn up her Morphine drip to 100 and said that she could give her an extra Morphine bolus and that really seemed to help with the pain. She calmed down for about an hour until she had a wet diaper. For some reason she doesn't like to sit in wet pants...cant imagine why. Hopefully with a couple more Morphine boluses and increasing the rate, the doctors will be able to get on top of her pain which will help with her numbers overall. After they bolused her the first time her oxygen satruations were in the mid 90's, her blood pressure was lower (oh yah, Elli now is having high blood pressures 80's/60's, so they stopped her Dopamine drip) and pulse.

As far as her blood gases go, they have been pretty consistent, no real ups or downs. The next gas is at 4 but who knows what that will look like. It doesn't sound like Dr. K is to intent on weaning the vent settings until he can get Elli's pain manageable, so hopefully that will happen tonight. Brian and I just feel so helpless that we cant really do anything to calm or comfort our baby. Even just touching her makes her more agitated, so we have just been trying to let her rest.

As far as her closure surgery yesterday, everything looks good. Dr. K changed her dressing on her abdomen today and said that it looks nice and pink, no redness and it doesn't appear to be getting too swollen and tight, so that is good news. Also her chest/abdominal x-ray looks good. The hematoma appears to be almost gone, the right lung is well inflated and the left lung is still incredibly small but also inflated.

A lot of people have been asking us for our address at the Ronald McDonald house so I thought that I would just post it so whoever wanted it could copy it down.

Ronald Mc. Donald House

2501 Cherry St.

Kansas City, MO 64108

Attn: Brian and Cassi Reed Room 207

So it is a pretty quiet day down here in Elli's room, least wise we are trying to keep it that way. Still much of the same, staring at monitors, visiting with doctors, and holding our breath for the next steps, knowing Elli will take her time and progress at her own pace. If Elli is up for it I will try to get some more pictures to post, but as for now we are all trying to keep a low profile and keep Elli as comfy as possible. I guess we now need some Pain Management prayers. We continue to be in awe of the amazing outpouring of support. Thanks to all. Brian, Cassi and Elli