Wednesday, September 29, 2010

Ups and Downs

After a rough morning and great afternoon, tonight was a mess. Brandy figured this one out before I did, but it just reinforces that when your child is in the hospital you need to be with them 24-7.

From 11am to 7pm we had Sherry as our nurse and she was very good. The shift changed at 7pm and a really sweet young nurse named Gladys took over. She's also great and today is her last day of work before maternity leave, so she looks like she is ready to pop at any moment. Anyway, the point is that both of them are great, competent, and love their jobs.

Today, at some point after receiving her pain meds, Maya got sick and vomited. No big deal, but with a recent sternotomy, it is very painful. Then, she was fine and you kind of think, "OK, so she threw up. Happens with kids, especially after anesthesia. Happens to me sometimes." But Brandy didn't blow it off like I did, and she also noticed that along with the vomiting was a distinct red coloration across Maya's cheeks and nose. She told me that she thought it was the pain medicine, but we couldn't put together which one or if it was even related because this type of thing is so common even this long after general anesthesia, surgery, intubation, bypass, all the medicines, etc. At one point, Maya also said, "I can't breathe," which got our attention even among a myriad of other complaints.

So, later in the afternoon we start paying better attention. Sherry gives the central line Toradol. Maya is a little sluggish but OK. About 6 pm it comes time for the oral Lortab and Maya absolutely does not want to take it. She says it's what make her puke earlier. We make her take it and she cries. It goes downhill from there. She says her stomach hurts, she feels dizzy, nauseous, the red spreads all over her face and some on her throat. Probably three hours of moaning and misery ensue. Nothing can make her happy or comfortable. I was frustrated because we were seeing a reversal in progress as she wouldn't eat or drink. Brandy said, "Look at her, she has the same look she did earlier, but it's worse." Just a bad evening and night.

The shift change happens and Gladys comes on. Brandy decides to bring it to a head by forcing water on Maya to either bring it back up or dilute it. At some point, Maya throws up again--all over the place--and needs a bath. We bathe her in bed, wash all the stuff out of her hair, and get her re-settled. Brandy tells me it's the Lortab. I agree and we tell Gladys. She knew we suspected it because we'd been asking questions about it and Toradol. But they get that all the time as we are worried parents just like everyone else.

Gladys says it's probably one of the other things I discussed above (anesthesia, etc.) and she will monitor it after the 12am dose. Brandy's not going to have it and I know it so I just say we need to see the doctor; Maya's not taking that stuff anymore because it is making her sick. So, Gladys goes to the doctor who tells her that the Lortab may not be necessary anymore anyway, so cancel the 12 am dose and stop it completely. Here is Maya a little while ago--I missed her big smile but you can see she is well:

Between shift changes of new nurses every 8 hours with medicines on six hour dosages and just not knowing her like Brandy does, Brandy stopped something that was getting worse. So, I looked up the side effects of Lortab when people react badly to it and it is a symptom list for Maya over the past 14 hours: urine reduction, rashes, difficulty breathing, dizziness, vomiting, short shallow breathing, on and on. She tolerated the first dose and just was nauseous and dizzy. The second dose produced that plus a rash, difficulty breathing, and made her sick all over like someone with the flu. When she threw it up, she was great. The third dose was even worse than the second.
Looking back it all seems so obvious, but it's not when you're living it. We don't know anything about medicine, but we know our kids better than they do. Brandy, of course, knows Maya like no one should ever have to know another person because of what they've been through and I think we'd be staying in ICU another day or two if that wasn't so.
Something funny is that when we told Maya she didn't have to take the oral pain killer anymore because we thought it was making her sick, she said, "I know," so smugly it made us all laugh.
It's 11:30 pm and Maya is sleeping like a little angel. Brandy is in the chair next to her asleep as well. Angel and guardian angel.

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