....stiiiiiiilllll in the picu

Yep.

We're still in the PICU.

(this is going to be a long post, I've been trying to write it for a week. More stuff keeps happening.)

When I posted four days ago I thought this would be over-and-out in a matter of days. At the very least I was sure we would be out of the intensive care unit in a few hours.

I was very wrong.

Maisie is one sick little girl. They've confirmed pneumonia/pleurisy/pleural effusion. All that on top of her already-weak lungs is why we're still here. She isn't breathing on her own.

So she's still on the ventilator. She had to be intubated again around eleven Monday morning so she's still on the vent, but weaning. Slowly.

(I think I made a mistake in my earlier post; she was intubated in the ambulance, switched to a BiPAP around 8:30 in the morning, made it about two hours crashed, intubated. Looking back the timing in that post makes almost no sense. Forgive me, the ER is not the best place to get a good night's sleep.)

The pneumonia/pleurisy is being treated with two different antibiotics and Prednisone, which finally started making a difference today. She has a chest tube draining the pleural cavity and is on albuterol every four hours.

The vent is doing I think like seventeen breaths per minute, which is better than the thirty she was originally on, but still not great. Her regular breathing rate is 22 breaths per minute, so she's doing maybe five on her own. 

At this point she is resting comfortably and breathing fairly easily, if not by herself.

Ick, that sounds like she's dying.

She's not dying, folks. 

Even if her lungs fail her completely and she can no longer breathe on her own at all, she's not going to die.

That's the miracle of modern medicine.

My daughter is alive only because of the advances we have made in technology.

There's even this thing they can do where they cut a hole in your throat so a ventilator can breathe through your neck for you.

Yeah, I heard the word "tracheostomy" for the first time today.

We might be going there. I don't know for sure yet. Our pulmonologist is kind of young and has never prescribed a trach before, so she asked two other pulms who happened to be in the building today to pop in and evaluate Maisie. The three of them will pow-wow and then I'll get to say my piece, and we'll have a whole meeting with her "sick-team" which consists of the pulm(s), the pedi, child psychologist, and like four other doctors. 

^^^That meeting just happened (this post has been now seven days in the works). 

The consensus is no trach. Yet.

Her lungs have cleared up and she is still relying on the ventilator only because her muscles are too weak to move air into and out of her lungs on their own. At this point (three days after I posted about her breaths/minute) the vent is doing fifteen breaths per minute, and Maisie is taking seven on her own. Which is progress. I don't know if it's enough progress, but progress is progress.

Actually it might not be progress at all. On Sunday when she was intubated she was on thirty breaths per minute and not breathing on her own at all. On Monday afternoon we were able to take her down to seventeen breaths per minute (her regular respiratory rate is 22 breaths p/m) with her doing about five on her own. Now she's down to fifteen breaths per minute from the vent, but she might have been able to do seven breaths on her own from the beginning. Ah well.

The thought is to try to take her down as much as possible today. If she can get to eleven breaths from the vent and eleven breaths on her own, the trach will be completely off the table.

That's not to say if she can't make that much progress she'll be trached tomorrow. We'll re-assess tomorrow if that's the case. 

*le sigh*

OH! She is out of the PICU as of yesterday night though. Her lungs are clear, her vitals are good, and she's totally stable. So that's good news.

My new babe is seventeen weeks! Everything seems pretty good. I had an ultrasound while we are here and so far, so good. The tech was a little worried about her right arm, but she's pretty confident that she couldn't see it because of the position the baby was in.

Either way, I have a level 2 ultrasound scheduled for next week just as a precaution, given the complications around Maisie's pregnancy and birth, but I'm not worried. Too much worry is spent on my Maisie the Great, I guess.