Friday, August 2, 2013

Post-op PICU Day 1

Dr. del Nido stopped by early this morning.  He said the chest x-ray and everything else looked good.  He is ready to start weaning Diego off meds and machines.  This will be a very slow process with big leaps forward and occasional small steps backwards.  Overall this is a very good sign.
The first machine to be disconnected was the pacemaker.  They would like to see Diego’s heart rate stay at 80 or above.  Diego’s HR is hovering around 77.  They are optimistic that Diego has a naturally slow heart rate. 


He had a nice treat this morning, his nurse brushed Diego's teeth and cleaned his mouth for himJ

Diego’s good buddy, Forrest’s mom stopped by when passing through Boston today.  Just before Marlow arrived (approximately 12:00pm) the nurse stopped the paralysis meds.  While Marlow was bedside with me they removed Diego’s left atrial line (approximately 1:30pm).  Diego is still pretty quiet.  He is not opening his eyes or moving much at all.  The nurse is happy with the slow progress and said while he is resting he can work on draining more fluids.  


Early in the evening, Diego had some abnormal heart rhythms.  His HR had been 67 for most of the afternoon then jumped to the mid 90s.  They performed an EKG and said it was junctional rhythm.  So he is back on the pacemaker.  They are pacing his heart over the junctional rhythm so his current pacing HR is 111. 

He is still highly sedated so he isn’t really moving around much.  They are waiting to get more fluid off him before reducing his meds and removing the ventilator.    If his fluid number is in the negative this will help him breathe on his own easier.  We can see on the monitor that he is already breathing a little on his own.  

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