I might have spoken too soon

Well I will start off with the fact that Olivia's chest was closed late last night around 10:30 PM.  Whether we will call it a complete success is another story.  I typically call the PSHU at least once a night to check on the little one and last night was no different.  When I spoke with Olivia's nurse she started off with "I was just about to call you".  Uh oh...no parent wants to hear that from their child's nurse in the middle of the night.  Apparently, Olivia's levels were starting to widely fluctuate from her previous stable numbers as a side effect from the stress of the chest closure.  

What does that mean?  Well originally I was content to lay back down knowing that it was non-emergent and wait for an update later in the morning, but I couldn't really sleep.  I was only a few minutes away from her, so I figured I would rather get up and check on her myself.  Good thing, because shortly after I got to her room, things continued to decline.  All of her blood work was coming back with large indications that her body was just not tolerating the changes brought on by the closure.  The attending Cardio Fellow was very honest with me and said that she thought that this would mean ECMO for Olivia to recover before making anymore forward progress.  ECMO is a dirty word in the Peds world; it's essentially an external bypass machine that will alleviate strain on your child's heart and lungs - yes it's a good thing to have but you don't want to be in the position that you need such a machine to begin with.  

At that point I had to call Brian.  No one wants to make a call in the middle of the night to family members to give them somewhat bad news.  To his credit he was at the hospital within an hour looking alert but of course concerned by the 10 staff members that were huddled around our baby trying to figure out what in the world was going on.  I love the fact that the doctors were so confident in Olivia's ability to fight that they made the nurses change out every single piece of machinery to make sure it was nothing mechanical causing the issue.  Unfortunately, it was nothing mechanical, her body was just too dehydrated to handle the additional vessel leakage that was going on post closure.  The solution?  Well they had to literally pump her full of fluids for hours on end and adjust her meds on an hourly basis until she stabilized around 7:30 this morning.  

Things are relatively quiet this evening, her vent settings continue to be lowered as do the level of meds.  While we're still not where we were yesterday pre-closure, they are happy with her progress.  I for one am happy that they are happy.  Brian will be staying here tonight to make sure there's no more surprises in the meantime and hopefully we'll get a few good hours of sleep.  Here's to hoping for a boring tomorrow!