Night 1 Post Op went better than I anticipated. This was the first time I have been able to stay with him the night after heart surgery. The other two times he was a baby in the baby pod of the old CVICU where you were lucky if you had a chair bedside some days. The new CVICU has individual rooms for each patient with a parent bed. The evening was spent getting him all settled. The plan for the night was to monitor his vitals and if things looked good we would work on waking him up a bit more and take the breathing tube out around midnight. They came in around 11 and said they were good and were ready to take the tube out. It seemed like all at once we had about 5 nurses, 2 doctors and 2 respiratory therapists in the room swarming around. It was an intense 30 minutes of taking the tube out and figuring out the best option for oxygen support. We tried high flow nasal cannula and then opted to switch to CPAP. Once things were settled, Brody would sleep, but any time he would start to wake, he would get super agitated and his oxygen levels would drop. He was on a continuous dose of morphine, but if he seemed in pain or unsettled the nurse could give an extra dose every 10 minutes. I think he ended up needing about 4 extra doses over night. It stayed relatively quiet and I got more rest than I expected, but woke up every couple of hours when he would start stirring and whimpering, but was able to go back to sleep when he would get his extra morphine.
This morning has played out much differently. Brody has been super irritated and his oxygen numbers have been hanging out in the 80's. They came in and switched him to BiPAP, but that wasn't helpful. The question has been is it the BiPAP, pain or irritability that is causing him to be so restless. I think it's a combination of the three. Overnight Brody had gotten the 4 extra doses of morphine. From the time the day nurse came on until about 9 am, she had already had to give him 8 extra doses or morphine with no real success.
One of the ICU doctor's was talking to me and that he was hoping to try some things and keep the breathing tube from having to go back in, but that it could be a possibility. Within about 5 minutes, there was about 15 different doctors and nurses swarming around and they made the decision that they would put him back on the breathing tube. I wasn't really surprised as his oxygen is always an issue after procedures and I am used to proceeding very cautiously with "the plan," because nothing ever goes as planned.
I had to step out of the room why they got him re-intubated and waited for them to finish. It is so incredibly hard to watch so many people flock to his room and rush around. I am good at staying calm in the moment, but dang. After the tube was in they told me that he had some very thick secretions and he never would have been able to get them up on his own, so putting the tube back in was definitely the right move. Currently, even with the tube in, we are having issues keeping his oxygen up. They are giving him a couple of different treatments through the ventilator, but they are not getting much up. The plan, for now, is to keep working through these treatments and see if we can get his oxygen more stable. Once they can get better oxygen numbers, they will do a Bronchial scope on him and go in with a camera to deliver these treatments directly into the lungs to assist with breaking up whatever is in there.
It is proving to be an intense day of hurry up and wait. I will say though, I absolutely love his team. It really helps to make the difficult things a little bit easier.
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