Mood today: nervous

Today, Finley and I spent the day today in the ER at Childrens.  She woke this morning around 4 am and was fussy, sweating profusely and breathing pretty heavy.  All things that are not normal for her.  She was pretty inconsolable and so I decided to run out to Jewel to get some Motrin (I had to throw ALL of my Motrin and Tylenol away because of the recall).  I called the cardiology fellow that was on call on my way to find out the correct dose to give Finley.  She was concerned, and told me that if the Motrin didn't make her 100% better, to bring her to the ER - that they didn't want to take any chances.  After the Motrin, Finley seemed better - for about 20  minutes.  Then she started crying again, and wouldn't stop, and so we packed up and headed to the ER.  She fell asleep on the way there and of course, when we got in to the ER - she was all smiles!

She did great while we were there - they drew blood, took cultures (blood and urine), did a chest xray, echo and EKG.  All of her labs came back normal, although they did show she was slightly dehydrated so her cardiologist (who happened to be on duty today) stopped one of her doses of Lasix (diuretic) and her Aldactone.  Finley was sleeping when the technician came in to do her echo, and so while she was only supposed to do a limited echo, she ended up doing a more extensive one since Finley was so cooperative and since Finley had a fit during her echo before they she left the hospital and they were unable to finish it.  Her echo showed that she has a lot of pressure (90%) around her pulmonary valve.  Based on what I could gather, it sounded like the valve might still be too narrow (although some extra pressure is common post surgery).  So what does this mean?  Well - it could mean that Finley may need another surgery to correct it - either a catheterization or perhaps another open heart procedure.  Both of which we don't even want think about entertaining.  The other option is to wait a bit to see if the pressure begins to subside.  Our cardiologist, Dr. Lay, is going to talk to Finley's surgeons on Tuesday to see how they want to proceed.  Obviously we are very nervous about this.  Dr. Lay said though since Finley seemed to be fine otherwise, there was no need for her to stay at the hospital until she had a chance to talk to Dr. Backer and Dr. Russell - her oxygen saturations were good while we were there (100%!) and she was in a pretty good mood.  Dr. Lay said the fussiness could have been because of the extra pressure or she just might not be feeling good.  Since her labs and everything else looked good - we went home.

Since we've been home, Finley has been very sleepy.  She had a two hour nap and when she woke, she vomited a little and had some diarrhea.  I am hoping perhaps that she has a little bug that is just working its way out.  The thing about having a special needs child though is that the little bugs - that suck regardless of "special needs" or not - are a WHOLE lot more nerve wracking in this situation.  Its funny though because we do tend to automatically go to the worst case scenario when something happens because every issue we have tends to be so complex.  That is why we were so happy when Finley's post surgery infection 'only' turned out to be a UTI.  And so I guess we wait.

In the meantime, mommy is going to have a glass (maybe two) of wine because my run didn't manage to help me unwind.  Please keep Finley in your prayers.

1 comments:

Melissa said...

Hi T - Just stopping by to check in on you guys and see that you had a venture to the ER. Will be thinking of you all and am so glad that you are home with Miss Finley. I love the pics you have taken since she has been home - ADORABLE!!! Big hugs all around! Take care! ~ Melissa

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Finley's Medical History

Born on 8/8/2009 - Finley is taken to Children's Memorial Hospital via the transport team 12 hours after she is born.  She is having trouble breathing and is turning blue.  She is immediately admitted to the NICU.

8/9/2009 - Finley is diagnosed with Tetralogy of Fallot, a congenital heart defect and laryngomalacia, a condition that causes her to aspirate whatever she swallows in to her lungs.

8/21/2009 - Finley has open heart surgery to place a Blalock Taussig shunt to help facilitate proper blood flow.  When she is older, she will require a full repair of her heart.

9/10/2009 - Finley is released from the NICU.  Because of her laryngomalacia and reflux, she is fed 100% through a nasal gastric tube.

9/14/2009 - Finley is re-admitted to the hospital for an infection in her surgical wound.  Finley's genetic test comes back - she is diagnosed with CHARGE Syndrome.

9/15/2009 - During a CT scan to assess the infection, the doctors notice something strange on her CT.  It appears Finley has a malrotated bowel and will require surgery.

9/23/2009 - Finley is examined by the opthalmologist and she is found to have colobomas, a condition common with CHARGE Syndrome, in both eyes.  The degree of her visual impairment is unknown.

9/30/2009 - Finley has the Ladd's Procedure to correct the malrotation and also has a g-tube placed.  

10/7/2009 - Finley has a sedated ABR to check her hearing.  She has a mild hearing loss in her right ear and a moderate to severe loss in her left.  Her loss can be at least partially corrected with hearing aids.

10/8/2009 - Finley is supposed to be released from the hospital today but she has been having low blood sugars.  The endocrinology is called in to evaluate her.

10/29/2009 - Finley is finally released from the hospital with a unconfirmed diagnosis of hyperinsulinism.  Actual diagnosis requires fasting blood tests - because of her heart condition, it is not safe for her to fast.  She needs to have her blood sugar tested every three hours and we are taught how to administer an emergency glucagon injection in case her blood sugar gets to low.

11/1/2009 - Finley requires emergency injection because she cannot sustain her blood sugar.  She is taken to the local ER and transported via the transport team to Childrens Memorial.

11/10/2009 - Finley is discharged from the hospital on a 24 hour continuous feed.  We add polycose to her milk to help her keep her blood sugar at an acceptable level.

11/22/2009 - Finley is taken to the local emergency room with a bad cold - she is having trouble breathing and her oxygen saturations are low.   She is transported via the transport team up to Children's Memorial.

11/25/2009 - Finley is released from the hospital - just in time for Thanksgiving.

12/8/2009 - Finley is taken to the local emergency room for observation - she has a bad cold.

12/21/2009 - Nate is chasing the dog and the dog runs in to Finley's IV pole, knocks it down and pulls out her g-tube.  She is taken to the ER at Childrens to have it put back in.

2/10/2010 - Finley is admitted through the ER at Childrens - she has a bad cold again.  Oxygen saturations are low and breathing is labored.

2/13/2010 - Finley is released from the hospital.

4/17/2010 - Finley is taken to the ER at Childrens - she has pus draining from her belly button.  They suspect a urachal cyst - they send us home with orders to return on  Tuesday (during our scheduled visit) for an abdominal ultrasound.

4/20/2010 - Finley is admitted to Childrens for an overnight stay.  She will have a swallow study and abdominal ultrasound on Tuesday and a CT and sedated echocardiogram on Wednesday which will require anesthesia.

4/21/2010 - The anesthesiologists have trouble intubating Finley, so they call in her ENT to have a look at her.  He observes that her airway is 75% closed off - partially due to scar tissue from previous intubation and partially due to an infection.  The diagnosis is subglottic stenosis and may require her to have surgery on her airway.  She is immediately admitted to the PICU and put on a 24/7 breathing treatment and antibiotics and steroids to help reduce the inflammation.

4/26/2010 - Finley is well enough to be taken off of all oxygen.  Immunology and Infectious Disease are called in to examine Finley because the culture of her throat are growing staph and strep.  Infectious Disease is trying to figure out what could have caused her infection.  Immunology labs will be drawn to determine if Finley has an immune problem which sometime occurs with children with CHARGE.  This is the second significant infection she has had since she was born.

4/27/2010 - The lab calls to say that they mis-read Finley's airway culture.  It's not growing staph - its only growing strep.

4/28/2010 - Immunology labs are back and don't show anything significant.  Finley's lymphocyte counts are low but that isn't unusual for a child who is fighting an infection.  The doctor wants to re-examine her before her first birthday.  In the meantime she cannot have any live vaccines.

4/29/2010 - Finley is discharged from the hospital.  The ENT will do a bronchoscopy before her heart repair surgery to determine next steps on her airway issue.

5/11/2010 - Finley has open heart surgery to repair her heart.

5/17/2010 - Finley begins to show signs of infection which is later identified as a urinary tract infection.

5/25/2010 - Finley is discharged from the hospital.

5/30/2010 - Finley goes to the ER at Childrens because of fussiness, sweating, heavy breathing.  And echo later identifies that the pressure gradient around Finley's pulmonary valve is an astounding 90%.

6/1/2010 - Finley is admitted to Childrens to try a medication called Propranolol to help ease the pressure in her heart.

6/2/2010 - The Propranolol brings the pressure in Finley's heart down from 90% to 50%.  Finley has a positive test for C. difficile which will require antibiotic treatment.

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