Always something

Sorry for the delayed update - Blogger wasn't keen on me logging in last night - I tried several times and I couldn't create a post.  Lots has happened since then.

The medication they started Finley on yesterday is called Propanolol.  Its a beta blocker intended to lower the pressure around her pulmonary valve.  Its not typically used post repair - they do however use it frequently in un-repaired kids who have pulmonary stenosis and it works quite well.  They weren't sure if it'd work for Finley - but so far it has!  In the ER on Sunday the pressure gradient around her heart was 90% - which is pretty much the "alarming" level (the doctors called it something else - equally as scary : o ).  After three doses, her pressure was down to 50% - which is "moderate" (normal is 10-20%).  The doctors ultimately hope that she can remain on this medication and it will continue to work for her for several months which will allow her to grow, and it will allow her heart to grow and hopefully negate the need for another surgery.  At the very least, the purpose is to carry her forward at least several weeks so she can at least heal from the last surgery.  Admittedly, its tough to be optimistic on this.  Finley always seems to choose the road less traveled.  The other thing that quite frankly sucks the most is that this is happening at all.  Imagine gearing up for something for 9 months.  The biggest, most stressful moment of your life - a life changing event that you wanted more than anything in the world to go right.  A day that you feared the most but could not wait to come for when it was past, it would be the first day of the rest of your child's life.  And then it goes wrong.  An essentially, we might be back to square one.  This wasn't supposed to happen.  We had always just assumed that Finley would have her repair surgery and that would be it.  Huge hurdle cleared.  Behind us.  It sucks.  And as much as I try to always be positive, its been hard this week.

So, the good news about the heart medication working came with some bad too (seems to always happen that way).  In an effort to find out what was causing Finley's vomiting and diarrhea that had been going on since Sunday (which I think was attributed to her antibiotic) they took a stool sample that ended up testing positive for C. difficile.  Its basically a nasty stomach bug that tends to occur in people who have been in the hospital and who have been on antibiotics (check and check).  The trouble is, in children under 1, the test gets a lot of false positives because c.difficile bacteria are normally occurring in a lot of babies.  In order to be safe, they stopped Finley's feeds for a while last night in to today, did another abdominal xray (which came back normal) and they just monitored her for a while to see if she continued to have diarrhea.  She actually had a great day today and for the first time since Saturday, didn't have an incredibly fussy period that preceded a big poop and then some vomit.  But, I also had them stop the offending antibiotic today and they discontinued another medication - I still think that was the culprit.  In any event, what all of this simply means is that they are going to start her on yet another antibiotic to treat the
the c. difficile.  And this, as you can imagine, is the least of our worries, but yet another annoying thing that Finley has to endure.

I did have one small victory at the hospital today and that was that I successfully negotiated the cancellation of a CT scan that they wanted to do on Finley.  This would have entailed going under anesthesia again and being intubated (not to mention the exposure to radiation)- which would have meant recovery in the PICU and potential re-irritation of her airway - the one thing that ISN'T a concern right at this moment.  I was adamant about the fact that I really didn't want Finley to have to go through this as it not only meant potentially complicating things further, but it undoubtedly meant a longer hospital stay - and at this point - I can't get her through that door quick enough. And thus the good news came that her cardiologist agreed to let it pass for this admission and so Finley will get a little break.

I have to admit, when I got to the hospital this morning, I wasn't in the greatest of spirits.  I was tired and to be honest felt a little defeated.  And then I walked in to room 523 - and there was my little girl - a smile wide across her face - kicking her feet in unison - and clapping her hands.  Suddenly, everything seemed alright.

1 comments:

Melissa said...

Trace: Been thinking of you all a lot! You guys have been through a rough time this week and I hope that you know that you have lots of people thinking of you and wishing the very best for you all. : ) Much Love! 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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