Thursday, January 22, 2009

Spoke to Donald, Mom Gail, my mom, and the Nurse at the hospital today. As it turns out Christy was having a seizure when the Neurologist (brain doctor) assessed her and that was the reason for ordering the Ativan we talked about yesterday. The neurologist sat down with Donald today and explained what that sort of seizure looks like so he can also look out for them to notify the nurse on duty. He also did not feel at this time that it was appropriate to move Chris to another unit. He said that Christy did not receive Ativan during the night and that meant that no seizure activity was going on. We will continue to monitor Christy closely and try to control any seizure activity going on & to keep her comfortable. Donald, Mom Gail, and the rest of the family and Christy's close friends have been at Christy's side daily and are wonderful Advocates for her. Christy is still receiving many prayers & healing touch often.

There has been discussion about moving the feeding tube from Christy's mouth and placing it directly into the stomach. The tube she currently has goes from Christy's mouth, down the esophagus to her stomach. You may refer to the diagram to the upper left to get an idea about the Gastro-intestinal anatomy. Originally this tube was placed in the ICU and went down her mouth, past the esophagus, past the stomach and ended in the very top of her small intestine (Duodenum). Remember, they also had a tube draining any gastric contents (bile) out of her stomach as they were feeding her in the small intestine (2 separate tubes). The second tube hooked to suction was in place to check for any excess bile or back up of food into the stomach. It was potentially dangerous for her to have food in her stomach backed up because of risk of aspiration (choking). You know when your food or drink "went down the wrong pipe"? That's aspiration. Only we aspirate just a little & we can cough it out really good and are fine. If we didn't know Christy had to barf, and she did, it could easily come up from her stomach & slip down in to her lungs and cause an aspiration pneumonia. Even if the nurses were giving her a bath or pulling her up in bed and she was laying flat it could come up & get inhaled. Because we eat, barf, and breathe from our mouth, the windpipe (leads to the lungs) and the esophagus (leads to the stomach) are so close together. Luckily Christy had no problems with backed up food and no episodes of aspiration. So a couple days ago, they pulled the feeding tube back from the top of the small intestine to the stomach. They removed the second tube that was to suction. They are finding out right now if Christy is tolerating food delivered to her stomach instead of the small intestine. So far so good. Why that is important is that they want to place a P.E.G. P.E.G. stands for Percutaneous Endoscopic Gastrostomy. A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope (a flexible, lighted instrument) to determine where to place the feeding tube in the stomach and secure it in place. This will make Christy's mouth more comfortable - no more tubes in there. Also, eventually leaving a tube in her mouth down to her stomach may start to irritate the tissues it touches and damage them. A PEG is the choice for a more long term recovery, meaning we know she won't be eating a plate lunch tomorrow or the next day, because she still is unable to swallow or eat food on her own. Here is a picture of what a P.E.G. looks like. Christy's will be similar, but with much less hair around it! ha!

That's all for today.... like always, please keep the prayer going. We love you Christy!