Tuesday, January 27, 2009

Kaeo and I are back, and we were so anxious to go see our Christy.  She was still active today, arms, kicking that right leg alot!  She's had another stable day... but no real big news. 

Christy had some small progressions today.  Christy's on 28% oxygen now.... closer to room air.  They still have the same size trach in, and she's got a great cough.  A good cough is essential for the mucus to be able to come up and out of the lungs!  That way Christy can fight infection.  Her oxygen is still humidified for easy breathing.  Christy's strong, big arm movements can displace her oxygen mask and has to be watched well and replaced at times.  If the nurse wasn't in the room when Christy accidentally hit the oxygen, she has continuous pulse oximetry machine (see picture below) which will alarm for the nurses to come see what's wrong.  She breathes on her own and requires very little oxygen over the amount  in room air, so it's not an emergency situation.  having mucus stuck in her trach is more dangerous.  Christy's strong cough could clear the mucus & her pulse oximeter would also alarm in this case.  She almost always has family or a friend with her at all times.  Keli'i is sleeping in her room tonight.  The pulse oximeter you see here looks similar, but isn't exact.  The waveform you see is picked up in the finger probe and can also be skewed if the fingers are moving too much or clenching.  You can place the probe on an ear or a toe, etc. It also measure s the heart beat which is the number "87" in this picture.  We talked about Oxygen Saturation before-- 97% is the reading on this person.  97% of 100%.  94-95% oxygen saturation or better is ideal.  This number for Christy is there and stable! 

The P.E.G. was in use 24 hours after it was inserted.  Christy is being fed through it and receives medications through it as well.  It seems to be working fine with no problems!  

This is a general picture of how Christy is fed.  A liquid pre-prepared food is hung and connected to a pump (the pump is missing in this picture) which connects to the PEG. 

Christy was receiving two separate kinds of pain medications today-- Fentanyl and Lor-tab (Vicodin) tonight.  It is still somewhat unclear if she is in pain and if that is what is causing some of the restlessness, or if it is purely reflexive.  When we left tonight she had received her Dilantin (anti-convulsant) and Lor-tab.  The Dilantin can make you sleepy & the pain medication as well.  Christy was finally able to sleep peacefully without the forceful movements.  We turned her lights down low & the room was nice & cool.  It made me happy to see Christy rest & build up her energy for a new day tomorrow.