No Breathing Tube!

Well today’s big excitement was obviously the fact that Annabelle was able to get extubated (aka pulling out her breathing tube).  After good bloodwork, a clear liver ultrasound, and a great cpap trial they were able to pull the plug on the tube.  In the process, they have also taken her off all sedation. Unforunately, this has made for a not-so-happy Annabelle due to the soarness in her throat and likely pain from the surgery.  However, she’s been a trooper and hasn’t cried any; she’s just managed to let out a few pitiful wimpers.  The doctors have started her on a small amount of morphine every four hours to help with the pain. 

Transplant wise everything is looking about as good as could be expected.  Her liver numbers look great, her blood pressure is great, her breathing is perfect, and her ammonia is staying under control (today it was in the 80’s and 70’s but that was great considering the stress on her body and the fact that they added in some protein back into her system).  The only number of concern for the doctors is Annabelle’s lactate because it started creeping up.  Post-transplant it was 2.8 but has since risen to 4.6 (they like it to be below 2.0).   The doctors say this is common post-transplant especially with metabolic kiddos so they are going to keep a close eye on it.  Lactate is a good indication if the body is using up it’s own energy so it could be that Annabelle is just dehydrated from the lasix they are giving her to make her pee out excess fluid.  Since her chest x-ray came back well this evening they are going to cut back on the lasix to see if that helps.  Otherwise, those high lactate levels could point to an infection (let’s hope not!).

As far as Mike a I go, we’re getting plenty of rest and breaks.  It’s very helpful to have my mom and Mike’s parents here to take shifts.  Right now they are rotating nights so that Mike and I can sleep in the apartment each night.  We know we’ll need to be well-rested to care for Annabelle once she gets out of the PICU and our parents go home.  We’ve enjoyed getting real sleep for the first time in 10 months!

Hopefully in the coming days Annabelle will continue to get more alert and stronger.  We’re also hoping they will remove the nose canula and NG tube in her nose as those are making her very uncomfortable.  For now, we just take it one day at a time.

Prayer Requests:

1.) Continue to pray for the donor’s family greiving during this time.

2.) Pray for Annabelle’s lactate levels to decline.

3.) Pray for Annabelle’s ammonia levels to continue to drop.

4.) Pray for no infections, no rejecton, and no clotting!

5.) Pray for wisdom for her medical team as they balance her meds and manage her care.

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