Tuesday, May 22, 2007

Another Delay in Brianna's Road to Wellness

Brianna (right) is fooling around with her friend Chelsea, who sent these photos to me along with a very sweet comment on the blog. I can't help but cry when I see her having fun with her dear friend, and pray for that day to come again.

Brianna was supposed to be put on a conventional ventilator, but that did not happen. When my mom and I left the hospital yesterday around 6:30 pm, Brianna's ventilator settings were 19 on the MAP, her oxygen was 50 percent and her oxygen saturation was 95. This morning when we walked into the room, her MAP was back up to 20, the oxygen they were giving was 60 percent and her O2 saturation dropped to 89. I was not expecting this at all.

Also, last night they had to put a new naso-gastro tube up through Brianna's nose to her stomach because the one she had got clogged up with a pill they had ground down. When they put the medication in the tube, it turned to a thick gel and wouldn't move. About this time, Brianna started to "wake up" and became very agitated. When she wakes up and is not on the paralytic, she fights the osciallating ventilator. It's not a natural way of breathing, and if she tries to breathe against it, her oxygen saturation drops. We watched it happen a few days ago when her O2 saturation went from 98 to 89 because she was moving her chest up and down and trying to breathe normally.

So why all the drop in her overall lung status? This morning the doctors think it's too much fluid over the past four days, a possible bacterial infection and her will to breathe against the oscillator. (Remember, the oscillator provides 600 tiny breaths a minute sort of like hyper ventilating. Obviously, much different than the regular rise and fall of the chest about 20 times average per minute.)

Over the last few days they allowed her to have a little more fluid to make her kidneys better. Her kidneys started to object on Friday, when her creatnine and Urea Nitrogen (BUN) crept up to a high level. Those numbers indicate how well the kidneys are functioning and when those numbers are high, it means the kidneys are not passing fluid waste as well as they should. It also means that many of the drugs that can damage the kidneys are in her system longer and at higher levels.

The way to heal the kidneys is to give them more fluid. Brianna's been on a Lasix drip ever since she's been in the PICU, and they added another diuretic every 12 hours. To say she was dry is an understatment. Almost every day she would wind up negative on her fluid balance.

During the past four days, she was 500 milliliters positive every day. So over that time, she was two liters positive. Every day I'd walk in and ask how her fluid balance was for the 24-hour period and they'd tell me she was 500 positive, I'd wonder when it would start to affect her lungs. Supposedly, that time came this morning.

In addition, the doctors still feel that she got some sort of ventilator related bacterial infection. They've given her three new antibiotics on top of the Vancomyecin, which kills staph infections. The hope is that these drugs combined with more diuretics should clear her lungs more and get her back on track to a conventional ventilator.

I feel like there is a recorder in my head and it keeps replaying some of these same conversations I've had with the doctors. Before we got to the PICU, Brianna's x-ray started to look bad and the doctors thought it was too much fluid. But that wasn't it and she continued to worsen until she needed to go to the PICU.

They have been testing her C-reactive protein levels in her blood, which are a measure of inflammation in the body. It was 19 on Saturday and has decreased to 16 today. The doctors take this as a sign that whatever she has, it's getting better. But I continue to ask why has she declined in her respiratory status?

I know I have to be thankful for the major gains Brianna has made. And she has made them - going from 36 on the amount of pressure being used to force oxygen into her lungs down to 20 now. But I can't help but be a little gun shy about any signs that she's having more trouble with her lungs. And here we are again with the doctors not really knowing what is causing this and her condition isn't getting better.

I also realize that maybe I've just been here too long. It is now 100 days of hospitalization and one-third of that has been spent with Brianna in the PICU. I think my stamina and strength are almost depleted and I'm wallowing in doubt, fear and anxiety.

I know our call for prayers has been long and loud, but please continue. This has been so difficult for us, and I'm sure it's been difficult for you to read every other day too. And I'm afraid the journey will continue to be long and bumpy. But, we are grateful to all of you who continue to lift us up with your comments to the blog and emails. We are blessed with family, friends and those I have not met - friends of friends - who have sent their well wishes and prayers. We are blessed to have so many people cheering for us.

I pray that tomorrow will bring better news abour her x-rays.


Carolee said...

Hi Iva ~ Just wanted to let you know I'm still praying very hard here every day, and have sent prayer requests out to everyone I know. So many people are joining hands and keeping Brianna - and all of you - in their thoughts and prayers. {{{Hugs}}}...

~ Carolee

Sam I Am said...

Tomorrow WILL bring better news...and Brianna WILL fight this .. she WILL. period.
We won't stop our prayers for all of you.. please dont stop leaning on us for support..we're all here for you.
We love you two like our own :)

Kitty Forseth said...

Oh Iva,

Ditto on what Sammie and Carolee said, we are not going anywhere. We're all here for you, everyday, always. You will take your beautiful daughter home, healthy and happy, we have FAITH!

We'll only pray harder now.. you rest your weary head sweet lady.. we love you!!


Christy said...

We are never too tired to pray, urge, yell, and cheer for Miss Brianna! Tomorrow will bring you more strength, and hope that she will be talking to you before you know it. Sleep tight Iva. God Bless you all! Christy

Dixie Redmond said...

Iva - I'm still praying for Brianna and your whole family. I pray for wisdom for the doctors. I pray for the nursing staff to be able to love Brianna as they care for her.


Kingfisher Farm said...

Iva, you are always in my thoughts and prayers, lean on us if you wish! Sam is right! Strong hands from heaven are reaching down, and holding you, supporting you, and Brianna. HUGS Pam

Stephanie Coop, said...

Hi, Just want you to know that my family is still praying for you and your daughter. I pray God will give you and extra helping of encouragement today!!!! You sound like a great Mom! Having a seventeen year old daughter myself,helps me get just a glimpse of how hard it is for you.

Soft in the Head said...

My Dearest Iva...We are all here and we AREN'T going anywhere. You hang in there....Much love and encouragement coming your way...Pam

Lisa said...

Stay strong Iva. I know this must be incredibly hard on you and your family. Brianna will pull through this in her own time. Bless you all as you are always in our prayers. Lisa

Anonymous said...

contantly praying Iva!
love you jo

Ingrid weber said...

Iva, Keep the faith. Everyday we pray for Brianna, you, John, and Trevor. Can't wait to meet this amazing girl.

Doreen said...

Hello again Iva. Just wanted to let you know I was thinking of Brianna, you and your family.

Last night I took a long walk...and she was all I could think about. i have been praying hard for her...and you as well, and will continue to do so. I am sorry for this setback....but keep the faith...tomorrow will be a better day. Keep up your strength and hang in there.

doreen & Family

the magpie said...

Iva...never feel you've requested "too much" prayer as such a thing just doesn't exist!! I am praying for Brianna everyday and for peace that passeth to touch your whole family...


Kitty Forseth said...

Heard today's GOOD news from Colleen!!! We're all looking forward to tonight's post.

Oh Iva.. I am elated that she is showing progress, thank the LORD!



Debbie said...


What a great picture Chelsea sent of her and Brianna. Brianna is a beautiful woman. She is our wonder woman. Her strength and will-power is helping her to heal. We are here for you both keeping the path of healing and positive thougths. Hugs and Kisses and much love.....
Debbie and Tom

Anonymous said...

Iva, I am keeping your beautiful daughter in my prayers and all that have a hand in her care.
Take care of you too.