6.16.21 ICU Update 3

What a long day! Aimee has made lots of progress since this morning. Her pain is majorly improved, which is such a relief. She is grouchy and uncomfortable, but actually had a period of semi alertness in the evening. She doesn’t panic at the slightest touch now. We haven’t been able to do any breaks from bipap yet, but the team wanted to get pain management under control first since her breath holding seemed related to that. I am expecting that at tomorrow’s rounds they will decide to trial some time off of bipap. 

We were able to get some enteral pain meds this evening. The IV meds are great because they act quickly, but they seem to cause a lot of peaks and valleys rather than a steady control. We are hopeful that with the new combination she will be able to rest comfortably tonight. 

PT came this afternoon and inclined her bed slightly, which causes some retching so we did have to add a nausea med. Tomorrow we will be meeting with the PT and equipment company to see if her wheelchair back rest will still work for her given the change in shape.

Blood pressure is extremely low again this evening, so constant monitoring and more IV bolus on top of her maintenance fluid. Her puffiness has just started going down too. :/ She is definitely more pale. Her drains, particularly the deeper one, have continued to produce blood, but are slowing down. Her labs are looking better, though still low in a few areas. She has particularly needed several doses of magnesium today. 

Overall, we are hopeful and more optimistic about tonight. Miraculously we have the same night nurse (a repeat is so infrequent), which helps so much as she is already familiar with what Aimee’s pain looks like and what will help best.