I skipped yesterday on accident. Time and dates are always so difficult to track inside the hospital. How many days? What day of the week?
Yesterday we had a couple of concerns. One was low blood pressure, which continued through last night. She hasn’t has any other shaky episodes though, so we are just monitoring it.
The other concern was hydration, feeds, and fluid output. This one is still a work in progress. The ileostomy output has changed quite a bit since yesterday morning, so I am less concerned. She was losing so much fluid through it that they were considering adding another medication to help retain more water.
Prior to surgery the hope was that her slow motility would actually work in her favor. That it would allow her body to absorb enough fluids in the small intestine before dumping it out. As of yesterday morning she was dumping out tons of liquid, so we were concerned that she would just dehydrate herself. We’ll see, but I am hopeful that the output seems less and that our original thinking will still be correct.
It feels like a new world we are moving into hydration wise. Before we were giving her giant amounts of laxatives and also flushing out her large intestine with saline once a day. She needed more fluids to compensate. Now we are draining everything out at the end of her small intestine, so she loses the opportunity to absorb water through the large intestine. Not sure how things will settle and how much fluids we will need to give. Will it be more volume than she can handle receiving through the j-tube or will it be less than she needed before? Thankfully the surgeon said that they won’t send us home to sort this out on our own. They want to be sure that she is able to stay hydrated and that we know what volumes are needed.
We still have some work to do to increase her feeds all the way and get her off of IV fluids. Today we hope to increase her rates more. We have made it to about 30%, which is enough that we are going to lower her IV rate finally later this morning. Baby steps. :)
Later today we are hoping to have more training on the ostomy, particularly on how to change the bag. We’ve been emptying it, but much more to learn!
I am getting really hopeful and excited as Aimee becomes more alert. Last night she grinned at us and watched part of a movie. So good to see her smile. This new ostomy is going to be life changing for her I think. Of course she will not have to have her flush or her enimas. That is 2 hours plus of her life back! Also she will be so much more comfortable with less bloating and cramping. Less infections! Less crying! Less pain! Hooray!
