The PCICU team just stopped by for rounds. They invited us to join them, which is common practice in the unit. They spoke quickly and in a somewhat foreign language.

Here is what I was able to glean from the conversation.

Becky is currently sedated and intubated. Becky’s O2 stats were low both going into and during surgery. But they have now recovered. They plan to spend the day weaning her off the ventilator with the goal of extubating her sometime this afternoon. They will start her on a CPAP machine and eventually give her forced air through a nasal cannula.

I took copious notes during rounds and have gathered some questions. I am waiting to speak with the nurse practitioner to ask a few questions, particularly regarding her chest x-ray which is not as clear as they would like. 

I recently spoke with the nutritionist. There is some concern that Becky may have a leak in her lymphatic system called a chylothorax. Chyle is a byproduct of fat digestion, specifically the digestion of long chain fatty acids. As they begin feeding Becky again, they will monitor the output from her chest tube. If she begins producing a milky white fluid, this will indicate a chylothorax. This is relatively common with both Down syndrome and cardiac surgery. If this is the case, it will necessitate another change in feedings for Becky though not for me. She would need a medical grade formula. The good news is this will heal over time.

But my favorite phrase from this morning’s rounds? Becky is intermittently agitated. In lay terms this means she sometimes wakes up and is royally irritated that there is a breathing tube down her throat. These episodes are hard to watch but the staff does an amazing job soothing her and talking to her. Intermittently agitated? That’s an understatement. Thankfully, she has been resting comfortably most of the morning.

It should be a big afternoon. I can’t wait to see her breathing on her own. And that first smile.