Today is post-op day 2.

Becky is 48+ hours from her surgery and is making good progress.

A couple of highlights from today:

1. Becky was moved from a high flow to a regular nasal cannula. She was put on 1-2 liters of oxygen, which is her home dose.
2. She cannot be laid prone today due to concerns regarding incision integrity. 
3. It appears there is a chylothorax. This will be monitored and discussed in further depth with the nutritionist on Monday. We’ve dealt with this before.
4. Becky resumed full feeds today and seems happier with a full stomach.
5. The team wants to hold off on dual therapy vasodilators until an echo can measure the pressures in her right ventricle and pulmonary artery. I am hopeful that we can avoid one of the more toxic medications that necessitates monthly blood draws and can negatively impact her liver function.

Becky’s x-ray continues to show some haziness and opacity. She did well with her CPT today and prefers receiving the sodium chloride through this nifty device.

Greta enjoyed some cuddle time and tried to read a John Steinbeck novel for a class. I think she’ll be switching to the Cliff Notes version.

Sam brought the kids down for a visit. We spent some time outdoors and the kids polished off a box of Thin Mints in record time. While the younger kids stayed with Greta in the RMH, Sam and I went out. I had this crazy plan that we would work on our taxes while enjoying dinner. I should have known better as those two things don’t really go together. We ended up talking and enjoying the fabulous 1950s vibe of a local restaurant.

When I returned to the hospital, I was immediately concerned about Becky’s breathing. She was belly breathing and her CVP number was slightly increased. The PCICU team takes a parent’s concerns seriously. The team worked quickly and an had an x-ray taken. Unfortunately, the upper lobe of Becky’s right lung collapsed. Becky was switched back to the high-flow nasal cannula and given additional diuretics. Hopefully these measures, in addition to aggressive CPT targeting the collapsed area, will be enough to re-inflate this area of her lung.

Becky seems to like collapsing her lungs on a Sunday night. She did this during our last PCICU stay as well. It’s a bad habit. But she gave me this smile today.

And that far outweighs the trouble she caused.